NURSING CONCEPTS: COMPARISON OF THE THEORIES OF NEUMAN AND OREM
The nursing theories of Betty Neuman and Dorothea Orem are compared within the context of the four major concepts of the metaparadigm of nursing. These four concepts are person, environment, health, and nursing (Wesley, 1994, p. 2).
Orem's theory of nursing is the Self-Care Model (Foote, Holcombe, Piazza, & Wright, 1993, pp. 26-32). Self-care is defined as the practice of activities by individuals which they personally initiate and perform in their own behalf in maintaining their own life, health, and well-being. The self-care model is structured around six central concepts and one peripheral concept (Orem & Taylor, 1986, pp. 37-71). The six central concepts are (1) self-care, (2) self-care agency, (3) therapeutic self-care demand, (4) self-care agency, (5) nursing agency, and (6) nursing system, while the peripheral concept is a set of basic conditioning factors. There are six elements involved in the application of Orem's self-care nursing model, as follows:
1. Goals of action. In the model, these goals are to (a) accomplish the patient's self-care demand, (b) move the patient toward responsible self-care, and (c) involve in care, or transfer responsibility for care from nursing to the members of the patient's family, or significant others who attend patient.
2. Patiency. Nursing intervention is required when a patient self-care deficiency exists. Balance is restored through the educative and developmental efforts of the nurse.
3. Actor's role. Actions are required on the part of both patient and nurse to restore balance to the patient's system.
4. Source of difficulty. The source of difficulty is identified as either the change in health state, or some other demand which has created a self-care deficit.
5. Intervention focus and mode. The intervention focus is concerned with the self-care agency, which consists of the patient's ...