Dorothea Orem's Self-Care Deficit Theory is a nursing theory that focuses on the concept of self-

care and self-care deficits. This theory merges and integrates several different theories and
concepts from nursing and healthcare to provide a comprehensive framework for understanding
and addressing patients' self-care needs. Here are three of the main theories and concepts
connected and merged within Orem's Self-Care Deficit Theory:

Self-Care Theory
The core concept of Orem's theory is self-care. Orem defines self-care as the practice of activities
that individuals initiate and perform on their own to maintain life, health, and well-being. Self-care
includes various activities, such as eating, bathing, dressing, and managing chronic conditions like
diabetes. Orem's theory emphasizes the importance of individuals taking responsibility for their
own self-care to achieve optimal health outcomes. It encompasses three categories of self-care
requisites that outline the actions necessary for individuals to provide self-care. These categories
are:

1. Universal Self-Care Requisites:

- These requisites are associated with basic life processes and the maintenance of the human
structure and functioning integrity. They include:
- Ensuring a sufficient intake of air for respiration.
- Maintaining an adequate intake of water to support bodily functions.
- Providing the body with a sufficient intake of food for nutrition.
- Managing care associated with the elimination process and excrements.
- Maintaining a balance between activity and rest to support physical and mental well-being.
- Balancing solitude and social interaction to meet psychological and social needs.
- Preventing hazards to human life, functioning, and well-being.
-Promoting human functioning and development within social groups, in alignment with
individual potential and limitations.

2. Developmental Self-Care Requisites:

- These requisites are specific to developmental processes and may be specialized expressions
of universal self-care requisites or entirely new requisites arising from particular developmental
conditions or events.

3. Health Deviation Self-Care Requisites:

- These requisites are necessary in cases of illness, injury, or disease, or when medical measures
are required to diagnose and address a condition. They involve:
- Seeking and securing appropriate medical assistance when needed.
- Being aware of and addressing the effects and results of pathological conditions.
- Effectively carrying out medically prescribed diagnostic, therapeutic, and rehabilitative
measures.
- Being aware of and managing discomfort or adverse effects of prescribed medical
interventions.
- Adjusting one's self-concept and self-image to accept their specific state of health and the
need for particular forms of healthcare.
- Learning to live with the effects of pathological conditions, medical treatments, and diagnostic
measures in a way that supports ongoing personal development.
Self-Care Deficit Theory:
Orem's theory introduces the concept of self-care deficit, which occurs when an individual is
unable to perform adequate self-care to meet their health needs. The theory suggests that
nursing care is required when there is a deficit in self-care capabilities. Nurses, according to
Orem, play a vital role in identifying self-care deficits and providing support, education, and
assistance to help individuals regain or improve their ability to perform self-care activities.
Orem identified 5 methods of helping:
Acting for and doing for others
Guiding others
Supporting another
Providing an environment promoting personal development about meet future demands
Teaching another

Nursing Systems Theory:

Within Orem's theory, the concept of nursing systems is integral. Nursing systems are defined as
the methods and strategies employed by nurses to meet the self-care needs of individuals. These
systems can be wholly compensatory, partially compensatory, or supportive-educative,
depending on the individual's level of self-care deficit. Orem's theory recognizes that not all
patients require the same level of nursing intervention, and nursing care should be tailored to the
individual's specific self-care abilities and limitations.

The theory categorizes nursing systems into three types:

1. Wholly Compensatory Nursing System:
This system is used when individuals are unable to engage in self-care actions that require
self-directed movement or manipulation, or when medical instructions require them to
refrain from such activities. These individuals are socially dependent on others for their well-
being and existence.
2. Partial Compensatory Nursing System:
In this system, both the nurse and the individual engage in care measures or actions that
involve manipulation or movement. Either the patient or the nurse may take a significant role
in performing these care measures, depending on the individual's capabilities.
3. Supportive-Educative System:
This system, also known as a supportive-developmental system, is applied when a person can
perform or learn to perform required therapeutic self-care measures but requires assistance
to do so. It is used to support and educate the individual in self-care, helping them acquire
the necessary skills and knowledge.
 1. Wholly Compensatory Nursing System:
Scenario: A Patient Recovering from Major Surgery
Description: Picture a patient who had major surgery and can't move or take care of themselves.
They need help with everything like bathing, dressing, and taking medicine. Their doctor says they
can't put weight on their legs.
Nursing Care: In this case, the nurse does everything for the patient. They help with all activities
like bathing, dressing, and giving medications. The patient can't do anything on their own, so they rely
completely on the nurse.
2. Partial Compensatory Nursing System:
Scenario: A Diabetic Patient with Shaky Hands
Description: Think of a patient with diabetes who needs insulin shots several times a day. They
can usually do it themselves, but sometimes their hands shake, and it's hard to give the right dose.
Nursing Care: In this situation, the nurse and the patient work together. The patient gives
themselves insulin when they can, and the nurse steps in when needed. The nurse also teaches the
patient about insulin and checks on them to help when necessary.
3.Supportive-Educative Nursing System:
Scenario: A First-Time Mom Learning Baby Care
Description: Imagine a new mom who just had her first baby and doesn't know how to care for an
infant. She wants to learn how to bathe, feed, and change her baby but needs guidance.
Nursing Care: In this case, the nurse acts as a teacher and supporter. They show the new mom how
to take care of her baby, answer her questions, and offer guidance. Over time, the mom becomes
more confident and skilled in caring for her baby with the nurse's help.

In the wholly compensatory system, the nurse does everything for the patient. In the partial
compensatory system, the nurse and the patient share the care responsibilities. In the supportive-
educative system, the nurse educates and supports the person in learning how to care for themselves
or someone else.

Nursing
Nursing is 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.
Humans
Humans are 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.
Environment
The environment has physical, chemical, and biological features. It includes the family,
culture, and community.
Health
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.