DOROTHEA OREM'S

Self-Care Deficit Theory

BSN 1 - CORAL
Dorothea Orem 1914-2007
• Born 1914 in Baltimore, Maryland
• She began her nursing career at
Providence Hospital School of Nursing
Washington, DC
•Earned her diploma at Providence
Hospital, Washington, DC
• 1939 - BSN Ed., Catholic University
of America (CUA)
• 1945 - MSN Ed., Catholic University
of America (CUA)
Dorothea Orem 1914-2007
• She worked as a staff nurse, private
duty nurse, nurse educator and
administrator, and nurse consultant.
• Received honorary degree Doctor of
Science in 1976.
• Theory was first published in
Nursing: Concepts of Practice in 1971,
second in 1980, in 1995, and 2001.
Overview of Self-Care Deficit Theory
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 the 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 Self-Care or Self-Care Deficit Theory of
Nursing is composed of three interrelated
theories:
Theory of self-care
Theory of self-care deficit
Theory of nursing systems
A. Theory of Self-Care
• This theory includes:
• Self care - practice of activities that an individual initiates and
performs on his/her own behalf in maintaining life, health and well
being

• Self care agency - is a human ability which is "the ability for engaging
in self care"; conditioned by age, developmental state, life experience,
sociocultural orientation, health, and available resources
• Therapeutic self care demand - "totality of self 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.

3 categories of self care requisites are:

• Universal self care requisites

• Developmental self care requisites

• Health deviation self care requisites

1. Universal Self-Care Requisites
• Associated with life processes and the
maintenance of the integrity of human
structure and functioning

• Common to all; activities of daily living

Identifies these requisites as:
- Maintenance of sufficient intake of air, water, and 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 and

- Promotion of human ftunctioning

2. Developmental Self-Care Requisites
• Associated with developmental
processes/ derived from a condition or
associated with an event.
E.g.
- adjusting to a new job
- adjusting to body changes
3. Health Deviation Self-Care
• 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 in 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

B. Theory of Self-Care Deficit
• Specifies when nursing is needed

• Nursing is required when an adult (or in the

case of a dependent, the parent) is incapable or
limited in the provision of continuous effective
self care.
Orem identifies 5 methods of helping:

- Acting for and doing for others

- Guiding others

- Supporting another

- Providing an environment promoting personal development

in relation to meet future demands

- Teaching another
C. Theory of Nursing Systems
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 the
available self-care agency, leading to nursing.
Identifies 3 classifications of nursing system
to meet the self care requisites of the
patient:

• Wholly compensatory system

• Partly compensatory system
• Supportive - educative system
Wholly compensatory systems - "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"

Partly compensatory systems - "both nurse and patient perform

care measures or other actions involving manipulative tasks or
ambulation"

Supportive - educative systems - "for situations where the

patient is able to perform required measures of externally or
internally oriented therapeutic self-care but cannot do so
without assistance"
NURSING METAPARADIGM
NURSING - an art through which the practitioner of
nursing gives specialized assistance to persons with
disabilities, making more than ordinary assistance
necessary to meet self-care needs. The nurse also
intelligently participates in the medical care the
individual receives from the physician.
NURSING METAPARADIGM
HUMANS - defined as “men, women, and children
cared for either singly or as social units” and are the
“material object” of nurses and others who provide
direct care.
NURSING METAPARADIGM
ENVIRONMENT - It has physical, chemical, and
biological features. It includes the family, culture,
and community.
NURSING METAPARADIGM
HEALTH - is “being structurally and functionally
whole or sound.” Also, health is a state that
encompasses both the health of individuals and
groups, and human health is the ability to reflect on
oneself, symbolize experience, and communicate
with others.
CONCLUSION
Orem’s theory is relatively simple but generalizable to apply to a
wide variety of patients. It explains the terms self-care, nursing
systems, and self-care deficit essential to students who plan to
start their nursing careers.

Moreover, this theory signifies that all patients want to care for
themselves. They can 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 where patients are encouraged to be independent.
CONCLUSION
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 infants and the aged.
 PRESENTED BY:

Ana B. Macarayan John Gabriel Maestrado

Thank You!