PRESENTED BY MELISSA KUREK, NICHOLAS KUREK, KIMBERLY
MARINO AND HEATHER NOWAK
DOROTHEA OREM’S THEORY OF
SELF CARE DEFICIT
Born in Baltimore, Maryland
in 1914
Orem’s parents
Father was a construction
worker
Mother was a homemaker
1930- graduated from
Providence Hospital
School of Nursing,
Washington, DC
1935- BSN from Catholic
University of America
1945-MSN from Catholic
University of America
Orem’s World of Academia
 1959- Dean of the School of Nursing at Catholic University of America
 1976- Doctorate of Science from Georgetown University
 1988- Doctor of Humane Letters from Illinois Wesleyan University
 1998- Doctor of Nursing Honoris Causae from University of Missouri
 Retired in 1984
Orem’s nursing experience
 Operating room nurse
 Staff nurse
 Private duty nurse
 Nurse educator
 Nurse administrator
 Nurse consultant
Died June 22, 2007
The Historical Evolution of
Orem’s Model
19491957
Orem
worked on
developing
nursing
curriculum
and nursing
practice
19581960
Worked for the
Office of
Education, in the
U.S. Dept. of
Health,
Education and
Welfare as a
curriculum
consultant
19581960
cont’d
Guidelines for
Developing
Curricula for the
Education of
Practical Nurses
was developed
( Tomey and
Alligood,
2006).
Evolution continued
19601970
Eventually served
as the acting
dean of the
School of
Nursing at the
Catholic
University of
America
1971
Published
Nursing:
Concepts of
Practice
Metaparadigms of Orem’s
Model
Person
Environment
Health
Nursing
Metaparadigm: Person
 An individual or group of individuals who
have the ability to acquire the knowledge
necessary to perform tasks of self care.
 Ability to integrate self-care tasks and family,
community and individual needs.
 Motivation to accomplish self care tasks.
 Intellectual ability to cognitively perform,
delegate and evaluate tasks performed.
Metaparadigm: Health
 “Promotes function
and development
within social groups in
accordance with
human potential,
known human
limitation, and the
human desire to return
to normal” (Tomey &
Alligood, 2006 p. 279).
Metaparadigm: Environment
4 realms of state are
encompassed in
Environment:
 Physical
 Chemical
 Biological
 Socioeconomical
Environment continued
 Environment – Physical
 Shelter
 Security- internal and
external
 Climate
 Amenities eg. Heat,
electricity, indoor
plumbing, sanitation…
Environment-Chemical
 Chemical
 Pollutants:
 Air
 Water
 Physical
 Lead paints
 Mercury
 Asbestos
Environment-Biological
 Biological
 Molds
 Pollens
 Allergens
 Mites
 Animal waste and its by-
products
Environment-Socioeconomic
 Socioeconomic
 Family income
 Education level
 Occupation
 Social status
 Resources
Metaparadigm: Nursing
The skilled professional
who evaluates and
acknowledges a
patient’s health deficit.
Nursing plans and
implements care based
on the actual and
potential self-care
deficits.
Task
Performance
Coordinated
Supportive
Self-Care
Promotion
Demographics
Concepts Unique to Orem’s Model
Three Nursing Theories
1. The Theory of Self
Care
2. The Theory of SelfCare Deficit
3. The Theory of
Nursing Systems
Theory of Self-Care
 “Self –care comprises the practice of
activities that maturing and mature persons
initiate and perform, within time frames, on
their own behalf in the interest of
maintaining life, healthful functioning,
continuing personal development and wellbeing through meeting known requisites for
functional and developmental
regulations”(Tomey & Alligood, 2006 p.269).
Theory of Self-Care continued
 The Theory of SelfCare has three
components: universal
self-care needs,
developmental selfcare needs and health
deviation.
Theory of Self-Care Deficit
 A self-care deficit occurs
when an individual cannot
carry out self-care
requisites.
 Examples of self-care
requisites are:
 Wound care
 Activities of Daily Living
 Bowel program
 Glucose monitoring
Universal Self-Care Requisites
The 8 elements :
 Air
 Food
 Water
 Elimination/Excretion
 Activity & Rest
 Solitude/Social
interaction
 Functioning/Well-being
 Normalcy
Developmental Self-Care
Requisites
 Composed of 3 needs
 Promote development
 Engage in self-
development
 Preventing or
overcoming adverse
human conditions and
life situations
Health Deviation Self-Care
Requisites
 When a condition permanently
or temporarily alters structural,
physiological or psychological
function.
 Comatose states
 Autism
 Mental Retardation
Theory of Nursing Systems
 Total compensatory support- patient is
unable to complete any self-care
independently; nursing compensates for
patient’s inability to perform self-care.
 Partial compensatory support- patient is able
to perform self-care tasks with partial or no
assistance from nursing.
 Educative/supportive compensatory– patient
able to perform tasks independently. Nursing
provides ongoing education and support.
Clinical Practice Models for Patient
Assessment
Theory applies to multiple
clinical settings.
 Home
 By the patient alone or with
assistance provided
 Doctor’s office
 Education provided and care
supervised by a nurse
 Hospital
 Needs identified, assessed
and plan of care
implemented
 Extended care facility
Theory applied in order to:
 Help identify the patient’s
ability for self-care deficits
that need to be addressed
to promote health.
 Help identify support
available to patient such as
family and environment.
 Encourage patient to
develop self-care abilities
Orem’s Theory Applied to Nursing
Education
 Teaches the student to
encourage compensatory
care in the patient
population.
 Conceptualize patients’
current and potential selfcare deficits.
 Supports the nursing
process in all 3 nursing
theories.
Research Status of Orem’s Model
 Model used by multiple
nursing specialties due
to encompassing
nature of Orem’s
theory.
 Current research using
Orem’s theory would
include:
 Chinese Medicine
 Battered woman
counseling
Orem’s Strengths
 The Self Care Deficit Theory is
specific to nursing.
 The Theory can be used in
multiple nursing specialties.
 The concept of self-care and
health maintenance are
congruent with
contemporary literature in
healthcare.
 The theory creates a
coordinated nursing care plan
that adjusts to the patient’s
needs throughout recovery.
Orem’s Limitations
 Time consuming for
nurses
 Direct contact is
necessary throughout
the nursing process.
 Multiple levels of the
theory to consider Self
care, self care deficit and
self care deficit potential.
 Does not address
cultural needs
Analysis and Insights
 Three theories
combined into one.
 Cumbersome
 Completely dependent
on nursing to assess
the patient and family’s
ability to complete
self-care requisites and
deficits
 Culturally diverse
References
Marrier Tomey, A. & Alligood, M. (2006). Nursing theorists and their
work. (6th ed.) St. Louis, MO : Mosby Elsevier.
Bruce, E., Gagnon, C., Gendron, Puteris, L., & Tamblyn, A.(2009,
November 7). Dorothea Orem’s Theory of Self Care. Retrieved from
http://www.nipissingu.ca/faculty/arohap/aphome/NURS3006/Resour
ces/DorotheaOremTheory.ppt
Dorothea Orem, Nursing Theory ( 2009, November 7). Retrieved from
http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps
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