self care theory

1. PRESENTED BY EDILLO, ETIONG, GARCIA
DOROTHEA OREM’S THEORY OF
SELF CARE DEFICIT

2. Born in Baltimore, Maryland
in 1914

3. Orem’s Parents
Mother was a homemaker
Father was a construction
worker

4. 1930- graduatedfrom
Providence Hospital
School of Nursing,
Washington, DC
1935- BSN from Catholic
University of America
1945-MSN from Catholic
University of America

5. Orem’s 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 IllinoisWesleyan University
 1998- Doctor of Nursing Honoris Causae from University of Missouri
 Retired in 1984

6. Orem’s Nursing Experience
 Operating room nurse
 Staff nurse
 Private duty nurse
 Nurse educator
 Nurse administrator
 Nurse consultant

7. Died June 22, 2007

8. The Historical Evolution of
Orem’s Model
Orem
worked on
developing
nursing
curriculum
and nursing
practice
1949-
1957
Worked for the
Office of
Education, in the
U.S. Dept. of
Health,
Education and
Welfare as a
curriculum
consultant
1958-
1960
Guidelines for
Developing
Curricula for the
Education of
Practical Nurses
was developed
(Tomey and
Alligood,
2006).
1958-
1960
cont’d

9. Evolution continued..
Eventually served
as the acting
dean of the
School of
Nursing at the
Catholic
University of
America
1960-
1970
Published
Nursing:
Concepts of
Practice
1971

10. Metaparadigms of Orem’s
Model
Person Environment Health Nursing

11. 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.

12. 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).

13. Metaparadigm: Environment
4 Realms of state that are
encompassed in
Environment:
 Physical
 Chemical
 Biological
 Socio-economical

14. Environment continued..
 Environment – Physical
 Shelter
 Security- internal and
external
 Climate
 Amenities eg. Heat,
electricity, indoor
plumbing, sanitation…

15. Environment-Chemical
 Chemical
 Pollutants
 Air
 Water
 Physical
 Mercury
 Lead paints
 Asbestos

16. Environment-Biological
 Biological
 Molds
 Pollens
 Allergens
 Mites
 Animal waste and its
by-products

17. Environment:
Socio-economic
 Socio-economic
 Family income
 Education level
 Occupation
 Social status
 Resources

18. Concepts Unique to Orem’s Model
Three NursingTheories
1. TheTheory of Self
Care
2. TheTheory of Self-
Care Deficit
3. TheTheory of
Nursing Systems

19. 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).

20. Theory of Self-Care continued
 TheTheory of Self-
Care has three
components: universal
self-care needs,
developmental self-
care needs and health
deviation.

21. 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

22. Universal Self-Care Requisites
The 8 elements :
 Air
 Food
 Water
 Elimination/Excretion
 Activity & Rest
 Solitude/Social
interaction
 Functioning/Well-being
 Normalcy

23. Theory of Nursing Systems
 Total compensatory support- patient is
unable to complete any self-care
independently; nursing compensates for
patient’s 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.

24. Orem’s 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.

25. Research Status of Orem’s Model
 Model used by multiple
nursing specialties due
to encompassing
nature of Orem’s
theory.
 Current research using
Orem’s theory would
include:
 Chinese Medicine
 Battered woman
counseling

26. Orem’s Strengths
 The Self Care DeficitTheory is
specific to nursing.
 TheTheory 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 patient’s
needs throughout recovery.

27. Orem’s 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

28. Analysis and Insights
 Three theories
combined into one.
 Cumbersome
 Completely dependent
on nursing to assess
the patient and family’s
ability to complete
self-care requisites and
deficits
 Culturally diverse

30. References
MarrierTomey, 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 Orem’sTheory of Self Care. Retrieved from
http://www.nipissingu.ca/faculty/arohap/aphome/NURS3006/Resour
ces/DorotheaOremTheory.ppt
Dorothea Orem, NursingTheory ( 2009, November 7). Retrieved from
http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps