Dorothea Orem

Self-Care Deficit Theory

BACKGROUND OF THE THEORIST

 Born on 1914 in Baltimore, Maryland

 Began her nursing education at Providence Hospital School of Nursing in
Washington DC
 In 1939, she earned her BSN education at the Catholic University of
America
 Earned he MSN from Catholic University of America in 1946
 Her nursing experiences included:
 Operating room nursing
 Private duty nursing (home & hospital)
 Hospital staff nursing on pediatric & adult medical & surgical units
 Evening supervisor in the E.R.
 Biological science teacher
 She was a curriculum consultant in 1958-1960
 In 1959, “Guides for developing the curricula for the Education of Practical
Nurses” was published
 In 1971, “Nursing Concepts of Practice” (Orem’s 1st book) was published
 Orem’s theory addresses client’s self-care needs
 It is defined as goal-oriented activities that are set towards generating
interest in the part of the client to maintain life & health development
 The theory is aimed towards making the clients perform self-care
activities in order to live independently
NURSING METAPARADIGMS
a.) Person
 Defined as the “patient”, a being who functions biologically, symbolically
& socially and who has the potential for learning & development
 Is an individual subject to the forces of nature, with a capacity for self-
knowledge, who can engage in deliberate action, interpret experiences &
perform beneficial actions
 Is an individual who can learn to meet self-care requisites; if for some
reason, the person cannot learn self-care measures, others must provide
the care
 b.) Health
 Orem supports the WHO’s definition of health as the “state of physical,
mental, and social well-being & not merely the absence of disease or
infirmity”
 Consists of physical, psychological, interpersonal & social aspects;
according to Orem, these aspects are inseparable
 Includes promotion & maintenance of health, treatment of illness &
prevention of complications

c.) Environment
 Consists of:
External & psychosocial surroundings
 Environmental factors
 Environmental elements
 Environmental conditions
Promotion of personal development through motivation to establish
appropriate goals & to adjust behavior to meet these goals; includes
formation of ore change in attitudes & values, creativity, self-concept &
physical development

d.) Nursing
 Helping clients to establish or identify ways to perform self-care activities
 Nursing actions are geared towards the independence of the client
 Nursing is a human service. Its focus is on persons with inabilities to
maintain continuous provision of healthcare
 Nursing is based on values

SELF-CARE DEFICIT THEORY AS GENERAL THEORY IS COMPOSED OF 3

RELATED THEORIES
1. The Theory of Self-Care
 Describes why & how people care for themselves
 Self-care: refers to those activities an individual performs independently
throughout life to promote & maintain personal well-being
 Self-care agency: the complex acquired ability of mature & maturing
persons to know & meet their continuing requirements for deliberate,
purposive action to regulate their own functioning & development.
 Consists of 2 agents (an agent is an individual who is engaged in meeting
the need of a person; like bridges that facilitate what has been done &
what needs to be done)
 Self-Care Agent: provides the self-care
 Dependent Care Agent: person other than the individual who
provides care
 Self-care requisites or Self-care needs: are insights of actions or
requirements that a person must be able to meet & perform in order to
achieve well-being

 Categories of Self-care requisites

A. Universal Self-Care B. Developmental C. Health Deviation
Requisites Self-Care Self-Care
Requisites Requisites
- These are - Result from - Requisites that
universally set maturation or result from
goals that must be associated with illness, injury or
undertaken in conditions or disease or its
order for an events such as treatment; they
individual to adjusting to a include such
function in scope change in body actions as
of healthy living image or loss of seeking medical
spouse assistance,
- They promote carrying out a
processes for life & prescribed
maturation & treatment or
prevent conditions learning to live
deleterious to with the effects of
maturation or illness or
those that lessens treatment
those effects - These health care
deviations et
standards to
which the degree
of self-care
demand is
needed
1. Maintenance of
sufficient intake
of air
2. Maintenance of
sufficient intake
of food
3. Maintenance of
 sufficient intake
of water
4. Provision of care
associated with
elimination
5. Maintenance of
balance between
activity & rest
6. Maintenance of
balance between
solitude & social
interaction
7. Prevention of
hazards to
human life,
human
functioning &
human well-
being
8. Promotion of
human
functioning &
development

 Therapeutic Self-care Demand: refers to all self-care activities required to

meet existing self-care requisites; involves the use of actions to maintain
health & well-being, each patient’s therapeutic self-care demands varies
throughout life

2. The Theory of Self-Care Deficit

 Describes & explains why people can be helped through nursing
 Self-care Deficit: arises when self-care agency cannot meet self-care
requisites
 Helping methods:
 Acting or doing for another
 Guiding & directing
 Providing physical or psychological support
 Teaching
 Providing & maintaining an environment that supports personal
development

3. The Theory of Nursing Systems

  Describes & explains relationships that must be brought about &
maintained for nursing to be produced
 Refers to the series of actions a nurse takes to meet a patient’s self-care
requisites
 Nursing Agency: set of established capabilities of a nurse who can
legitimately perform activities of care for a client. Helps a person achieve
their health care demand
 Nursing Design: these are professional functions that must be performed
by the nurse in order to meet client’s needs. It serves as a guideline of
needed & foreseen results in the production of nursing toward the
achievement of nursing goals

3 TYPES OF NURSING SYSTEMS

Each system describes nursing responsibilities, roles of the nurse & patient,
rationales for the nurse-patient relationship & types of actions needed to meet the
patient’s self-care agency & therapeutic self-care demand.
1. A Wholly Compensatory Nursing System
 Used when a patient’s self-care agency is so limited that the patient
depends on others for well being
2. A Partly Compensatory Nursing System
 Is used when a patient can meet some self-care requisites but needs a
nurse to help meet others
 The nurse & the patient play major roles in performing self-care
3. Supportive – Educative Nursing System
 Used when a patient can meet self-care requisites but needs assistance
with decision making, behavior control or knowledge acquisition skills

BASIC NURSING SYSTEMS