DOROTHEA ELIZABETH OREM “Self-Care Deficit
Nursing Theory”
OREM’S GENERAL THEORY OF NURSING
Orem’s general theory of nursing in three
related parts:
 Theory of self care
 Theory of self care deficit
 Theory of nursing system
A. Theory of Self Care
This theory Includes:
Self care – practice of activities that individual
initiates and perform on their own behalf in
maintaining life , health and well being
Self care agency – is a human ability which is
"the ability for engaging in self care"
-conditioned by age
developmental state, life experience
sociocultural orientation health and
available resources
Therapeutic self care demand – "totality of self
care actions to be performed for some duration
in order to meet self care requisites by using
valid methods and related sets of operations
and actions"
Self care requisites - action directed towards
provision of self care.
3 categories of self care requisites are
 Universal self care requisites
 Associated with life processes
and the maintenance of the
integrity of human structure
and functioning
 Common to all , ADL
 Identifies these requisites as:
Maintenance of sufficient
intake of air ,water, food
Provision of care assoc with
elimination process
Balance between activity and
rest, between solitude and social
interaction
Prevention of hazards to human
life well being and
Promotion of human
functioning
 Developmental self care requisites
 Associated with developmental
processes/ derived from a
condition…. Or associated with
an event
E.g. adjusting to a new job
adjusting to body changes
 Health deviation self care requisites
 Required in conditions of
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 measures
 Modifying self concepts in
accepting oneself as being in a
particular state of health and in
specific forms of health care
 Learning to live with effects of
pathologic conditions
B. Theory of self care deficit
 Nursing is required when an adult (or in
the case of a dependent, the parent) is
incapable or limited in the provision of
continuous effective self care.
Orem identifies 5 methods of helping:
 Acting for and doing for others
 Guiding others
 Supporting another
 Providing an environment to promote
patient ability
  Teaching another

C. Theory of Nursing Systems

Describes how the patient’s self care needs will

be met by the nurse , the patient, or both

Identifies 3 classifications of nursing system to

meet the self care requisites of the patient:

 Wholly compensatory system

 Partly compensatory system
 Supportive – educative system