Dorothea Orem

+ Born on July 15, 1914, in

Baltimore, Maryland
+ In 1934, received nursing
diploma at Providence
Hospital of Nursing in
Washington, D.C.
+ In 1939, she earned a BSN
Ed. from Catholic
University of America in
Washington, D.C.
+ In 1945, earned her MSN
Ed. from the Catholic
University of America
+ She worked as a staff nurse, private duty nurse,
nurse educator and administrator and nurse
consultant.
+ Worked on many different nursing units –
medical-surgical, emergency room, operating
room.
+ Orem received many honors and awards for her
lifetime of achievements.
+ In 1991, The International Orem Society for
Nursing Science and Scholarship was formed in
Missouri
+ Orem first began thinking of her theory as an
answer to why people needed nursing.
+ Ideas were first formulated in 1956.
+ First published her Nursing Concept of Self-
care in 1959.
+ Nursing: Concepts of Practice was first
published in 1971; Orem continually refined
her theory over the years. Latest edition was
in 2001.
+ Orem's initial definition of nursing's concern
included "man's need for self-care action and
the provision and management of it on a
continuous basis in order to sustain life and
health, recover from disease or injury, and
cope with their effects." (Orem, 1959, p. 3)
+ More simply stated, her definition of nursing's
goal was "overcoming human limitations"
(Orem, 1959, p. 4)
+ Each person strives to meet their own self
care needs in order to maintain optimal health
and wellness.
+ Each person has the ability to care for
themselves and their dependents (i.e.
children)

Orem's theory is made up of
3 related theories:
(1) Theory of Self Care
(2) Theory of Self Care
Deficit
(3) Theory of Nursing
System
According to Orem, "the
three-part theory focuses
not on individuals, but on
persons in relations. Each of
the three theories has as its
focus a specific dimension
of the person: the theory of
self-care focuses on the self,
the I; the theory of self-care
deficit focuses on you and
me; and the theory of
nursing system focuses on
we, persons in community"
(1990, p. 49).
Why and how people care for themselves; how nursing
is required to assist in performing self-care due to
patient limitations
Divided into 4 parts:
Self-care

Self-care agency

Therapeutic Self-care demand

Self-care requisites
+ Is the performance or practice of activities
that individuals initiate and perform on their
own behalf to maintain life, health and well-
being.
+ Is the human’s ability or power to engage in
self-care and is affected by basic conditioning
factors.
+ Is the totality of “self-care actions to be
performed for some duration in order to meet
known self-care requisites by using valid
methods and related sets of actions and
operations.”
+ Actions directed toward the provision of self-
care
+ It is presented in 3 categories:
– Universal self-care requisites
– Developmental self-care requisites
– Health deviation self-care requisites
+ are associated with life processes and the
maintenance of the integrity of human
structure and functioning.
+ Common to everyone , includes ADL.
These requisites are:
+ Maintenance of sufficient intake of air ,water,
food
+ Provision of care associated with elimination
process
+ Balance between activity and rest, between
solitude and social interaction
+ Prevention of hazards to human life well being
+ Promotion of human functioning
 Associated with
developmental processes/
derived from a condition…or
associated with an event.
+ Health deviation self-care is required in conditions of
illness, injury, or disease.

These include:
– 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
– Modifying self-concepts to accept oneself as being in a
particular state of health and in specific forms of health
care
– Learning to live with the effects of pathologic conditions.
Self-care deficit occurs when patient or parents
of dependents are unable to meet self-care
requisites. Therefore, nursing help is needed.
Here are 5 methods nurses use to help patients
meet their self-care deficits:
(1) Acting for and doing for others
(2) Guiding others
(3) Supporting another
(4) Providing an environment promoting
personal development in relation to meet
future demands
(5) Teaching
Describes how the patient’s self care needs will
be met by the nurse , the patient, or both.
3 Nursing Systems nurses use to meet patient's
self-care requisites or need:
(1) Wholly compensatory
(2) Partially compensatory
(3) Supportive-educative
+ Nurse should be compensating for a patient’s total
inability for (or prescriptions against) engaging in
self-care activities that require ambulation and
manipulation movements.
+ Nurse accomplishes most or all of care
+ represented by a situation in which “both nurse and
perform care measures or other actions involving
manipulative tasks or ambulation… [Either] the
patient or the nurse may have the major role in the
performance of care measures.”

Nurse can assist

postoperative client to
ambulate
+ also known as supportive-developmental system, the person
“is able to perform or can and should learn to perform
required measures of externally or internally oriented
therapeutic self-care but cannot do so without assistance.”
+ nurse is required for support, education, knowledge, and
decision making to promote the patient as a self-care agent.
+ https://sites.google.com/site/oremstheory/description-of-the-model
+ https://nurseslabs.com/dorothea-orems-self-care-theory/
+ https://www.slideshare.net/JosephineAnnNecor/05-dorothea-orems-self-care-
theory
+ http://nursingtheories.weebly.com/dorothea-e-orem.html
+ http://www.whyiwanttobeanurse.org/nursing-theorists/dorothea-orem.php