Categories
Theorists

Dorothea E. Orem

Dorothea E. Orem
Dorothea E. Orem

Person/Client:

A unity who can be viewed as functioning biologically, symbolically, and socially and who initiates  and performs self-care activities on own behalf in maintaining life, health and well-being; self-care activities deal with air, water, food elimination, activity and rest, solitude and social interaction, prevention of hazards to life and well-being, and promotion of human functioning.

Environment:

The environment is linked to the individual, forming an integrated and interactive system.

Health:

Health is a state that is characterized by soundness or wholeness of developed human structures and of bodily and mental functioning. It includes physical, psychologic, interpersonal, and social aspects. Well-being is used in the sense of individual’s perceived condition of existence. Well-being is a state characterized by experiences of contentment, pleasure and certain kinds  of happiness; by spiritual experiences; by movement toward fulfillment of one’s ideal; and by continuing personalization. Well-being is associated with health, with success in  personal endeavors, and with sufficiency of resources.

Nursing:

A helping or assisting service to persons who are wholly or partly dependent-infants, children and adults – when they, their parents, guardians, or other adults responsible for their care are no longer able to give  or supervise their care.  A creative effort of one human being to help another human being. Nursing is deliberate action, a function of the practical intelligence of nurses, and action to bring about humanely desirable conditions in persons and their environments. It is distinguished from other human services and other forms of care by its focus on human beings.

Orem’s Self-Care Deficit Theory

Dorothy Orem’s self-care deficit theory, published first in 1971, has been widely accepted by the nursing community. It includes three related theories of self-care, self-care deficit, and nursing system. Self-care theory postulates that self-care and the self-care of dependents are learned behaviors that individuals initiate and perform on theri own behalf to maintian life, health, and well-being. The individual’s ability to perform self care is called self-care agency. Adults care for themselves, whereas infants, the aged, the ill, and the disabled require assistance with self-care activities.

These are three kinds of self-care requisites:

1. Universal requisites, common to all people, include the maintenance of air, water, food, elimination, activity and rest, solitude and social interaction; prevention of hazards to life and well-being; and the promotion of human functioning.

2. Developmental requisites are those associated with conditions that promote known developmental processes throughout the life cycle.

3. Health deviation requisites relates to defects and deviations from normal structure and integrity that impair an individual’s ability to perform self-care.

Self-care deficit theory asserts that people benefit from nursing because they have health-related limitations in providing self-care. Limitations may result from illness, injury, of form the effects of medical tests or treatments.Two variables affect these deficits: self-care agency (ability) and therapeutic self-care demands (the measures of care required to meet existing requisites). Self-care deficit results when self-care agency is not adequate to meet he known self-care demand.

Nursing system theory postulates that nursing systems form when nurses prescribe, design, and provide nursing that regulates the individual’s self-care capabilities and meets therapeutic self-care requirements. Three types of nursing systems are identified:

1. Wholly compensatory systems are required for individuals unable to control and monitor their environment and process information.

2. Partially compensatory systems are designed for individuals who are unable to perform some (but not all) self-care activities.

3. Supportive-educative (developmental) systems are designed for persons who need to learn to perform self-care measures ans need assistance to do so.

 

Reference:

Kozier, Barbara et.al Fundamentals of Nursing 5th edition

Addison-Wesley Publishing Company, Inc 1998 p.51

Categories
Theorists

Dorothy E. Johnson

Dorothy E. Johnson
Dorothy E. Johnson

Behavioral System Model (1959,1968,1974,1980)

Person/Client:

A behavioral system composed of seven subsystems: affiliative, achievement, dependence, aggressive, eliminative, ingestive, and sexual.

Environment:

Consists of all factors that are not part of the individual’s behavioral system but that influence the system and some of which can be manipulated by the nurse to achieve the health goal of the client. The individual links to and interacts with the environment.

Health:

Health is an elusive, dynamic state of influenced by biologic, psychologic, and social factors. Health is reflected by the organization, interdependence, and integration of the subsystem. Human attempt to achieve a balance in this system; this balance leads to functional behavior. A lack of balance in the structural or functional requirements of the subsystem leads to a poor health.

Nursing:

An external regulatory force that acts to preserve the organization and integration of the client’s behavior at an optimal level under those conditions in which the behavior constitutes a threat to physical or social health or in which illness is found.

 

Johnson’s Behavioral System Model

Dorothy Johnson used her observations of behavior over many years to formulate a general theory of man as a behavioral system. The theory was originally presented orally in 1968 but was not published until 1980. Johnson defines a system as a whole that functions as a whole by virtue of the interdependence of its parts. Individuals strive to maintian stability and balance in these parts through adjustments and adaptations to the forces that impinge on them. A behavioral system is patterned, repetitive, and purposeful.

Johnson’s key concepts describe the individual  as a behavioral system composed of seven subsystems:

1. The attachment-affiliative subsystem provides survival and security. Its consequences are social inclusion, intimacy, and the formation and  maintenance of a strong social bond.

2. The dependency subsystem promotes helping behavior that calls for a nurturing response. Its consequences are approval, attention or recognition, and p[physical assistance.

3. The ingestive subsystem satisfies appetite. It is governed by social and psychologic considerations as well as biologic.

4. The eliminative subsystem excrete body wastes.

5. The sexual subsystem functions dually for procreation and gratification.

6. The achievement subsystem attempts to manipulate the environment. It controls or masters an aspect of the self or environment to some standard of excellence.

7. The aggressive subsystem protects and preserves the self and society within the limits imposed by society.

Each of the above subsystem has the same functional requirements: protection, nurturance, and stimulation. The subsystems’ responses are developed through motivation, experience, and learning and are influenced by biopsychosocial factors.

Other concepts associated with Johnson’s model are equilibrium, a stabilized more or less transitory resting state in which the individual is in harmony with the self and the environment; tension, a state of being stretched or strained; and stressors, internal or external stimuli that produce tension ans result in a degree of instability.

 

Reference:

Kozier, Barbara Fundamental of Nursing 5th edition

Addison-Wesley Publishing Company, Inc 1998 p.49