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06 ROGERS, OREM, KING

Dr. Ma. Luisa Uayan || October 2022 NCMA110
Transcribers: Kathleen Venus

OUTLINE D. HOMODYNAMIC PRINCIPLES

I. MARTHA ROGERS: SCIENCE OF UNITARY Resonance
HUMAN BEINGS - Is an arrangement for human and environment
that undergo transformation
II. DOROTEA OREM: SELF-CARE DEFICIT
III. IMOGENE KING: GOAL ATTAINMENT Helicy
THEORY - is the nature of change is unpredictable,
continuous and innovative
I. MARTHA ROGERS: SCIENCE OF UNITARY HUMAN
BEINGS Integrality
- is the energy fields of human and environment in
a continuous mutual process
A. BACKGROUND
• Martha E. Rogers was born in 1914 E. METAPARADIGM
in Dallas, Texas. The life process of the
• She received her nursing diploma unitary human being is one
from the Knoxville General Hospital PERSON of wholeness and continuity
as well as dynamic and
School of Nursing in 1936, then
creative change.
earned her Public Health Nursing defines as irreducible pan
degree from George Peabody dimensional energy field
College in Tennessee in 1937. identified by pattern and
ENVIRONMENT
• Her Master’s degree was from Teachers College at manifesting characteristics
Columbia University in 1945, and her Doctorate in different from those of the
Nursing was earned at from Johns Hopkins University parts
symbolize wellness and the
in Baltimore in 1954. Rogers died on March 13, 1994.
HEALTH absence of disease and
• Rogers worked as a professor at New York major illness
University’s School of Nursing. is both art and science and
• She was also a Fellow for the American Academy of NURSING the nurse is a factor in
Nursing. healing environment
• Her publications include: Theoretical Basis of
F. IMPLICATIONS OF ROGERS THEORY
Nursing (1970), Nursing Science and Art: A
Prospective (1988),Nursing: Science of Unitary,
NURSING
Irreducible, Human Beings Update (1990), and Vision EDUCATION RESEARCH
PRACTICE
of Space Based Nursing (1990). Evaluative and
It was found that
diagnostic phase That students
the theory applies
B. ASSUMPTIONS includes have individual
to any
Human being is considered determining the personalities and
environment that
Wholeness patients’ and their patterns to their
as united whole contains human
family’s well-being work.
A person and his beings.
status at the time
environment are Her theory
Openness
continuously exchanging They are all focuses nursing
energy with each other unitary human interventions on
The life process of human beings and should the patient well -
being evolves irreversibly be interacted with being overall and
Unidirectionality differently not just their
and unidirectional i.e from
disease state
birth to death Culture, family,
Pattern identifies individuals Interventive how
and experiences
the nurse will go
Pattern and organization and reflects their innovative affect their
about
wholeness reasons and
implementing
Humans are the only motives to
nursing It encourages the
become a nurse
organisms able to think, interventions for use of guided
Sentence and thought Beings focuses on
imagine, have language and the patient. imagery,
“the integrality of
emotions relaxation,
person and
therapeutic touch,
environment, the
and meditation
C. MAJOR CONCEPTS individual’s active
participation in
Energy Field change, and each
person’s
individual pattern

