Hudson Shawna, Macdonald Marilyn
Capital District Health Authority, Halifax, Nova Scotia, Canada.
Clin Nurse Spec. 2010 Nov-Dec;24(6):304-12. doi: 10.1097/NUR.0b013e3181f903b8.
PURPOSE/OBJECTIVES: This article discusses how Orem's theory was applied to the revision of supporting documents in the patient-teaching process and subsequently the nurse's role in the patient's learning experience.
BACKGROUND/RATIONALE: Teaching based on didactic, provider-focused objectives is ineffective in meeting patient's learning needs. There is a lack of conclusive research on the development of appropriate patient-teaching endeavors for the acquisition of knowledge and skills related to the performance of hemodialysis arteriovenous fistula self-cannulation.
DESCRIPTION OF THE PROJECT/INNOVATION: To prepare patients for home hemodialysis, Orem's self-care-deficit nursing theory was used to guide the revisions of a patient assessment and learning documentation template, the development of a self-cannulation teaching resource and to foster a renewed sense of the nurse's role in the teaching process.
INTERPRETATION/CONCLUSION: The application of self-care-deficit nursing theory to the update and development of patient-teaching documentation and resources for self-cannulation provides the nurse with a theoretical approach to assess, plan, evaluate, and document teaching from a patient-focused perspective. Theory in practice provides a means to support and highlight the role of nurses in the patient-learning process. The utilization of practical activities to introduce theory into teaching provides a means to structure care processes and to enhance nurse's adoption of theory in practice.
Orem's theory provides a relevant, useful framework to guide nurses in teaching patients self-care. Research on the exploration of nurse's attitudes related to the benefit of adopting theory when teaching patients to perform hemodialysis self-care is needed.
目的/目标：本文探讨了奥瑞姆理论如何应用于患者教育过程中辅助文件的修订，以及护士在患者学习体验中的作用。
背景/基本原理：基于说教式、以提供者为中心的目标进行教学，在满足患者学习需求方面效果不佳。对于开发适当的患者教育活动以获取与血液透析动静脉内瘘自我穿刺相关的知识和技能，缺乏确凿的研究。
项目/创新描述：为使患者为家庭血液透析做好准备，奥瑞姆的自我护理缺陷护理理论被用于指导患者评估和学习文档模板的修订、自我穿刺教学资源的开发，并在教学过程中重塑护士角色的意识。
解读/结论：将自我护理缺陷护理理论应用于自我穿刺患者教育文档和资源的更新与开发，为护士提供了一种从以患者为中心的角度进行评估、计划、评价和记录教学的理论方法。理论在实践中为支持和凸显护士在患者学习过程中的作用提供了一种手段。利用实践活动将理论引入教学，为构建护理流程和增强护士在实践中对理论的应用提供了一种方法。
奥瑞姆理论为指导护士对患者进行自我护理教育提供了一个相关且有用的框架。需要开展研究，探讨护士在教导患者进行血液透析自我护理时对采用该理论的益处的态度。
