Introduction: Orem defines self-care as a learned, goal oriented activity directed towards the self in the interest of maintaining life, health, development and well being. The goal of Orem’s theory is to help the client perform self-care. Biography of theorist Dorothea E Orem: Dorothea E Orem was born in Baltimore, Maryland on July 15, 1914. She was a nursing theorist and creator of the ‘ Self-care deficit ’ nursing theory, also known as the Orem model of nursing. Orem’s General Theory Of Nursing: Orem (1991) states her general theory. Orem developed the Self-Care Deficit Theory Of Nursing, which is composed of three interrelated theories: 1) Theory of self-care: Self-care, self-care agency, basic conditioning factors, the therapeutic self-care demand, self-care requisites- Universal (Activities of daily living [ADL]), Developmental, Health deviation 2) Theory of self-care deficit, 3) Theory of nursing systems: Wholly compensatory system, partly compensatory system, supportive educative system. Orem’s theory and nursing metaparadigm:Definition of metaparadigm- “ the concept that identify the phenomenon of central interest to a discipline ; the prepositions that describe those concepts and their relationships to each other.” Nursing metaparadigm concepts: *Nursing,* Health, *Environment, *Human being. Orem’s theory and nursing process: Nursing process- 1)Assessment, 2)Nursing diagnosis, 3)Plans with scientific rationale, 4)Implementation, 5)Evaluation Orem’s nursing process- 1)Diagnosis and prescription ; determine why nursing is needed. Analyze and interpret- make judgements regarding care. 2)Design of a nursing system and plan for delivery of care. 3)Production and management of nursing systems. Orem’s work and the characteristics of a theory:- *Theories must be logical in nature,* simple yet generalizable,*basis of hypothesis that can be tested,* assist in increasing the general body of knowledge,* practitioners to guide and improve their practice,* consistent with other validated theories , laws and principles. Strengths of Orem’s theory:- Limitations of Orem’s theory:- Application of Orem's Self-Care Deficit theory: Evaluation of the application of self care deficit theory: Summary: Orem presents her general theory of nursing, The self care deficit theory of nursing , which is composed of three interrelated theories of self care, self care deficit and nursing systems. This theory is used as basis for nursing school curriculum and base of nursing information system.

1. SHREYAS COLLEGE OF NURSING,
G.E. ROAD, SUPELA
SUBJECT: ADVANCE CLINICAL
NURSING
SEMINAR ON:
OREM’S THEORY

2. Biography of theorist Dorothea E Orem
 Born in Baltimore, Maryland on July 15, 1914.
Nursing theorist and creator of the ‘ Self-care deficit ’
nursing theory, also known as the Orem model of nursing.
Bachelor of Science in Nursing Education in 1939
Master of Science in Nursing Education in1945.
Awarded honorary doctoral degrees from Georgetown
University, Incarnate Word College and Illinois Wesleyan
University.
Cont…

3.  Received Catholic University Of America’s Alumni
Achievement Award for Nursing Theory in 1980.
 Linda Richards Award from the National League Of
Nursing in 1991.
 In 1971 published Nursing: Concepts of practice.
 Second , third and fourth editions of this book were
published in1980, 1985, 1991 and fifth in1995 and
sixth in 2001.

4. Orem’s General Theory Of
Nursing:
Orem (1991) states her general theory
composed of three interrelated theories :
1)Theory of self-care
2)Theory of self-care deficit
3)Theory of nursing systems

5. 1.Theory of self-care:-
Self-care
Self-care agency
Basic conditioning factors
The therapeutic self-care demand
Self-care requisites

6. Self-care
The performance or practice of activities that individuals
initiate and perform on their own behalf to maintain life,
health and well being.
Self-care agency
• The human’s ability or power to engage in self-care.
• Affected by basic conditioning factors.
Basic conditioning factors
Age, gender, developmental state, health state, socio-cultural
orientation, health care system factors, family system factors,
pattern of living , environmental factors and resource
adequacy and availability.

7. The therapeutic self-care demand
“Self-care actions to be performed for some
duration in order to meet known self care
requisites by using valid methods and related
sets of operations and actions.”
Self-care requisites
“ Actions directed toward the provision of self
care.” They are common to all the stages of
the life cycle.

8. Orem identifies self-care requisites
as follows:-
A. Universal (Activities of daily living [ADL])
B. Developmental
C. Health deviation

9. 2.Theory of self-care deficit:
 Core of Orem’s theory of nursing
 It delineates when nursing is needed.
Nursing may be provided if
 “ care abilities are less than those required for meeting a self
care demand ”
 “ to incorporate newly prescribed , complex self care measures
into their self care systems, the performance of which requires
specialized knowledge and skills to be acquired through
training and experience ”
 “ in recovering from disease or injury or in coping with their
effects.”

10. 3.Theory of nursing systems:
Based on the self care needs and abilities of the
patient to perform self care activities.
Three classification of nursing systems to meet self
care requisites of the patient.
a) Wholly compensatory system
b) Partly compensatory system
c) Supportive educative system
Eg.- Woman in labor may move from supportive educative
system to partly compensatory system in early labor and then
wholly compensatory if she requires a cesarean delivery.

11. It describes the relation between components. R
indicates the relationship between the components; <
indicates a current or potential deficit where nursing
would be required.

12. Nursing metaparadigm concepts:
Nursing – It is art , a helping service and a
technology.
Health-It refers to the patient’s level of wellness.
Environment- The environment consist of internal ,
external and social factors that impact a patient’s
health.
Human being-It includes the total being with
universal and developmental needs.

13. Comparison of Orem’s nursing process
and nursing process
Nursing process-
 Assessment
 Nursing diagnosis
 Plans with scientific rationale
 Implementation
 Evaluation
Orem’s nursing process-
 Diagnosis and prescription ; determine why nursing is needed. Analyze and
interpret- make judgements regarding care.
 Design of a nursing system and plan for delivery of care.
 Production and management of nursing systems.

14. Orem’s work and the characteristics of
a theory:-
 Interrelate concepts
 Logical
Simple yet generalizable
Basis of hypothesis that can be tested
Increase body of knowledge of dicipline
Guide to improve practice
Consisted with other theories but leave unanswered
questions to be investigated

15. Strengths of Orem’s theory:-
 Provides a comprehensive basis to nursing practice.
 Utility for professional nursing in areas of nursing practice, nursing
education and administration, curricular, research and nursing
education.
 It is applicable for nursing by the beginning practitioner as well as
the advanced clinicians.
 She defines when nursing is needed.
 Promotes the concepts of professional nursing.
 Includes continuing education as part of the professional component
of nursing education.
 Individual self care to include multi-person units.

16. Limitations of Orem’s theory:
 The term self care is used with numerous configurations. The use of
self-care in multitude of terms, such as self-care agency, self-care
demand, self-care deficit, self-care requisites, and universal self-care,
can be very confusing to the reader.
 Orem’s definition of health was confined in three static conditions
which she refers to a “concrete nursing system,” which connotes
rigidity.
 Throughout her work, there is limited acknowledgement of the
individual’s emotional needs.
 Appears that the theory is illness oriented rather with no indication
of its use in wellness settings.

17. Application of Orem's Self-
Care Deficit theory