DOROTHEA

OREM: THE SELF- Presented by:

Leo Franco B. Baldoza

CARE DEFICIT Rhoan Jwyneth Palma

THEORY
 DOROTHEA ELIZABETH
OREM
Born: July 15, 1914 in Baltimore, Maryland

Died: June 22, 2007 in Savannah, Georgia

- American nursing theorist

- Developed the ‘Self-Care Deficit Nursing Theory’ known as the ‘Orem
Model of Nursing’
- She worked as a staff nurse, private nurse, nurse educator and
administrator, and nurse consultant.

 Her clinical practice included staff nurse in the operating room, pediatrics
and adult medical surgical units.
 She also did private-duty nursing in private homes and the hospital and
was an emergency room supervisor.
 DOROTHEA ELIZABETH
OREM
 She occupied important nursing positions, like the directorship of both the
nursing school and the nursing department at Providence Hospital, Detroit,
from 1940 to 1949
 She also taught biological sciences and nursing from 1939 to 1941
 She served as Assistant Professor at the Catholic University of America
from 1959 to 1964, Associate Professor from 1964 to 1970, and Dean of
the School of Nursing from 1965 to 1966.
 She also served as curriculum consultant to the Office of Education,
United States Department of Health, Education and Welfare, Practical
Nurse Section in 1958, 1959, and 1960, to the Division of Hospital and
Institutional Services, The Indiana State Board of Health from 1949 to
1957, and to the Center for Experimentation and Development in Nursing,
The Johns Hopkins Hospital, 1969-1971, and to the Director of Nursing,
Wilmer Clinic, The Johns Hopkins Hospital, 1975-1976.
 DOROTHEA ELIZABETH
OREM
EDUCATION:

• In the early 1930’s she earned her nursing diploma from the Providence
Hospital School of Nursing in Washing ton D.C.
• She attended Seton High School in Baltimore and graduated in 1931.
• She received a diploma from Providence Hospital School of Nursing in
Washington, D.C. in 1934.
• Received several honorary degrees
• 1939 – she completed Bachelor of Science in Nursing Education from
Catholic University of America Washington D.C.
• 1945 – Master of Science in Nursing Education from Catholic University of
America Washington D.C.
 DOROTHEA ELIZABETH
OREM
 1958 – she was the consultant to the office of education where she began
working on her self-care theory.
 1976 – honorary Doctorate of Science from Georgetown University.
 1980 – Incarnate Word College
 1988 – honorary Doctorate of Humane Letters from Illinois Wesleyan
University

• 1998 – Doctorate Honoris Causa from the University of Missuori in

Columbia
 DOROTHEA ELIZABETH
OREM
AWARDS:

 1980 – The Catholic University of America Alumni Achievement Award

for Nursing Theory
 1991 – she received Linda Richards Award from National League for
Nursing
 1992 – received honorary fellow of the American Academy of Nursing
 She also received accolades for her contributions to nursing, including
honorary degrees from Georgetown University, Incarnate Word College,
Illinois Wesleyan University, and the University of Missouri-Columbia.
 She was inducted into the American Academy of Nursing and received
awards from the National League for Nursing and the Sigma Theta Tau
Nursing Honor Society.
 DOROTHEA ELIZABETH
OREM
PUBLICATIONS:

 1959 – first published her theory “Guidelines for Developing Curricula

For the Education of Practical Nurse”.
 1962 – The Hope of Nursing
 1971 – Nursing: Concept and Practices
 1972 – Concept Formalization in Nursing: Process and Product.
 1979 – Levels of nursing education and practice.

 The second, third, fourth, fifth, and sixth edition of Nursing: Concepts of
practice were published in 1980,1985, 1991. 1995, and 2001 respectively. 
• 1st edition: focus on individual. (1971)
 DOROTHEA ELIZABETH
OREM
• 2nd edition: include multiperson units (families, groups, and
communities). (1980)
• 3rd edition: Orem’s general theory of nursing, comprised of three related
theoretical constructs: self-care, self-care deficit, and nursing system.
(1985)
• 4th edition: fully developed the ideas presented. (1991)
• 5th edition: provided an increased emphasis on multiperson situation.
(1995)
• 6th edition: continued development of Orem’s ideas (2001)
 DOROTHEA ELIZABETH
OREM
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.”
 CONCEPTS
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.

