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PART TWO:

Applications

of Dorothea

Orem’s Self-

Care Deficit

Nursing

Theory

Marjorie A. Isenberg

Research

Practice

Summary

References

According to Orem (2001), it is the special focus
on human beings that distinguishes or differenti-
ates nursing from other human services. From this

point of view, the role of nursing in society is to en-

able individuals to develop and exercise their self-

care abilities to the extent that they can provide for

themselves the amount and quality of care re-

quired. According to the theory, individuals whose

requirements for self-care exceed their capabilities

for engaging in self-care are said to be experiencing

a self-care deficit. Moreover, it is the presence of an

existing or potential self-care deficit that identifies

those persons in need of nursing. Thus, Orem’s

Self-Care Deficit Nursing Theory explains when

and why nursing is required.

Orem (2001) describes the Self-Care Deficit

Nursing Theory as a general theory of nursing.

General theories of nursing are applicable across all

practice situations in which persons need nursing

care. As such, the Self-Care Deficit Nursing Theory

describes and explains the key concepts common to

all nursing practice situations (Orem, 1995). The

theory consists of four concepts about persons

under the care of nurses, two nurse-related con-

cepts, and three interrelated theories (the Theory of

Nursing Systems, the Theory of Self-Care Deficit,

and the Theory of Self-Care). Concepts in the gen-

eral theory include, self-care, self-care agency, ther-

apeutic self-care demand, self-care deficit, nursing

agency, and nursing systems. The theory describes

and explains the relationship between the capabili-

ties of individuals to engage in self-care (self-care

agency) and their requirements for self-care (thera-

peutic self-care demand). 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

thanthe demand for self-care.

The comprehensive development of the self-care

concepts enhances the usefulness of the Self-Care

Deficit Nursing Theory as a guide to nursing prac-

tice situations involving individuals across the life

span who are experiencing health or illness, and to

nurse-client situations aimed at health promotion,

health restoration, or health maintenance.

According to this theory, nurses use their spe-

cialized capabilities to create a helping system in

Nurses use their specialized capabilities to

create a helping system in situations

where persons are deemed to have an

existent or potential self-care deficit.

situations where persons are deemed to have an ex-

istent or potential self-care deficit. Decisions about

CHAPTER 12 Applications of Dorothea Orem’s Self-Care Deficit Nursing Theory 149