Chronicles of Orem: The

Autobiography of Dorothea
Elizabeth Orem and The Self
Care Deficit Theory
Prepared by:
Romnick Villasor Salih, RN
 Background
 
 July 15, 1914- Born in Baltimore, Maryland
(Wayne, 2014)
 Father was a construction worker and mother
was a homemaker. Had one sister (Wayne, 2014)
 June 22, 2007- Died in Savannah, Georgia. She
was 92 (Wayne, 2014)

DOROTHEA ELIZABETH OREM

 EDUCATION
 Early 1930s- Diploma in Nursing from Providence Hospital
School of Nursing in Washington, D.C. (Wayne, 2014)
 1939- BS in Nursing Education from the Catholic University
of America in Washington, D.C. (Wayne, 2014)
 1945- MS in Nursing Education from the Catholic University
of America in Washington, D.C. (Wayne, 2014)
 Honorary Doctorates of Science from both Georgetown
University in 1976 and Incarnate Word College in 1980
 1998- Doctorate Honoris Causae from the University of
Missouri in Columbia
 CAREER 1959
 Published her concept of self care (Black, 2014)
 Orem helped publish the “Guidelines for
Developing Curricula for the Education of Practical
Nurses” (Wayne, 2014)

 1971- published Nursing: Concepts of Practice which

outlines her nursing theory. Because of this work,
Orem is known as one of the leading theorists in
nursing practice and education (Wayne, 2014).
 1973- Chairperson of the Nursing Development Conference Group (Wayne,
2014)
 1980- America Alumni Achievement Award for Nursing Theory (Wayne, 2014)
 1991- Linda Richards Award from the National League for Nursing (Wayne,
2014)
 1992- Honorary Fellow of the American Academy of Nursing (Wayne, 2014)
 2001- Nursing: Concepts of Practice published (Black, 2014)
 Orem’s Model
Assumption:
“Ordinary people in  Normal people who live
contemporary society in the community want to
want to be in control remain as independent
of their lives” (Black, and in control as possible
 Individuals are
2014)
responsible for their own
care
 Orem’s Model
Formalized three Nursing theories which
are interconnected into one model (Black,
2014):
 Theory of self-care
 Theory of self-care deficit
 Theory of nursing system
 OREM’S MODEL

SELF CARE SELF CARE NURSING

THEORY DEFICIT THEORY SYSTEM THEORY
THEORY
OF
NURSING
SYSTEM
 THEORY OF Nursing should be altered to meet
NURSING SYSTEM the needs of the patient
o Necessary when one cannot engage in self-
care actions (Gonzalo, 2011 )
o Patient is dependent on the nurse to
accomplish patient’s therapeutic self-care
1. WHOLLY (Gonzalo, 2011)
COMPENSATORY
o Necessary when one is unable to engage in some
but not all self-care activities (Gonzalo, 2011)
o Nurse and patient work together to meet
2. PARTIALLY patient’s self-care needs (Gonzalo, 2011)
COMPENSATORY
o Necessary when one needs to learn to perform self-care
activities but needs assistance to do so (Gonzalo, 2011)
o Patient provides essential self-care and the nurse
3. SUPPORTIVE- supports/educates patient in development of self-care
EDUCATIVE (Gonzalo, 2011)
LETS EXERCISE OUR
UNDERSTANDING!!!!!!
 A teenager mother who ask advice on how to
SUPPORTIVE-EDUCATIVE
breastfeed her baby .....

Unconscious patient that needs daily bath and

WHOLLY COMPENSATORY
hygiene.....

Patient newly recovered from surgery who PARTIALLY

needs assistance in ambulation..... COMPENSATORY

A mental retarded patient who can not move his

left side extremities but able to raised his right WHOLLY COMPENSATORY
hand....
A group of parents who ask advice on how to
prevent cross contamination of infection among SUPPORTIVE-EDUCATIVE
cancer patient....

