MARTHA ROGERS

EARLY LIFE o The life process of human being evolves

irreversibly/one way and unidirectional/
BORN: May 12 1914, Dallas Texas, USA (same
irreparable i.e from birth to death.
birthday as Florence)
(4) PATTERN AND ORGANIZATION
DIED: March 13, 1994
Diploma: Knoxville General Hospital School of o Pattern identifies individuals and reflects
Nursing (1936) their innovative wholeness.
Graduation in Public Health Nursing: George (5) SENTENCE AND THOUGHT
Peabody College (1937) o Humans are the only organisms able to
MA: Teachers College, Columbia University, think, imagine, have language and
New York, 1945 emotions
MPH: Johns Hopkins University, Baltimore, 1952 o Ability to adapt to new changes
Doctorate in Nursing: John Hopkins University,
Baltimore, 1954 MAJOR CONCEPTS
Position:
• All human beings are viewed as integral
• Professor at Division of Nursing, New York part of universe
University and Consultant, (1) ENERGY FIELD
• Speaker o is inevitable part of life.
• American Nurse o Human and environment both have
• Theorist energy field which is open i.e. energy
• Author can freely flow between human and
environment
Publications of Martha Rogers: (2) OPENNESS
• Theoretical Basis of Nursing (1970) o There is no boundary or barrier that can
• Nursing Science and Art: A Prospective inhibit the flow of energy between
(1988) human and environment which leads to
• Nursing: Science of Unitary, Irreducible, the continuous movement or matter of
Human Beings (1990) energy.
• Vision of Space Based Nursing (1990) (3) PATTERN
o is defined as the distinguishing
SCIENCE OF UNITARY HUMAN BEINGS AND characteristic of an energy field
NURSING PROCESS perceived as a single wave
• Focuses on unitary-human environment o is an abstraction and it gives identity to
mutual process the field.
• Process of change that patient is (4) PANDIMENSIONALITY
experiencing, change is facilitated by o is defined as “nonlinear domain without
patient and environment spatial or temporal attributes “
o Human being are pandimensional being
MOTIVATION and have more than three dimension.
• Rogers believed that there was a unique o Undeviating field that is not constricted
body of knowledge for nursing and she 7 by space or time, an infinite domain
• set out to develop that, based on the without boundary
strong belief that a true picture of human
beings cannot be obtained by looking at HOMODYNAMIC PRINCIPLES
the parts, or even the sum of the parts, a • Homeodynamics is the balance
traditional view widely known as holism. between dynamic life process and
environment
ASSUMPTIONS
(1) PRINCIPLES OF INTEGRALITY (Synchrony +
(1) WHOLENESS Reciprocity
o Human being are considered as united o Human and environmental energy
whole and cannot be viewed as fields are in a continuous mutual
subparts. process or in constant interaction with
(2) OPENNESS human and environment
o A person and his environment are o we effect our environment and our
continuously exchanging energy with environment affects us.
each other. o Meditation and humor works to
o Energy flows freely produce positive environment.
(3) UNINDIRECTIONALITY a) RECIPROCITY
➢ Human and environment are
inseparable
 b) SYNCHRONY o Mutual-interaction between client
➢ Change is determined by and nurse
simultaneous response to o Mutual patterning of the human and
environment environmental fields includes:
(2) PRINCIPLES OF RESONANCY ➢ sharing knowledge
➢ the continuous change from lower to ➢ offering choices
higher frequency wave patterns in ➢ empowering the patient
human and environmental fields. ➢ fostering patterning
➢ Made by touch, imagery activities, ➢ repeat pattern appraisal,
drawing and other use of which includes nutrition, work/
imagination. leisure activities, wake/ sleep
➢ Symphony of interacting vibrations cycles, relationships, pain, and
(3) PRINCIPLES OF HELICY fear/ hopes
➢ The nature of change is continuous, (3) EVALUATION
innovative, and unpredictable due o Repeating pattern appraisal after
to the constant interchange mutual patterning to determine
between the human and extents of dissonance and harmony
environment. o Self-reflection for patient
➢ Human and environment are
APPLICATION OF THEORY
dynamic open systems.