Pan- Major Openness

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dimensionality Concepts
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Pattern
[NCMA110] 1.06 ROGERS, OREM, KING – Dr. Ma. Luisa Uayan
G. ANALYSIS OF THE THEORY
Clarify
- It is difficult-to-understand principles, lack of
operational definitions, and inadequate tools for
measurement model has passed the test of time
for the development of nursing science as nursing
matured as a science
Simplicity
- when the model is examined in total perspective,
some still classify it as complex. With its
continued use in practice, research, and
education, nurses will come to appreciate the
model’s elegant simplicity
Generality
- Rogers’ conceptual model is abstract and
therefore generalizable and powerful. It is broad in
scope, providing a framework for the development
of nursing knowledge through the generation of
grand and middle-range theories
Importance
- Rogers’ science has the fundamental intent of
understanding human evolution and its potential
for human betterment. The science “coordinates a
universe of open systems to identify the focus of a
new paradigm and initiate nursing’s identity as a
science”
H. APPLICATION TO NURSING
Mary is a 53-year-old woman who is in end stage leukemia.
She has had two failed bone marrow transplants and three
rounds of chemotherapy. She is moving into hospice home
care, and the family and Mary become your client. Mary is the
mother of four children: 25, 23, 20, and 17. One child lives at
home. Pattern appraisal includes: Mary—frail, quiet, almost
translucent in appearance, resting comfortably in hospital bed
in living room, nasal O2 in place Tom—husband, quiet, pacing
Home—clean, orderly, many personal articles, large window
facing north and looking into the yard. Noise level low. Dog
sleeping on floor
i. ANALYSIS
1. End of life is a process of merging of the past, present,
and future
2. Nursing care for Mary offers the opportunity to
incorporate a variety of patterning
3. As Mary nears and prepares for the end of her life,
many patterning concerns must be addressed for
peaceful closure to her life and the change to another
energy form
4. The visible rhythmical pattern is a manifestation of
peace (Mary) and a human environmental
manifestation of anxiety in husband
5. The unknown and preparation for loss is the focus.
The pattern appraisal is ongoing
6. Harmony is noted in her relationship with her husband
and family and with her sense of how she has
progressed through this disease process.
II. DOROTEA OREM: SELF-CARE DEFICIT
A. BACKGROUND
• Dorothea E. Orem (1914-2007), one of
the prime US theorists born in
Baltimore, Maryland
• Obtain her basic diploma in nursing at
School of Nursing Washington, BSN
(1939) and MSN in 1945 from Catholic
University of America, and Doctorate degrees
(honorary Doctorates awarded from different
Universities).
• She began her nursing career at Providence Hospital
School of Nursing in Washington, DC, where she
received a diploma of nursing in the early 1930s.
• She published her theory in 1959 for the first time and
revised in 1971, 1983, 1987, and 2001. Her
contributions enabled her to achieve Excellency from
prominent societies like Sigma Theta Tau International
Society, the National League for Nursing, and the
American Academy of Nursing.
B. OREM PHILOSOPHY
• “Nursing is the ability to care for another human being,
most importantly when they are unable to care for
themselves. The ultimate goal is achieving an optimal
level of health and wellness for our patients”. Orem
(1971)
C. CONCEPTS OF OREM’S MODEL
1. The Self-Care Deficit Theory developed as a result
of working toward her goal of improving the quality of
nursing in general hospitals in her state.
2. The model interrelates concepts in such a way as to
create a different way of looking at a particular
phenomenon.
3. The theory is relatively simple, but generalizable to
apply to a wide variety of patients.
4. It can be used by nurses to guide and improve
practice, but it must be consistent with other validated
theories, laws and principles
D. CONCEPTS AND DEFINITION
The self-care deficit nursing theory is a general theory
composed of the following four related theories
• The theory of self-care, which describes why and how
people care for themselves
• The theory of dependent-care, which explains how
family members and/or friends provide dependent-
care for a person who is socially dependent
• The theory of self-care deficit, which describes and
explains why people can be helped through nursing
• The theory of nursing systems, which describes and
explains relationships that must be brought about and
maintained for nursing to be produced
E. THEORY OF SELF-CARE
1. Self Care Agent provides the foundation for
understanding the action requirements and action
limitations of persons who may benefit from nursing.
2. Theory of dependent care “explains how the self-
care system is modified when it is directed toward a
person who is socially dependent and needs
assistance in meeting his or her self-care requisites”
3. Therapeutic self-care demand is the totality of self-
care actions to be performed for some duration in
order to meet self-care requisites by using valid
methods and related sets of operations and actions.
F. 3 COMPONENTS OF SELF-CARE
• Universal Self Care Needs
o Air, food, water, elimination/excretion, activity
& rest, solitude/social interaction,
functioning/well being, normalcy
• Developmental Self Care Requisites
o more specific to the process of growth and
development and are influenced by what is
happening during the life cycle, It can be
positive or negative.
• Health Deviation Self Care Requisites
o When a condition permanently or temporarily
alters structural, physiological or
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psychological function
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[NCMA110] 1.06 ROGERS, OREM, KING – Dr. Ma. Luisa Uayan
G. SELF-CARE K. METAPARADIGM
1. Self-Care Agent is a state characterized by
provides the foundation for understanding the soundness or wholeness of
action requirements and action limitations of HEALTH developed human structures
persons who may benefit from nursing. and of bodily and mental
functioning.
2. Theory of dependent care is viewed biologically,
“explains how the self-care system is symbolically and socially but
modified when it is directed toward a person PEOPLE still as a whole person. This
who is socially dependent and needs person is considered to be
assistance in meeting his or her self-care able to provide self-care
requisites” is how a healthcare
professional develops a plan
NURSING
3. Therapeutic self-care of care to meet the patient’s
demand is the totality of self-care actions to self-care needs
be performed for some duration in order to is the physical, chemical,
meet self-care requisites by using valid biologic and social factors
methods and related sets of operations and ENVIRONMENT
that make up who a person
actions is.

