Among the relatively simple, but widely applicable nursing theories, a particularly curious one is the Self-Care Deficit Nursing Theory (SCDNT) developed by Dorothea Orem. At its core, the model encourages patients to be as independent as possible and practice self-care themselves instead of relying on nurses and other medical staff. The SCDNT has been effective at improving patients’ well-being and reducing hospitalization duration and cost (Afrasiabi Far et al., 2019). The theory’s framework works in a series of steps, the first of which is to establish the level of care that a patient needs and the level of self-care that they feasibly can or know how to provide for themselves (Yip, 2021). Then the nursing interventions needed are indicated and the ways to improve patients’ ability to practice self-care are determined.
This model can be used to educate pregnant women about vaccinations against COVID-19. Many mothers-to-be are reported to be unsure about getting vaccinated due to the concerns about the effects it might have on their baby’s health. The We Can Do This (2022) initiative informs that there is evidence of COVID vaccines being safe: thousands of pregnant and breastfeeding women have gotten it with no health issues for them or their babies. For pregnant women, vaccination lowers their chances of contracting COVID and helps build an immune response protecting the baby as well. However, if pregnant and unvaccinated, a woman and her child have higher chances becoming seriously ill and hospitalized in the case of getting COVID. In terms of educating women about that with the help of the SCDNT, first a medical practitioner should establish an understanding of the patient’s level of knowledge on the subject and her attitude towards vaccinations. From this information, one would pick the best form of educational practice and how it-depth it will be required to be.
The first of these steps is establishing therapeutic self-care demand, which describes the requirements for the patient’s effective self-care. These include the universal (common to all), developmental (specific to an age group), and health-based (special requirements based on the patient’s medical condition) requirements. The second step is to establish self-care agency – that is, the individual’s ability to care for oneself based on the priorly-established requirements. Next is establishing the state of the 10 basic conditioning factors (including age, gender, state of health, resources, and others) in relation to the patient. Of these, the power components – factors that will allow the patient to practice self-care – are established. For a pregnant woman, a power component could be an excess of resources or a good family structure that could provide support for her outside the hospital system. Finally, based on the above-gathered information, the presence or absence of self-care deficit is established. Self-care deficit is described as “the balance between the individual’s therapeutic self-care demand and his or her self-care agency” (Hackel & Fawcett, 2018, 265). If the demand for care exceeds the ability to self-care, a deficit is present.
The second part of the model deals with the nurse’s ability to offer assistance to the patient and how much help should be offered. The first step is to establish which nursing intervention type is the most appropriate based on the presence and severity of self-care deficit. There are three types: wholly compensatory, partly compensatory, and supportive-educative. After that, methods of helping are established, deciding the means by which the elected nursing interventions will be implemented. This includes direct support of the patient, providing an environment for learning, emotional or physical support, and education on self-care practices (Hackel & Fawcett, 2018). In the case of COVID-19 vaccination for pregnant women, all of the above-mentioned practices are possibly applicable.
References
Afrasiabi Far, A., Mehri, Z., & Ghaffarian Shirazi, H. R. (2020). Orem’s self-care model with multiple sclerosis patients’ balance and motor function. Nursing Science Quarterly, 33(1), 46–54. Web.
Hackel, J., & Fawcett, J. (2018). Teaching and learning from case studies: The added value of using a nursing conceptual model to construct cases. Nursing Science Quarterly, 31(3), 263–271. Web.
We Can Do This: COVID-19 Public Education Campaign. (2022). Ask a doctor: Are COVID vaccines safe for pregnant and breastfeeding people? [Video]. Web.
Yip, J. Y. C. (2021). Theory-based advanced nursing practice: A practice update on the application of Orem’s self-care deficit nursing theory. SAGE Open Nursing, 7, 1-7. Web.