Dorothea Orem’s Self-Care Theory

There are three part of Orem’s Self-care Theory mainly the:

The theory of self-care, theory of self-care deficit, and the
theory of nursing system. First of all, let us discuss these
different part of Orem’s Self-care theory.
1. Theory of self-care – which focuses on the performance or
practice of activities that individuals perform on their
own behalf. Those might be actions to maintain one’s life
and life functioning, develop oneself or correct a health
deviation or condition.
2. Theory of self-care deficit – defines when nursing is needed
because a person is limited or incapable of providing self-
care and needs help.
3. Theory of nursing system – focuses on the relationship
between a nurse and a client and the whole or partial
compensatory nursing system and supportive-educative system
that takes place between nurse and a person
According to Orem, “the three-art theory focuses not on the
individuals, but on the person in relations. Each of the three
theories has its focus on a specific dimension of a 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, person of community”
What is Orem’s self-care Theory?
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.
Strength of Self-care theory

 it is applicable for nursing by the beginning practitioner

as well as the advanced clinicians.
 provides a comprehensive basis for nursing practice. It has
utility for professional nursing in the areas of nursing
practice, nursing education and administration.
 easily understood by the beginning student nurse and can be
explored in greater depth as the nurse gains more knowledge
and experience.
Limitations

 viewed as a single whole thing while Orem defines a system

as a single whole thing.
 The use of self-care in multitudes of terms, such as self-
care agency, self-care demand, self-care deficit, self-care
requisites, and universal self-care, can be very confusing
to the reader.
 definition of health was confined in three static conditions
which she refers to a concrete nursing system, which
connotes rigidity.
How it is applied in patient care?
There is a point in an individual’s life where he is not
able to cope up with the stressors and confine himself in a box
from which it is a difficult challenge for a person to come out
of the trap. In such circumstances, a person lacks interest in
taking care of own self. This makes the person wholly dependent
on the caregiver. Here, a nurse plays a major role to take care
of that patient by providing basic to supportive care. A similar
scenario happened in a clinical setting in which Orem’s theory is
fully incorporated into practice that resulted in positive
changes in an individual’s health which helped the patient to
accept the reality and to become responsible for his health and
related concerns. The importance of this theory is to take care
of the patient at the correct time with an appropriate decision
so the patient can recover rapidly with a decrease hospital stay.
Basic conditioning factors are age, gender, developmental state,
health state, socio-cultural orientation, health care system
factors, family system factors, patterns of living, environmental
factors, and resource adequacy and availability. Therapeutic
Self-care Demand 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.” Self-care Deficit delineates when nursing is needed.
Nursing is required when an adult (or in the case of a dependent,
the parent or guardian) is incapable of or limited in the
provision of continuous effective self-care. Nursing Agency is a
complex property or attribute of people educated and trained as
nurses that enables them to act, to know, and to help others meet
their therapeutic self-care demands by exercising or developing
their own self-care agency. Nursing System is the product of a
series of relations between the persons: legitimate nurse and
legitimate client. This system is activated when the client’s
therapeutic self-care demand exceeds available self-care agency,
leading to the need for nursing.