NURSING METAPARADIGM • CLINICAL PRACTICE
- The more importance should be
(1) PERSON on the management of pain,
➢ Patients are considered “unitary supportive therapy and
human beings,” who cannot be rehabilitation
divided into parts, but have to be - Interventions include noninvasive
looked at as a whole. factors like guided imaginary,
(2) ENVIRONMENT humor, therapeutic touch, and
➢ Patients could not be separated from music.
their environment when addressing A) Nursing assessment and diagnosis
health and treatments. B) Intervention and rehab
➢ Entire energy field other than a C) Prevention of illness
person. D) Maintenance of health
(3) HEALTH E) Promotion of health
➢ an expression of the life process. To • NURSING EDUCATION
that end, illness and health are part of - Emphasis should be given on the
the same continuum, and the events understanding of the patient and
occurring throughout the patient’s self, energy field and environment
life show how the patient is achieving - More focus on teaching non-
his or her health potential. invasive modalities.
➢ Determined by interaction between • RESEARCH
energy fields - Rogerian theory has been used in
(4) NURSING many research works and has
➢ Is a science and an art. The practice always found testable and
of nursing, according to Rogers, applicable in researcH
should be focused on pain DIMENSIONS
management, and supportive
psychotherapy for rehabilitation. • SCIENCE OF NURSING
➢ Interaction of person and o the knowledge specific to the
environment to maximize health field of nursing that comes from
potential scientific research;
• ARTS OF NURSING
NURSING PROCESS
o involves using the science of
(1) ASSESSMENT/ PATTERN APPRAISAL nursing creatively to help better
o Assessment of human and the life of the patient.
environment energy fields
o Nurses validate entire appraisal along
with client
(2) VOLUNTARY MUTUAL PATTERNING
 CLINICAL SCENARIO human and environmental fields, help
the patient in the process of change,
A. ASSESSMENT
and to help patients move toward better
➢ Mr. X is experiencing pattern of
health.
dissonance, like depression with
• allows nurses to operate from a place of
suicidal ideation, MI, pain, fear,
scientific assurance in the work they do,
sleep pattern disturbances,
all the while maintaining focus on the
impaired nutritional status,
patient they work with
tendencies to commit suicide,
• The theory is a useful model for
and appraisal is essential for all
addressing the growing issue of nursing
these symptoms
burnout, which is known to cause
B. MUTUAL PATTERNING
increase rates of morbidity & mortality in
➢ The interaction between Mr. X
the clinical setting
and nurse for changing pattern
• Emphasized the need for non-invasive
and making emerging pattern as
nursing modalities.
unitary pattern
➢ Therapeutic touches, meditation,
guided imagery are patterning
planned for Mr. X
➢ Involvement of family for
environment patterning
➢ Advices given for changing
dietary pattern and improving
personal hygiene
➢ Participating in group helps him
develop self confidence
C. EVALUATION
➢ Repeating pattern appraisal after
mutual patterning to determine
extents of dissonance
➢ Current symptoms experienced is
shared with himself and if
changes is needed in MP that can
be incorporated the same time.

CRITIQUE
(1) SIMPLICITY
o Parsimonious theory that is based on
simple assumption but proves to be
valuable
(2) CLARITY
o Complex theory but still efforts are
going to clarify complex concepts
(3) GENERALITY
o Non-invasive modalities are useful
o SUBH is foundation of many theories
and can be apply in variety of setting
and all spheres of life
(4) EMPIRICAL PRECISION
o Limitations have been identified by
researches such as difficult to
understand concepts and lack of
operational definitions.
EMPHASIS

• SUBH leads to new way of seeing the

person
• The interventions of nurses are meant to
coordinate the rhythm between the
 DOROTHY JOHNSON

EARLY LIFE systems, attempting to achieve a

level of equilibrium.
BORN: August 21, 1919 (Savannah, Georgia) o Johnson was able to focus more
DIED: February 04, 1999; age of 80 on the individual and not so much
BSN DIPLOMA: Vanderbilt University in Nashville, on external factors affecting the
Tennessee (1942) patients
MPH: Harvard University in Boston (1948) • TEACHING
PROFESSIONAL EXPERIENCES: o as a teacher she was asked to
• Teaching determine what courses content
• Staff nurse (Chatham-Savannah Health constitutes nursing knowledge.
Council, 1943-1944) Unable to differentiate between
• Instructor and professor in pediatric medical knowledge and science
nursing (Vanderbilt University School of knowledge.
