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CHAPTER 14 Dorothea E. Orem 245

MAJOR CONCEPTS & DEFINITIONS—cont’d
Universal Self-Care Requisites and treatment. The characteristics of health devia-
Universally required goals are to be met through self- tion as conditions extending over time determine
care or dependent care, and they have their origins in the types of care demands that individuals experi-
what is known and what is validated, or what is in the ence as they live with the effects of pathological
process of being validated, about human structural conditions and live through their durations.
and functional integrity at various stages of the life Disease or injury affects not only specific struc-
cycle. The following eight self-care requisites common tures and physiological or psychological mechanisms,
to men, women, and children are suggested: but also integrated human functioning. When inte-
1. Maintenance of a sufficient intake of air grated functioning is affected seriously (severe mental
2. Maintenance of a sufficient intake of food retardation and comatose states), the individual’s
3. Maintenance of a sufficient intake of water developing or developed powers of agency are seri-
4. Provision of care associated with elimination ously impaired, either permanently or temporarily. In
processes and excrements abnormal states of health, self-care requisites arise
5. Maintenance of balance between activity and rest from both the disease state and the measures used in
6. Maintenance of balance between solitude and its diagnosis or treatment.
social interaction Care measures to meet existent health deviation
7. Prevention of hazards to human life, human self-care requisites must be made action components
functioning, and human well-being of an individual’s systems of self-care or dependent
8. Promotion of human functioning and devel- care. The complexity of self-care or dependent care
opment within social groups in accordance systems is increased by the number of health deviation
with human potential, known human limita- requisites that must be met within specific time frames.
tions, and the human desire to be normal.
Normalcy is used in the sense of that which Therapeutic Self-Care Demand
is essentially human and that which is in Therapeutic self-care demand consists of the sum-
accordance with the genetic and constitutional mation of care measures necessary at specific times
characteristics and talents of individuals or over a duration of time to meet all of an individ-
(Orem, 2001, p. 225). ual’s known self-care requisites, particularized for
existent conditions and circumstances by methods
Developmental Self-Care Requisites appropriate for the following:
Developmental self-care requisites (DSCRs) were n Controlling or managing factors identified in
separated from universal self-care requisites in the the requisites, the values of which are regulatory
second edition of Nursing: Concepts of Practice of human functioning (sufficiency of air, water,
(Orem, 1980). Three sets of DSCRs have been iden- and food)
tified, as follows: n Fulfilling the activity element of the requisites
1. Provision of conditions that promote development (maintenance, promotion, prevention, and pro-
2. Engagement in self-development vision) (Orem, 2001, p. 523)
3. Prevention of or overcoming effects of human Therapeutic self-care demand at any time (1)
conditions and life situations that can adversely describes factors in the patient or the environment
affect human development (Orem, 1980, p. 231) that must be held steady within a range of values or
brought within and held within such a range for the
Health Deviation Self-Care Requisites sake of the patient’s life, health, or well-being, and
These self-care requisites exist for persons who are (2) has a known degree of instrumental effectiveness
ill or injured, who have specific forms of pathologi- derived from the choice of technologies and specific
cal conditions or disorders, including defects and techniques for using, changing, or in some way con-
disabilities, and who are under medical diagnosis trolling patient or environmental factors.
Continued