Holland Porter
7340 Bibliography Card #1
Simmons, L. (2009). Dorthea Orem’s Self-Care Theory as related to nursing practice in
hemodialysis. Nephrology Nursing Journal, 36(4), 419-421. Retrieved from
http://web.ebscohost.com.libproxy.troy.edu/ehost/pdfviewer/pdfviewer?vid=6&sid=da99
e6c5-f3c5-4046-a811-2b645d472dd1%40sessionmgr112&hid=20
Main Idea
The number of older adults with chronic illnesses is increasing as this
demographic of the U.S. population increases. Chronic illnesses such as diabetes, obesity and
end stage renal disease continue to place an enormous financial burden on the U.S. economy.
The author suggests that enabling this group of older Americans with chronic illnesses to manage
their own care can lead to improved patient outcomes.
Summary
Dorthea Orem’s Self-Care Theory states that individuals are in a self-care deficit
when their desire to engage in the management of their care outweighs their abilities to do so.
Utilizing Orem’s theory in the teaching of older adults about symptoms, medication adherence
and lifestyle choices involves them in the management of their care. The author uses a dialysis
patient as an example of a patient that requires education about their disease. Educating the
patient on the management of their chronic illness encourages self-care, which in turn can
increase quality of life.
Synthesis
Dorthea Orem’s Self-Care Theory can be applied to numerous patient situations
to improve patient adherence and quality of life. Diabetes patients are often susceptible to selfcare deficits as managing their illness requires a vast body of knowledge, skills and motivation.
Discharge planning for newly diagnosed diabetes patients should be modeled around Orem’s
Self-Care Theory. Patients need to be adequately equipped with the knowledge to manage their
care at home to avoid frequent hospitalizations and disease progression.
Application As a nurse when I think about Orem’s Self Care Theory, I mostly think about the
patient during hospitalization. I have been applying this theory to practice by enabling my
patients to make choices about their care in the hospital setting. Most interesting to me was to see
the theory applied in an outpatient setting. For example, doctor’s offices and dialysis clinics
seem to be the most beneficial place to apply this theory since the healthcare provider can
monitor progress and reinforce teaching at each periodic visit. The author’s purpose is to show
the importance of applying theory to practice. Simmons chose to elaborate on dimensions of
Orem’s Self-Care Theory in order to demonstrate how to adequately prepare a patient to engage
in their own care. The author assumes that all patients want to participate in their own care, this
may be true for every patient at some point however from my experience this is not so. I have
had the opportunity to care for patients that chose to engage in self-destructive activities. This
article really has brought to my attention the importance of applying theory to practice as a nurse
practitioner. I see how important it is to apply Orem’s Self-Care Theory in a nurse practitioners’
practice as these health care providers have the opportunity to extensively teach their patients
self-care activities and can monitor their progress at each follow up visit. The potential
implications of nurse practitioners consistently applying Orem’s Self-Care Theory to their
practice in the outpatient setting could greatly impact patient’s adherence to their specified
regimen. The increase in patient adherence to medication regimens and lifestyle behaviors
specific to their illness could result in fewer hospitalizations for this group which could greatly
impact the healthcare economy. Question: To what extent could the healthcare economy be
impacted if more healthcare providers modeled their care around engaging their patients in selfcare?