Nursing) o She was influenced to answer the
• Assistant of pediatric nursing differences “what made nursing
• Associate professor of nursing unique”
• Professor of nursing (University of • Empirical approach to nursing
California) o “Nursing is what nurses do”, big in
• Pediatric nursing advisor (Christian the late 1940 into early 1950’s, task
Medical College School of Nursing in orientated studies to varied and
Vellore, South India;1955- 1956) not good EBP,
• Chairperson (Committee of California o depressed her because of the
Nurses Association,1965-1967) many variations however she was
AWARDS: grateful that it kept her focused
• 1975 Faculty Award on not people but on ill or
• 1977 Lulu Hassenplug Distinguished prevention of illness in people.
Achievement Award (CNA) • an external regulatory force which acts
• 1981 VUSN Award for Excellence in
HOW THE THEORY DEFINES NURSING
Nursing
to preserve the organization and
BEHAVIORAL SYSTEM MODEL OF NURSING
integration of the patient’s behaviors at
• Proposed that Nursing Care facilitates an optimum level under those conditions
the client’s maintenance of a STATE OF in which the behavior constitutes a
EQUILIBRIUM threat to the physical or social health, or
• Clients are STRESSED by a stimulus of in which illness is found.
either an internal or external nature • each individual has patterned,
• These stressful stimuli create such purposeful, repetitive ways of acting that
disturbances TENSIONS in the patient comprises a behavioral system specific
that a state of disequilibrium occured. to that individual.
• the efficient and effective behavioral
ORIGIN/ INFLUENCE
functioning in the patient to prevent
• influenced by Nightingale and Hans illness.
Selye (father of stress) (1) To assist the patient whose behavior is
• Hans Selye- General Adaptation GOALS OF NURSING
Syndrome (G.A.S.),
o introduced in 1936, to explain the proportional to social demands.
process under which the body (2) To assist the patient who can modify his
confronts "stress" or "noxious behavior in ways that supports biological
agents “. imperatives.
o It was through Selye’s work on (3) To assist the patient who can benefit to
stress that Johnson was able to the fullest extent during illness from the
expand on stress within her theory. physician’s knowledge and skill.
o Johnson focused on the person's (4) To assist the patient whose behavior
response to stress of the illness does not give evidence of unnecessary
and how they would react to trauma as a consequence of illness.
these stresses. (1) ABOUT SYSTEM
• Florence Nightingale- ASSUMPTIONS
o Focus on the person not the
disease Johnson stressed the a. There is organization, interaction,
importance of the nurse in caring interdependency and integration
for the patient. of the parts and elements of
o Johnson focused on all aspects of behaviors that go to make up the
the patient and their behavioral system.
 b. A system “tends to achieve a some degree… adaptation is
balance among the various functionally efficient and effective.
forces operating within and upon (4) Nursing
it, and that man strives continually ➢ an external regulatory force that acts
to maintain a behavioral system to preserve the organization and
balance and steady-state by integrate the patient’s behavior at an
more or less automatic optimal level under those conditions
adjustments and adaptations to in which the behavior constitutes a
the natural forces occurring on threat to physical or social health or in
him.” which illness is found.”
c. A behavioral system, which (5) Behavioral system
requires and results in regularity ➢ Man is a system that indicates the
and constancy in behavior, is state of the system through
essential to man. It is functionally behaviors.
significant because it serves a (6) System
useful purpose in social life and ➢ which functions as a whole under
the individual. organized independent interaction of
d. “System balance reflects its parts.
adjustments and adaptations that (7) Subsystem
are successful in some way and to ➢ mini system is maintained concerning
some degree.” the entire system when it or the
(2) STRUCTURE AND FUNCTION environment is not disturbed.
a. From the form the behavior takes SUBCONCEPTS
and the consequences it
achieves can be inferred what (1) Structure
‘drive’ has been stimulated or ➢ The parts of the system that make up
what ‘goal’ is being sought.” the whole.
b. Each person has a “predisposition (2) Variables
to act concerning the goal, in ➢ Factors outside the system influence
certain ways rather than the other the system’s behavior, but the system
ways.” This predisposition is called lacks the power to change.
a “set.” (3) Boundaries
c. Each subsystem has a repertoire ➢ point that differentiates the interior of
of choices called a “scope of the system from the exterior.
action.” (4) Homeostasis
d. The individual patient’s behavior ➢ Process of maintaining stability.
produces an outcome that can (5) Stability
be observed ➢ Balance or steady-state in
MAJOR CONCEPTS/ METAPARADIGM maintaining a balance of behavior
within an acceptable range.
