CHAPTER II
DISCUSSION
DISCUSSION
2.1 Biography of Dorothea E. Orem
Dorothea E. Orem nursery school education at Providence Hospital in Washington DC. Bachelor graduated in 1930. Graduated Master of nursing education in 1939. In 1945 work at Catholic University in America during his career he has worked as a staff nurse, private duty nurses, educators, nursing administration and as a consultant (1970).
1. Year 1958 - 1959 as a consultant in the Department of Health on the education and welfare of nursing participated in the training project
2. In 1959 the concept was first published Orem care
3. In 1965 joined the Catholic University in the U.S. to form a theoretical model of community nursing
4. In 1968 formed a group of nursing development conference, which resulted in cooperation on the care and discipline of nursing
5. In 1976 received a Doctorate Honoris Causa
6. In 1980 received his award from the Catholic University of America alumni about nursing theory
7. Orem subsequently developed the concept of self-care nursing and nursing, published in (Concept of Pratice 1971).
8. In 1980 published a second book which contains the first edition expanded to families, groups and communities.
9. In 1985 published a second book which contains about three theories, namely; Theory of self care, self care deficit theory, theory of nursing systems.
2.2 Orem Nursing Model Concept
According to Orem Nursing Model known as Self Care Model. Self Care model gives the sense that the shape viewed from a nursing service
implementation of individual activities can be done in meeting basic needs with the aim order to sustain life, health, welfare in accordance with good health and illness. This nursing model developed since 1959-2001.
Model Self Care (personal care) have beliefs and values that exist in the nursing of them in action on the implementation berdaarkan keampuan. Self Care is based on the deliberation and decisions made as a guide in action.
In understanding the concept of nursing, especially in view of the fulfillment of basic needs, Orem share in the concept of basic needs consist of:
1. Air (air): pengambian pemelihraan in the air.
2. Water (water): pemeliaraan taking water
3. Food (food): maintenance of the food consumed
4. Elimination (elimination): the maintenance needs of the process of elimination
5. Rest and Activity (Rest and activity): a balance between rest and activity.
6. Solitude and Social Interaction (loneliness and social interaction): the maintenance of a balance between solitude and social interaction.
7. Hazard Prevention (risk prevention): the need for prevention of risks to human life in good health.
8. Promotion of normality
2.3 Orem Nursing Theory
View of Orem's theory in order nursing services directed to the needs of individuals in independent nursing action and set in its needs. In practice nursing concept developed three forms of the theory of Orem Self Care, including:
THEORY SELF CARE
Orem believes that self-care theory he advances, is part of the conceptual model of nursing that can be implemented by all professionals working in the field of health services, such as doctors, physiotherapists, speech therapists, etc. in view of Orem, self-care is a personal process is unique, as well as an initial step performed by a nurse that took place in accordance with state and continue its existence, and is influenced by following factors:
age
Gender
health
growth and development
social environment / culture
health care system
Family
lifestyle
Self-care is a practical activity of a person in preserving their health and sustain life. Relationship occurs between the buyer and the recipient of self-care self-care in a therapeutic relationship. Orem suggests three categories / self-care requirements are:
1. Universal self-care needs / Universal self-care requisite:
It is common for all individuals, such as the need to ensure a person that he is eating and drinking, getting enough rest, elimination, and related to the humanitarian functions and processes of life, usually referring to basic human needs. Universal self care requisite is meant is:
- Maintenance of sufficient intake air
- Maintenance of adequate fluid intake
- Maintenance of the adequacy of food intake
- Maintenance of a balance between activity and rest
- Maintenance of a balance between solitut and social interaction
- Prevent the threat of human life, human functioning and human welfare.
- Inventories of care associated with the processes of elimination and exrement.
2. Self-care needs of the development / Developmental self-care requisite:
it occurred in connection with the level of individual development and the environment in which they live, which is associated with changes in one's life or the life cycle.
3. Health deviation needs / Health Deviation self-care requisite:
arise because health is unhealthy and needs to be real because of illness or disability who want change in self-care behaviors.
