Implementation of Orem's Self Care Theory in Chronic Kidney Disease Patients in the Hospital: A Systematic Review

Abstract

Introduction: Chronic Kidney Disease (CKD) requires long-term care and patient self-care engagement. Orem's Self-Care Theory offers a framework for patient empowerment, although implementation challenges remain across clinical settings.

Objectives: This study identifies and evaluates Orem's Self-Care theory implementation in nursing interventions for CKD patients, assessing its effectiveness on self-care, therapy adherence, and quality of life.

Methods: This PRISMA-based systematic review searched literature through multiple databases with keywords: "implementation", "chronic kidney failure", "self-care", "Orem", and "hospital". Selected articles (2014-2025) included quantitative and mixed-method designs implementing Orem's theory in hospitals. From 1,311 identified articles, 15 met inclusion criteria after quality assessment using JBI Critical Appraisal Tools.

Results: Orem-based nursing interventions positively impacted daily activities, diet and fluid adherence, and psychosocial quality of life through support-educational systems and partial compensation. Studies from diverse regions show similar positive outcomes with culturally-adapted approaches. Implementation challenges included patient compliance issues and limited long-term effectiveness.

Conclusions: Orem's theory effectively improves independence and quality of life in CKD patients, requiring personalized and sustainable approaches. Family-centered care models can enhance intervention effectiveness across cultural contexts.