1. Dorothea E. Orem
Dr. Dorothea E. Orem
RN BSN, Ed. MSN, Ed.
Born: 1914, Baltimore, Maryland.
Education: Diploma (early 1930's), Providence Hospital School of Nursing,
Washington, DC; BSN Ed. (1939) and MSN Ed. (1945) from the Catholic University of
America, Washington, DC.
Honorary Doctorates: Doctor of Science from Georgetown University (1976) and
Incarnate Word College in San Antonio, Texas (1980); Doctor of Humane Letters from
Illinois Wesleyan University, Bloomington, Illinois (1988); Doctor Honoris Causae,
University of Missouri-Columbia (1998).
Dr. Orem continues to be active in theory development. She completed the 6th edition
of Nursing: Concepts of Practice, published by Mosby in January 2001.
• Orem’s Self-Care Model: Self-Care Theory in the Ambulatory Setting. Ann M.
Mayo. San Diego University.
• Self-Care Deficit Nursing Theory - SCDNT - International Orem Society for
Nursing Science and Scholarship web site. It is for the discussion and
dissemination of information related to Orem's Self-Care Deficit Nursing
Theory.
• Self-Care Framework - The basic premise of the model is that individuals can
take responsibility for their health and the health of others. In a general sense,
individuals have the capacity to care for themselves or their dependents.
(Information from Nursingtheory.net)
Background
Dorothea Orem is one of America’s well-known nursing theorists. She began her nursing career
with a diploma degree in 1930 from the Providence Hospital School of Nursing in Washington,
DC and furthered her nursing education receiving her BSN from the Catholic University of
America and her Master’s of Science in nursing education in 1945.
In 1959, she began working on her Self-Care Deficit Theory, publishing her theory in 1971. Her
self-care deficit Theory of Nursing is a client-based theory. Human functioning and
development is identified by the theory. Self-care is important in determining the level that the
patient is able to return to their highest level. By using the nursing process, nurses are able to
design a plan of care for patients.

2. Nursing: Concepts of Practice
Orem's search for the meaning of nursing was structured by three questions:
What do nurses do and what should nurses do as practitioners of nursing?
Why do nurses do what they do?
What results from what nurses do as practitioners of nursing?
This in turn led to the central concepts of the theory.
Self-care deficit theory
This consists of three related theories: (sub theories)
Theory of self-care
Theory of self-care deficit
Theory of nursing system
The Self -care theory postulates that self-care and the self-care of dependents are learned
behaviours that individuals initiate and perform on their own behalf to maintain life, health,
and well-being. The individual's ability to perform self-care is called self-care agency. Adults
care for themselves, whereas infants, the aged, the ill and the disabled require assistance with
self-care activities (Kozier, Erb, Blais & Wilkinson, 1998).
Self-care deficit theory teaches that people benefit from nursing because they have health-
related limitations in providing self-care. Limitations may result from illness, injury, or from
the effects of medical tests or treatments. Two variables affect these deficits: self care agency
(ability) and therapeutic self-care demands (the measures of care required to meet existing
requisites). Self-care deficit results when self-care agency is not adequate to meet the known
self-care demand.
Nursing system theory suggests that nursing systems form when nurses prescribe, design, and
provide nursing that relates the individual's self-care capabilities and meets therapeutic self-
care requirements.
Three nursing systems exist within the model
Compensatory system-nurse provides total care
Partially compensatory system-nurse & patient share responsibility for care
Supportive/Educative-development system-client has primary responsibility for personal
health, with nurse acting as a consultant
Example case studies
1.Compensatory System-nurse provides total care
2.Partially compensatory system- nurse & patient share responsibility for care

3. 3. Educative-development system-client has primary responsibility for personal health, with
nurse acting as a consultant