Self care

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The theory of self-care was developed and tested by Dorothea Orem . In 1971 she published the book "nursing concepts of practice" and presented this theory to the public.

Orem understands self-care to mean all targeted and conscious actions that are carried out in order to achieve, maintain or restore health and well-being. These activities can either be carried out by yourself or by third parties. Alternative names are the self-care deficit model or self-care deficit for short .

Dependency maintenance

For Orem, dependent care is care by non-professional staff, i.e. family, relatives, friends or acquaintances. They take over the act of self-care from those in need of care who are unable to do so due to their age (e.g. infants, preschool children) or illness (e.g. people with dementia). So for Orem the human being is a social being, he helps each other (voluntarily).

Self-care requirements

The need for self-care depends on people's needs and is also related to age, level of development and health. Orem calls these needs 'self-care needs' and divides them into three groups:

General or universal self-care requirements

Everyone has these requirements equally. This includes maintaining oxygen uptake, water uptake, food intake and excretion.

Developmental self-care needs

Due to the different phases of life, some self-care requirements change. The phases are:

  • embryo
  • infant
  • small child
  • Preschool child
  • School age child
  • during youth
  • Adults into old age

Health-related self-care needs

Due to health restrictions such as illness or disability, new self-care requirements sometimes arise or other self-care requirements shift.

Self-care skills

Self-care competence describes the ability to correctly assess the need for self-care, to correctly make the decision to carry out the activities, to carry out the activities properly and to check the efficiency of the same. Illnesses can limit or even completely lose self-care skills, so that outside help is then required, which can be provided by professional health and nursing staff or family carers .

Self-care deficit

If there is an imbalance between need for self-care (generality of self-care requirements) and self-care competence, which cannot be compensated by dependent care, Orem speaks of self-care deficits. Professional care is always required when a self-care deficit is determined.

Care systems

Since only as much care should be given as is necessary, it is important to analyze the self-care competence precisely and compare it with the self-care needs. One of the care systems defined by Orem should then be selected:

Completely compensating (full transfer)

Here the nurse takes over the entire self-care activities, the patient does not contribute in any way to the performance of the measures.

Partly compensating (partial takeover)

Here, some self-care measures are carried out by the patient himself, others, with which the patient has difficulties, are carried out by the nurse.

Supportive and educational (guidance, assistance)

The nurse is limited to the motivation, guidance and encouragement to carry out the self-care activities. The focus here is on teaching the patient.

The care systems are to be understood as dynamic systems. It is quite possible that in one situation a patient will use all three care systems in parallel. For example, he cannot wash his feet on his own, but he can wash his upper body under instruction. Thus, he makes use of the partially compensatory and the supportive-educational care system.

See also

literature

  • Connie M. Dennis: Dorothea Orem. Self-care and self-care deficit theory. Hans Huber, Bern / Göttingen / Toronto / Seattle 2001, 192 pages, ISBN 3-456-83300-8
  • DE Orem: Structural Concepts of Nursing Practice. Ullstein Mosby, Berlin / Wiesbaden 1997, 532 pages, ISBN 3-86126-548-6

Web links