Orem’s Self-Care Deficit Nursing Theory

1. Orem’s Self-Care Deficit Nursing Theory

2. Orem’s Self-Care Deficit Nursing Theory (SCDNT) • Original Source • Impetus was to define content for practical nursing curricula for Department of Health, Education, and Welfare • References Parson’s structure of social action and von Bertalanfy’s system theory • Ontology • moderate realism • Focus • person as agent Source: McEwen & Wills (2007)

3. SCDNT Paradigmatic Origins Needs Theory (Henderson, 1966) Functional Theory (Abdellah, Beland, Martin, & Matheney, 1961) Uniqueness of Orem’s theory – individual is capable of engaging in own self-care Source: Meleis(1997)

4. SCDNT Overview • Composed of 3 nested theories: • Self-care • Self-care deficit • Nursing systems • Relationship between the 3 theories: • “The theory nursing systems subsumes the theory of self-care deficit, which subsumes the theory of self-care” (Orem, 1991, p. 66)

5. SCDNT Overview • Based on 4 concepts • Self-care • Activities an individual performs independently throughout life to promote & maintain well-being • Self-care agency • Individual’s ability to perform self-care activities • Self-care requisites • Measures or actions to provide self-care • Therapeutic self-care demand • Self-care activities required to meet self-care requisites Source: Berman, Snyder, Kozier & Erb (2008)

6. SCDNT Overview • Self-care deficit results when the self-care agency can not meet self-care demands • Explains when nursing care is needed • Explains how people can be assisted through 5 methods of helping: • Acting or doing for • Guiding • Teaching • Supporting • Providing an environment to promote the person’s abilities to meet current & future demands

7. Orem’s 3 Types of Nursing Systems • Wholly compensatory • Required when one cannot control/monitor their environment • Nurse accomplishes patient’s therapeutic self-care • Partly compensatory • Required when one is unable to perform some but not all self-care activities • Nurse and patient work together to meet patient’s self-care needs • Supportive-educative • Required when one needs to learn to perform self-care activities & needs assistance to do so • Patient provides necessary self-care and nurse supports/educates client in development of self-care agency Sources: Berman, Snyder, Kozier & Erb (2008) Meleis (1997)