Orem’s Self-Care Theory: A Critical Theory to Tanzania Nurses in the Wake of COVID-19

Guest author: Katunzi Mutalemwa
with Rosemary Eustace

see also Practice Exemplar
Self-Care Theory in Tanzania

Self-care is an integral part of nursing care delivery systems. Pioneered by Dr. Dorothea Orem, the self-care theory offers nurses with unique opportunities for health promotion, disease prevention and rehabilitation care worldwide. Self-care supportive-educative strategies through health promotion and prevention initiatives have been instrumental in health care service delivery in Tanzania, especially in primary care clinics. The emerging COVID-19 pandemic has delineated new care demands on self-care requisites that Tanzania populations need to meet in order to stay healthy and free of the illness.  With such a pandemic, nurses are being tasked to find new ways of assisting clients to effectively meet their self-care needs that best fit the cultural context.  So the following question remains to be answered: What kind of nursing system(s) are in demand in Tanzania in this COVID-19 era? 

The Orem’s Self-care theory guided the practice exemplar “Self Care Theory in Tanzania.” This exemplar highlights two common self-care strategies utilized in Tanzania in the wake of COVID-19, that we identify as Non-pharmaceutical (NP) and Alternative pharmaceutical (AP) self-care nursing interventions.  The first example is focused on hand washing as a basic NP self-care strategy.  The second example relates to complimentary alterative medicines (CAM) as an Alternative pharmaceutical (AP) self-care strategy in particular herbal steam therapy (commonly known as kujifukiza in Kiswahili).

As the most trusted health care professionals in the world, we “nurses” have the duty and responsibility to help individuals, families and communities to be able to choose and select the right information for self-care.   In the wake of COVID-19, nursing self-care delivery systems should focus on prevention and health promotion in a safe and cost-effective manner. This approach supports Dr Jacqueline Fawcett assertion that “Nursology has an answer to how to emphasize primary prevention.” [Read her blog The Value of Primary Prevention]. This is the right time to do so.  We have to be part of the solution by being proactive and advocating for effective non-pharmaceutical (NP) and Alternative pharmaceutical (AP) self-care policies through the lens of unique nursing perspectives, in this case, Orem’s Self-Care theory. 

The two exemplars clearly tell the story that upon planning of any successful health-related project, it is important to understand the extent of self-care practices in a community, collaboration, training needs in self-care and development of guidelines/protocols. The “Kujifukiza” (i.e. herbal steam therapy) phenomenon was eye opening. It is not surprising to see that Sub-Saharan nurses are receptive of alternative modalities but lack appropriate knowledge about complementary health therapies (Gyasi, 2018).   For example, I (Katunzi) am one of those nurses who lack appropriate knowledge about CAM. I was not fortunate to have this kind of education in my nursing program beside a one-day CAM observational opportunity during a palliative care rotation. I am now compelled to advocate for nursology-led initiatives to study and promote evidence-based protocols or guidelines. 

There is a lot to be done and a lot to learn from each other about Orem’s self-care theory guided practice related to NP and AP self-care strategies. To continue this dialogue on NP and AP self-care strategies, we would like to invite nurses and nursing students around the world to reflect on the COVID-19 pandemic as it relates to these important self-care issues:

  1. How has hand washing, a non-pharmaceutical (NP) self-care public health strategy been utilized within your cultural context (family, workplace or community)?
  2. How has alternative pharmaceutical (AP) self-care public health strategies been utilized in your cultural context (family, work place or community)?
  3. If Dorothea Orem lived to see the COVID-19 pandemic, what do you think she would say about nurses, nursing and self-care?

Please share your thoughts in the comment chat box. We look forward to hearing from you!

Suggested Readings

Mutalemwa, K. & Eustace, R. (2020). Self-Care Theory in Tanzania. Nursology.net Practice Exemplar https://nursology.net/practice-theory-exemplars/self-care-theory-in-tanzania/

Dorothea Orem: Self-Care Deficit Theory https://nurseslabs.com/dorothea-orems-self-care-theory/  web accessed on 29/05/2020

Gyasi, R. M. (2018). Unmasking the practices of nurses and intercultural health in sub-Saharan Africa: a useful way to improve health care?. Journal of evidence-based integrative medicine, 23 2515690X18791124.

Orem, D. (1991). Nursing: Concepts of practice. (4th ed.). In George, J. (Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange https://www.who.int/reproductivehealth/self-care-interventions/definitions/en/ web accessed on 08/06/2020

About Katunzi Mutalemwa

Katunzi Mutalemwa, BScN is an evolving young Tanzanian nurse leader who just completed his baccalaureate nursing education in the Fall 2019. He is currently working on a Non-Communicable Diseases (NCDs) project in Tanzania and waiting to start his one year nursing internship at Kilimanjaro Christian Medical Center in November 2020. Mr. Katunzi was honored to write his BScN thesis on ‘Nurses Experiences of Caring LGBTQ Patients with HIV Infections guided by Travelbee’s Human-to-Human Relationship Model’ at Swedish Red Cross University in Sweden. He recently published a book titled “Nurses the Cornerstone of Health Care System” to inspire his fellow nurses in Tanzania. He is the former Chairperson of the University Nursing Students Association of Tanzania (UNSATA). He would like to thank Dr Rosemary Eustace for her mentorship in preparing this information for Nursology.net.

3 thoughts on “Orem’s Self-Care Theory: A Critical Theory to Tanzania Nurses in the Wake of COVID-19

  1. Good questions for reflection. I think I would conceptualize the USCD in the handwashing scenario as protection from hazard, and that seems to apply whether we are creating a nursing system for an individual or for communities/societies including professional and family caregivers. So how would we conceptualize the SCD in terms of community (public health)? I haven’t kept up with developments in Orem’s SCDNT over the past two decades but in doing this kind of analysis, when I worked within this theory, I usually found it helpful to start at the endpoint (in this scenario, handwashing) and work my way back to the specifying the SCD.

    Liked by 1 person

  2. Thank you so much Dr Savina Schoenhofer for your insightful responses. I appreciate your thought on how to conceptualize the self-care deficit in this case. Using the handwashing scenario, the deficits would include factors such as lack of access to resources, leadership, compliance, beliefs, knowledge, etc. I would like to hear more information about this.

    Like

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