Dorothea Orem’ Self-Care Deficit Theory of Nursing

Description of key points of the theory

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The self-care deficit theory “provides a way of looking at and investigating what nurses do” (Blais & Hayes, 2011, p. 102). It speaks to activities that individuals can perform independently to maintain life, health, and wellbeing. The theory outlines the three different categories of self-care requisites – which is required by all individuals. It revealed that overtime there may be the need to obtain assistance, and making adjustments because of changes in health, development or body image. When there is a self-care deficit, an individual experiences health related limitations and at this point he or she is unable to perform tasks independently, and so he or she benefits from nursing care. However, the concept of the nursing system, allows nurses to support individuals according to his or her ability to perform personal care (Blais & Hayes, p. 102, 2011).

Historical background

Dorothea Orem was born 1914 in Baltimore Maryland. She began her nursing career in Washington D.C. and got her diploma in the early 1930’s (Nursing Theories, 2014). She developed the Self-care Deficit Nursing Theory –SCDNT in 1956 (Alligood, p. 261, 2010). Orem’s theory highlights self-care as a human need, and allows nurses to develop interventions to encourage self-care. The aim of the theory is to help individuals and their families to maintain control of their health during the continuum of life. The general theory is referred to as the Self-care deficit theory of nursing and was first published in 1971 (Blais & Hayes, p. 102, 2011). Orem’s idea of an individual’s independence is manifested in her sub theories: self-care, self-care deficit and nursing systems (Kozier, Erb, Berman, & Snyder, 2004). The self-care theory is further broken down into four ideas: self-care – which refers to how individuals can help themselves, self-care agency – the potential of the person to perform care, self-care requisites – are the actions that are taken to perform self-care, and the therapeutic self-care demand – all the actions employed to maintain health (Kozier, et al, 2004). For persons who are unable to act as self- care agents, the nursing system adequately supports them so that their needs can be met.

Explain how the selected theorist’s approach to each element of the metaparadigm applies to the following:

Nursing practice
Nursing education
Nursing research


Applied to Nursing Practice
Applied to Nursing Education
Applied to Nursing Research

According to Nursing Theories (2014), “In Orem’s nursing theory a person is defined as the recipient of care who has the potential for learning and development. A person can engage in deliberate actions, interpret experiences and perform beneficial actions” (para 2) With the use of Orem’ theory, the nurse is able to identify the patients’ developmental level and the care that is required. The theory allows autonomy for nursing as a profession through the continuous use of evidence based practice in decision making.

Through education, balance is maintained in nursing practice. Patients are allowed primary control over their health although health care providers assist with education, promote and encourage healthy practices, and lifestyle modification. According to Bernier (2002) “Orem’s Theory guides nursing practice with theoretical concepts and goal setting providing a foundation upon which nurses can question the practice and expand the avenue for nursing research” (p. 384-90).


Orem’s definition of health was similar to that of the World Health organization. (Nursing Theories, 2014). According to Nursing Theories (2014), health is “state of physical, mental, and social well-being and not merely the absence of disease of infirmity” (para 5).

As the theory applies to health and the nursing practice, it reflects patients’ self-care limitations. However, it permits judgments to be made so that the appropriate plan of care can be created, administered, and the benefits reaped by the patients. The theory also allows patients to use self-care to maintain optimal health and independence while nurses perform primary evaluation and implement the nursing process to meet other needs in order of priority.

The nurse has an important, and possible challenging role at this moment. However, to improve health, it is important that patients are educated about current illness and the plan of care that will be performed so that optimal health can be restored. Education on medication regimen is important because it encourages compliance with treatment and increases knowledge on maintenance of good health. Orem’s theory impacts health, and boost nursing research through the gathering and analyzing of patients’ data. The information that is collected is used appropriately to measure the nursing care that can be implemented to improve an individual’s health.


Nursing is a personal service that help individuals to identify and develop ways to help or care for them self (Nursing Theories, 2014). Orem’ theory encourages patient – nurse relationship, care being the primary focus and the ultimate goal is health restoration. It encourages patient’ independence while holistic care is administered through constant reassessments. A plan of care is implemented through evidence based practice, and a comprehensive assessment performed using the self-care requisites. Through supportive –education, nurses are able to strengthen patients as self-care agency. This is done primarily through teaching and guiding. Patients are encouraged to voice concerns, and together nurses and patients explore the most appropriate choices that will enhance the healing process. Nurses ensure that there is a collaboration by making self-care agents provide input into decision making. Through Orem’s control operations, nurses evaluate the quality and quantity of self-care that the self-care agent is able to perform, and judge the effectiveness of the measures (Alligood, p. 268, 2010). Through evidence based practice, plan of care is revised, and corrective measures are put in place.


Environment is the surrounding of an individual that affects his or her capability to perform self-care tasks (Nursing Theories, 2014). Self-care is a learned behavior and it is influenced by an individual’s environment. For an individual to be able to perform self-care, he or she has to be in an environment that is conducive to such act, while he or she is provided with psychological support. To promote self-care, it is important that individuals are educated about their environment and tools that are available to help with the maintenance of health. Through education patients are able to practice self-care, while nurses monitor and regulate his or her actions. An individual’ health status is influenced by his or her environment. With the aid of the patient and involved family members, information about the individual’s environment can be gathered and the necessary plan of care implemented.


Alligood, M. R. (2010). Nursing Theory: Utilization and Application (4th ed.). Retrieved from University of Phoenix eBook Collection database Bernier, F. (2002). Applying orem’s self-care deficit theory of nursing to continence care: Part 2. Urologic Nursing, 22(6), 384-90. Blais, K. K., & Hayes, J. S. (2011). Professional Nursing Practice: Concepts and Perspectives (6th ed.). Retrieved from University of Phoenix eBook Collection database. Kozier, B., Erb, G., Berman, A., & Snyder, S. (2004). Fundamentals of Nursing: concepts, process, and practice (7th ed.). Upper saddle River, New Jersey: Pearson Education, Inc., Nursing Theories. (2014). Biography of Dorothea Orem. Retrieve from Nursing Theories. (2014). Dorothea Orem: Self Care Deficit Nursing Theory. Retrieve from

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