care demands placed on the patient and to then determine the nursing diagnosis according to the self-care deficits present.
Nursing intervention, as delineated by Orem's model, focuses on teaching as a method for increasing the self-care of the patient. In other words, the nurse carries out not only the function of health care but also an instructional function in which patients are taught how to care for themselves by making sure that their medical needs are met.
In evaluation, the nurse providing home health care using Orem's model, uses performance criteria to evaluate the outcome of the nursing system in relation to changes in the patient's self-care agency and self-care behavior. Thus, the self-care concept of nursing lends support to the education of patients in nursing practice.
There have been a number of studies which have found that utilization of Orem's model for situations related to home health care is associated with positive medical outcomes. For example, Becker (1993) evaluated whether the provision of nursing care to elderly patients in their home by nurses using Orem's model was significantly related to lessening rehospitalization. All patients in the study had just been discharged from a hospital.
An audit tool developed by the researcher was used to collect data from patient care records maintained by a certified home health agency. Results of the study showed that the nursing care provided in the home setting by nurses using Orem's model prevented rehospitalization for the same condition. Also, the provision of nursing care had a positive influence on the elderly individuals in their self-care abilities.
Home Health Care and Community Resources
Raffel and Raffel (1994) have discussed the need for home health care to maximally exploit community resources so as to deliver comprehensive quality services. According to the authors, one difficulty in home health care arises from the variabi...