Various kinds of self-care theory:
Various kinds of self-care theory:
• Self Care Agency:
an individual's ability in performing self-care, which can be affected oeh age, developmental, sociocultural, health and others.
• Self Care Theurapetic Demand:
• Self Care Theurapetic Demand:
demands or requests in self-care which is the independent actions undertaken within the specified time for self-care by using the methods and tools in the appropriate action.
• Self Care requisites:
• Self Care requisites:
the need for self-care is an act aimed at the provision and self-care is universal and is associated with the process of human life and in an effort mepertahankan body functions. Self Care Reuisites consists of several types, namely: Universal Self Care requisites (universal human needs that are basic needs), Developmental Self Care requisites (needs related developments indvidu) and Health Deviation requisites (needs arising as a result of the patient's condition).
2. Self Care Deficit
Self Care Deficit is an important part in the general treatment in which all the planning of nursing care provided at the time it takes. Nursing a person is required at the time were unable or limited to perform a self carenya continuously. Self care deficit can be applied to minors, or needs that exceed the capabilities and the expected decline in the ability to care and in improving self-care demands, both in quality and quantity. In fulfillment of self-care and assist in problem-solving process, Orem has a method to process such act or acts for another person, as a mentor others, give support, enhance the development environment for personal development as well as teach or educate others.
3. Theory of Nursing Systems
Ø Nursing Systems Theory is a theory that outline clearly how patient self-care needs are met by the nurse or the patient himself. In view of this system, Orem provide identification in the system of nursing services including:
1. Help System In Full (Wholly Copensatory System).
Is an act of nursing by providing full assistance to the patients because patients in meeting self-care actions that need help in the movement, pngontrolan, and ambulansi as well as the manipulation of the movement. Relief system can be performed on people who are unable to perform activities such as the patient deliberately coma in patients who are conscious and may still be able to make an observation and assessment of injury or other problems but not capable of doing action, that require ambulation or manipulation movements, such as in patients who fracture vetebrata and in patients who are unable to take care of itself, make judgments and decisions in his self care and the patient is still able to perform ambulation and may be able to perform some act of his self-care through guidance to continue as in patients with mental retardation.
2. Systems partial assistance (Partially Compensasi System)
In care delivery system is partially self-only and intended for patients who require minimal assistance as in patients post abdominal surgery where the patient is having capabilities such as washing hands, brushing teeth, wash my face but it needs help nurses in ambulation and perform wound care .
3. supportive and educational systems.
Is a system of assistance provided to patients who need to support education in hopes of patients were able to independently require treatment. These systems do allow the patient to take action after learning of nursing. The provision of these systems can be performed on patients who need the information in the birth setting.
4. Method of assistance:
The nurse helps the client by using the system and through the five methods of assistance which includes:
1. Acting or done something for a client
2. Teach the client
3. Directing clients
4. Supports client
To implement this, the five main areas for nursing practice in diskripsikan as follows:
a. Enter into and maintain relationships nurse - client with individuals, families or groups of clients to be allowed home from treatment.
b. Establish if and how the client can be helped through treatment.
c. Responding to client needs, desires and his need for contact with nurses and assistants.
d. Coordinate and integrate nursing and client's daily life, health services needed or received, or the social services and counseling is needed or received
2.4 Relationship with the paradigm model of nursing include:
Is an act of nursing by providing full assistance to the patients because patients in meeting self-care actions that need help in the movement, pngontrolan, and ambulansi as well as the manipulation of the movement. Relief system can be performed on people who are unable to perform activities such as the patient deliberately coma in patients who are conscious and may still be able to make an observation and assessment of injury or other problems but not capable of doing action, that require ambulation or manipulation movements, such as in patients who fracture vetebrata and in patients who are unable to take care of itself, make judgments and decisions in his self care and the patient is still able to perform ambulation and may be able to perform some act of his self-care through guidance to continue as in patients with mental retardation.
