Dorothea Orem's Self-Care Deficit Theory of Nursing focuses on the concepts of self-care, self-care deficit, and nursing systems. The theory proposes that individuals require self-care to maintain health but may experience self-care deficits requiring nursing care. Orem identified three types of nursing systems - wholly compensatory, partially compensatory, and supportive-educative - to describe the level of care and support needed when a self-care deficit exists.

1. Dorothea Elizabeth Orem
1914 – June 22, 2007 Ratna Wirawati Rosyida, S.Kep.,Ns.,M.Kep

2.  Self-care comprises those activities
performed independently by an individual to
promote and maintain person well-being
 Self care agency is the individual’s ability to
perform self care activities

3.  Self- care deficit occurs when the person
cannot carry out self-care
 The nurse then meets the self-care needs by
acting or doing for;guiding, teaching,
supporting or providing the environment to
promote patient’s ability

4.  Wholly compensatory nursing system
◦ Patient dependent
 Partially compensatory
◦ Patient can meet some needs but needs nursing
assistance
 Supportive educative
◦ Patient can meet self care requisites, but needs
assistance with decision making or knowledge

5.  Highly regarded worldwide for its
usefulness in all aspects of nursing,
Orem’s Self Care Model continues to be
the organizing framework of many nurse
researchers, educators, and providers of
patient care.
 Many Schools of Nursing use the Orem
model as an organizer & many health
care institutions use it as a model for
care.

6.  Orems’ quest for greater understanding of
 the nature of nursing focused on three
 questions:
 What do nurses do, and what should nurses
 do, as practitioners of nursing?
 Why do nurses do what they do?
 What are the results of nursing interventions?
Orem & Taylor 1986

7.  The patient/client/recipient of
care
 May include
◦ Individuals
◦ Families
◦ Communities
◦ Populations

8. Human being
Environment
Health and sick Nursing
Orem Theory and Nursing Paradigm

9.  A being who functions biologically,
functionally & socially
 Has capacity for self-knowledge, can engage
in deliberate action, interpret experience, and
perform beneficial actions. As such persons
are capable of SELF CARE
 Client is person. Nurse is person

10.  Health (soundness & wholeness of
bodily & mental structures &
processes) and wellness
(characterized by feelings of
contentment, pleasure, happiness,
spiritual experiences, maturation,
personalization).

11.  An individual’s capacity for performing self-
care. Self care agency develops through
living and learning. Understanding
meanings, changing observable things,
acquiring knowledge, making choices, &
acting on choices.
 Unless we are on life support we have some
self care agency.

12.  Adequacy of Self Care agency is challenged
by demand. Orem calls these challenges
“Therapeutic Self Care Demands”

13.  Contributes to self image
 Is deliberate, continuous & learned
 Is essential to survival
 Includes seeking help, support & assistance

14.  Social
 Political
 Cultural
 Economic
 Ecological (physical, chemical, biologic)

15.  Generally seen as actions taken by the nurse
on behalf of or in cooperation with the
“client”. Usually seen as involving
◦ Caring
◦ Nursing process
◦ Teaching & Learning
◦ Coordinating & prioritizing

16.  Is required when a person’s therapeutic self
care demand exceeds their self care agency.

17.  Wholly Compensatory
 Partially Compensatory
 Educative Supportive

18. Each person has a need for self care in
order to maintain optimal health and
wellness.
Each person possesses the ability and
responsibility to care for themselves and
dependants.
Model is separated into three conceptual
theories which include: self care, self care
deficit and nursing system.

19. Self care is the ability to perform activities
and meet personal needs with the goal of
maintaining health and wellness of mind,
body and spirit.
Self care is a learned behaviour influenced
by the metaparadigm of person,
environment, health and nursing.
Three components: universal self care
needs, developmental self care needs, and
health deviation.

20. This includes activities which are essential
to health and vitality.
Eight elements identified these include: air,
water, food, elimination, activity and rest,
solitude and social interactions, prevention
of harm, and promotion of normality.

21. These include the interventions and
teachings designed to return a person to or
sustain a level of optimal health and well
being.
Examples can include such things as toilet
training a child or learning healthy eating.

22. This encompasses the variations in self care
which may occur as a result of disability,
illness, or injury.
In other words the person with a variation is
meeting self care and maintaining health
and wellness in a more individualize
meaning.

23. Every mature person has the ability to meet
self care needs, but when a person
experiences the inability to do so due to
limitations, thus exists a self care deficit.
A person benefits from nursing intervention
when a health situation inhibits their ability
to perform self care or creates a situation
where their abilities are not sufficient to
maintain own health and wellness.
Nursing action focuses on identification of
limitation/deficit and implementing
appropriate interventions to meet the needs
of person.

24. The ability of the nurse to aid the person in
meeting current and potential self care
demands.
Focused on person
Three support modalities identified in
theory including: total compensatory,
partial compensatory, and
educative/supportive compensatory.
The client’s ability for self care involvement
will determine under which support
modality they would be considered.

25. Universal
Self care
needs
Self care
abilities
Health care demands and human
ability
• The idea of balancing demands and abilities is central to
Orems model.

26. Universal
Self care
needs
Health
deviation
Self care
abilities
Health-deviation self-care
requisites
• Individual still able to meet requisites

27. Universal
Self care
needs
Health
deviation
Self care
abilities
Health-deviation self-care
requisites
• Individual unable to meet requisites

30. Nursing Systems
“ A continuing series of actions.. That are
directed to meet [the patients] therapeutic self-
care demands or to regulate their self-care
agency” Orem ( 1985)
3 Types of compensatory systems:

31. Total compensatory support encompasses
total nurse care- client unable to do for
themselves.
Partial compensatory support involves both
the nurse and the client sharing in the self
care requirements.
Educative/supportive compensatory support
elicits the help of the nurse solely as a
consultant, teacher or resource person.
Client is responsible for their own self care.
A person can fluctuate between support
modalities at any given time throughout
life.

33. The nurse’s role in helping the client to
achieve or maintain a level of optimal health
and wellness is to act as an advocate,
redirector, support person and teacher,
and to provide an environment conducive to
therapeutic development.

34. Orem’s theory of self-care is applied to
many undergraduate nursing curricula.
The nursing care plan is one example of
how her theory of self-care can be applied
to nursing process

35. Nursing Process Nursing Process Orem’s
(Assessment)
Nursing Diagnosis
Planning with logic
rational
Implementasi
Evaluasi
Diagnosis dan Preskripsi
► Menentukan mengapa diperlukan
perawatan
► Analisa dan interpretasi –
membuat perkiraan berhubungan
dengan perawatan
Desain sistem keperawatan dan
merencanakan untuk pemberian
perawatan
Produksi dan manajemen sistem
keperawatan

40. 1. Please divided into 2 groups
2. Do a presentation about self concept:
1. Group 1: self concept (definition, component of self concept,
factors affected self concept, problems of self concept)
2. Group 2: nursing care in self concept problem (assessment,
diagnose, outcome, intervention, implementation, and evaluation
based on 3S)
Just arrange
your group
freely
NB:
- Make a ppt format only
- Explain using Bahasa if u use
English in ppt, and explain
using English if u use Bahasa
in ppt