H. THEORY OF DEPENDENT CARE L. SIGNIFICANCE OF THE THEORY

Dependent care refers to the care that is provided to a person Nursing Practice Education Research
who, because of age or related factors, is unable to perform the The SCDNT was Using the SCDNT
self-care needed to maintain life, healthful functioning, introduced as the or components,
continuing personal development, and well-being. basic structure for Biggs (2008)
nursing found more than
Dependent-Care Self-Care Dependent-Care Has achieved a management in 800 references.
Demand Agency Agency significant level of German hospital Berbiglia identified
The self-care acceptance by the DRG (diagnosis- selected practice
Summation of agency is a Refers to the international related group) settings and
care measures at complex acquired acquired ability of nursing implementation. SCDNT
a specific point in ability of mature a person to know community, as The movement conceptual foci
time or over a and maturing and meet the evidence by the toward SCDNT- from a review of
duration of time persons to know therapeutic self- magnitude of based nursing more than 3
for meeting the and meet their care demand of published material management decades of use
dependent’s continuing the dependent and presentations the SCDNT in
therapeutic self- requirements for person and/or The influence of
at the practice and
care demand deliberate, regulate the Orem’s SCDNT
international research and
when his or her purposive action development and has continued at
Orem Society publicized
self-care agency to regulate their exercise of the the international
World selected
is not adequate or own human dependent’s self- level through the
Congresses international
operational. functioning and care agency translation of
SCDNT practice
development Nursing Concepts
models for the
of Practice into
twenty-first
I. THEORY OF SELF-CARE DEFICIT several languages
century
1. A self-care deficit occurs when an individual cannot
carry out self-care requisites. M. ANALYSIS OF THE THEORY
2. Orem identifies method of helping: 1. Clarity
a. Acting for and doing for others - Orem defined the term and elaborated the
b. Guiding and directing substantive structure of the concept in a way that
c. Providing Physical and Psychological support is unique while also congruent with other
d. Environment of promoting personal interpretations
development 2. Simplicity
e. Teaching - Orem’s theory is expressed in a limited number of
Examples of self-care requisites are: terms. These terms are defined and used
• Wound care consistently in the expression of the theory.
• Activities of Daily Living Orem’s general theory, the SCDNT, comprises
• Bowel program the following four constituent theories: self-care,
• Glucose monitoring dependent-care, self-care deficit, and nursing
systems
J. THEORY OF NURSING SYSTEMS 3. Generality
1. Wholly compensatory support- patient is unable to - As a general theory, it serves nurses engaged in
complete any self-care independently; nursing nursing practice, in development and validation of
compensates for patient’s inability to perform self-care. nursing knowledge, and in teaching and learning
2. Partial compensatory support- patient is able to nursing
perform self-care tasks with partial or no assistance 4. Accessibility
from nursing. - As a general theory, the SCDNT provides a
3. Supportive/educative compensatory– patient able to descriptive explanation of why persons require
perform tasks independently. Nursing provides nursing and what processes are needed for the
ongoing education and support. production of required nursing care
- The SCDNT differentiates the focus of nursing
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from other disciplines. Although other disciplines

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find the theory of self-care helpful and contribute

[NCMA110] 1.06 ROGERS, OREM, KING – Dr. Ma. Luisa Uayan
to its development, the theory of nursing systems
provides a unique focus for nursing