2. Systems partial assistance (Partially Compensasi System)
In care delivery system is partially self-only and intended for patients who require minimal assistance as in patients post abdominal surgery where the patient is having capabilities such as washing hands, brushing teeth, wash my face but it needs help nurses in ambulation and perform wound care .
3. supportive and educational systems.
Is a system of assistance provided to patients who need to support education in hopes of patients were able to independently require treatment. These systems do allow the patient to take action after learning of nursing. The provision of these systems can be performed on patients who need the information in the birth setting.
4. Method of assistance:
The nurse helps the client by using the system and through the five methods of assistance which includes:
1. Acting or done something for a client
2. Teach the client
3. Directing clients
4. Supports client
To implement this, the five main areas for nursing practice in diskripsikan as follows:
a. Enter into and maintain relationships nurse - client with individuals, families or groups of clients to be allowed home from treatment.
b. Establish if and how the client can be helped through treatment.
c. Responding to client needs, desires and his need for contact with nurses and assistants.
d. Coordinate and integrate nursing and client's daily life, health services needed or received, or the social services and counseling is needed or received
2.4 Relationship with the paradigm model of nursing include:
Human
Orem Model clearly discussed with the individual and focuses on the idea of self and self-care. however, a person is considered the most exclusive in this context, while the complexity of human care and human action tiddak considered.
Environment
Environment is also discussed clearly in this model. however, it is mainly regarded as a situation where a lack of self-care or self care.
Health and Illness
This idea is also present in the model, but is discussed in kaitanya with self-care. The reason is that if individuals in good health they can fulfill their own self-care deficit they experienced.
Nursing
This model mebahas in a clear and systematic nature of nursing and frameworks to provide care keperawatan.Harus known that it is displayed in entuk mechanistic approach based on supportive-educative approach, partial compensation, and total compensation. approach is a direct approach that can be carried out in order. Because that's what this model is very popular among the practitioners who argue that more complex models difficult to for implement
2.5 Application of Orem Nursing Model
1.
Application of Orem Nursing Model, can be seen from the following case:
Case:
Tn. J (50 years), diagnosed with type 2 diabetes. He has a history of hypertension and he was a heavy smoker (30 cigarettes per day). Treatment can be given epada Mr. J based on Orem's nursing model is:
1. Water (educative / supportive). Nurses should be able to provide information about the relationship of hypertension with smoking.
2. Water (educative / supportive). Nurses must be able to meykinkan the hydration-enough risk of triggering polydipsia Hyperglycaemia (high sugar levels in the blood)
3. Food (partial compensatory). Nurses provide yan diet suitable for hypertension and diabetes, as well as controlling blood sugar after meals.
4. Elimination (educative / supporif). Clients require monitoring.
5. Activity and Rest (adecative / supportive). The nurse informs the patient about the activities that are suitable for diabetic patients.
6. Solitude and Social Interaction (partial compensatory). Social interactions with nurses can provide tigkah interaction and social change.
7. Hazard Prevention (partial compensatory). Nurses provide education to patients about the advantages and disadvantages of treatment to be taken by the patient.
8. Promote normality (partial compensatory). Nurses are expected to help patients to restore the patient's lifestyle, so it becomes normal again.
2.6 Objectives
Orem model of nursing at the destination "s in general are:
1. Lowering the demands of self-care at a level where the client can afford, this means eliminating self-care deficit.
2. Allows clients to improve its ability to meet the demands of self care.
3. Allows people which means (meaning) for clients to provide dependent care if self care is not possible, therefore, any self-care deficit is eliminated.
If all three ditas not achieved nurses can directly meet the needs of self-care clients.
