Nursing Care for Patients with Chronic Thromboembolism pulmonary hypertension and Heart Failure According to Orem's Self-Care Framework: Case Study

Abstract

This case study focuses on a 49-year-old Thai male patient with a history of chronic shortness of breath who received care through the application of Orem’s nursing theory framework, which comprises three interrelated sub-theories: 1) the self-care theory,  2) the self-care deficit theory, and 3) the nursing systems theory. The objective of this study was to facilitate understanding and application of Orem’s nursing theory, with particular emphasis on the self-care deficit theory, in managing patients with chronic conditions who require specialized nursing care. The goal was to achieve optimal nursing outcomes and improve the patient’s self-care abilities prior to discharge.
The nursing process involved four key steps: 1) a comprehensive assessment of  the patient's self-care deficits, 2) the formulation of an individualized nursing care plan based on Orem’s theoretical framework, 3) the promotion of the patient’s self-care capabilities, and 4) the provision of holistic care that addresses the patient’s physical, psychological, and social needs.
The results of the care demonstrated that the patient acknowledged his self-care limitations and accepted assistance from the nurse. This support facilitated the resolution of issues such as proper nutrition, hydration, and adherence to the treatment plan. With guidance, the patient was able to enhance his self-care abilities, leading to an improvement in quality of life and overall satisfaction upon discharge. By applying Orem’s theory, the nurse was able to develop a structured care plan, foster the patient’s understanding of his condition, and ensure adherence to the prescribed treatment regimen. This approach not only enhanced nursing practice but also contributed to the long-term well-being of the patient with a chronic condition.