P R ES EN TED BY M ELISS A K U R EK , N IC H O LA S K U R EK , K IM B ER LY M A R IN O A N D H EATH ER N O W A K

D O R O TH EA O R EM S TH EO R Y O F S ELF C A R E D EFIC IT
Born in Baltim ore,M aryland in
1914
O rem s parents

Father was a
construction worker

Mother was a
homemaker
1930- graduated 1935- BSN from
from Providence Catholic University
Hospital School of of America
Nursing, Washington, 1945-MSN from
DC Catholic University
of America
O rem s W orld ofAcadem ia

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
O rem s nursing experience

Operating room
nurse
Staff nurse
Private duty nurse
Nurse educator
Nurse
administrator
Nurse consultant
Died June 22, 2007
The H istoricalEvolution ofO rem s M odel
Evolution continued
M etaparadigm s ofO rem s
M odel
M etaparadigm :Person

An 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.
Motivation to accomplish self care
tasks.
Intellectual ability to cognitively
M etaparadigm :H ealth
Promotes function
and development
within social
groups in
accordance with
human potential,
known human
limitation, and the
human desire to
return to normal
(Tomey & Alligood,
2006 p. 279).
M etaparadigm :Environm ent
4 realms of state are
encompassed in
Environment:

Physical
Chemical
Biological
Socioeconomical
Environm ent continued

Environment
Physical
Shelter
Security- internal
and external
Climate
Amenities eg. Heat,
electricity, indoor
plumbing,
sanitation
Environm ent-Chem ical

Chemical
Pollutants:
Air
Water
Physical
Lead paints
Mercury
Asbestos
Environm ent-Biological

Biological
Molds
Pollens
Allergens
Mites
Animal waste and
its by-products
Environm ent-Socioeconom ic

Socioeconomic
Family income
Education level
Occupation
Social status
Resources
M etaparadigm :N ursing

The skilled
professional who
evaluates and
acknowledges a
patients health
deficit.

Nursing plans and

implements care
based on the actual
and potential self-
care deficits.
Concepts U nique to O rem s M odel
Three Nursing
Theories
1. The Theory of
Self Care
2. The Theory of
Self-Care Deficit
3. The Theory of
Nursing Systems
Theory ofSelf-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(Tomey &
Alligood, 2006 p.269).
Theory ofSelf-Care continued

The Theory of Self-

Care has three
components:
universal self-care
needs,
developmental
self-care needs
and health
deviation.
Theory ofSelf-Care D efi
cit

A 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
U niversalSelf-Care Requisites

The 8 elements :
Air
Food
Water
Elimination/Excretio
n
Activity & Rest
Solitude/Social
interaction
Functioning/Well-
being
Normalcy
D evelopm entalSelf-Care Requisites

Composed of 3
needs
Promote
development
Engage in self-
development
Preventing or
overcoming adverse
human conditions
and life situations
H ealth D eviation Self-Care
When a condition
Requisites permanently or
temporarily alters
structural, physiological
or psychological function.
Comatose states
Autism
Mental Retardation
Theory ofN ursing System s

Total compensatory support- patient

is unable to complete any self-care
independently; nursing compensates
for patients 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
ClinicalPractice M odels for Patient
Assessm ent
Theory applies to
Home
multiple clinical Theory applied in
Help identify the
By the patient alone or order to:
settings. patients ability for
with assistance self-care deficits that
provided
need to be addressed
Doctors office to promote health.
Education provided and
Help identify support
care supervised by a
nurse available to patient
Hospital such as family and
Needs identified, environment.
assessed and plan of Encourage patient to
care implemented develop self-care
Extended care facility abilities
O rem s Theory Applied to N ursing Education

Teaches the student

to encourage
compensatory care in
the patient
population.
Conceptualize
patients current and
potential self-care
deficits.
Supports the nursing
process in all 3
nursing theories.
 Model used by
Research Status ofO rem s M odel
multiple nursing
specialties due to
encompassing
nature of Orems
theory.
Current research
using Orems
theory would
include:
Chinese Medicine
Battered woman
counseling
O rem s Strengths
The Self Care Deficit Theory
is specific to nursing.
The Theory can be used in
multiple nursing specialties.
The concept of self-care and
health maintenance are
congruent with
contemporary literature in
healthcare.
The theory creates a
coordinated nursing care
plan that adjusts to the
patients needs throughout
recovery.
O rem s Lim itations
Time consuming for
nurses
Direct contact is
necessary throughout
the nursing process.
Multiple levels of the
theory to consider
Self care, self care
deficit and self care
deficit potential.
Does not address
cultural needs
Analysis and Insights

Three theories
combined into one.
Cumbersome
Completely
dependent on
nursing to assess
the patient and
familys ability to
complete self-care
requisites and
deficits
 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 Orems Theory of Self
Care. Retrieved from
http://www.nipissingu.ca/faculty/arohap/aphome/NURS3
006/Resources/DorotheaOremTheory.ppt
Dorothea Orem, Nursing Theory ( 2009, November 7).
Retrieved from http://faculty.ucc.edu/nursing-
gervase/Orem%5B1%5D.pps
 Like ityou do.
Like it you
do. An A
you must
give,
Educated
One.