65yrs old Elderly who ask assitance and PARTIALLY

instruction in using a cane...... COMPENSATORY
THEORY
OF SELF
CARE
SELF CARE THEORY
   Developing the Self-Care Theory
One must first determine the patients’ ability to
provide self-care. This determination is
initiated by the nurse and involves the
development of a nurse-patient relationship.
Many factors are considered such as the
patients gender, age, environment,
developmental status and health related
necessities for the patient.(Black, 2014)
 SELF CARE
THEORY

Self-Care Therapeutic
Agency Self-Care
Self-Care Demand
Self-Care: the performance or practice of activities
that individuals initiate and perform on their own behalf to
maintain life, health and well-being (Gonzalo, 2011).
Self-Care Agency: is considered the human’s
ability or power to engage in self-care and is affected by basic
conditioning factors (Gonzalo, 2011).
Therapeutic Self-Care Demand: is the totality of
“self-care actions to be performed for some duration in order
to meet known self-care requisites by using valid methods
and related sets of actions and operations.” (Gonzalo, 2011).
THEORY
OF SELF
CARE
DEFICIT
 THEORY OF SELF CARE
DEFICIT:
“The inabilities of people to care for
themselves at times when they need
assistance because of their state of personal
health” (Orem 1959)
 This theory delineates when nursing is needed.
Nursing is required when an adult (or in the
case of a dependent, the parent or guardian) is
incapable of or limited in providing continuous
effective self-care. Orem identified 5 methods of
helping:
5 METHODS OF HELPING:
1. Acting for and doing for
others
2. Guiding others
3. Supporting another
4. Providing an environment promoting personal
development about meet future demands
5. Teaching another
METAPARADIG
M
 Relevance And Contributions To
Practice

Nursing has evolved due to advancement in

technology, an aging population, and an increase
in patient care acuity. The nurse is expected and
required to maximize His/her ability to care for
her patients.
 Relevance And Contributions To
Practice

Putting Orem’s theory to practice allows the

nurse to utilize the patient’s own self-care
abilities to their entirety. In doing so, the nurse
can maximize his/her skills for the needs of the
patient from an individualized plan of care.
 Relevance And Contributions To
Practice

Using Orem’s theory promotes patient autonomy

and independence. Without truly assessing a patients
capacity and willingness to care for themselves, the
nurse has the potential to waste his/her efforts on
something the patient could have done for
themselves or is not willing to do.
 Relevance And Contributions To
Practice
• Nurses focuses on self-care much more than any other
discipline in healthcare.
• Nursing interventions related to the Self-Care Model
include: Education regrading one’s illness or lack of
ability to perform self-care, identification of symptoms,
adherence to follow-up appointments, physical and
occupational therapy, medication management, pain
management, and nutritional counseling.
 Relevance And Contributions To
Practice

• Orem’s Self-care model has been used to

promote and build the structure for much
research in nursing over the years. It has
also been used in the development and
modification of nursing programs.
 How Orem Relates To Today’s Nurses

Orem’s theory is what we are taught to

practice as nurses. It embodies the concept
of maintaining holistic health. In order to
have a healthy physiological and
psychological self-concept: self-care is a
MUST!!
 O OFTEN

R REMINDS
OREM E EVERYDAY

M MAINTENANCE
 REFERENCES:
 Black, B. (2014). Professional Nursing: Concepts & Challenges (7th ed). St.
Louis, MI: Elsevier Inc.
 Dorothea Orem's Self-Care Theory. (n.d.). Retrieved October 12, 2016, from
 Dorothea Orem - Nursing Theorist. (n.d.). Retrieved October 09, 2016, from
 Gonzalo, A. (2011). The Self-Care Deficit Nursing Theory. Retrieved from:
 Green, R., (2013). Application of the self care deficit nursing theory: The
community context. Self-Care, Dependent-Care, & Nursing 20(1), 5-15.
 Self Care Deficit Theory. (n.d.). Retrieved October 09, 2016, from theory.php
 Wayne, G. (2014). Dorothea Orem - Self Care Nursing Theory - Nurseslabs.
Retrieved October 13, 2016, from theory
REFERENCES: