Self-Care

Deficit
Nursing
Theory
DOROTHEA OREM
 • Dorothea Elizabeth Orem was born on July 15, 1914 in
Baltimore, Maryland.

EARLY • Her father was a construction worker and her mother

was a homemaker.

LIFE • She was the youngest among two daughters.

2
 • 1931- Attended Seton High School in Baltimore
• 1934- Received a diploma from the Providence
EDUCATION Hospital School of Nursing in Washington D.C.
• 1939- went on the Catholic University of America to
earn a B.S. in Nursing Education
• 1945- M.S. in Nursing Education
• 1976- Honorary Doctorates of Science from both
Georgetown University
• 1980- Incarnate Word College
• 1988- Honorary Doctorate of Humane Letters from
Illinois Wesleyan University
• 1998- Doctorate Honoris Causae from the University of
Missouri in Columbia 3
 • Guidelines for Developing Curricula for the Education
of Practical Nurses (1959)

WORKS • Nursing: Concepts of Practice (1971)

• Edited the book “Concept Formalization in Nursing”
(1973)
• The International Orem Society was founded to foster
research and the continued development of Orem’s
theories of nursing.
• 2nd edition of Nursing: Concept of Practice (1980)
• 3rd edition of Nursing: Concept of Practice (1985)
• 4th edition of Nursing: Concept of Practice (1991)
• 6th edition of Nursing: Concept of practice (2001)
4
AWARDS
• Catholic University of America Alumni Achievement
Award for Nursing Theory (1980)

AND • Linda Richards Award from National League for

Nursing (1991)

HONORS • Honorary Fellow of American Academy of Nursing

(1992)
• Honorary degrees from Georgetown University,
Incarnate Word College, Illinois Wesleyan University,
and the University of Missouri-Columbia
• Inducted into the American Academy of Nursing
• Received award from the National League for Nursing
and the Sigma Theta Tau Nursing Honor Society

5
 She died on June 22, 2007 in Savannah,
OREM’S Georgia, where she had spent the last 25
DEATH years of her life as a consultant and
author. She was 92 years old.

6
 This theory was developed by Orem between
1959 and 2001, it is considered a grand nursing theory,
which means the theory covers broad scope with general
concepts that can be applied to all instances of nursing.

Self-care There are instances wherein patients are

Nursing
encouraged to bring out the best in them despite being ill
for a period of time. This is very particular in

Theory Or rehabilitation settings, in which patients are entitled to

be more independent after being cared for by physicians
Orem Model and nurses.

Of Nursing
7
 Dorothea Orem’s Self-Care Deficit Theory defined Nursing as “The act of assisting others in
the provision and management of self-care to maintain or improve human functioning at home level of
effectiveness.” It focuses on each individual’s ability to perform self-care, defined as “the practice of
activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-
being.”
“The condition that validates the existence of a requirement for nursing in an adult is the
absence of the ability to maintain continuously that amount and quality of self-care which is
therapeutic in sustaining life and health, in recovering from disease or injury, or in coping with their
effects. With children, the condition is the inability of the parent (or guardian) to maintain
continuously for the child the amount and quality of care that is therapeutic.” (Orem, 1991)

8
 1. People should be self-reliant and responsible for
their own care and others in their family needing
care.
2. People are distinct individuals.

Assumptions
3. Nursing is a form of action-interaction between two
or more persons.

of the Self- 4. Successfully meeting universal and development

self-care requisites is an important component of
Care Deficit primary care prevention and ill health.

Theory 5. A person’s knowledge of potential health problems

is necessary for promoting self care behaviors.
6. Self care and dependent care are behaviors learned
within a socio-cultural context
9
 • NURSING
• HEALTH
• ENVIRONMENT
• HUMAN BEING
Major • NURSING CLIENT
Concepts Of • NURSING PROBLEM
The Self- • NURSING PROCESS
care Deficit • NURSING THERAPEUTICS

Theory
10
 • It is an art, a helping service, and a technology
• Actions deliberately selected and performed by nurses
to help individuals or groups under their care to
maintain or change conditions in themselves or their

NURSING
environments.
• Encompasses the patient’s perspective of health
condition, the physician’s perspective , and the nursing
perspective
• Goal of nursing – to render the patient’s self care needs
• To maintain a state of health
• To regain normal or near normal state of health in the
event of disease or injury
• To stabilize, control, or minimize the effects of chronic
poor health or disability
11
 • Health or healthy are terms used to describe living
things
• It is when they are structurally and functionally whole
or sound, wholeness or integrity, includes that which

HEALTH makes a person human

12
 • environment components are enthronement factors,
enthronement elements, conditions, and developed
environment

ENVIRONMENT

13
 • has the capacity to reflect, symbolize and use symbols
• Conceptualized as a total being with universal,

HUMAN developmental needs and capable of continuous self

care

BEING • A unity that can function biologically, symbolically and

socially

14
 • A human being who has health related/health derived
limitations that render him incapable of continuous self

NURSING
care or dependent care or limitations that result in
ineffective/incomplete care.

CLIENT • A human being is the focus of nursing only when a self

–care requisites exceeds self care capabilities

15
 • deficits in universal, developmental, and health derived
or health related conditions

NURSING
PROBLEM

16
 A system to determine:
1. why a person is under care

NURSING 2. a plan for care

PROCESS
3. the implementation of care

17
 • deliberate, systematic and purposeful action

NURSING
THERAPEUTICS

18
 • Theory of self care
• Theory of self care deficit
• Theory of nursing system
Orem’s
General
Theory Of
Nursing
19
THEORY
• Self care- practice of activities that individual initiates
and perform in maintaining life, health, and well being.

OF SELF • Self care agency- "the ability for engaging in self care“
• Therapeutic self care demand- totality of self care
CARE actions to be performed for some duration in order to
meet self care requisites by using valid methods and
related sets of operations and actions
• Self care requisites- action directed towards provision
of self care. There are 3 categories
1. Universal self care requisites
2. Developmental self care requisites
3. Health deviation self care requisites

20
1. Universal self care requisites
• Associated with life processes and the maintenance of the integrity of human structure and
functioning.
• Common to all
• Identifies this requisites:
a. Maintenance of sufficient intake of air ,water, food
b. Provision of care associated with elimination process
c. Balance between activity and rest, between solitude and social interaction
d. Prevention of hazards to human life well being and
e. Promotion of human functioning
2. Developmental self care requisites
• Associated with developmental process or derived from a condition or associated with an event
(example: adjusting to new job, adjusting to body changes) 21
3. Health deviation self care- required in conditions of illness, injury, 0r disease. Includes:
• Seeking and securing appropriate medical assistance
• Being aware of and attending to the effects and results of pathologic conditions
• Effectively carrying out medically prescribed measures
• Accepting oneself as being in a particular state of health and in specific forms of health care
• Learning to live with effects of pathologic conditions

22
THEORY • Specifies when nursing is needed

OF SELF
• Nursing is required when an adult is incapable or
limited in the provision of continuous effective self

CARE care.

DEFICIT Orem identifies 5 methods of helping:

1. Acting for and doing for others
2. Guiding others
3. Supporting others
4. Providing an environment and promoting personal
development in relation to meet future demands
5. Teaching another

23
 • Describes how the patient’s self care needs will be met
THEORY by the nurse

OF
• Scope of nursing responsibility in health care situations
• Identifies 3 classifications of nursing system to meet
NURSING the self care requisites of the patient: (1) wholly
compensatory, (2) partly compensatory, (3) supportive-
SYSTEM educative system
• A technology is systematized information about a
process or a method for affecting some desired result
through deliberate practical endeavor, with or without
use of materials or instruments.

24
CATEGORIES OF TECHNOLOGIES:
1. Social or interpersonal
• Communication adjusted to age, health status
• Maintaining interpersonal, intra group or inter group relations for coordination of efforts
• Maintaining therapeutic relationship in light of psychosocial modes of functioning in health and disease
• Giving human assistance adapted to human needs, action abilities, and limitations
2. Regulatory technologies
• Maintaining and promoting life processes
• Regulating psycho physiological modes of functioning in health and disease
• Promoting human growth and development
• Regulating position and movement in space

25
 • Nursing process presents a method to determine the
self care deficits and then to define the roles of person
or nurse to meet the self care demands.
• The steps within the approach are considered to be
Orem’s the technical component of the nursing process.

Theory • Orem emphasizes that the technological component

must be coordinated with interpersonal and social

and processes within nursing situations.

Nursing
Process
26
 NURSING PROCESS OREM’S NURSING PROCESS
• Assessment • Determine why nursing is needed
• Design of a nursing system and plan for delivery of
care
• Production and management of nursing systems
STEP 1- Collect data in six areas:
1. Person’s health status
2. Physician’s perspective of the person’s health
3. Person’s perspective of his/her health
4. Health goals within the context of life, history, life
style, and health status
5. Person’s requirements for self care
6. Person’s capacity to perform self care
• Nursing diagnosis STEP 2
• Plans with scientific rationale • Nurse designs a system that is wholly or partly
compensatory or supportive-educative
• Bringing out a good organization of the
components of patients’ therapeutic self care
demands
27
• Selection of combination of ways of helping that
will be effective and efficient in compensating for
patient’s self care deficits
NURSING PROCESS OREM’S NURSING PROCESS
• Implementation STEP 3
• evaluation • Nurse assists the patient or family in self care
matters to achieve identified and described health
and health related results.
• Actions are directed by etiology component of
nursing diagnosis
• Evaluation

28
 This theory signifies that all patients want to
care for themselves, and they are able to recover more
quickly and holistically by performing their own self-care
as much as they’re able. This theory is particularly used in
rehabilitation and primary care or other settings in which
CONCLUSION patients are encouraged to be independent.
Though this theory greatly influences every
patient’s independence, the definition of self-care cannot
be directly applied to those who need complete care or
assistance with self-care activities such as the infants and
the aged.

29
REFERENCES:
• Orem, D.E. (1991). Nursing: Concepts of practice (4th ed.). St. Louis, MO: Mosby-Year Book Inc.
• Taylor, S.G. (2006). Dorthea E. Orem: Self-care deficit theory of nursing. In A.M.
• Tomey, A. & Alligood, M. (2002). Significance of theory for nursing as a discipline and profession.
Nursing Theorists and their work. Mosby, St. Louis, Missouri, United States of America.
• Whelan, E. G. (1984). Analysis and application of Dorothea Orem’s Self-care Practuce Model. Retrieved
October 31, 2006.
• George B. Julia , Nursing Theories- The base for professional Nursing Practice, 3rd ed. Norwalk,
Appleton & Lange.
• Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott
Williams& wilkins.
• Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed.
Philadelphia, Lippincott.
• Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott.
• Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. 30
London Mosby Year Book.