1. Dorothea Orem and the Self Care Deficit Theory
Cerrianne Leatherland
NSG 463

2. Background July 15, 1914- Born in Baltimore, Maryland (Wayne, 2014)
Father was a construction worker and mother was a homemaker. Had one sister (Wayne, 2014)
June 22, Died in Savannah, Georgia. She was 92 (Wayne, 2014)

3. Education
Early 1930s- Diploma in Nursing from Providence Hospital School of Nursing in Washington, D.C. (Wayne, 2014)
1939- BS in Nursing Education from the Catholic University of America in Washington, D.C. (Wayne, 2014)
1945- MS in Nursing Education from the Catholic University of America in Washington, D.C. (Wayne, 2014)
Honorary Doctorates of Science from both Georgetown University in 1976 and Incarnate Word College in 1980
1998- Doctorate Honoris Causae from the University of Missouri in Columbia

4. Career
1959
Published her concept of self care (Black, 2014)
Orem helped publish the “Guidelines for Developing Curricula for the Education of Practical Nurses” (Wayne, 2014)
1971- published Nursing: Concepts of Practice which outlines her nursing theory. Because of this work, Orem is known as one of the leading theorists in nursing practice and education (Wayne, 2014).
1973- Chairperson of the Nursing Development Conference Group (Wayne, 2014)
1980- America Alumni Achievement Award for Nursing Theory (Wayne, 2014)
1991- Linda Richards Award from the National League for Nursing (Wayne, 2014)
1992- Honorary Fellow of the American Academy of Nursing (Wayne, 2014)
2001- Nursing: Concepts of Practice published (Black, 2014)

5. Orem’s Model
“Ordinary people in contemporary society want to be in control of their lives” (Black, 2014)
Assumption:
Normal people who live in the community want to remain as independent and in control as possible
Individuals are responsible for their own care
Formalized three Nursing theories which are interconnected into one model (Black, 2014):
Theory of self-care
Theory of self-care deficit
Theory of nursing system

6. Activities of Daily Living as Defined by Orem
Universal (Petiprin, 2015)
Sufficient intake of food, air, and water
Care related to the elimination process
Balancing activities and rest as well as social contact and seclusion
Prevention of threats to health and well-being
Promote human functioning
Developmental (Petiprin, 2015)
Self care related to stages of development
Health Deviation (Petiprin, 2015)
Learning to function with pathologic illnesses
Finding appropriate medical assistance
Fulfilling medical needs (wound care, medical equipment, etc.)
Self acceptance
Remaining educated regarding stages of illness

7. Self Care Deficit and Nursing
Self care deficit: the extent of which the patient is unable to provide adequate self care (Black, 2014)
Assess patients ability to provide self care and developing nursing interventions to meet each patient’s needs (Black, 2014)
The nurse advocates and adjusts the nursing system in regards to the patient’s individual self-care deficit (Black, 2014)

8. Diagnostic Assessment Nurse- patient relationship (Black, 2014)
Determining current and potential self-care needs (Black, 2014)
Factors: Age, gender, developmental status, environment, culture (Black, 2014)
Determine patient’s baseline ability to provide self care (Black, 2014)
Limitations in providing effective self-care are considered self care deficits (Black, 2014)

9. Prescriptive
Plan
“to use teaching as a method of assisting others, it requires that the helper know thoroughly what the person to be helped needs to know” –Dorothea Orem
Fundamentals are determined based on the patient’s deficits (Black, 2014)
Nurse-patient communication and agreement on deficits (Black, 2014)
Plan of care (methods, priorities, and actions) established with patient (Black, 2014)

10. Regulatory The nurse implements a system for care (Black, 2014)
Implementation and Evaluation
The nurse implements a system for care (Black, 2014)
Compensatory (wholly and partly)
Patients with little to no ability to provide self care (Black, 2014)
Supportive-Educative
Patients who are capable of providing adequate self care, but need additional education or further development to promote self care (Black, 2014)

11. Nurse Responsibilities
The nurse should adapt to the needs of the patient (Petiprin, 2015)
Five methods of helping (Petiprin, 2015):
Doing for
Education
Guide
Support
Providing an environment conducive for self development

12. How I Relate to this Theory

13. References
Black, B. (2014). Professional nursing: Concepts & Challenges (7 edition). St. Louis, MO: Elsevier Saunders.
Petiprin, A. (2015). Self-care deficit theory. Nursing Theory. Retrieved from: deficit-theory.php
Wayne, G. (2014). Dorothea E. Orem. Retrieved from