A borderline case and a contrary case. Lastly,

A Concept
Analysis: Self-Care

            A
concept provides the basic foundations and the essential framework for any
discipline. The concept itself represents an icon of the advanced thought known
as the theory, the concept of the theory is what the researcher will be
concentrating on in order to attest or justify their assumptions. The concept I
will be centering on will be Self-Care, the nursing theory associated with
Self-Care is Dorotheas Orem’s Theory of Self-Care Deficit. The selected nursing
practice will be nursing education which where I will apply how I am able to
use theory within my selected practice. Within this paper I will be explaining
the concept of Self-Care and its theme and ideas using scholarly literature
sources. I will also be defining attributes of Self-Care, as well identifying
antecedents and consequences, two empirical referents of the nursing concept of
Self-Care and be identifying a model case, borderline case and a contrary case.
Lastly, I will speak on the theoretical application of the concept by
explaining the purpose of the concept analysis to the theory and how the
concept applies to the theory. Concept analysis is an imperative step needed in
order to provide precision that is needed in order to help the researcher
identify the antecedents, consequences and attributes.

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Explanation of Self-Care

The definition
of Self-Care is the practice of taking action to preserve or improve one’s own
health. The practice of taking an active role in protecting one’s own health,
well-being and happiness. It is also known as the care of self without medical
or other consultation. Care for one self. (Merriam Webster Dictionary) Humans
instinctively need to sustain their health mentally and psychologically. Dynamics
that broadly influence the patient to regress on Self-Care can be influences
such as depression, beliefs, socioeconomic status, education level and of
course environmental factors. Self-Care is referred to as one’s independence,
autonomy, individual accountability and self-guidance. (Hasanpour-Dehkordi,
2016)

Literature Review

The theme of the
concept Self-Care is to help encourage individuals to play an active role in
their own care. The significance of the Self-Care concept is related to how human
needs are for maintaining and promoting health and recovery. Self-Care activities
alleviate symptoms and complications of diseases, shorten recovery, and reduce
hospital stay and rehabilitation rate. (Hasanpour-Dehkordi, Mohammadi, &
Nikbakht-Nasrabadi, 2016) Orem’s postulations of Self-Care was that people should
be self-reliant and accountable for their own care. Orem identified the provisions
also known as the ADL’s as a person’s intake of food, air and water. How they
deal with elimination care, their balance between activities and rest, how they
balance solitude and social interactions, the prevention of hazards, and the promotion
of functioning. (Self-Care Deficit Theory, 2016) The attributes related to
self-care defined by humans are having the mental competences to be able to assess
a situation, judge it and make decisions about the factors and how they will
contribute to their health. (Orem, Renpenning, & Taylor, 2003) These
attributes act as the ideas of exactly what we are looking for within the
concept of self-care. When looking into the idea of self-care as professional
nurses in order for us to determine the presence of self-care patients need to
be asked questions and we need to make sure we receive verbal read back of
information given. Asking patients questions about how they produce self-care
for themselves will help measure their knowledge of their deficit. (Self-Care
Deficit Theory, 2016) If patients demonstrate positive self-care habits they will
reach optimal health, which is the goal.

 

 

Defining Attributes

Three attributes of the concept of Self-Care defined by humans
are having the mental competences to be able to assess a situation, judge it and
make decisions about the factors and how they will contribute to their health. (Orem,
Renpenning, & Taylor, 2003) For example, a mentally ill patient whom was
discharged and placed on a medication regimen whom feels after a couple weeks
that he feels better and no longer needs to be on medications. He then chooses
to come off medication and perhaps even self-medicate with drugs or alcohol. He
is unable to assess the situation and judge his actions. He is deficit in the
concept of self-care. Second attribute is the persons self interest in being
able to take care of ones-self in order to achieve the competency of self-care.
For example, a patient whom is discharged and continues to go to all outpatient
appointments, sticks to medication regimen and wants to take care of himself in
order to optimize his health. Third attribute I feel is the fact that the
patient is able to actually perform the self-care task fittingly. Orem’s theory
comes into play because as professional nurses, our task is to be able to
identify where the patient is deficient in and help the patient with education
on his self-care deficits. (Self-Care Deficit Theory, 2016)

Antecedent and Consequences

An antecedent is an identifiable occurrence
that precedes an event. An antecedent of self-care is knowledge. As the nurse,
we must be able to identify if a patient is knowledgeable about themselves. Does
the patient know how to take care of themselves, does the patient understand
why they must perform certain acts in order to promote optimal health. Being
able to identify the occurrences of self-care deficit will hopefully prevent
the consequences. (Orem, Renpenning, & Taylor, 2003) A consequence follows or is the result of an event. So,
if an antecedent isn’t identified and corrected we then have a consequence. A
consequence to a patients’ self-care would be a lapse of care or perhaps medication.
This can lead to readmission, worsening of illness and possibly even can be fatal
depending on the situation. (Hartweg, 1995)

