untitled

research, the Self-Care Deficit Nursing Theory is
being used to guide research programs to identify
the self-care requisites and self-care behaviors of
specific clinical populations. Intervention studies
designed to enhance self-care performance are also
under way. For example, Dodd has launched a pro-
gram of research focused on the self-care of cancer
patients who were receiving chemotherapy or radi-
ation therapy. Her early descriptive studies clarified
the health-deviation self-care requisites of this pop-
ulation and documented the therapeutic self-care
demand (Dodd, 1982, 1984). More recent work de-
scribed specific self-care behaviors initiated by pa-
tients receiving these therapies and led to the
identification of a patient profile of self-care that
can be used in practice to target specific patient
groups who are in most need of nursing interven-
tions (Dodd, 1997). Dodd’s intervention studies
demonstrated that with targeted information,
patients can learn more about their treatment and
can perform more effective self-care behaviors
(Dodd, 1997). Her work has advanced to con-
ducting randomized control trials to test a self-
care intervention called PRO-SELF©to decrease
chemotherapy-related morbidity (Dodd, 1997).
Through her 20-year program of descriptive, pre-
dictive, and intervention studies based on self-care
theory, Dodd’s research has demonstrated how to
enhance patients’ knowledge of their treatment and
how to increase effective self-care activities. Dodd
clearly qualifies as a pioneer in self-care theory-
based research.
Investigators have used Orem’s theory to iden-
tify the self-care requisites and self-care capabilities
of patients across a broad range of health devia-
tions. Based on the theory, Utz and Ramos (1993)
have conducted a sequence of studies to explore
and describe the self-care needs of people with
symptomatic mitral valve prolapse. The self-care
capabilities and the self-care needs (requisites) of
persons with rheumatoid arthritis have also been
described. The most frequently reported universal
self-care requisites for these clients were the main-
tenance of a balance between activity and rest, the
promotion of normalcy, and the prevention of haz-
ards (Ailinger & Dear, 1997). Duration of illness
(health state) and educational level were found to
be related to self-care agency (Ailinger & Dear,
1993). Aish (1993) tested the effect of an Orem-
based nursing intervention on the nutritional
self-care of myocardial infarction patients. A

supportive-educative nursing system was reported

to be effective in promoting healthy low-fat eating

behavior (Aish, 1993). Metcalfe (1996) studied the

therapeutic self-care demand, self-care agency, and

the self-care actions of individuals with chronic ob-

structive lung disease. Health state was found to

offer significant explanation of variations in the

self-care actions of this population. Based on the

universal, developmental, and health deviation self-

care requisites, Riley (1996) developed a tool to

measure the performance and frequency of the self-

care actions of patients with chronic obstructive

lung disease. This tool has the potential to be useful

as an outcome measure in future intervention stud-

ies designed to enhance the self-care abilities of this

population.

Moore (1995) has used the Self-Care Deficit

Nursing Theory as the basis for her program of re-

search with children. She has developed the Child

and Adolescent Self-Care Practice questionnaire,

which can be used to assess the self-care perfor-

mance of children and adolescents. In a study of

children with cancer, Mosher and Moore (1998)

reported a significant relationship between self-

concept and self-care. Children with higher

self-concept scores were found to perform more

self-care activities than children with low self-

concept scores (Mosher & Moore, 1998).

THE CROSS-CULTURAL AND

INTERNATIONAL RESEARCH APPLICATIONS

The utility of the Self-Care Deficit Nursing Theory

beyond our national borders can be explained in

The utility of the Self-Care Deficit Nursing

Theory beyond our national borders can

be explained in part by the fact that

Orem’s intention was to develop a general

theory of nursing that would be useful in

describing and explaining universal nursing

knowledge.

part by the fact that Orem’s intention was to de-

velop a general theory of nursing that would be

useful in describing and explaining universal nurs-

ing knowledge. The theory’s applicability beyond

Western civilizations may be further explained by

the inclusion of culture as a primary influence on

people’s care beliefs and practices. According to the

152 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration