untitled

• A basic psychological model of action with three
  submodels:
  The personal frame of reference of the basic
  psychologic model of action.
  The veridical (coinciding with reality) frame of
  reference of the basic psychologic model of
  action.
  The sociocultural frame of reference of the basic
  psychologic model of action.


• A physiologic model of action.

The Hartnett-Rauckhorst theoretical models set
forth structural features of the process of voluntary
human action (that is, deliberate action). These
models develop the agent view; however, their
structure reflects the person, the user of symbols,
and the organism views of individual human be-
ings (Nursing Development Conference Group,
1979).
The study of these and other general theoretical
models of deliberate action stimulated some mem-
bers of the Nursing Development Conference
Group to investigate and formalize the conceptual
structure of self-care agency, conceptualizing it as
the developed power to engage in a specific kind of
deliberate action. The goal of these efforts was the
construction of models to identify types of relevant
information and to aid in the development of tech-
niques for collection and analysis of data about
self-care agency. By 1979, the following theoretical
models were developed:

1. A model of self-care operations, and estimative,
   decision making, and productive operations and
   their results.


2. A model of power components operationally in-
   volved with and enabling for performance of
   self-care operations.


3. A model of human capabilities and dispositions
   foundational for:
   a. the development and operability of the
   power components.
   b. the performance of the self-care operations
   in time and place frames of reference.

(Refer to Orem, 1995, for descriptions of these
models and highlights of their development.)
When considered together in their articulations,
the three theoretical models that are descriptive
and explanatory of self-care agency constitute
the elements for process models of the operation

of self-care agency, a process with a specified

structure. The first model, self-care operations, is

modeled on deliberate action. The power compo-

nent model names specific enabling capabilities

necessary for performing each of the named opera-

tions. (Capabilitiesare powers that can be devel-

oped or lost without a substantial change in the

possessor of the power.) The foundational capabil-

ities and dispositions model expresses physiologi-

cally or psychologically described capabilities

and dispositions that permit for or facilitate or

hinder persons’ performance of self-care opera-

tions or the development or adequacy of the power

components.

The nursing-specific view that every individual

human being has a therapeutic self-care demand to

be continuously met over time was conceptually

developed through the construction of theoretical

models using the broad views of human beings.

Models of categories of constituent care requisites

within the demand (universal, developmental, and

health deviation types) were developed as well as a

model to show the constituent content elements of

a therapeutic self-care demand and their derivation

(Orem, 1995). A process model of the structural el-

ements of an action system to meet a specific self-

care requisite particularized for an individual was

developed as an example of what actions must be

performed to meet each of the self-care requisites

of individuals.

These models express the content elements of

the conceptual entity therapeutic self-care demand.

The models also express the derivation of the con-

tent elements, the relationships among them, and

the regulatory results sought. The therapeutic self-

care demand models represent what is to be known

and met by individuals through their exercise of

self-care agency or met for them when required by

reason of self-care agency limitations.

These examples of models demonstrate that

nursing theorists and scholars involved in develop-

ment of Self-Care Deficit Nursing Theory used

both nursing-specific and more general views of in-

dividual human beings in the process of model

building. The examples also demonstrate that in

model development, theorists used knowledge

from more than one science or discipline of knowl-

edge. The subjects of the models (namely, nursing

systems, deliberate action, self-care agency, and

therapeutic self-care demand) also differed from

CHAPTER 12 Dorothea E. Orem’s Self-Care Deficit Nursing Theory 147