Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem's Self-Care Deficit Nursing Theory

Abstract

Introduction Many researchers have commended the self-care deficit nursing theory (SCDNT) developed by Orem as a means of improving patients' health outcomes through nurses' contributions. However, experimental research has investigated specific aspects of SCDNT, such as self-care agency and self-care requisites, rather than how the construct is practiced and understood as a whole. The current research presents a case study in which an advanced practice nurse (APN) used SCDNT-led practice within a primary healthcare setting that illustrates how the theory is applied to case management. Methods A case study was conducted by observing an APN during her work in the asthma clinic of a public hospital in Hong Kong. A comparison was made between the case management of the APN under observation with the nursing processes stipulated by the SCDNT across four key operations: diagnostic, prescriptive, treatment or regulatory, and case management. Conclusion During the observed consultation, the APN applied the four key operations. In SCDNT, the role of the APN is to apply practical nursing knowledge by determining how a patient can best undertake self-care within the circumstances of their living arrangements and support facilities. The case study also demonstrated that SCDNT-based nursing practice has strengths and limitations in a primary healthcare setting. The study concluded that Orem's SCDNT serves as an appropriate theoretical framework for nursing practice within primary healthcare settings. One practical consequence of using SCDNT is that it enables APNs to use nurse-sensitive indicators when evaluating their clinical practice. This study offers a practice update to increase the accountability of nursing practice for nurse-led healthcare services.

Effect of Orem’s Self-Care Theory Combined with Active Pain Assessment on Pain, Stress and Psychological State of Children with Nephroblastoma Surgery

“…Assessment of postoperative active pain in children is also an effective means to relieve pain in children ( 19 ). At present, most hospitals in many countries around the world have established assessment programs for postoperative active pain, but little attention has been paid to the effect of postoperative pain on functional activities in China ( 20 ). Some scholars pointed out that the application of active pain assessment in clinical practice can be used as the basis for the evaluation of analgesic efficacy and treatment of active pain, which can effectively control the pain in patients and improve the quality of postoperative pain management.…”

Critical Thinking in the Nursing Profession: Analysis with a Socratic Method and Nurse Theorist Philosophy

“…Due to the swift alteration in clinical circumstances, the Neuman system model consents widely to identify the interrelation between recognized systems, parts, subparts, and atmosphere that can lead to subsequent and logical nursing actions. Consequently, the conceptualized nursing phenomena encourage effective CT process, including application, analysis, synthesis, and evaluation, and it further classifies the nursing process into nursing diagnosis, nursing goals, and nursing conclusions to formulate format owing to decisive CT and decision making Critical thinking in the nursing profession that interprets to nursing action [23] . As far as critical thinking is concerned, Orem's self-care deficit nursing theory sturdily underlined four structured cognitive operations such as diagnostic, prescriptive, regulatory, and control.…”

“…Thirdly, the regulatory phase involves designing, planning, and producing the regulatory nursing systems. Fourthly, in control operations, it is established that evaluations happen in the control phase [23] . From Jean Watson's nurse theorist viewpoint about CT, caring is the essence of the nursing profession and certainly involves healing the patient, who ultimately reflects the caring perspective.…”

Knowledge and Attitudes on Selfcare Practices Following Child Birth by Caesarean Section at Marondera Hospital in Zimbabwe

“…education is an important aspect of selfcare [27,28], supported with the ZDHS (2015), which states that, "poor maternal socio-economic status and lower educational level are important factors associated with poor self-care practices [29,30].…”