The purpose of nursing at Orem's model is applied into the practice of family nursing / community are:
1. Helping clients in this family for independent therapeutic nursing
2. Helping clients move toward an act-an act of self care
3. Helping family members to care for family members who experience problems competently
Thus, the focus of nursing care on Orem's model is applied to the practice keperawtan keluaga / community are:
1. Interpersonal Aspects: relationships within family
2. The social aspect: family relationship with the surrounding community.
3. procedural aspect; train basic skills so that families are able to anticipate the changes that occur
4. Technical Aspects: teaches the family about the basic technique done at home, for example to compress the action correctlyv
CHAPTER III
CLOSING
3.1 Conclusion
By studying the model concept or self-care nursing theory to mean that all humans have a need for self-care needs and they have the right to own memperolehya unless otherwise afford. Thus the nurses recognized the potential patients to participate in care of herself at his ability level and help determine the level of care can be provided. Nursing independent (self care) according to Orem's are:
"An implementation of the activities initiated and carried out by the individuals themselves to meet the needs to sustain life, health and welfare in accordance with the circumstances, whether healthy or sick" (Orem's, 1980). There are three kinds of self-care teory. And to be able to apply the concept or model of nursing theory and skills required an in-depth knowledge of nursing theory and technical skills in order to obtain a therapeutic attitude.
Application of Orem Nursing Model, can be seen from the following case:
Case:
Tn. J (50 years), diagnosed with type 2 diabetes. He has a history of hypertension and he was a heavy smoker (30 cigarettes per day). Treatment can be given epada Mr. J based on Orem's nursing model is:
1. Water (educative / supportive). Nurses should be able to provide information about the relationship of hypertension with smoking.
2. Water (educative / supportive). Nurses must be able to meykinkan the hydration-enough risk of triggering polydipsia Hyperglycaemia (high sugar levels in the blood)
3. Food (partial compensatory). Nurses provide yan diet suitable for hypertension and diabetes, as well as controlling blood sugar after meals.
4. Elimination (educative / supporif). Clients require monitoring.
5. Activity and Rest (adecative / supportive). The nurse informs the patient about the activities that are suitable for diabetic patients.
6. Solitude and Social Interaction (partial compensatory). Social interactions with nurses can provide tigkah interaction and social change.
7. Hazard Prevention (partial compensatory). Nurses provide education to patients about the advantages and disadvantages of treatment to be taken by the patient.
8. Promote normality (partial compensatory). Nurses are expected to help patients to restore the patient's lifestyle, so it becomes normal again.
2.6 Objectives
Orem model of nursing at the destination "s in general are:
1. Lowering the demands of self-care at a level where the client can afford, this means eliminating self-care deficit.
2. Allows clients to improve its ability to meet the demands of self care.
3. Allows people which means (meaning) for clients to provide dependent care if self care is not possible, therefore, any self-care deficit is eliminated.
If all three ditas not achieved nurses can directly meet the needs of self-care clients.
The purpose of nursing at Orem's model is applied into the practice of family nursing / community are:
1. Helping clients in this family for independent therapeutic nursing
2. Helping clients move toward an act-an act of self care
3. Helping family members to care for family members who experience problems competently
Thus, the focus of nursing care on Orem's model is applied to the practice keperawtan keluaga / community are:
1. Interpersonal Aspects: relationships within family
2. The social aspect: family relationship with the surrounding community.
3. procedural aspect; train basic skills so that families are able to anticipate the changes that occur
4. Technical Aspects: teaches the family about the basic technique done at home, for example to compress the action correctlyv
CHAPTER III
CLOSING
3.1 Conclusion
By studying the model concept or self-care nursing theory to mean that all humans have a need for self-care needs and they have the right to own memperolehya unless otherwise afford. Thus the nurses recognized the potential patients to participate in care of herself at his ability level and help determine the level of care can be provided. Nursing independent (self care) according to Orem's are:
"An implementation of the activities initiated and carried out by the individuals themselves to meet the needs to sustain life, health and welfare in accordance with the circumstances, whether healthy or sick" (Orem's, 1980). There are three kinds of self-care teory. And to be able to apply the concept or model of nursing theory and skills required an in-depth knowledge of nursing theory and technical skills in order to obtain a therapeutic attitude.
BalasHapusThat's really cool buddy.....Obviously the lady was logical.
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