Thursday, September 26, 2002

This presentation is part of : Instruments and Strategies to Promote Health

ASTHMA SELF-CARE: A TEST OF OREM'S SELF-CARE DEFICIT THEORY

Barbara Frances Velsor-Friedrich, RN, PhD, associate professor, Theresa O. Pigott, PhD, and Brenda J. Srof, MSN. Department of Health Promotion, Loyola University Chicago Niehoff School of Nursing, Chicago, IL, USA

Empirical testing of mid-range theories such as Orem's Self-Care Deficit Theory of Nursing is important to determine the validity of such theories as well as their contribution to nursing knowledge.

Objective: This study tested the effects of a school-based asthma intervention program on the self-care capabilities, self-care practices, and health outcomes of 8-12 year old inner-city, African-American students with asthma. In addition, Orem's (2001) theoretical propositions between selected basic conditioning factors, dimensions of self-care capabilities, self-care practices and health outcomes were tested.

Design: This study used a longitudinal pretest-posttest design.

Sample: The sample was composed of 52 African-American children ages 8-13 years who attended four inner-city schools with school-based health centers.

Intervention and Outcome Variables: The intervention was composed of student participation in an asthma education program, Open Airways, followed by 5 monthly visits with a PNP or FNP. The outcome variables included measures of asthma knowledge, asthma self-efficacy, general self-care capabilities, asthma self-care practice, and health outcomes.

Methods: Data was collected at pretest and at 2 week, 5 month and 12 month posttest times.

Findings: Path analysis was used to evaluate whether the theory provided a reasonable fit to the data as well as to examine the relationships between and among concepts inherent in the theory. Three basic conditioning factors (age, gender & number of siblings) emerged as predictors of self-care abilities. Asthma self-efficacy and asthma knowledge accounted for 45% of the variance in asthma self-care practice.

Conclusion: Data from this study supports the ability of Orem's Self-Care Deficit Nursing Theory to be both explanatory and predicitve of self-care practices.

Implications: Orem's Self-Care Deficit Theory of Nursing can be effectively used to guide nursing research. Testing of theories can assist in extending the theory as well as contributing to the developing knowledge base of nursing.

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