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
Frey et al. (2004) reported that adolescents with insulin-dependent diabetes mellitus who were in poor metabolic control did not engage in self-care consistent with that recommended to maintain control. Moore and Beckwitt (2003) found that although children with cancer performed considerable universal self-care, they engaged in less illness-related or health deviation self-care. Dashiff et al. (2006) reported that although adolescents with Type 1 diabetes engaged in universal and health deviation self-care, there was room for improvement. Specifically, health deviation self-care decreased with age, suggesting the necessity to build foundational self-care practices during the early stage of adolescent development.

Self-Care Agency
Self-care agency is composed of three related but conceptually distinct human properties or traits arranged in hierarchical order: (a) foundational capabilities and dispositions; (b) power components; and (c) capabilities to perform self-care operations (Gast et al., 1989; Orem, 2001). The interrelatedness of the various dimensions of self-care agency was also addressed by Orem (2001, pp. 254–277). Selected foundational capabilities and power components of self-care agency were included in this study. Foundational Capabilities and Dispositions Foundational to all deliberate actions, including self-care, are general human capabilities such as