PRESENTED BY MELISSA KUREK, NICHOLAS KUREK, KIMBERLY MARINO AND HEATHER NOWAK

DOROTHEA OREMS THEORY OF SELF CARE DEFICIT

Born in Baltimore, Maryland
in 1914
Orems parents

Father was a construction

worker

Mother was a homemaker

1930- graduated from 1935- BSN from Catholic
Providence Hospital University of America
School of Nursing, 1945-MSN from Catholic
Washington, DC University of America
Orems 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
Retired in 1984
Orems nursing experience

Operating room nurse

Staff nurse
Private duty nurse
Nurse educator
Nurse administrator
Nurse consultant
Died June 22, 2007
 The Historical Evolution of Orems Model

Worked for the Office Guidelines for

Orem worked on
of Education, in the Developing Curricula
1958-
developing 1958-
1949- U.S. Dept. of Health, for the Education of
1960
nursing 1960
1957 Education and Welfare Practical Nurses was
contd
curriculum and
as a curriculum developed ( Tomey
nursing practice
consultant and Alligood, 2006).
Evolution continued

Eventually served as the

1960-
acting dean of the School
of Nursing at the Catholic 1971 Published Nursing:
Concepts of Practice
1970University of America
Metaparadigms of Orems
Model

Environmen
Person Health Nursing
t
Metaparadigm: 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 perform,
delegate and evaluate tasks performed.
Metaparadigm: Health

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).
Metaparadigm: Environment
4 realms of state are
encompassed in
Environment:

Physical
Chemical
Biological
Socioeconomical
Environment continued

Environment Physical
Shelter
Security- internal and
external
Climate
Amenities eg. Heat,
electricity, indoor
plumbing, sanitation
Environment-Chemical

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

Biological
Molds
Pollens
Allergens
Mites
Animal waste and its by-
products
Environment-Socioeconomic

Socioeconomic
Family income
Education level
Occupation
Social status
Resources
Metaparadigm: Nursing
The skilled professional
who evaluates and
Task
acknowledges a Performance
patients health deficit.

Nursing plans and Self-Care

Coordinated
implements care based Promotion

on the actual and

potential self-care
deficits.

Supportive Demographics
Concepts Unique to Orems Model
Three Nursing Theories
1. The Theory of Self
Care
2. The Theory of Self-
Care Deficit
3. The Theory of
Nursing Systems
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(Tomey & Alligood, 2006 p.269).
Theory of Self-Care continued

The Theory of Self-Care

has three components:
universal self-care
needs, developmental
self-care needs and
health deviation.
Theory of Self-Care Deficit

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
Universal Self-Care Requisites

The 8 elements :
Air
Food
Water
Elimination/Excretion
Activity & Rest
Solitude/Social
interaction
Functioning/Well-being
Normalcy
Developmental Self-Care
Requisites
Composed of 3 needs
Promote development
Engage in self-
development
Preventing or
overcoming adverse
human conditions and
life situations
Health Deviation Self-Care
Requisites
When a condition permanently
or temporarily alters structural,
physiological or psychological
function.
Comatose states
Autism
Mental Retardation
Theory of Nursing Systems

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 patient
able to perform tasks independently. Nursing
provides ongoing education and support.
Clinical Practice Models for Patient
Assessment
Theory applies to multiple Theory applied in order to:
clinical settings.
Home Help identify the patients
By the patient alone or with ability for self-care deficits
assistance provided that need to be addressed
Doctors office to promote health.
Education provided and care Help identify support
supervised by a nurse
available to patient such as
Hospital family and environment.
Needs identified, assessed
Encourage patient to
and plan of care
implemented develop self-care abilities
Extended care facility
Orems Theory Applied to Nursing 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.
Research Status of Orems Model

Model used by multiple

nursing specialties due
to encompassing
nature of Orems
theory.
Current research using
Orems theory would
include:
Chinese Medicine
Battered woman
counseling
Orems 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.
Orems Limitations

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
Culturally diverse
 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/NURS3006/Resour
ces/DorotheaOremTheory.ppt
Dorothea Orem, Nursing Theory ( 2009, November 7). Retrieved from
http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps
 Like it you do.
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