(1) Human Beings/ Person (6) Stressor
➢ Johnson views human beings as ➢ stimulus from the internal or external
having two major systems: the world that results in stress or instability.
biological system and the behavioral (7) Tension
system. ➢ The system’s adjustment to demands,
➢ It is the role of medicine to focus on change or growth, or to actual
the biological system disruptions.
➢ nursing focuses on the behavioral (8) Instability
system. ➢ State in which the system output of
➢ a behavioral system that strives to energy depletes the energy needed
make continual adjustments to to maintain stability.
achieve, maintain, or regain balance (9) Set
to the steady-state adaptation. ➢ The predisposition to act. It implies
(2) Environment that despite having only a few
➢ all elements of the human system’s alternatives to select a behavioral
surroundings and includes interior response, the individual will rank
and external stressors. those options and choose the option
(3) Health considered most desirable.
➢ the opposite of illness (10) Function
➢ “some degree of regularity and ➢ Consequences or purposes of action.
constancy in behavior.
➢ The behavioral system reflects
adjustments and adaptations that
are successful somehow, and to
 7 BEHAVIORAL SUBSYSTEMS ➢ Intellectual, physical, creative,
mechanical and social skills
(1) Attachment or affiliative subsystem ➢ Example: Giving positive feedback
➢ Forms the basis of all social such as praises after completing a
organization task. Validate their efforts.
➢ Development and maintenance of (8) Restorative (Added by Grubb later)
Interpersonal relationships ➢ Behaviors associated with
➢ Most critical and important as it maintaining or restoring energy
provides survival and security equilibrium,
➢ Social bonding/ sense of relatedness ➢ Example: relief from fatigue, recovery
➢ Example: Allowing family members to from illness, sleep behavior,
visit patients leisure/recreational interests and sick
(2) Dependency subsystem role behavior, ADL’s.
➢ Being dependent to other people/
obtaining assistance from others for FUNCTIONAL REQUIREMENTS
completing tasks (1) The system must be protected from toxic
➢ Complete reliance on others for influences with which the system cannot
survival cope.
➢ Examples: Giving approval, attention (2) Each system has to be nurtured through
or recognition and physical the input of appropriate supplies from
assistance the environment.
(3) Aggressive subsystem (3) The system must be stimulated for use to
➢ Protection and self- preservation enhance growth and prevent
➢ Defensive, evasive response for self- stagnation.
protection when threatened
➢ Identification of potential danger
➢ Example: a patient refuses to take the
medication as she thinks it is more
harmful to her and the nurse explains
its mechanism to her
(4) Ingestive subsystem
➢ Emphasis on the meaning and
structures of the social events
surrounding the occasion when the
food is eaten
➢ When, how, what, how much, and
under what conditions we eat.
➢ This can relate to nightingale's 13
canons “food and food intake”
➢ Example: considering patient
preferences in food choices
(5) Eliminative subsystem
➢ When, how, and under what
conditions eliminate
➢ Malibang or mangihi, singot,
excretion
➢ Release of physical waste products
➢ Example: promoting regular bowel
elimination (e.g every morning
malibang)
(6) Sexual subsystem
➢ Procreation and gratification; sex
➢ Development of gender role identity
and
➢ sex role behaviors
➢ Example: promoting a mother
perform her maternal role in the
sexual subsystem
(7) Achievement subsystem
➢ Control or mastery of an aspect of self
or environment to some standard of
excellence
➢ Areas that are in your expertise
 JEAN WATSON
(4) Caring responses accept person to
EARLY LIFE
choose best action for self
BORN: in Southern West Virginia (5) Caring environment offers development
EDUCATION: of potential
• Baccalaureate degree in nursing (6) Caring is “healthogenic” than is curing
(Boulder Campus, 1964) (7) Caring is central to nursing practice
• Master’s Degree in Psychiatric- Mental (8) Nursing care promotes better than
Health Nursing (Health Sciences medical care
Campus, 1966) (9) Caring for patient promotes growth
• Doctorate in Educational Psychology (10) Caring environment accepts
and Counseling (Graduate School, person as they are
Boulder Campus, 1973) CARATIVE FACTORS
PROFESSIONAL EXPERIENCES:
• Coordinator and Director of Nursing PhD • Serves as guide to what referred to as
program (University of Colorado School “core of nursing”, in contrast to nursing’s
of Nursing, 1978-1981) “trim”.
