Self- Care

Deficit Theory
Orem's Self-Care Deficit Theory of Nursing is a grand theory, which is comprised of three interrelated theories: 1) the theory of self-care, (2) the self-care deficit theory, and (3) the theory of nursing systems. Incorporated within these three theories are six central concepts and one peripheral concept. Having a thorough understanding of these central concepts of self-care, self-care agency, therapeutic self-care demand, selfcare deficit, nursing agency, and nursing system, as well as the peripheral concept of basic conditioning factors, is essential to understanding her general theory (George, 1995, p. 100)

In our case study we chose this theory, because Patient X is already in adulthood phase and he is preoccupied with certain illness that lead him to be dependent in other people. Self care deficit theory is related to Patient X situation. Orems Self care deficit theory explains not only when nursing is needed but also how people can be assisted through five methods of helping, acting, or doing for , guiding, teaching supporting and providing an environment that promotes the individuals abilities to meet current and future demands. Orems applicable in assisting elderly person since they are dependent and incapable of doing their activity of daily living. To provide a more clear understanding to the self-care theory, Orem believed that human's has the ability or power to engage in self-care, this concept is know as Self-care agency. The individual's ability to engage in self-care is affected by basic conditioning factors namely age, gender, developmental state, health state, sociocultural orientation, family system factors,... resource adequacy and availability (George, 1995). According to Orem, basic conditioning factors are conditions or events in a time-place matrix that affect the value of person's ability to care for themselves. It is important to note that the influence of the basic conditioning factors on the self-care agency is not assumed to be operative at all times (Parker, 2005, p.150). Within the theory of self-care, Orem identified three categories of self-care requisites: universal self-care requisites, developmental self-care requisites, and health-deviation self-care requisites. Universal self-care requisites are common to all human beings and include physiological and social interaction needs. For example, the sufficient intake of water, air, food and the maintenance of balance in all area of one's life. Developmental self-care requisites are the needs that arise as the individual grows and develops. This is has to do with more specific events in an individual's life, e.g. adjusting to the loss of a job, or adjusting to the birth of a newborn. Health-deviation self-care requisites result from the needs produced by disease or illness (DeLaune, Ladner 2002, p. 34). The theory of self-care deficit is the core of Orem's grand theory of nursing because it delineates when nursing is needed. Nursing is required when an adult (or in the case of a dependent, the parent or guardian) is incapable of or limited in the provision of continuous effective self-care (George 1995). The term "deficit" refers to a particular relationship between self-care agency and self-care demand that is said to exist when capabilities for engaging in self-care are less than the demand for self-care

(Parker, 2005, p. 149).