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Nurse: Nursing and Self Care

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Nurse: Nursing and Self Care
practice & research

Exploring Orem’s self-care deficit nursing theory in learning disability nursing:
Philosophical parity paper: part 1

In a two-part article, Paul Horan and colleagues explore the relevance of this popular nursing model from a variety of perspectives. Can Orem’s self-care deficit nursing theory be helpful in meeting the needs of people with learning disabilities?

(Taylor 2002) and is one of the most frequently used theories in general nursing practice (Alligood and Marriner-Tomey 2002). This paper attempts to evaluate the theory as a means to address the unique needs of people with intellectual disabilities. Fawcett’s (1995) template for critically analysing conceptual models is used. Fawcett (1995) noted that the concepts and propositions of this theory could also be considered at the level of abstraction and generality of conceptual models, and referred to it as Orem’s selfcare framework. This author (Fawcett 2000) acknowledged that this framework is widely recognised as a conceptual model. In discussion and practical application it is also referred to as ‘the self-care model’ (Pearson et al 2000). This term will be used throughout this discussion. Prior to commencing this appraisal the authors held the belief that the self-care model (Orem 2001) was too complex to be
28 LEARNING DISABILITY PRACTICE vol 7 no 4 May 2004

O

rem’s self-care deficit nursing theory (Orem 2001) is widely used and accepted by nurses

applied successfully to the needs of those with an intellectual disability. This initial view was potentially in response to its relative under use in intellectual disability settings in the UK and Ireland, together with negative perceptions of the use of other conceptual models of nursing borrowed from the general nursing domain. This paper aims to examine the potential of Orem’s (2001) self-care model to meet the needs of people with varying degrees of intellectual disabilities and additional physical care needs, in



References: Aggleton P and Chalmers H (2000) Nursing Models and Nursing Practice (2nd edition). New York, Palgrave. Alligood MR (2002) The nature of knowledge needed for nursing practice. In Alligood MR and Marriner-Tomey A (eds) Nursing Theory Utilisation & Application. London, Mosby. Cavanagh SJ (1991) Orem’s Model in Action. London, Macmillan Press. Cormack DFS and Reynolds W (1992) Criteria for evaluating the clinical and practical utility of models used by nurses. Journal of Advanced Nursing. 12, 17, 1472-1478. Fawcett J (1984) Analysis and Evaluation of Conceptual Models of Nursing (2nd edition). Philadelphia, FA Davis. Fawcett J (1993) Analysis and Evaluation Nursing Theories. Philadelphia, FA Davis. Fawcett J (1995) Analysis and evaluation of Conceptual Models of Nursing (3rd edition). Philadelphia, FA Davies. Fawcett J (1999) The state of nursing science: Hallmarks of the 20th and 21st centuries. Nursing Science Quarterly. 12, 4, 311-314. Heath H (1998) Paradigm dialogues and dogma: finding a place for research, nursing models and reflective practice. Journal of Advanced Nursing. 28, 2, 288-294. Orem D E (2001) Nursing: Concepts of Practice (6th edition). London, Mosby. Pearson A et al (1996) Nursing Models for Practice (2nd edition). Oxford, Butterworth-Heinemann. Rawnsley MM (1999) Response to Fawcett’s ‘The State of Nursing Science’. Nursing Science Quarterly. 12, 4, 315-318. vol 7 no 4 May 2004 LEARNING DISABILITY PRACTICE 37

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