Orem’s Self-Care Deficit
Nursing Theory
Orem’s Self-Care Deficit Nursing
Theory (SCDNT)
 Original Source
 Impetus was to define content for practical nursing
curricula for Department of Health, Education, and
Welfare
 References Parson’s structure of social action and von
Bertalanfy’s system theory
 Ontology

moderate realism
 Focus
 person as agent
Source: McEwen & Wills (2007)
SCDNT Paradigmatic Origins
Needs Theory (Henderson, 1966)
Functional Theory (Abdellah, Beland, Martin, & Matheney,
1961)
Uniqueness of Orem’s theory – individual is capable of
engaging in own self-care
Orem credits reflection on own practice & others for theory
beginnings
Source: Meleis (1997)
SCDNT Overview
 “Relationship between self-care agency and therapeutic
self-care demands, distinguishing self-care deficit from
dependent care” (Romeo & Devereaux, 2006)
 Composed of 3 nested theories:
 Self-care
 Self-care deficit
 Nursing systems
 Relationship between the 3 theories:
 “The theory nursing systems subsumes the theory of self-care
deficit, which subsumes the theory of self-care” (Orem, 1991,
p. 66)
SCDNT Overview
 Based on 4 concepts
 Self-care

Activities an individual performs independently throughout life to
promote & maintain well-being
 Self-care agency
 Individual’s ability to perform self-care activities
 Self-care requisites
 Measures or actions to provide self-care
 Therapeutic self-care demand
 Self-care activities required to meet self-care requisites
Source: Berman, Snyder, Kozier & Erb (2008)
SCDNT Overview
 Self-care deficit results when the self-care agency can not
meet self-care demands
 Explains when nursing care is needed
 Explains how people can be assisted through 5 methods of
helping:
 Acting or doing for
 Guiding
 Teaching
 Supporting
 Providing an environment to promote the person’s abilities to
meet current & future demands
Orem’s 3 Types of Nursing Systems
 Wholly compensatory
 Required when one cannot control/monitor their environment
 Nurse accomplishes patient’s therapeutic self-care
 Partly compensatory
 Required when one is unable to perform some but not all self-care
activities
 Nurse and patient work together to meet patient’s self-care needs
 Supportive-educative
 Required when one needs to learn to perform self-care activities &
needs assistance to do so
 Patient provides necessary self-care and nurse supports/educates client
in development of self-care agency
Sources: Berman, Snyder, Kozier & Erb (2008)
Meleis (1997)
SCDNT and Research
Jenny, J. (1991). Self-care deficit theory and nursing
diagnosis: A test of conceptual fit. Journal of Nursing
Education, 30(5), 227-232.
Kumar, C. P. (2007). Application of Orem’s self-care
deficit theory and standardized nursing languages in a
case study of a woman with diabetes. International
Journal of Nursing Terminologies and Classifications,
18(3), 103- 110.
Moore, J. B. (1993). Predictors of children’s self-care
performance: Testing the theory of self-care deficit.
Scholarly Inquiry for Nursing Practice, 7(3), 199-212.
SCDNT Applied to Nursing Practice
 Burks, K. J. (1999). A nursing practice model for chronic
illness. Rehabilitation Nursing, 24(5), 197-200.
 Frey, M. A. & Fox, M. A. (1990). Assessing and teaching
self-care to youths with diabetes mellitus. Pediatric
Nursing, 16, 597-800.
 Geden, E. A., Sang-Arun, I., & Taylor, S. (2001). Self-care
deficit nursing theory and the nurse practitioner’s practice.
Nursing Science Quarterly, 14(1), 29.
 Harrison-Raines, K. (1993). Nursing and self-care theory
applied to utilization review: Concepts and cases. American
Journal of Medical Quality, 8(4), 197-199.
Application of SCDNT To My
Practice
 As a nurse educator, I can use SCDNT to help students
identify when patients should receive help to meet
their heath care needs. In addition, this theory
identifies to what degree the client needs help. I
believe in allowing an individual to do what they can
for themselves and to support those efforts the best I
can. Finally, SCDNT identifies the concept of
educating clients, an important role of the
professional nurse.