Self-Care Deficit Theory of

Nursing

 “Individuals ,
families, groups,
and communities
need to be taught
self-care”.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

 Dorothea Elizabeth Orem
 One of America’s foremost nursing theorist.
 Her early nursing experiences included operating room nursing, private duty
nursing (home and hospital), hospital staff nursing on pediatric and adult
medical-surgical units, evening supervisor in emergency room, and
biological science teaching.
 Her goal was to upgrade the quality of nursing in general hospitals
throughout the states.
 Orem’s first published book in 1971 was Nursing: Concept of Practice
(Orem, 1971).
 She was editor for the Nursing Development Conference Group (NDCG) as
they prepared and later revised Concept Formulation in Nursing Process
and Product (NDCG, 1972, 1979). Subsequent editions of Nursing
Concept of Practice were published in 1980, 1985, 1991, 1995, 1nd 2001.
 She retired in 1984 and resides in Savannah, Georgia. She continues
working alone and with colleagues on the development of Self-Care Deficit
Nursing Theory.
FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING
 Orem’s theory addresses
client’s self-care needs. It
is defined as goal-oriented
activities that are set
towards generating
interest in the part of the
client to maintain life and
health development.
 The theory is aimed
towards making the clients
perform self-care activities
in order to live
independently.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

MAJOR ASSUMPTIONS CONCEPTS &
RELATIONSHIPS

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

 Orem’s theory changed to fit the times most
notably in the concept of the individual and of
the nursing system.
 The original theory, however, remains largely
intact.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

 CONCEPTS
 Orem (1995, 2001) defined the metaparadigm concepts as follows:

 Nursing is seen as an art through which the practitioner of nursing gives

 specialized assistance to persons with disabilities which makes more than
 ordinary assistance necessary to meet needs for self-care. The nurse also
 intelligently participates in the medical care the individual receives from
the physician.
 Humans are defined as “men, women, and children cared for either singly
or as social units,” and are the “material object” (p. 8) of nurses and others
who provide direct care.
 Environment has physical, chemical, and biological features. It includes
then family culture and community.
 Health is “being structurally and functionally whole or sound” (p. 96). Also,
 health is a state that encompasses both the health of individuals and of
groups, and human health is the ability to reflect on one’s self, to
symbolize experience, and to communicate with others.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING
 Person
>human beings are very much different from ,other living things in
terms of their capacity. They can symbolize experiences
that have been through by using words or ideas. Human
functioning is an integrated system comprises of physical,
psychological, interpersonal, and social aspects.
Health
>Orem believes that health should be perceived this way since she
believes that these integrated aspects of health are
inseparable.
Environment
>Orem’s view of health as phenomenon affected by inseparable
entities show her view of surrounding environment as an
external source of influence in the internal interaction of a
person’s different aspects.
Nursing
>nursing is helping clients to establish or identify ways to perform
self-care activities.
>she also defines nursing as a human service.
FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING
Self-care
 Is an activity that promotes a person’s well-
being. It is performed by a persons who
are aware of the time frames on behalf of
the maintaining life, continuing personal
development and a healthy functional
living.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Self-Care Requisites
-are insights of actions or requirements that a
person must be able to meet and perform in order to
achieve well-being.

The two elements of self-care requisite are:

1)The factor to be controlled or managed to keep as
aspect(s) of human functioning and development
within the norms compatible with life, health, and
personal well-being and;
2)The natured of the required action.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Universal Self-Care Requisites
These are the universally set goals that must be
undertaken in order for an individual to function kin scope of
healthy living.

The Eight Self-care Requisites common in men, women, and

children are as follows:

•Maintenance of a sufficient intake of air,

•Maintenance of a sufficient intake of food,
•Maintenance of a sufficient intake of water,
•Provision of care associated with limitation,
•Maintenance of balance between activity and rest,
•Maintenance of balance between solitude and social interaction,
•Prevention of hazards to human life, human functioning and
human well-being;
•Promotion of human functioning and development.
FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING
Developmental Self-Care Requisites
The actions to be undertaken that will provide
developmental growth:

•Provision of condition that promote development;

•Engagement in self-development and;
•Prevention of the effect s of human conditions that
threatens life.

Health Deviation Requisites

These are requisites required for a person to be
considered as sick or ill. These health deviations set
standards to which the degree of self-care demand
needed.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Therapeutic Self-Care Demand
These are summation of all activities needed to
alleviate the existing disease or illness. Controlling or
managing the factors will result to appropriate.

Self-Care Agency
These are the complex set of activities required to
purposively regulate the actions needed for planning a
care plan for client.

Agent
An agent is the individual who engage in meeting
the needs of a person. They are like bridges that facilitate
what has been done and what needs to be done.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Dependent Care Agent
These are the individuals who takes full responsibility of taking care
of a person who are incapable of providing care for themselves those who
are living dependently with others aid.