• Dean (UC School of Nursing); Associate • Core points to aspects that potentiate
Director of Nursing Practice (1983-1990) therapeutic healing processes
• Member of Executive Committee and • Affects the one caring and the one
Governing Board as officer for NLN (1993- being cared for
1996) (1) FORMATION OF HUMANISTIC-ALTRUISTIC
• President of National League of Nursing SYSTEM OF VALUES
(1995-1996) ➢ Begins at early age with values
AWARDS: shared with parents
• NLN Martha E. Rogers Award (1993) ➢ Mediated through own experiences
• Distinguished Nursing Scholar by NYU ➢ Necessary to nurse’s maturations that
(1998) promotes altruistic behavior
• First Murchison-Scoville Endowed Chair ➢ Treat patient as own family
of Caring Science (1999) ➢ Giving extension of sense of self
PUBLISHED BOOKS: (2) INSTILLATION OF FAITH-HOPE
• Nursing: The Philosophy and Science of ➢ Incorporate individual’s faith in
Caring (1979) assisting with acceptance of health
• Nursing: Human Science and Human status
Care – A theory of Nursing (1985) ➢ Provide sense of well-being through
• Postmodern Nursing and Beyond (1999) beliefs
• Instruments for Assessing and Measuring (3) CULTIVATION OF SENSITIVITY TO SELF AND
Caring in Nursing and Health Sciences OTHERS
(2002) ➢ Recognition of feeling leads to self-
• Caring Science as Sacred Science (2005) actualization
➢ Development of one’s own feelings
THEORY OF HUMAN CARING
to interact genuinely and sensitively
• According to Leo F. Buscaglia, we often ➢ Striving to become sensitive to
underestimate the power of touch, smile, become more authentic
kind word, listening ear, honest (4) DEVELOPMENT OF HELPING-TRUST
compliment, act of caring, which have RELATIONSHIP
potential to turn a life around ➢ Crucial for transpersonal caring
• According to Jean Watson, caring is not ➢ Communication builds rapport and
passed from generation to generation caring
but rather from nurse to patient and ➢ Characteristics needed are the ff.”
society. o Congruence (truthful)
• Makes explicit values, philosophical o Empathy (understand feelings
orientation toward humanity of honoring and perception)
unity of mind, body, and spirit. o Warmth
• Compassion o Effective communication
• Caring starts with compassion and (5) PROMOTION AND ACCEPTANCE OF
caring or nurse EXPRESSION OF (+) AND (-) FEELINGS
➢ Risk-taking experience
ASSUMPTIONS
➢ Must recognize how intellectual and
(1) Caring can be effectively demonstrated emotional understanding differs
and practiced interpersonally only ➢ Awareness of feelings
(2) Caring consists of carative factors that ➢ Feelings alter thoughts and behaviors
result in satisfaction of human needs
(3) Caring promotes health and individual or
family growth
(6) SYSTEMATIC USE OF SCIENTIFIC PROBLEM-
CARITAS PROCESSES
SOLVING METHOD FOR DECISION
MAKING • Caritas is from Greek word which means
➢ Allows control and prediction, and to cherish, appreciate
permits self-correction • “At this time, I make new connections
➢ Similar to research process between carative, caritas, and invoke L
➢ Brings scientific problem- solving word, which caritas conveys, that is love.
