Post on 14-Jul-2015
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Dorothea OremWho she is and how the
theory was formulated
Dorothea Orem●One of the leading nursing theorists
●Born in Baltimore, Maryland in 1914
●Greatly involved in practice, service, and education in
nursing
●Received many honorary degrees and professional
awards
●During her professional career, her roles as a nurse
included: staff, private duty, administrator, professor,
director, and consultant
●Worked in pediatrics, emergency rooms, operating
rooms, adult medical and surgical units
Timeline
●1930s – received her diploma in nursing at Providence Hospital
in Washington, DC
●1939 – received BSN from Catholic University of America (CUA)
●1945 – received MSN from Catholic University of America (CUA)
●1976 - received honorary degree in Doctor of Science
●1986 – retired and lived in Savannah, Georgia
●2007 – passed at 92 years of age
Development of Orem’s Theory●Orem has developed her self-care deficit theory early in her
career and refined it throughout her career and retirement
●From 1949-1957, Orem worked for the Division of Hospital and
Institutional Services of the Indiana State Board of Health.
During this time, she saw a need to upgrade the nursing quality
in this state’s general hospitals. This has led her to develop her
definition of nursing practice. Her first ideas were formulated in
1956.
●In 1959, Orem then worked for CUA school of Nursing, serving
as acting dean and assistant professor of nursing education.
During this time, she continued to develop her concept of
nursing and self care.
oShe first published her nursing concept of self-care during this year.
Development of Orem’s Theory
●In 1971, Orem first published her formal
articulation of ideas in Nursing: Concepts of
Practice
●Orem continued to refine her theory in subsequent
works, which were later published in 1980, 1985,
1991, 1995, and 2001.
●In 1985, Orem introduced the three theories
associated with her self-care framework
●In 1980, she published her 1st edition. In 2001,
she published her 6th edition.
References●Masters, K. (2011). Nursing Theories: A Framework for Professional Practice.
Sudbury, MA: Jones and Bartlett Learning, LLC.
●Nursing Theories. (2011). Dorothea Orem’s Self-Care Theory. Retrieved from:
http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
●Sitzman, K. L. & Eichelberger, L.W. (2011). Understanding the Work of Nurse
Theorists: A creative beginning (2nd ed.). Sudbury, MA: Jones and Bartlett
Publishers, LLC.
Theory of Self Care
Why and how people care for
themselves; how nursing is
required to assist in performing
self-care due to patient limitations
Key Terms
Self care
Self care agency
Therapeutic self care demand
Self care requisites
Key Terms - continuedSelf careActivities that an
individual practices,
performs, or initiates on
his or her own behalf in
order to maintain life,
health and well- being
Self care agencyPerson’s ability to engage in self-care,
which is conditioned by factors:
Age
Gender
Developmental stage
Life experience
Sociocultural factors
Health
Pattern of living
Healthcare/family system
Available resources
Three categories of self-care
requisites
1.Universal
2.Developmental
3.Health deviation
1. Universal Self-care requisitesAssociated with life processes and in maintaining the integrity of human
structure and functioning
Common to everyone, includes ADLs
These requisites are:air
water
food
elimination
activity and rest
solitude and social interaction
prevention of hazards
promotion of human functioning
Key Terms - continuedTherapeutic self care
demandAll self-care actions needed at
various times in a person’s life to
meet all of an individual’s self-care
requisites
Self care requisitesGroup of actions or needs for
self care
2. Developmental self care requisitesRelated to different stages in human life cycle
i.e. college, marriage, retirement
Maturational, which are associated with developmental processes
and derived from a condition
Situational, which are associated with an event
E.g. adjusting to a new job or adjusting to body changes
Needs are:
Maintaining good health and promoting human
development/maturation
Preventing or treating illness and disease that affects human
development/maturation
3. Health deviation requisites
Needs and conditions arising from illness, injury, or disease
These include:
“Seeking and securing appropriate medical assistance
Being aware of and attending to the effects and results of pathologic
conditions
Effectively carrying out medically prescribed treatments
Being aware of and attending to side effects of treatment
Modifying self concepts in accepting oneself in a particular state of
health
Learning to live with effects of illness and medical treatment” (Orem,
1985, p. 99-100)
References
Masters, K. (2011). Nursing Theories: A framework for professional
practice. Sudbury, MA: Jones and Bartlett learning, LLC.
Nursing Theories. (2011). Dorothea Orem’s Self-Care Theory.