Empirical Referents

Empirical referent is an objective way to
measure or determine the presence of a nursing concept. The nursing concept we
are focusing on is self-care relating to the theory of self-care deficit. In
order to determine the presence of self-care patients need to be asked
questions and we need to make sure we receive verbal read back of information
given. Asking patients questions about how they produce self-care for
themselves will help measure their knowledge of their deficit. (Self-Care
Deficit Theory, 2016) For example, if a patient has diabetes and that patient is
asked when do you take your blood sugar? When do you administer insulin? What range
should you be in? ect. We will have a better understanding of the knowledge the
patient has and the knowledge that is needed. Another way to determine if
self-care is present is through their understanding. When educating the patient
about their illness or lifestyle changes it is a good method to ask the patient
to verbally read back what you have taught them, this will measure their
understanding of the material taught. Using these two empirical referents in
order to determine whether or not the patient has good self-care or has
self-care deficit will help you follow through with the nursing theory and find
ways to help the patient in the areas they struggle. (Hartweg, 1995)

 

 

Construct Cases

Model Case:

The following
real-life situation is at my clinical practice where an adult man with bipolar
disorder characterizes the traits of assuming accountability for self-care. The
patient in this situation demonstrated the mental competency in assessing his
situation, making decisions and knowing how it will impact him.

Patient with 7-year history of bipolar disorder came in
due to signs of increase mania. Patient felt as if he might need an increase in
his medications in order to stabilize his moods. Patient assessed that he was
feeling moments of grandiose behaviors and was displaying signs of increased
mania. When assessed he made the decisions to bring himself into the emergency
room in order to be admitted and adjust his medications as well as be watched
for side effects. The patient made this decision due to knowing that he needed
to have a stable mood in order to function at his job and be able to function
in everyday society.

Borderline Case:

The following
real-life situation is at my clinical practice where an adult man whom held a
position as a police officer with major depression had most of his attributes
of self-care missing. The patient in this situation demonstrated the mental
competency in assessing his situation, but wasn’t able to make decisions or
knowing how it will impact him in the long run.

Patient with a long history of undiagnosed major
depression came in due to himself writing a suicide note and thinking about
attempting suicide. When patient assessed that these thoughts were too strong
for him to “ignore” or “sleep off” he turned to his wife to get help. His wife recommended
he go to the emergency room. Where the patient lacked self-care was his
decisions, patient would not tell staff any of his feelings. Patient denied
feeling depressed or anxious and said, “it was a mistake, it will never happen
again.” He was in denial and that decision to not work on his problems were
causing harm to himself. Bringing us to how he was lacking the next attribute
of realizing how it will impact him on the long run. He did not take in
consideration his job will not let him return if he doesn’t receive help, he
did not care that he had a family to go home to and needed to be better in
order to be around for a longtime happily.

Contrary Case:

The following
real-life situation is at my clinical practice where a young adult female whom unfourtantly
had a substance abuse issue and also suffered with major depression had all the
attributes of self-care missing. The patient in this situation was unable to
demonstrate the mental competency in assessing her situation, wasn’t able to make
decisions or knowing how it will impact her in the long run.

Young female admitted 3 times in the last month for
intentional overdoses. The last admission the patient was angry when she was
revived. Patient has a long history of heroin abuse as well as a long history
of depression. Patient demonstrates no care for her situation. Patient is
unable to assess her situation due to the mental competency lacking. Patient
continues to place herself in situations where she overdoses. Patient unable to
make the decision to go to inpatient rehab instead of not going to her
outpatient rehab and relapsing. Patient has no care for how it will impact her
in the long run, unfortunately her self-care deficit may lead to death.

Theoretical Applications of the Concept

The concept of
self-care relates to the selected nursing theory of Dorotheas Orem self-care
deficit theory. Self- Care is the act of taking care of oneself, patient whom demonstrate
the capability to be able to care about themselves and care of themselves are
able to promote optimal health. Orem’s theory was towards professional nurses
to be able to identify the patient deficits within self-care and be able to educate
them in order to help them take care of themselves and help find services or
programs to help them if they can’t themselves. The importance of the concept
analysis relationship to the theory is if the patient doesn’t demonstrate
self-care, we then look to Orem as our foundation on how to help the patient
with their deficits.

Conclusion

The definition
of Self-Care is the practice of taking action to preserve or improve one’s own
health. The practice of taking an active role in protecting one’s own health,
well-being and happiness. It is also known as the care of self without medical
or other professional consultation. A concept provides the basic
foundations and the essential framework for any discipline. The concept itself
represents an icon of the advanced thought known as the theory, the concept of
the theory is what the researcher will be concentrating on in order to attest
or justify their assumptions. The nursing theory associated with Self-Care is
Dorotheas Orem’s Theory of Self-Care Deficit. Three attributes of the concept of Self-Care defined
by humans are having the mental competences to be able to assess a situation,
judge it and make decisions about the factors and how they will contribute to
their health. (Orem, Renpenning, & Taylor, 2003) The concept analysis of
self-care applies to advanced practice nursing of education because as an
educator I will help promote the act of making sure patients are well educated
in order to promote autonomy for themselves. I will also be able to re-educate
and educate nurses and new nurses about being aware of the act of determining
what exactly your patient knows and understands about their health and how to
act autonomously. Self-reflecting on the new knowledge I have gained from
conducting a concept analysis about self-care I have learned that measuring and
determining are critical. We can’t determine what attributes they lack or how
we can educate them without finding out where they lack within their knowledge.
Being more mindful within my practice now I will try to lean off of just giving
information and try the approach of asking them questions to see exactly what
they are aware of about their medications and even their illness.