approach to nursing care Allowing love and caring coming
➢ Caring shouldn’t be always neutral together for new form of deep
and objective transpersonal caring.” (Watson, 1998)
(7) PROMOTION OF INTERPERSONAL CARATIVE FACTORS TO CARITAS PROCESSES:
TEACHING-LEARNING (1) Practice of loving-kindness and
➢ Separates caring from curing equanimity within context of caring
➢ Allows patient to be informed consciousness
➢ Facilitates with teaching (2) Being authentically present, and
➢ Focus on learning process as much as enabling and sustaining the deep belief
teaching process system and subjective life-world of self
➢ Understanding perception of and one being cared for
situation helps nurse to prepare plan (3) Cultivation of one’s own spiritual
(8) PROVISION FOR A SUPPORTIVE, practices and transpersonal self, going
PROTECTICE, CORRECTIVE MENTAL, beyond ego self
PHYSICAL, SOCIO-CULTURAL AND (4) Developing and sustaining a helping-
SPIRITUAL ENVIRONMENT trusting, authentic caring relationship
➢ Eternal and internal variables, where (5) Being present to, and supportive of
the nurse manipulates in order to expression of (+) and (-) feelings as a
provide support and protection for connection with deeper spirit of self and
person’s well-being one being cared for
➢ Nurse must provide comfort, privacy (6) Creative use of self and all ways of
and safety knowing as part of caring process; to
(9) ASSISTANCE WITH GRATIFICATION OF engage in artistry of caring-healing
HUMAN NEEDS practices
➢ Based on hierarchy of need (7) Engaging in genuine teaching-learning
➢ Needs deserve to be attended to experience that attends to unity of being
and valued and meaning attempting to stay within
➢ Needs are important for quality other’s frame of reference
nursing care and promotion of (8) Creating healing environment at all
optimal health levels, whereby wholeness, beauty,
➢ Watson Ordering of Needs: comfort, dignity, and peace are
o BIOPHYSICAL NEEDS (LOW) potentiated
▪ Food and fluid (9) Assisting with basic needs, with an
▪ Elimination intentional caring consciousness;
▪ Ventilation tending to both embodied spirit and
o PSYCHOPHYSICAL NEEDS evolving spiritual emergence
▪ Activity-inactivity (10) Opening and attending to
▪ Sexuality spiritual-mysterious, and existential
o PSYCHOSOCIAL NEEDS (HIGH) dimensions of one’s own life-death; soul
▪ Achievement care for self and the one-being-care-for.
▪ Affiliation
o INTRA-INTERPERSONAL NEEDS TRANSPERSONAL CARING
▪ Self-actualization • Foundational to the theory
(10) ALLOWANCE FOR EXISTENTIAL- • A special kind of human care
PHENOMENOLOGIC-SPIRITUAL FORCES relationship
➢ Phenomenology is a way to • Union with another person
understand people from their view • High regard for whole person and their
➢ Existential psych is study of human being-in-the-world
existence using phenomenological
analysis METAPARADIGM/ MAJOR CONCEPTS
➢ Helps nurse to reconcile and mediate (1) NURSING
the incongruity of viewing the person ➢ Health promotion and treatment of
➢ Nurse assists person to find strength to disease
confront life or death ➢ Human science of persons and
human health-illness experiences
that are mediated by professional,
 personal, scientific, esthetic and
ethical human transactions
➢ Consists knowledge, thought, values,
philosophy, commitment and action,
passion
➢ Concerned with promoting health,
preventing illness, caring for sick and
restoring health
(2) HEALTH
➢ Positive state of physical, mental, and
social well-being with:
o High level of overall well-being
functioning
o General adaptive-
maintenance level of daily
functioning
o Absence of illness
➢ Unity and harmony within mind, body
and soul
➢ Degree of congruence between the
self as perceived and self as
experienced
➢ Illness is not necessarily disease,
instead a subjective turmoil of
disharmony
(3) HUMAN BEING/PERSON
➢ Unity of mind, body, spirit, nature
➢ Personhood is tied to notions that
one’s soul possess a body that is not
confined by objective time and
space
(4) ENVIRONMENT
➢ Healing spaces can be used to help
others transcend illness, pain and
suffering
➢ Caring attitude is transmitted by
culture of profession as unique way of
coping with environment
CARING OCCASION/MOMENT

• Moment when nurse and another person

come together where human caring is
created
• Both persons have the possibility to come
together in a human-to-human
transaction
• Phenomenal fluid corresponds to
person’s frame of reference consisting of
feelings, sensations, thoughts, beliefs,
goals, etc.; based upon experiences.
 DOROTHEA OREM
➢ Nursing is HUMAN SERVICE
EARLY LIFE
(3) Health
BORN: July 15, 1914 (Baltimore, Maryland) ➢ Is a state that is characterized by
DIED: June 22, 2007 soundness or wholeness of
DIPLOMA: Providence Hospital School of Nursing developed human structures and of
(1934) bodily and mental functioning.
BSN: Catholic University of America (1939) ➢ It includes physical, physiologic,
MSN: Catholic University of America (1945) interpersonal and social aspects.