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.
 CONCEPTS
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.
 CONCEPTS

Orem’s theory changed to fit the times, most notably in the concept of
the individual and of the nursing system. She delineated three nested
theories:

• Theory of self-care

• Theory of self-care deficit

• Theory of nursing systems

 CONCEPTS
I. SELF CARE
• Activity of person on their own in maintaining their health and well-being
• When there is demand to care for oneself and that individual is capable to
meet that demand, self-care is possible
KEY POINTS:
 Therapeutic self-care demand- nurse’s assistance in meeting the client or
client dependent’s self-care needs is done therapeutically as a result of the
client’s inability to calculate or to meet therapeutic self-care needs.
 Self-care agency- the complex acquired ability to meet one's continuing
requirements for care that regulates life processes, maintains and promotes
integrity of human structure and functioning and human development, and
promotes well- being (Orem, 1991).
 CONCEPTS

 Self-care requisites- part of self-care; expressions of actions to be

performed by or for individuals in the interest of controlling human or
environmental factors that affect human functioning or development.
Three types:
• Universal self-care requisites- self-care requisites common to all humans
• Developmental self-care requisites- self-care requisites necessary for
growth and development.
• Health deviation self-care requisites- self-care requisites associated with
health deficits.
 CONCEPTS
II. SELF-CARE DEFICIT
• When individual is not capable to meet the demand of care for self, self-care
deficit occurs
• This is the key to Orem’s theory
• Nursing is required in self-care deficit to guide in meeting the demand of a
client.
5 Methods:
 Acting for or doing for patient
 Teaching patient
 Directing patient
 Supporting patient
 Providing environment for patient
 CONCEPTS
III. NURSING SYSTEM
• Addresses and plans how needs of the patient can be met by the nurse,
patient and/or both.
• 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.
Three types:
 Wholly compensatory system- patients are not capable to perform self-
care
 Partly compensatory system- limited mobility due to illness
 Supportive\educative system- patient is capable of learning to perform the
process
 CONCEPTS
KEY POINTS:
 Deliberate action- action knowingly taken with some motivation or some
outcome sought by the person, as self-care or dependent care.
 Product of nursing- Nursing has two products: an intellectual product (the
design for helping the client) and a system of care of long or short duration
for persons requiring nursing.
CONCEPTUAL FRAMEWORK
 RELATIONSHIPS

An underlying premise of Orem’s theory are:

• The belief that humans engage in continuous communication and
interchange among themselves and their environments to remain alive and
to function.
• Mature human beings experience privations in the form of action in care of
self and others involving making life-sustaining and function-regulating
actions.
• 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.
 PURPOSE OF THE THEORY

• To help and promote patient to perform self-care

• Patient can recover faster if they are encouraged to perform self-care
tasks to maintain their health and well-being
• Theory can apply to all types of nursing ex: rehab, primary care
settings, nursing home and elders.
 VALUE

1. Practical applicability
• Ex. Patients with a stroke can have extensive self-care limitations .

2. Realistic reflection
• Serves as a commentary to the nursing science
"A PERSON UNDER THE CARE OF A NURSE; A
TOTAL BEING WITH UNIVERSAL,
DEVELOPMENTAL AND HEALTH DEVIATION
NEEDS WHO IS CAPABLE OF SELF CARE."
 REFERENCES
Gonzalo, A. B. (2021b, March 5). Dorothea Orem: Self-Care Deficit Theory.
Nurseslabs. Retrieved October 16, 2022, from
https://nurseslabs.com/dorothea-orems-self-care-theory/

Twining, A. (n.d.). Dorothea Orem. prezi.com. Retrieved October 16, 2022,

from https://prezi.com/v8dsmyab8ib6/dorothea-orem/

View of Conceptual analysis of self-care agency | Online Brazilian Journal of

Nursing. (n.d.). Retrieved October 16, 2022, from
https://www.objnursing.uff.br/index.php/nursing/article/view/4811/html_413

McEwen, M., & Wills, E. M. (2018). Theoretical basis for nursing (5th ed.).

Philadelphia, PA: Lippincott Williams and Wilkins.