BACKGROUND
• Born in 1914 in Baltimore, MD
• Diploma degree from Providence Hospital School of Nursing
• Earned a BSN Ed from Catholic University of America
• Held faculty positions at Catholic University of America &
Provident Hospital School of Nursing in Detroit
• Earned a MSN Ed at Catholic University
• Held position of Director of Nursing Service & Education at
Provident in Detroit after receiving her MSN Ed
Parker & Smith, 2010
INFLUENCES
• Personal life experiences
• Formal education
• Employment experiences
• Works of Aristotle, Thomas Aquinas, Harre & Wallace
Parker & Smith, 2010
ASSUMPTIONS
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People should be self-reliant & responsible for their own care
•
People are individuals
•
Nursing is a form of action – interaction between two or more persons
•
Successfully meeting universal & development self-care requisites is an
important component of primary care prevention & ill health
•
Person’s knowledge of potential health problems is necessary for promoting selfcare behaviors
•
Self care & dependent care are behaviors learned within a socio-cultural content
Current Nursing, 2011
THEORY OVERVIEW
• Began developing her concept of nursing while
working as assistant professor and dean of
CUA nursing school.
• Nursing Development Conference Group
(NDCG) at CUA, all contributed to the
development of her nursing theory.
• Nursing : Concepts of Practice in 1970
 Published again in ‘80, ‘85, ‘91, ‘95, ’01
Tomey & Alligood, 2002
THEORY OVERVIEW
• No particular nursing leader had a direct
influence in theory development
• Credits her theory to all the nurses she
worked with and graduate students she
taught.
• Identified her philosophical view as that
of a moderate realism
FOUNDATIONS OF SCDNT
“the view of human being as dynamic, unitary
beings who exist in their environments, who
are in the process of becoming, and who
possess free-will as well as other essential
human qualities”
Tomey & Alligood, 2002
Orem’s Beliefs
• Believed that individuals engage in actions
required for functioning in life
• People Self-determine and have the ability to
grow in life
• People have the capacity and right to so
• The nurse collaborates with the patient to
meet their needs
SCDNT EXPRESSED IN THREE THEORIES
Theory of self-care
• Expresses the purpose, methods, and outcome
of taking care of self
• Theory of self-care deficit
• Demonstrates why people need nurses
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Theory of nursing systems
•
The three theories together constitute the Self
Care Deficit Nursing Theory
Definitions
• Self Care- caring for one’s self to maintain life,
health and well-being
• Self-care agency- Provider to supplement or
replace self care needs
• Self-care deficit- demand on the patient is
greater than the ability to meet the demands
of human functioning
SELF-CARE
•
•
The practice of activities that maturing and
mature persons initiate and perform within time
frames, on their own behalf, and in the interest of
maintaining life and healthful functioning and
continuing personal development and well being.
Human regulatory function that individuals must,
with deliberation, perform themselves or have
performed for them to maintain life, health,
development, and well being.
Tomey & Alligood, 2002
Self-Care
• Self care is learned and deliberate
• Self care may vary in different cultures
• Dependent care may occur when self care has
not been learned or is not operable
Injury
Trauma
Denyes, Orem & Bekel, 2001
Development of Self Care
• Interventions and teachings to return a person
to a level of optimal health and well-being
• Examples of this include toilet training a child
or teaching a diabetic patient about healthy
eating patterns
UNIVERSAL SELF-CARE REQUISITES
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Six common requisites for men, women, and
children
1. sufficient intake of air, water and food
2. elimination
3. balance between activity and rest
4. balance between solitude and social interaction
5. prevention of hazards to human life
6. promotion of human functioning and
development with social group in accordance with
human potential
Tomey & Alligood, 2002
SELF-CARE REQUISITES
• Actions that are important to human
functioning
• Factors to be controlled to keep life within
norms compatible with life and health and
person well being
• The nature of the action which expresses the
intended or desired results of the individual
THEORY OF SELF-CARE DEFICIT
•
People are affected by limitations that make it
difficult to meet human self care needs
 Disease
 Age
 Mental
•
These limitations deem them unable to know the
extent of regulatory care for themselves or a
dependent
•
AKA inability to care for self or their dependent
Theory of Self Care Deficit
• A person benefits from nursing intervention
when their state of health inhibits their ability
to provide self care
• Nursing actions focused on identifying the
limitations or deficits and implementing
interventions to meet needs of the patient
THEORY OF NURSING SYSTEMS
•
Nursing is human action, focused on a person
•
The ability of the nurse to aid the person to meet
current and future self care needs.
•
Nursing Systems are action systems formed by
nurses through the exercise of their nursing
agency for person with health-derived or healthassociated limitations of self-care
Current Nursing, 2011
Theory of Nursing System
• Nursing Agency includes concepts of deliberate action
• Intentionality and operations of diagnoses
• Prescription
• Regulation
• 3 Support Modalities identify the theory of nursing system
 Totally or whole compensatory
 Partially Compensatory
 Supportive/Educative compensatory
Modalities of Support
• W/C – wholly or totally compensatory
Nurse is to complete the care
 Client unable to care for themselves
• P/C- partially compensatory
Nurse and patient meet needs
 Patient and nurse collaboration to meet self care
needs
• S/E- Supportive/educative
Assistance with decision making, behavior control,
acquires knowledge and skills
 Client is responsible for self care needs
Tomey & Alligood, 2002
SELF-CARE DEFICIT MODEL
PARSIMONY
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Very easy concept to follow
• Requires a smart and educated nurse
• Not all nurses could identify the need for self-care
Orem did a great job of explaining her theory without the use of several different
models or diagrams
Easily applied to practice
• Required very little “new knowledge”
• Applying the nursing knowledge we all know already
• Language was easy to understand
Simple concepts to follow
Implementation of Orem’s Theory
• Can be applied to numerous different aspects
of nursing
• Several Nursing Programs apply Orem’s theory
as the bases of their nursing education
• Easily applied to the nursing care plan
The Dreaded Nursing Care Plan
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Assessment
NANDA Nursing Diagnoses
Identification of Outcomes
Nursing Intervention
Rationale
Evaluation
IMPLEMENTATION
• Can be seen in nearly all facets of nursing
• Especially seen in home health, hospice, and
hospital nursing
• Great teaching method for young nurses
CONCLUSION
• A very easy to follow method
• Focuses on the basic care needs of the patients
• Encourages the patients to do as much work for
themselves as possible
• Easily applied to nursing practice
• Any nurse can easily adapt this theory into their
everyday nursing
• Questions/Comments????
REFERENCES
Denyes, M. J., Orem, D. E., & Bekel, G. (2001). Self-care: a foundational science.
Nursing Science Quarterly, 14(1), 48-54. DOI: 10.1177/089431840101400113
Dorothea Orem’s self-care theory. (n.d.). Retrieved from
http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
Parker, M. E. & Smith, M. C. (2010). Nursing theories and nursing practice (3rd ed.).
Philadelphia, PA: F.A. Davis Company.
Tomey, A. M., & Alligood, M. R. (2002). Nursing theorist and their work. (5 ed., pp.
189-211). St. Louis, Missouri: Mosby. Retrieved from http://www.elsevier.com