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Orem's Theory
Predictors of Self-Care in Adolescents With Cystic Fibrosis: A Test of Orem's Theories of Self-Care and Self-Care Deficit
Lois K. Baker, PhD, RN, CPNP Mary J. Denyes, PhD, RN, FAAN

Pediatric nurses often struggle to find ways to encourage adolescents with cystic fibrosis (CF) to engage in self-care that is essential to their health and life. A study of predictors of self-care was conducted to provide a stronger evidence base for nursing practice with these youth. Orem's theories of self-care and self-care deficit were tested to explain and predict the universal and health deviation self-care of 123 adolescents with CF. Four dimensions of self-care agency emerged as predictors of universal self-care, two of which were also predictive of health deviation self-care. Seventy percent of the variance or change in universal self-care scores and 40% of health deviation self-care variance were explained. Clarification and extension of Orem's theories were also an important outcome. Development of nursing interventions designed to strengthen predictors of universal and health deviation-specific self-care identified in this research holds the potential to improve length and quality of life for adolescents with CF. © 2008 Elsevier Inc. All rights reserved.

EDIATRIC NURSES OFTEN observe an inconsistency in the performance of self-care in adolescents with cystic fibrosis (CF) and struggle to find ways to encourage them to engage in selfcare that is essential to their health and life. Owing to medical advances, children and youth with CF are now surviving many years longer as compared with the past. The current median life expectancy is 36.5 years (Cystic Fibrosis Foundation, 2005). In spite of impressive medical advances and increased survival rates, self-care remains to be a critical element for persons with CF. To survive and thrive, adolescents with CF not only require self-care supportive of general health and development but also self-care specific to the management



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