the extensive applications of the theory to nursing
practice. Since the pioneering efforts of Crews
(1972) and Backscheider (1974) in the use of the
theory in structuring and organizing nursing care
to patients in nurse-managed clinics, nurse scholars
have been proclaiming the usefulness of the theory
as a guide to practice. The theory has been used to
guide practice across a wide range of nursing situa-
tions in all types of care settings, ranging from
neonatal intensive care units (Tolentino, 1990)
to nursing home facilities (Anna, Christensen,
Hohon, Ord, & Wells, 1978). The theory’s relevance
to the care of patients in intensive care units
has also been examined. Jacobs (1990) concluded
that although most patients require wholly com-
pensatory systems of care, patient situations do
exist in which partly compensatory or supportive-
educative systems of care are more appropriate.
Orem-based nursing practice has been exten-
sively described in the care of patients of various
ages with all kinds of health-deviation self-care req-
uisites and developmental requisites. For example,
the theory has been applied to the long-term care
of ambulatory adolescent transplant recipients.
Nursing services based on Orem’s theory were
found to significantly enhance the quality of life of
this adolescent population (Norris, 1991). Haas
(1990) also reported on the usefulness of the Self-
Care Deficit Nursing Theory as a basis for nursing
practice aimed at meeting the care demands of chil-
dren with long-term chronic health problems.
Clearly, the extent of the documentation of this
work far exceeds the scope of this chapter. Selected
citations appear in the bibliography.
Dorothea E. Orem contended that identifica-
tion of nursing’s focus would enhance the
productivity of nurse scholars and scientists.
She set forth the premise that the Self-Care
Deficit Nursing Theory was the foundation
for developing nursing science, and then de-
scribed her views of nursing science. The
abundance of Orem-based research docu-
mented in the literature today supports the
validity of her convictions and the social util-
ity of the theory for the profession in guiding
the research and scholarship of nurses world-
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