DOI: 10.71340/njhs.2013885 ISSN: 3062-2247

Application of Orem's Self-Care Deficit Nursing Theory in the Nursing Care of a Patient With Postoperative Paraplegia Following Lumbar Disc Herniation Surgery: A Case Report

Sevil Bahadıroğlu, Naile Alankaya
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Postoperative paraplegia is a rare but devastating complication of lumbar disc herniation surgery that often results in long-term functional dependence and complex nursing care needs. This case report describes the application of Orem's Self-Care Deficit Nursing Theory in the nursing care of a 45-year-old man who developed permanent paraplegia following lumbar disc herniation surgery despite revision surgery. The patient's clinical condition was further complicated by an advanced infected sacral pressure injury, malnutrition, hypoalbuminemia, previous gastrointestinal bleeding, and polyneuropathy, resulting in extensive self-care deficits. Nursing care was systematically planned according to Orem's theoretical framework by assessing the patient's self-care agency, therapeutic self-care demands, self-care deficits, and appropriate nursing systems. Four individualized nursing care plans were developed by integrating Orem's Self-Care Deficit Nursing Theory with NANDA International (NANDA-I) nursing diagnoses, the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC). Nursing interventions focused on pressure injury management, mobility support, promotion of self-care activities, nutritional management, patient and family education, and rehabilitation. During follow-up, no additional pressure injuries, contractures, infections, or recurrent gastrointestinal bleeding were observed. The patient actively participated in rehabilitation within his functional capacity, while family caregivers supported the continuity of care as dependent-care agents. This case demonstrates that Orem's Self-Care Deficit Nursing Theory provides a practical and systematic framework for individualized nursing care in patients with complex postoperative neurological complications. Integrating theory-based nursing care with standardized nursing languages may facilitate clinical decision-making, promote self-care agency, and support rehabilitation outcomes in similar patients.

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