The effect of Orem's Self-Care Deficit Theory-based care during pregnancy and postpartum period on health outcomes: A systematic review and meta-analysis.
Maide Nur Tümkaya, Kafiye Eroğlu, Zekiye Karaçam
PMID 39209313WHAT IT FOUND
Orem-based maternity care improved self-care agency across pregnancy and postpartum.
In included studies it also improved discharge readiness and breastfeeding self-efficacy, reduced nipple pain and pain from abdominal distension, but did not improve blood pressure, body weight or proteinuria.
Key findings
01Across five studies, Orem-based maternity care significantly improved self-care agency during pregnancy and postpartum (standardized mean difference 1.30, 95% CI 0.71 to 1.90, p < .010, I2 = 89%).
02In included pregnancy studies, Orem-based care was associated with lower preterm birth probability (odds ratio 0.28, 95% CI 0.11 to 0.76, p = .01) and longer gestational period (mean difference 0.70 weeks, 95% CI 0.08 to 1.32, p = .030), while blood pressure, body weight and proteinuria did not differ significantly.
03Postpartum Orem-based care improved hospital discharge readiness (mean difference 25.82, 95% CI 18.79 to 32.85, p < .001) and breastfeeding self-efficacy (mean difference 9.39, 95% CI 7.04 to 11.74, p < .001), but did not significantly increase duration of exclusive breastfeeding (mean difference 0.53, 95% CI -0.14 to 1.20, p = .120).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only nine studies were included, with 839 participants in total, and many outcomes came from one small study rather than pooled data. The included studies were mostly from Turkey and Iran, so findings may not transfer to other maternity care systems. The pooled self-care agency analysis had substantial heterogeneity (I2 = 89%), meaning the studies differed too much to treat the result as one consistent effect. Five randomized controlled studies were rated moderate quality, and several appraisal items on randomization, allocation concealment, blinding and follow-up were not met. The interventions were packages of education, visits and follow-up, so the contribution of any single component cannot be separated. The preterm birth result came from one study, so it is not pooled evidence. Most outcomes were synthesized narratively, so they cannot be read with the same weight as the pooled self-care agency result.
Declared interests
The authors declared no conflicts of interest. The supplied text does not report funding.
The easy way to misread this
Do not conclude that Orem-based maternity care improves all maternal physical outcomes. Blood pressure, body weight, proteinuria, incision pain, shoulder or back pain, and duration of exclusive breastfeeding were not significantly improved in the included studies.