CPT JULIE-ANN M BORRA NC
AFPNSTC CL 16-18
Overview of Orem's Self-Care Deficit Theory of Nursing
Dorothea Orem
Theorist : Dorothea Orem (1914-2007)
Born 1914 in Baltimore, US
Earned her diploma at Providence Hospital – Washington, DC
1939 – BSN Ed., Catholic University of America
1945 – MSN Ed., Catholic University of America
She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant.
Received honorary Doctor of Science degree in 1976.
Theory was first published in Nursing: Concepts of Practice in 1971, second in 1980, in 1995, and 2001.
Development of theory
1949-1957 Orem worked for the Division of Hospital and institutional services of the Indiana State Board of health.
Her goal was to upgrade the quality of nursing in general hospital throughout the state. During this time she developed her
definition of nursing practice.
1959 Orem subsequently served as acting dean of the school of Nursing and as an assistant professor of nursing education
at CUA. She continued to develop her theory
Orem’s Nursig: concept of practice was first published in 1971 and subsequently in 1980,1985,1991 and 2001
Orem's initial definition of nursing's concern included "man's need for self-care action and the provision and management of it on a
continuous basis in order to sustain life and health, recover from disease or injury, and cope with their effects" (Orem, 1959, p. 3).
More simply stated, her definition of nursing's goal was "overcoming human limitations" (Orem, 1959, p. 4)
Orem's general theory of self-care deficit nursing states that a self-care demand exists when the patient of family members is not
able to provide care for him/herself and those self-care demands can be met by the nurse (Masters, 2011).
Orem's theory is made up of 3 related theories:
1. Theory of Self-Care
2. Theory of Self-Care Deficit
3. Theory of Nursing Systems
According to Orem, "the three-part theory focuses not on individuals, but on persons in relations. Each of the three theories has as
its focus a specific dimension of the 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, persons in community" (1990, p. 49).
How are the three theories related?
The theory of self-care delineates the demands of self-care requisites that an individual needs to meet in order to stay healthy or get
better from illness. When a person cannot meet these self-care demands, or when self-care requisites exceeds self-care capabilities,
nursing is needed. Nurses can help patients meet their self-care needs by utilizing the 5 methods in the Theory of Self Care Deficit.
However, the nurse must properly assess the level of self-care a patient requires so that the nurse can utilize the nursing system (as
stated in the Theory of Nursing System) that best fits the patient's ability to perform self-care. In the end, the nurse assists the
patient in meeting his/her self-care needs so that he/she is healthy and free of illness.
THEORETICAL FRAMEWORK
How are the four concepts related?
The person (or patient) is the central focus of nursing care. According to Orem, the person's health state is mediated by his/her
environment. A person, who is healthy, is capable of self-care. When there is illness in the person's health state, the person is not
able to complete all self-care requisites. When this occurs, nursing care is needed to assist the person in completing his/her self-care.
Nurses must assess the person's ability to provide his/her own self-care and the environmental context of the person in order to
overcome health-associated limitations.
Orem used her theory to examine the self-care needs of persons and nurse's role in assisting or supporting persons in meeting
those needs. Orem saw that in order for a person, in ill health, become healthy and well, certain self-care needs must be met. If a
person is not capable of providing any self-care, the nurse would be responsible for providing most of the care. On the other hand, if
the person is fully capable of providing basic self-care, the nurse would be the supporter/educator/facilitator of that self-care.
In summary, Orem's Self Care Theory examines how people or communities can achieve a healthy state through self-care, by
themselves or with the help of the nurse.