N. APPLICATION TO NURSING
Mr. Shoaib is a 62 years old male patient admitted to a medical
ward. He has right ischemic Cerebro Vascular Accident (CVA)
and a resultant left sided body paralysis. He has no sensations
or movement in the left side of the body. He has lost his gag
reflux and is unable to swallow food. A nasogastric (N/G) tube
is placed for providing him nutrition. Mr. Shoaib is not able to
change his position and is dependent on care givers for
changing his position. He is also not able to carry out his
routine daily life activities. His family is worried whether he
would be able to regain control of his life or not. They are also
worried whether they would be able to provide him the care he
needs when he is discharged from hospital

i. ANALYSIS
1. Universal Self care requisite
2. Health deviant self care D. ASSUMPTIONS
3. Development of self care requisite 1. Basic Assumptions of goal attainment theory is that
the nurse and patient communicate information, set
III. IMOGENE KING: GOAL ATTAINMENT THEORY mutual goal act to achieve these goals it is the basic
assumption of Nursing Process
A. BACKGROUND 2. Each human being perceives the world as a total
• Theorist : Imogene King - born in person in making transaction with individual and things
1923. in the environment
• Bachelor in science of nursing E. NURSE PATIENT TRANSACTION MODEL
from St. Louis University in 1948 1. Action is a means of behavior or activities that are
• Master of science in nursing from towards the accomplishments of certain act. It is both
St. Louis University in 1957 physical and mental.
• Doctorate from Teacher’s college, 2. Reaction is a form of reacting or a response to a
Columbia University. certain stimuli.
• Theory describes a dynamic, interpersonal relationship 3. Interaction is any situation wherein the nurse relates
in which a person grows and develops to attain certain and deals with a clientele or patient.
life goals. 4. Transaction is a unique observable in which human
• Factors which affects the attainment of goal are: roles, being communicate with the environment
stress, space & time
F. METAPARADIGM
B. KING’S OPEN SYSTEM FRAMEWORK existing in an open system
1. Nursing Focus is the care of human being PERSON who makes choices and
2. Nursing Goal is the health of the individual and health select alternative action
care for the group as continuous adjustment to
3. Human Beings are open system in constant interaction HEALTH stress in the internal and
with the environment external environment
as the process of balance
C. INTERACTING SYSTEMS IN THE THEORY OF GOAL involving internal and
ENVIRONMENT
ATTAINMENT external interactions inside
Personal Sytem the social system
1. Perception is an observable behavior
2. Self found in the health care
3. Growth and Development systems in society”. The goal
4. Body Image NURSING of nursing “is to help
5. Time individuals maintain their
6. Space health so they can function
Interpersonal System in their roles”
• How the nurse interrelates with a co-worker or patient,
particularly in a nurse-patient relationship G. SIGNIFICANCE
• Interaction Nursing Practice Education Research
• Communication Individualized the
• Transaction plans of care It is used in
• Role while encouraging curriculum design
It is design and
• Stress active in nursing
conducted to
Social System participation from programs
implement this
• An organized system of social role, behavior and clients
system in
practices It provides a
hospital,
• Organization The profession of systematic means
ambulatory,
• Authority nursing function of viewing nursing
community and
• Power through as profession, an
home care
individuals and organize body of
• Status nursing
groups within the knowledge and
• Decision Making
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environment clarifying nursing

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as discipline
[NCMA110] 1.06 ROGERS, OREM, KING – Dr. Ma. Luisa Uayan
H. ANALYSIS OF THE THEORY
1. Clarify
- Theory of Goal Attainment is the ease with which
it can be understood by nurses. Concepts are
concretely defined and illustrated.
2. Simplicity
- King’s definitions are clear and are conceptually
derived from research literature.
3. Generality
- It has been criticized for having limited application
in areas of nursing in which patients are unable to
interact competently with the nurse.
4. Accessibility
- A descriptive study was conducted to identify the
characteristics of transaction and whether nurses
made transactions with patients
5. Importance
- middle-range Theory of Goal Attainment focused
on all aspects of the nursing process:
assessment, planning, implementation, and
evaluation. The body of literature clearly
establishes King’s work as important for
knowledge building in the discipline of nursing.

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