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Dorothea E. Orem
Virginia Henderson
(/virginiahenderson.html) The SelfCare Deficit Nursing Theory.
Dorothea E. Orem
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Florence Nightingale Orem developed the SelfCare Deficit Theory of Nursing, which is composed of three interrelated theories: (1)
(/florencenightingale.html) the theory of selfcare, (2) the selfcare deficit theory, and (3) the theory of nursing systems.
Faye G. Abdellah (/fayeg “The condition that validates the existence of a requirement for nursing in an adult is the absence of the ability
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to maintain continuously that amount and quality of selfcare 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
Martha Rogers (/martha
rogers.html) the parent (or guardian) to maintain continuously for the child the amount and quality of care that is
therapeutic.” (Orem, 1991)
Dorothy Johnson
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Major Concepts Subconcepts
References
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Nursing is as art through which the practitioner of Selfcare Requisites or requirements can be
TFNWeebly Blogspot nursing gives specialized assistance to persons with defined as actions directed toward the provision of
(/tfnweeblyblogspot.html) disabilities which makes more than ordinary selfcare. It is presented in three categories:
assistance necessary to meet needs for selfcare.
Author's Portfolio The nurse also intelligently participates in the medical A. Universal selfcare requisites are associated
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care the individual receives from the physician. with life processes and the maintenance of the
integrity of human structure and functioning.
Humans are defined as “men, women, and children
cared for either singly or as social units,” and are the 1. The maintenance of a sufficient intake of air
“material object” of nurses and others who provide
direct care. 2. The maintenance of a sufficient intake of water
Environment has physical, chemical and biological 3. The maintenance of a sufficient intake of food
features. It includes the family, culture and
community. 4. The provision of care associated with elimination
process and excrements
Health is “being structurally and functionally whole or
sound.” Also, health is a state that encompasses 5. The maintenance of a balance between activity
both the health of individuals and of groups, and and rest
human health is the ability to reflect on one’s self, to
symbolize experience, and to communicate with 6. The maintenance of a balance between solitude
others. and social interaction
Selfcare is the performance or practice of activities 7. The prevention of hazards to human life, human
that individuals initiate and perform on their own functioning, and human wellbeing
behalf to maintain life, health and wellbeing.
8. The promotion of human functioning and
Selfcare agency is the human’s ability or power to development within social groups in accord with
engage in selfcare and is affected by basic human potential, known human limitations, and the
conditioning factors. human desire to be normal
Selfcare Deficit delineates when nursing is needed. C. Health deviation selfcare requisites are
Nursing is required when an adult (or in the case of a required in conditions of illness, injury, or disease or
dependent, the parent or guardian) is incapable of or may result from medical measures required to
limited in the provision of continuous effective self diagnose and correct the condition.
care.
1. Seeking and securing appropriate medical
Nursing Agency is a complex property or attribute assistance
of people educated and trained as nurses that
enables them to act, to know, and to help others 2. Being aware of and attending to the effects and
meet their therapeutic selfcare demands by results of pathologic conditions and states
exercising or developing their own selfcare agency.
3. Effectively carrying out medically prescribed
Nursing System is the product of a series of diagnostic, therapeutic, and rehabilitative measures
relations between the persons: legitimate nurse and
legitimate client. This system is activated when the 4. Being aware of and attending to or regulating the
client’s therapeutic selfcare demand exceeds discomforting or deleterious effects of prescribed
available selfcare agency, leading to the need for medical measures
nursing.
5. Modifying the selfconcept (and selfimage) in
accepting oneself as being in a particular state of
health and in need of specific forms of health care
6. Learning to live with the effects of pathologic
conditions and states and the effects of medical
diagnostic and treatment measures in a lifestyle that
promotes continued personal development
The Three Basic Nursing Systems:
(1) The wholly compensatory nursing system is
represented by a situation in which the individual is
unable “to engage in those selfcare actions
requiring selfdirected and controlled ambulation and
manipulative movement or the medical prescription
to refrain from such activity… Persons with these
limitations are socially dependent on others for their
continued existence and wellbeing.”
(2) The partly compensatory nursing system is
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.”
(3) In the supportiveeducative system also
known as supportivedevelopmental system, the
person “is able to perform or can and should learn to
perform required measures of externally or internally
oriented therapeutic selfcare but cannot do so
without assistance.”
Relationship of the major components of Orem’s selfcare deficit theory
R indicates a relationship between components; < indicates a current or potential deficit where nursing would
be required
Assumptions
Humans engage in continuous communication and interchange among themselves and their environments to
remain alive and to function.
In humans, the power to act deliberately is exercised to identify needs and to make needed judgments.
Mature human beings experience privations in the form of action in care of self and others involving making
lifesustaining and functionregulating actions.
Human agency is exercised in discovering, developing, and transmitting to others ways and means to identify
needs for, and make inputs into, self and others.
Finally, groups of human beings with structured relationships cluster tasks and allocate responsibilities for
providing care to group members who experience privations for making required deliberate decisions about
self and others (Orem, 1995).
Strengths/Weaknesses
Strengths:
A major strength of Orem’s theory is that it is applicable for nursing by the beginning practitioner as well as the
advanced clinicians.
The terms selfcare, nursing systems, and selfcare deficit are easily understood by the beginning student
nurse and can be explored in greater depth as the nurse gains more knowledge and experience.
She specifically defines when nursing is needed: Nursing is needed when the individual cannot maintain
continuously that amount and quality of selfcare necessary to sustain life and health, recover from disease
or injury, or cope with their effects.
Three identifiable nursing systems were clearly delineated and are easily understood.
Weaknesses:
Orem’s theory is simple yet complex. The use of selfcare in multitude of terms, such as selfcare agency,
selfcare demand, selfcare deficit, selfcare requisites, and universal selfcare, can be very confusing to the
reader.
Orem’s definition of health was confined in three static conditions which she refers to a “concrete nursing
system,” which connotes rigidity.
Throughout her work, there is limited acknowledgement of the individual’s emotional needs.
Analysis
There is a superb focus of Orem’s work which is selfcare. Even though there is a wide range of scope seen
in the encompassing theory of nursing systems, Orem’s goal of letting the readers view nursing care as a
way to provide assistance to people was apparent in every concept presented.
From the definition of health which is sought to be rigid, it can now be refined by making it suitable to the
general view of health as a dynamic and ever changing state.
The role of the environment to the nursepatient relationship, although defined by Orem was not discussed.
The role of nurses in maintaining health for the patient was set by Orem with great coherence in accordance
with the lifesustaining needs of every individual.
Although Orem viewed the importance of the parents or guardian in providing for their dependents, the
definition of selfcare cannot be directly applied to those who needs complete care or assistance with self
care activities such as the infants and the aged.
(c) 2011 Gonzalo, A. All rights reserved