Y

M
R
E
R HEO
OT T

A
I
C
E
I
F
H
T E DE
O
R C A RG
O F- IN
D EL RS
S

BACKGROUND

Born in 1914 in Baltimore, MD

Diploma degree from Providence Hospital

School of Nursing

Earned a BSN Ed from Catholic University of

America
Held faculty positions at Catholic University of
America & Provident Hospital School of Nursing in
Detroit

Earned a MSN Ed at Catholic University

Held position of Director of Nursing Service &
Education at Provident in Detroit after receiving her
Parker & Smith, 2010
MSN Ed

INFLUENCES
Personal life experiences
Formal education
Employment experiences
Works of Aristotle, Thomas Aquinas, Harre &
Wallace

Parker & Smith, 2010

ASSUMPTIONS

People should be self-reliant & responsible for their own

care

People are individuals

Nursing is a form of action interaction between two or

more persons

Successfully meeting universal & development self-care

requisites is an important component of primary care
prevention & ill health

Persons knowledge of potential health problems is

necessary for promoting self-care behaviors

Self care & dependent care are behaviors learned within a

socio-cultural content
Current Nursing, 2011

THEORY OVERVIEW
Began developing her concept of
nursing while working as assistant
professor and dean of CUA nursing
school.
Nursing Development Conference
Group (NDCG) at CUA, all contributed
to the development of her nursing
theory.
Nursing : Concepts of Practice in 1970
Published again in 80, 85, 91, 95,
01
Tomey & Alligood, 2002

THEORY OVERVIEW
No particular nursing leader had a
direct influence in theory development
Credits her theory to all the nurses she
worked with and graduate students
she taught.
Identified her philosophical view as
that of a moderate realism

FOUNDATIONS OF SCDNT
the view of human being as dynamic,
unitary beings who exist in their
environments, who are in the process
of becoming, and who possess free-will
as well as other essential human
qualities
Tomey & Alligood, 2002

Orems Beliefs
Believed that individuals engage in
actions required for functioning in life
People Self-determine and have the
ability to grow in life
People have the capacity and right to
so
The nurse collaborates with the
patient to meet their needs

SCDNT EXPRESSED IN THREE THEORIES

Theory of self-care
Expresses the purpose, methods, and
outcome of taking care of self
Theory of self-care deficit
Demonstrates why people need nurses

Theory of nursing systems

The three theories together

constitute the Self Care Deficit
Nursing Theory

Definitions
Self Care- caring for ones self to
maintain life, health and well-being
Self-care agency- Provider to
supplement or replace self care needs
Self-care deficit- demand on the
patient is greater than the ability to
meet the demands of human
functioning

SELF-CARE

The practice of activities that maturing

and mature persons initiate and perform
within time frames, on their own behalf,
and in the interest of maintaining life
and healthful functioning and continuing
personal development and well being.
Human regulatory function that
individuals must, with deliberation,
perform themselves or have performed
for them to maintain life, health,
development, and well being.

Tomey & Alligood, 2002

Self-Care
Self care is learned and deliberate
Self care may vary in different cultures
Dependent care may occur when self
care has not been learned or is not
operable
Injury
Trauma
Denyes, Orem & Bekel, 2001

Development of Self Care

Interventions and teachings to return a
person to a level of optimal health and
well-being
Examples of this include toilet training
a child or teaching a diabetic patient
about healthy eating patterns

UNIVERSAL SELF-CARE REQUISITES

Six common requisites for men,

women, and children
1. sufficient intake of air, water and food
2. elimination
3. balance between activity and rest
4. balance between solitude and social
interaction
5. prevention of hazards to human life
6. promotion of human functioning and
development with social group in
accordance with human potential

Tomey & Alligood, 2002

SELF-CARE REQUISITES
Actions that are important to
human functioning
Factors to be controlled to keep life
within norms compatible with life and
health and person well being
The nature of the action which
expresses the intended or desired
results of the individual

THEORY OF SELF-CARE DEFICIT

People are affected by limitations that

make it difficult to meet human self care
needs
Disease
Age
Mental

These limitations deem them unable to

know the extent of regulatory care for
themselves or a dependent

AKA inability to care for self or their

dependent

Theory of Self Care Deficit

A person benefits from nursing
intervention when their state of health
inhibits their ability to provide self care
Nursing actions focused on identifying
the limitations or deficits and
implementing interventions to meet
needs of the patient

THEORY OF NURSING SYSTEMS

Nursing is human action, focused on a

person

The ability of the nurse to aid the person

to meet current and future self care
needs.

Nursing Systems are action systems

formed by nurses through the exercise of
their nursing agency for person with
health-derived or health-associated
limitations of self-care
Current Nursing, 2011

Theory of Nursing System

Nursing Agency includes concepts of
deliberate action
Intentionality and operations of diagnoses
Prescription
Regulation
3 Support Modalities identify the theory of
nursing system
Totally or whole compensatory
Partially Compensatory
Supportive/Educative compensatory

Modalities of Support
W/C wholly or totally compensatory
Nurse is to complete the care
Client unable to care for themselves
P/C- partially compensatory
Nurse and patient meet needs
Patient and nurse collaboration to meet
self care needs
S/E- Supportive/educative
Assistance with decision making, behavior
control, acquires knowledge and skills
Client is responsible for self care needs
Tomey & Alligood, 2002

SELF-CARE DEFICIT MODEL

PARSIMONY

Very easy concept to follow

Requires a smart and educated nurse
Not all nurses could identify the need for self-care
Orem did a great job of explaining her theory without the
use of several different models or diagrams
Easily applied to practice
Required very little new knowledge
Applying the nursing knowledge we all know already
Language was easy to understand
Simple concepts to follow

Implementation of Orems Theory

Can be applied to numerous different
aspects of nursing
Several Nursing Programs apply
Orems theory as the bases of their
nursing education
Easily applied to the nursing care plan

The Dreaded Nursing Care Plan

Assessment
NANDA Nursing Diagnoses
Identification of Outcomes
Nursing Intervention
Rationale
Evaluation

IMPLEMENTATION
Can be seen in nearly all facets of
nursing
Especially seen in home health,
hospice, and hospital nursing
Great teaching method for young
nurses

CONCLUSION
A very easy to follow method
Focuses on the basic care needs of the
patients
Encourages the patients to do as much work
for themselves as possible
Easily applied to nursing practice
Any nurse can easily adapt this theory into
their everyday nursing
Questions/Comments????

REFERENCES
Denyes, M. J., Orem, D. E., & Bekel, G. (2001). Self-care: a foundational
science. Nursing Science Quarterly, 14(1), 48-54. DOI:
10.1177/089431840101400113
Dorothea Orems self-care theory. (n.d.). Retrieved from http://
currentnursing.com/nursing_theory/self_care_deficit_theory.html
Parker, M. E. & Smith, M. C. (2010). Nursing theories and nursing
practice (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Tomey, A. M., & Alligood, M. R. (2002). Nursing theorist and their work.
(5 ed., pp. 189-211). St. Louis, Missouri: Mosby. Retrieved from
http://www.elsevier.com