1. Presented by Melissa Kurek, Nicholas Kurek, Kimberly Marino and Heather Nowak Dorothea Orem’s Theory of Self Care Deficit

2. Born in Baltimore, Maryland in 1914

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

4. 1930- graduated from 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 Illinois Wesleyan 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
Worked for the Office of Education, in the U.S. Dept. of Health, Education and Welfare as a curriculum consultant
Guidelines for Developing Curricula for the Education of Practical Nurses was developed ( Tomey and Alligood, 2006).
cont’d

9. Published Nursing: Concepts of Practice
Evolution continued
Eventually served as the acting dean of the School of Nursing at the Catholic University of America
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 are encompassed in Environment:
Physical
Chemical
Biological
Socioeconomical

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

15. Environment-Chemical
Pollutants:
Air
Water
Physical
Lead paints
Mercury
Asbestos

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

17. Environment-Socioeconomic
Family income
Education level
Occupation
Social status
Resources

18. Metaparadigm: Nursing
The skilled professional who evaluates and acknowledges a patient’s health deficit.
Nursing plans and implements care based on the actual and potential self-care deficits.
Task Performance
Self-Care Promotion
Demographics
Supportive
Coordinated

19. Concepts Unique to Orem’s Model
Three Nursing Theories
The Theory of Self Care
The Theory of Self- Care Deficit
The Theory of Nursing Systems

20. 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, p.269).

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

22. 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

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

24. Developmental Self-Care Requisites
Composed of 3 needs
Promote development
Engage in self-development
Preventing or overcoming adverse human conditions and life situations

25. Health Deviation Self-Care Requisites
When a condition permanently or temporarily alters structural, physiological or psychological function.
Comatose states
Autism
Mental Retardation

26. 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.

27. Clinical Practice Models for Patient Assessment
Theory applied in order to:
Theory applies to multiple clinical settings.
Home
By the patient alone or with assistance provided
Doctor’s office
Education provided and care supervised by a nurse
Hospital
Needs identified, assessed and plan of care implemented
Extended care facility
Help identify the patient’s ability for self-care deficits that need to be addressed to promote health.
Help identify support available to patient such as family and environment.
Encourage patient to develop self-care abilities

28. 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.

29. 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

30. Orem’s Strengths The Self Care Deficit Theory is specific to nursing.
The Theory 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.

31. 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

32. 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

34. References
Marrier Tomey, 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’s Theory of Self Care. Retrieved from ces/DorotheaOremTheory.ppt Dorothea Orem, Nursing Theory ( 2009, November 7). Retrieved from

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