OREM- Theory Analysis: Is the theory logical - is there a model - does the
model explain the theory?


 Dorothea Orem developed the Self-Care Deficit Nursing Theory (SCDNT) as a conceptual model to apply to all nursing practice situations as well as to education and research (Orem & Taylor, 2011).  The basis for the SCDNT is that humans are capable of the deliberate action of self-care and that the goal of nursing is to provide specialized assistance to help people in meeting the required needs for self-care (Villarruel, Bishop, Simpson, Jemmott, & Fawcett, 2001).  The SCDNT is clear and organized.  The basic terms, concepts and assumptions are logically defined and used consistently throughout the theory.
 
Metaparadigm concept definition

Orem clearly defines these concepts in relation to the SCDNT (McEwen & Wills, 2011):

 ·        Nursing is an art through which nurses give specialized assistance to people in need of help in meeting their needs for self-care

 ·        Humans are children, women, and men who are cared for either as individuals or as part of social constructs

 ·        Environment includes physical, chemical and
biological features and may apply to the family culture and
community
 
·        Health  

         1.     Is being structurally and functionally whole

         2.    Is a state that includes individuals and groups

         3.     Is the ability to have self-reflection and communicate with others


These concepts are linked to one another in dynamic, multidirectional relationships.  Humans interact with one another and with their environment, whether physical or social, which impacts their health in positive and negative ways (McEwen & Wills, 2011).  Nursing interacts and collaborates with humans when there is a compromise in the health state (McCullock Melnyk, 1983).   

Self-Care Deficit Nursing Theory Model

The schematic representation noted below illustrates the relationship between the concepts of the SCDNT.  One can clearly see that the theory of nursing system encapsulates the theories of self-care deficit and self-care.  Orem’s three specific nursing systems can be seen in the center.   While this diagram partially clarifies one’s understanding of the theory, the direction of the effect the variables have on one another is not particularly enhanced.
 
Are outcomes or consequences stated or predicted?

By using Orem’s the three-step nursing process, expected outcomes or goals can be predicted.  In the first step, an assessment is done to determine if there is a self-care deficit and need for nursing care and a classification is made as to which nursing system the patient condition applies (Anna, Christensen, Hohon, Ord, & Wells, 1978).  The second step is when care delivery plans are created and goals and expected outcomes are formulated and stated (Anna et al., 1978).  The third step includes implementation, ongoing evaluation and revision of the plan (Anna et al., 1978). 
Picture
McEwen & Wills, 2011, p. 133, Figure 7-1

References

Anna, D. J., Christensen, D. G., Hohon, S. A., Ord, L., & Wells, S. R. (1978). Implementing Orem's conceptual framework. Journal of Nursing Administration, 8 (11), 8-11.

 McCullock Melnyk, K. A. (1983, May/June). The process of theory analysis: An examination of the nursing theory of Dorothea E. Orem. Nursing Research, 32(3), 170-174.

 McEwen, M., & Wills, E. M. (2011). Theoretical Basis for Nursing (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Orem, D. E., & Taylor, S. G. (2011). Reflections on nursing practice science: The nature, the structure, and the foundation of nursing sciences. Nursing Science Quarterly, 24(1), 35-41.

 Villarruel, A. M., Bishop, T. L., Simpson, E. M., Jemmott, L. S., & Fawcett, J. (2001). Borrowed theories, shared theories, and the advancement of nursing knowledge. Nursing Science Quarterly, 14(2), 158-163.