Nursing Agency
is a set of established capabilities of a nurse who can legitimately
perform activities of care for client. Nursing agency helps a person achieve
their health care demand.

Nursing Design
These are professional functions that must be performed by the
nurse in order to meet clients need. It serves as a guideline of needed and
foreseen results.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Practice
Orem’s Self-Care Deficit Theory has been used in studies in patients
having heart problems, cancer, and mental illness. The use of her theory gave
way for further studies in health promotion, self-care, and family caregiver stress.
Her theory was being used in defining the roles of the nurse in multiple
setting.

Education
The theory is used at all levels of curriculum and in continuing
education. Some American universities continuously use her theory as a strong
and effective framework for curricular design. Gradually , focus on preventive
health care is being introduced also in nursing school.

Research
A number of researches derived from Orem’s theory can be classified
relating to the development of research instruments for scientific measurement s
of the components of her theory and studies that test that these components.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Simplicity
Her theory is expressed in limited number of terms. These
terms are defined and used consistently in her theories. The self-
Care Deficit Theory of Nursing is a systematic synthesis of
knowledge about the theoretical entities such as self-care, self-
care agency, therapeutic self-care demand, the relational entity
self-care deficit and nursing agency.
In terms of simplicity, the theory could be well understood
as the theory is presented in a straightforward manner.
Generality
As Orem described her theory, Self-Care Deficit Theory
assists nurses in different areas in any clinical setting. The theory
she proposed helps nurses develop and validate nursing
knowledge, and in teaching and learning the nursing profession.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Empirical Precision
Orem’s theory is used in both quantitative and qualitative
methodologies. The significant value of Orem’s theory is in its
scope complexity , and clinical usefulness. It could be effectively
used in generating hypothesis and adding to the body of
knowledge of nursing.
Derivable Consequences
-Orem’s theory differentiates nursing from other
disciplines in terms of focus.
-Her theory gives direction to nursing specific outcomes
related to identifying and meeting the therapeutic self-care
demands and self-management system. In her works, she
defined nursing as a scientific structure and as a practical
science with on-going development of the nursing knowledge.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Assessment
 Keeping Orem’s Self-Care in mind, the nurse would then
identify probable needs and evaluate client’s potential for
independence. Nursing care would start at the patient’s wholly
compensatory state, which is from comatose to paralysis.
Then it would proceed to partially compensatory state, wherein
the client is taught the use of assistive device to aid in mobility.
 Nurse would recall the principle of crutch walking, including
correct usage, posture and pacing. The client’s support system
is also taken as an important consideration, including Eddie’s
perception of disability and possible lifestyle adjustments and
consideration.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Diagnosis
•Self Care deficit related to total paralysis
•Knowledge deficit related to use or crutches

Planning
The nurse would collaborate with patient in
setting attainable goals with emphasis on client
empowerment and attaining independent as
quickly as possible.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

Implementation
Assess client’s perception on disability, lifestyle changes, and coping
mechanisms.
1. Demonstrate use of crutch walking and pacing using visual aids,
proper therapeutic communication and demonstration.
2. Involve support system (family, loved ones) on the discussion and
address their questions and concerns.
3. Refer to the client to a physical therapist for collaboration and
further guidance.
4. Ask the client to demonstrate knowledge and competency to
evaluate self-care capacity.

Evaluation
The nurse together with the patient, after a few days of instruction
and counseling, would agree on whether the goal is met or not.

FREDELYN G. BICLAR RN,MN THEORETICAL FOUNDATION IN NURSING

REFERENCE:
1. Alligood, M.R., (2018).Nursing Theorists & Their Work (9th Ed.). St. Louis: Mosby-Elsevier.
2. George, J.B., (2014). Nursing Theories: The Base for Professional Nursing Practice (6th
Ed.).London, England. Pearson
Educational Ltd.
3. McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing. Philadelphia: Wolters
Kluwer/Lippincott
Williams & Wilkins.
4. McKenna, M. P., Pajnkihar,M., Murphy, F.A. (Eds.) (2014). Fundamentals of Nursing Models,
Theories and Practice (2nd Ed).
Wiley Blackwell
5. Morse, J.M. (2017). Analyzing and Conceptualizing the Theoretical Foundations of Nursing.
New York. Springer Publishing
Company
6. Smith, M.C. & Parker, M. (2014). Nursing Theories and Nursing Practice (4th Ed.).
Philadelphia. F.A. Davis Company
7. Smith, M.J., & Liehr, P.R. (Eds). (2018). Middle Range Theory for Nursing (4th Ed.). New
York. Springer Publishing Company

FREDELYN G. BICLAR THEORETICAL FOUNDATION IN NUSING 1ST SEM 2020-2021

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