DOROTHEA OREMS

GENERAL THEORY OF
NURSING
Individuals,families, groups and communities need to be
taught self care.
DOROTHEA OREM
1914-2007

One of foremost nursing theorists.
Born 1914 in Baltimore.
Earned her diploma at Providence Hospital Washington, DC
1939 BSN Ed., Catholic University of America
1945 MSN Ed., Catholic University of America
Involved in nursing practice, nursing service, and nursing education
During her professional career, she worked as a staff nurse, private duty
nurse, nurse educator and administrator and nurse consultant
Received honorary Doctor of Science degree in 1976
Published first formal articulation of her ideas in Nursing: Concepts of
Practice in 1971, second in 1980, and in 1995.

GENERAL THEORY OF
NURSING
Dorothea Orems theory is composed of three related parts which are self-
care, self-care deficit and nursing systems.



Self- Care
Self-Care Deficit
Nursing
Systems
SELF-CARE THEORY
WHY and HOW people care for themselves.
practice of activities that individual initiates and perform
on their own behalf in maintaining life ,health and well
being
Self-Care
individuals ability to perform self-care activities.
Self-Care Agency
action directed towards provision of self care

Self-Care
Requisites
"totality of self care actions to be performed for some
duration in order to meet self care requisites by using
valid methods and related sets of operations and actions"
Therapeutic Self-
Care Demand
Self-Care Agency

It consists of two agents:

Self-care Agent - person who provides the self-
care

Dependent Care Agent - person other than the
individual who provides the care (such as
a parent)

U
n
i
v
e
r
s
a
l


requisites/needs
that are common
to all individuals
D
e
v
e
l
o
p
m
e
n
t
a
l

needs resulting
from maturation
or develop due
to a condition or
event

H
e
a
l
t
h

D
e
v
i
a
t
i
o
n

needs resulting
from illness,
injury & disease
or its treatment

Self- Care Requisites
It is composed of the following categories:
Similar to Maslow's heirarchy of needs. Important for
sustaing life. Common to all people.
Air
Water
Food
satisfactory
eliminative functions
activity balance with rest
time spent alone balances with
time spent with others
prevention of danger to self
being normal
UNIVERSAL
Conditions that support life processes and promote
specific developmental stages.

a. Intra-uterine life and birth
b. Neonatal life
c. Infancy
d. Childhood
e. Adolescence
f. Adulthood
g. Pregnancy
DEVELOPMENTAL
HEALTH-DEVIATION


Categories:

1. Seeking and securing appropriate medical assistance

2. Being aware of and attending to the effects and results of
pathologic conditions and states

3. Effectively carrying out medically prescribed diagnostic,
therapeutic and rehabilitative measures

4. Being aware of and attending to or regulating the
discomforting or deleterious effects of prescribed medical
care measures

5. Modifying the self concept in accepting oneself as
being in a particular state of health and in need of specific
forms of health care

6. Learning to live with the effects of pathologic conditions
and states of medical diagnostic and treatment measures
in a life-style that promotes continued personal
development
SELF-CARE DEFICIT THEORY
WHY people can be helped through nursing
Self- Care Deficit: demand to care for oneself is greater
than the individuals capacity or ability to meet it.










Nursing is required when the client is incapable of
continuous and effective self-care. It determines the need
for nursing care.


Five Methods of Assistance
- is the central focus of Orems Grand Theory of Nursing
- explains when nursing is needed
- describes and explains how people can be helped through nursing
- results when the Self-care Agency (patient) cant meet her/his self-care needs or
administer self-care
-nursing meets these self-care needs through five methods of help


Five Methods of Nursing Help
-Acting or doing for
-Guiding
-Teaching
-Supporting
-Providing an environment to promote the patients ability to meet current or future
demands
THEORY OF NURSING
SYSTEMS
describes and explains RELATIONSHIPS that must
be made and maintained for nursing to be produced
It specifies how the clients self-care needs will be met by
the nurse, client or both. With this theory, the nurse
determines whether there is a legitimate need for nursing
care and if a self-care deficit exists. It is also the time
when a nurse plans care and identifies what should be
done and who should do it. In addition, it establishes 3
classifications of nursing system to meet the self-care
requisite of the client.
3 Classification of Nursing Systems
The nurse or caregiver does all care for
patient. Patient is unable to care for
themselves.

Wholly
Compensatory
Patient can do some care for themself
but still relies on the nurse or caregiver
for assistance.
Partly
Compensatory
Patient learns to provide care for
themself on their own without any
assistance from the nurse or care giver.
Suppportive-
Educative
Orems General Theory of
Nursing
Self
care
Nursing
Agency
Deficit
R R
R
R
R
C
o
n
d
i
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i
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n
i
n
g

f
a
c
t
o
r
s

C
o
n
d
i
t
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n
i
n
g

f
a
c
t
o
r
s

C
o
n
d
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f
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s

Therapeutic
Self care
demands
Self
Care /
Dep.
Care
Agency
R indicates a relationship between components; < indicates current or potential
deficit where nursing would be required.
CORE COMPETENCIES
Out of the 11 core competencies listed, few applies to
Dorothea Orems General Theory of Nursing. One main
competency that can be practiced using Orems theory is the
SAFE QUALITY CARE. To illustrate, the nurse can diagnose
self-care needs and deficit of his/her patient. Once, the
patients self-care need/deficit is identified, the nurse then
formulates a nursing care plan in which COLLABORATION
and COMMUNICATION competency comes in. In order to
formulate a nursing care plan, the nurse will have to
communicate with his/her patient. She would also have to
collaborate with his/her client and others so that they can help
apply the plan she developed.

If people cannot care for
themselves, they sure
need help. This is when
nurses come in to provide
assistance.
THATS ALL!