PROFESSIONAL EXPERIENCES: (4) Environment
• Directorship of nursing school and ➢ External source of influence in the
department (Providence Hospital, internal interaction of a person’s
Detroit, 1940-1949) different aspects
• Professor of Biological Sciences and
THEORY OF SELF-CARE
Nursing (1939-1941)
• Assistant Professor (CUA,1959-1964) • which focuses on the performance or
• Associate Professor (CUA, 1964-1970) practice of activities that individuals
• Dean of School of Nursing (CUA, 1965- perform on their own behalf.
1966) • might be actions to maintain one’s life
• Curriculum consultant (office of Ed., US and life functioning, develop oneself or
Dept. of Health, Ed. And Welfare, 1958- correct a health deviation or condition.
1959) • Self-care
• Division of Hospital and Institutional ➢ practice of activities that individual
services consultant (1960) initiates and perform on their own
• Indiana State Board of Health (1949- behalf in maintaining life, health and
1957) well being
• Center for Experimentation and • Self-care agency
Development in Nursing ➢ is a human ability which is "the ability
• John Hopkins Hospital (1969-1971) for engaging in self-care"
• Director of Nursing (Wilmer Clinic, 1975- ➢ conditioned by age developmental
1976) state, life experience sociocultural
AWARDS: orientation health and available
• CUA Alumni Achievement Award for resources.
Nursing Theory (1980) • Basic Conditioning Factors
• Linda Richards Award from NLN (1991) ➢ are age, gender, developmental
• Honorary Fellow of American Academy state, health state, socio-cultural
of Nursing (1992) orientation, health care system
• Received accolades from Georgetown factors, family system factors,
Univ., Incarnate World College, Illinois patterns of living, environmental
Wesleyan University, Univ. of Missouri- factors, and resource adequacy and
Columbia availability.
SELF-DEFICIT CARE THEORY • Therapeutic self-care demand
➢ "totality of self-care actions to be
• Defined nursing as “The act of assisting performed for some duration in order
others in the provision and management to meet self-care requisites by using
of self-care to maintain or improve valid methods and related sets of
human functioning at the home level of operations and actions"
effectiveness.” • Self-care requisites
• focuses on each individual’s ability to ➢ action directed towards provision of
perform self-care, self-care.
• defined as “the practice of activities that ➢ 3 categories of self-care requisites
individuals initiate and perform on their are:
own behalf in maintaining life, health, o Universal self-care requisites
and well-being.” o Developmental self-care
METAPARADIGM requisites
o Health deviation self-care
(1) Person requisites
➢ Who can be viewed as functioning (1) Universal self-care requisites
biologically, symbolically and socially ➢ Associated with life processes and
and who initiates and performs self- the maintenance of the integrity of
care activities on own behalf in human structure and functioning
maintaining life. ➢ Common to all, ADL
(2) Nursing ➢ Identifies these requisites as:
➢ Helping or assisting client to identify
ways to perform self-care activities.
 o The maintenance of a THEORY OF SELF-CARE DEFICIT
sufficient intake of air
o The maintenance of a • describes and explains WHY people can
sufficient intake of water be helped through nursing.
o The maintenance of a • Nursing is required when an adult is
sufficient intake of food incapable or limited in the provision of
o Provision of care associated continuous effective self-care.
with elimination process and • The theory asserts that people benefit
excrements from nursing because they have health-
o Balance between activity and related limitations in providing self-care.
rest • Agent- a person who engages in
o Balance between solitude meeting the needs of a person.; They are
and social interaction like bridges that facilitate what has been
o Prevention of hazards to done and what needs to be done.
human life well-being and o Two types:
o Promotion of human ▪ Self-Care Agent
functioning who perform self-care
(2) Developmental self-care requisites independently
➢ “either specialized expressions of ▪ Dependent Care Agent-
universal self-care requisites that takes full responsibility of
have been particularized for taking care of a person
developmental processes or they are who are incapable of
new requisites derived from a providing care for
condition or associated with an themselves
event.” • Nursing Agency – set of established
o E.g. adjusting to a new job capabilities of a nurse who can
o adjusting to body changes. legitimately perform activities of care for
(3) Health deviation self-care requisites a client. Includes concepts of deliberate
➢ These requisites exist for persons who action, including operations of diagnosis,
are ill or injured, including those with prescription, and regulation.
defects and disabilities. • Orem explains not only when nursing is
➢ These include: needed but also how people can be
o Seeking and securing assisted through the 5 methods of
appropriate medical helping:
assistance o Acting for and doing for others
o Being aware of and attending o Guiding others
to the effects and results of o Supporting another
pathologic conditions and o Providing an environment
states. promoting personal development
o Effectively carrying out in relation to meet future
medically prescribed demands
diagnostic, therapeutic, and o Teaching another
rehabilitative measures.
o Being aware of and attending THEORY OF NURSING SYSTEM
to or regulating the • describes how the patient’s self-care
discomforting or deleterious needs will be met by the nurse, the
effects of prescribed medical patient, or both.
measures. • action system formed by nurses through
o Modifying self-concepts (self - the exercise of their nursing agency for
image) in accepting oneself persons with health derived or health
as being in a particular state of associated limitations in self-care or
health and in specific forms of dependent care.
health care • describes and explains relationships that
o Learning to live with the effects must be brought about and maintained
of pathologic conditions and for nursing to be produced.
states and the effects of • Identifies 3 classifications of nursing
medical diagnostic and system to meet the self-care requisites of
treatment measures in a the patient:
lifestyle that promotes o Wholly compensatory system
continued personal o Partly compensatory system
development. o Supportive – educative system
(1) Wholly Compensatory Nursing System
➢ Required for individuals who are
unable to control and monitor their
 environment and process o The health goals within the
information. context of life history, lifestyle,
➢ “Doing for the patient...” and health status.
➢ Unable to engage in any form of o The person’s requirements for
action (e.g., coma) self-care
➢ Aware and who may be able to o The person’s capacity to
make observations or judgments, perform self-care
and decisions about selfcare but (2) Nursing Diagnosis and Care Plans
cannot/should not perform actions ➢ Step 2:
requiring ambulation and o The nurse designs a system
manipulative movements (e.g., that is wholly or partly
patients with C3-C4 vertebral compensatory or supportive-
fractures) educative.
➢ Unable to attend to themselves and o The two actions are:
make reasonable judgments about ▪ Bringing out a good
self-care but who can be ambulatory organization of the
and able to perform some self-care components of
with guidance (e.g.,severely patients’ therapeutic
mentally retarded) self-care demands.
(2) Partially Compensatory Nursing System ▪ Selection of a
➢ Designed for individuals who are combination of helping
unable to perform SOME, but not all methods will be
self-care activity. effective and efficient
➢ “Helping the patient do for in compensating/
himself/herself.” overcoming the
➢ a patient can meet some self-care patient’s self-care
requisites but needs a nurse to help deficits.
meet others; either the nurse or the (3) Implementation & Evaluation
patient has the major role in the ➢ Step 3:
performance of self-care E.g., a o A nurse assists the patient or
patient with recent abdominal family in self-care matters to
surgery identify and describe health
(3) Support-Educative System and health-related results.
➢ Designed for persons who need to o Collecting evidence in
learn to perform self-care measures evaluating results achieved
and need assistance to do so. against results specified in the
➢ Helping patient to learn self-care and nursing system design.
emphasizing on the importance of o The etiology component of
nurse’s role. nursing diagnosis directs
➢ A patient can meet self-care actions.
requisites but needs help in decision- STRENGTHS
making, behavior control, or
knowledge acquisition; the nurse’s • Provides a comprehensive base to
role is to promote the patient as a nursing practice.
self-care agent (teacher/consultant) • It has utility for professional nursing in the
➢ E.g., a 16-year-old who is requesting areas of nursing practice nursing
birth control information curricula, nursing education
administration, and nursing research.
NURSING PROCESS
• Specifies when nursing is needed.
(1) Assessment • Also includes continuing education as
➢ Diagnosis and prescription; part of the professional component of
determine why nursing is needed. nursing education.
➢ Analyze and interpret by making a • Her self-care approach is contemporary
judgment regarding care. with the concepts of health promotion
➢ Design of a nursing system and plan and health maintenance.
for delivery of care. • Expanded her focus of individual self-
➢ Production and management of care to include multiperson units.
nursing systems.
➢ STEP 1: COLLECT DATA IN 6 AREAS LIMITATIONS
o The person’s health status • Orem defines a system as a single whole
o The physician’s perspective of thing.
the person’s health status • Health is often viewed as dynamic and
o The person’s perspective of his ever changing. Orem’s visual
or health health presentation of the boxed nursing
 systems implies three static conditions of
health.
• Appears that the theory is illness oriented
rather with no indication of its use in
wellness settings.