their human powers of agency. Thus the view of
human beings as self-care agents fits within the
view of human beings as persons. “Agent of action”
is the general term attached to persons who act de-
liberately to produce a foreseen result. Within the
frame of reference of Self-Care Deficit Nursing
Theory, persons who deliberate about and engage
in self-care are referred to as “self-care agents” and
their power to do so is named “self-care agency.”
The power of persons who are nurses and provide
nursing is named “nursing agency.”
The idea is that the specialized powers and char-
acteristic properties ofhuman beings specified in
the conceptual elements of general nursing models
and theories are necessarily understood within the
context of broader views of human beings. Orem
(1995) and the Nursing Development Conference
Group (1979) suggest five broad views of human
beings that are necessary for developing under-
standing of the conceptual constructs of Self-Care
Deficit Nursing Theory and for understanding the
interpersonal and societal aspects of nursing sys-
tems. The five views are summarized as follows:
The view of person.Individual human beings are
viewed as embodied persons with inherent
rights that become sustained public rights who
live in coexistence with other persons. A mature
human being “is at once a self and a person with
a distinctive I and me...with private, publicly
viable rights and able to possess changes and
pluralities without endangering his [or her]
constancy or unity” (Weiss, 1980, p. 128).
The view of agent.Individual human beings are
viewed as persons who can bring about condi-
tions that do not presently exist in humans or in
their environmental situations by deliberately
acting using valid means or technologies to
bring about foreseen and desired results.
The view of user of symbols.Individual human
beings are viewed as persons who use symbols
to stand for things and attach meaning to them,
to formulate and express ideas, and to com-
municate ideas and information to others
through language and other means of commu-
nication.
The view of organism.Individuals are viewed as uni-
tary living beings who grow and develop ex-
hibiting biological characteristics of Homo
sapiensduring known stages of the human life
cycle.
The view of object.Individual human beings are
viewed as having the status of object subject to
physical forces whenever they are unable to act
to protect themselves against such forces.
Inability of individuals to surmount physical
forces, such as wind or forces of gravity, can
arise from both the individual and prevailing
environmental conditions.The person view is central to and an integrating
force for understanding and using the other four
views. All other views are subsumed by the person
view. The person view also is the view essential to
understanding nursing as a triad of action systems.
It is the view that nurses use (or should use) in all
interpersonal contacts with individuals under nurs-
ing care and with their family and friends.
The person-as-agent view is the essential opera-
tional view in understanding nursing. If there is
nursing, nursing agency is developed and opera-
tional. If there is self-care on the part of individu-
als, self-care agency is developed and operational.
The agent view incorporates not only discrete de-
liberate actions to achieve foreseen results and the
structure of processes to do so, but also the powers
and capabilities of persons who are the agents or
actors. The internal structure, the constitution, and
the nature of the powers of nursing agency and self-
care agency are content elements of nursing sci-
ence. The structure of the processes of designing
and producing nursing and self-care is also nursing
science content.
The view of person as user of symbols is essen-
tial in understanding the nature of interpersonal
systems of interaction and communication be-
tween nurses and persons who seek and receive
nursing. The age and developmental state, culture,
and experiences of persons receiving nursing care
affect their use of symbols and the meaning they at-
tach to events internal and external to them. The
ability of nurses to be with and communicate effec-
tively with persons receiving care and with their
families incorporates the use of meaningful lan-
guage and other forms of communication, knowl-
edge of appropriate social-cultural practices,
and willingness to search out the meaning of
what persons receiving care are endeavoring to
communicate.
The user-of-symbol view is relevant to how
nurses communicate with other nurses and other
health-care workers. Ideally, nurses use theCHAPTER 12 Dorothea E. Orem’s Self-Care Deficit Nursing Theory 145