Retrieved from: http://currentnursing.com/nursing_theory/
self_care_deficit_theory.html
Orem, D. (1985). Nursing: Concepts of practice (3rd ed.). St. Louis,
MO: Mosby.
Sitzman, K. L. & Eichelberger, L.W. (2011). Understanding the Work
of Nurse Theorists: A creative beginning (2nd ed.). Sudbury, MA:
Jones and Bartlett Publishers, LLC.
Theory of Self Care
Deficit & Theory of
Nursing Systems
Theory of Self Care Deficit
●Self care deficit occurs when patient or
parents of dependents are unable to
meet self care requisites.
●Therefore, nursing help is needed
●Nursing care is used to help people
enhance self-care abilities needed for
survival, well-being, and quality of life
●Orem identifies 5 methods nurses use to help
patients meet their self-care deficits : (used alone
or in conjunction with another)
o“Acting for and doing for another
oGuiding and directing
oProviding physical or psychological support
oProviding and maintaining an environment that
supports personal development
oTeaching”
(Orem, 2001, as cited in Masters, 2011, p. 183)
Theory of Nursing Systems
Theory of Nursing System●Describes how the patient’s self care needs will be met
by the nurse , the patient, or both
●Nurse-designed based on assessment of individual’s
self-care needs and ability to perform self care needs
odefines nurse’s role in patient care
●3 systems nurses use to meet patient’s self- care
requisites or needs
oWholly compensatory
oPartially compensatory
oSupportive-educative
The three systems of nursing1.Wholly compensatory
oPatient is unable to perform any self-care activities;
nurse accomplishes most or all of care
2.Partially compensatory
oSelf-care activities are performed by both nurse and
patient to meet self-care requirements; nurse assists with
care
3.Supportive-educative
oPatient performs own self-care, but nurse is required for
support, education, knowledge, decision-making to
promote the patient as a self-care agent
References●Masters, K. (2011). Nursing Theories: A Framework for Professional Practice. Sudbury,
MA: Jones and Bartlett Learning, LLC.
●Nursing Theories. (2011). Dorothea Orem’s Self-Care Theory. Retrieved from:
http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
●Sitzman, K. L. & Eichelberger, L.W. (2011). Understanding the Work of Nurse
Theorists: A creative beginning (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers,
LLC.
Major Concepts of Nursing
FOUR key concepts
●Interrelated
●Person (Patient or parent of
dependent)
●Environment
●Health
●Nursing
Person●The patient whom the nurse cares for
●Capable of self care
●Possesses developmental, universal, and
health deviation needs
●A functioning whole or unity that is viewed
socially, biologically, and symbolically
Environment●Provides the context within which the person exists
●Subcomponent of the person
●Along with the person, makes an integrated system, given that the
environment affects a patient’s health needs
●Can be modified by the nurse to meet patient’s needs
●Components consist of environmental elements, conditions, factors,
and developmental environment
Health
●“ a state characterized by soundness or wholeness of developed
human structures and of bodily and mental functioning” (Orem, 1995,
p. 101)
●Dependent on environment, therefore, health definition varies
●Includes ability to achieve a level of innate potential while living within
social, biological and physical environments
Nursing●Encompasses actions by nurses used to assist patients
o to accomplish therapeutic self-care,
omove towards responsible self-care,
oor maintain care with supervision and consultation
●Helps patients maintain a state of health
●Assists the patient with disease or injury to regain normal or near
normal state of health
●Stabilizes, controls, or minimizes the effects of chronic poor
health or disability
●Goal is to provide patient or family members the necessities
needed to meet the patient’s self care needs
Terms related to Nursing●Nursing client
oPerson who has "health related /health derived limitations that render him
incapable of continuous self care or dependent care or limitations that result
in ineffective / incomplete care.” (Nursing Theories, 2011)
●Nursing problem
odeficits in health-related conditions, including universal and developmental
dimensions
●Nursing process
osystem used to determine why a person requires care, plan of care, and
implementation of care
●Nursing therapeutics
oActions that are systematic and purposeful
References●Masters, K. (2011). Nursing Theories: A Framework for Professional Practice. Sudbury,
MA: Jones and Bartlett Learning, LLC.
●Nursing Theories. (2011). Dorothea Orem’s Self-Care Theory. Retrieved from:
http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
●Orem, D. (1995). Nursing: Concepts of practice (5th ed.). St. Louis, MO: Mosby.
●Sitzman, K. L. & Eichelberger, L.W. (2011). Understanding the Work of Nurse
Theorists: A creative beginning (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers,
LLC.