Dorothea Orem

Self care Theory

Born in Baltimore, Maryland in 1914
Orem’s parents
Father was a
construction
worker

Mother was a
homemaker
 1935- BSN from Catholic
1930- graduated from University of America
Providence Hospital
School of Nursing,
1945-MSN from Catholic
Washington, DC
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
Orem’s nursing experience
• Operating room nurse
• Staff nurse
• Private duty nurse
• Nurse educator
• Nurse administrator
• Nurse consultant
 The Historical Evolution of Orem’s Model

Guidelines for
Worked for the
Orem Developing
Office of
worked on Curricula for
Education, in the 1958-
developing 1958- the Education
1949- U.S. Dept. of 1960
1957
nursing 1960 of Practical
Health, Education cont’d
curriculum Nurses was
and Welfare as a
and nursing developed (
curriculum
practice Tomey and
consultant
Alligood, 2006).
Evolution
continued
Eventually served
as the acting
1960- dean of the
School of Nursing 1971
Published
Nursing:
Concepts of
1970 at the Catholic
University of Practice
America
Nursing Concepts of Practice
• Development of the self-
care deficit nursing
theory and illustrates its
relevance to nursing
practice with a common
sense approach.
TERMS
Self-care agency
• Human’s ability or
power to engage in
self-care and is
affected by basic
conditioning
factors.
 Basic conditioning factors
• Age, gender,
developmental state,
health state,
sociocultural
orientation, health care
system factors
• Family system factors,
patterns of living,
environmental factors,
and resource adequacy
and availability.
 Nursing Agency
• Complex property or
attribute of people
educated and trained as
nurses that enables them
to act, to know, and to
help others meet their
therapeutic self-care
demands
• By exercising or
developing their own
self-care agency.
Metaparadigms of
Orem’s Model

Person Environment Health Nursing

 Person
• 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.
Health
• Promotes function and
development within
social groups in
accordance with human
potential, known
human limitation, and
the human desire to
return to normal
Environment
4 realms of state are
encompassed in Environment:

– Physical
– Chemical
– Biological
– Socioeconomical
 A. Environment – Physical

– Shelter
– Security- internal and
external
– Climate
– Amenities eg. Heat,
electricity, indoor
plumbing, sanitation…
 B. Environment-Chemical
• Chemical
– Pollutants:
• Air
• Water
 C. Environment-Biological
• Biological
– Molds
– Pollens
– Allergens
– Mites
– Animal waste and its by-
products
D. Environment-Socioeconomic

• Socioeconomic
– Family income
– Education level
– Occupation
– Social status
– Resources
Nursing Task
Performance

• Skilled professional Self-Care

Coordinated
Promotion
who evaluates and
acknowledges a
patient’s health deficit.

• Nursing plans and

implements care based
Supportive Demographics
: actual and potential
self-care deficits
 Concepts Unique to
Orem’s Model
Three Nursing Theories
1. Theory of Self Care
2. Theory of Self-Care
Deficit
3. Theory of Nursing
Systems
 I. 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 well-being through
meeting known requisites for
functional and developmental
regulations”
II. Theory of 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
 Theory of Self-Care continued
• The Theory of Self-Care
has three components:
1. Universal self-care needs
2. Developmental self-care
needs
3. Health deviation.
 A. Universal Self-Care
Requisites
The 8 elements :
– Air
– Food
– Water
– Elimination/Excretion
– Activity & Rest
– Solitude/Social
interaction
– Functioning/Well-
being
– Normalcy
Data Collection
B. Developmental Self-Care
Requisites
• Composed of 3 needs
– Promote development
– Engage in self-
development
– Preventing or
overcoming adverse
human conditions and
life situations
C. Health Deviation Self-Care
Requisites
• When a condition permanently
or temporarily alters structural,
physiological or psychological
function.
– Comatose states
– Autism
– Mental Retardation
 III. 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.
 Orem’s Theory Applied to Nursing
Education
• Conceptualize patients’
current and potential self-
care deficits.

• Supports the nursing

process in all 3 nursing
theories.
Research Status of Orem’s Model
• Current research using
Orem’s theory would
include:
– Chinese Medicine
– Battered woman
counseling
 Orem’s Strengths
 Self Care Deficit Theory is
specific to nursing.
 Can be used in multiple
nursing specialties.
 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.
• Does not address
cultural needs
Died June 22, 2007
 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/Resources/
DorotheaOremTheory.ppt
Dorothea Orem, Nursing Theory ( 2009, November 7). Retrieved from
http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps