Dorothea Orem: Self-Care Deficit
Theory
Dorothea Elizabeth Orem (July 15, 1914 – June 22, 2007) was one of America’s
foremost nursing theorists who developed the Self-Care Deficit Nursing
Theory, also known as the Orem Model of Nursing.
Her theory defined Nursing as “The act of assisting others in the provision and
management of self-care to maintain or improve human functioning at the home
level of effectiveness.” It focuses on each individual’s ability to perform self-care,
defined as “the practice of activities that individuals initiate and perform on their
own behalf in maintaining life, health, and well-being.”
Major Concepts of the Self-Care Deficit Theory
In this section are the definitions of the major concepts of Dorothea Orem’s Self-
Care Deficit Theory:
Nursing
Nursing is an art through which the practitioner of nursing gives specialized
assistance to persons with disabilities, making more than ordinary assistance
necessary to meet self-care needs. The nurse also intelligently participates in the
medical care the individual receives from the physician.
Humans
Humans are defined as “men, women, and children cared for either singly or as
social units” and are the “material object” of nurses and others who provide
direct care.
Environment
The environment has physical, chemical, and biological features. It includes the
family, culture, and community.
Health
Health is “being structurally and functionally whole or sound.” Also, health is a
state that encompasses both the health of individuals and groups, and human
health is the ability to reflect on oneself, symbolize experience, and communicate
with others.
Self-Care
Self-care is the performance or practice of activities that individuals initiate and
perform on their own behalf to maintain life, health, and well-being.
Strengths
A major strength of Dorothea Orem’s theory is that it is applicable
for nursing by the beginning practitioner and the advanced
clinicians.
Orem’s theory provides a comprehensive basis for nursing practice. It
has utility for professional nursing in the areas of nursing practice,
nursing education, and administration.
The terms self-care, nursing systems, and self-care deficit are easily
understood by the beginning student nurse and can be explored in
greater depth as they gain more knowledge and experience.
She specifically defines when nursing is needed: Nursing is needed
when the individual cannot maintain continuously that amount and
quality of self-care necessary to sustain life and health, recover from
disease or injury, or cope with their effects.
Her self-care approach is contemporary with the concepts of health
promotion and health maintenance.
Three identifiable nursing systems were clearly delineated and are
easily understood.
Limitations
Orem’s theory, in general, is viewed as a single whole thing, while
Orem defines a system as a single whole thing.
Orem’s theory is simple yet complex. The use of self-care in
multitudes of terms, such as self-care agency, self-care demand, self-
care deficit, self-care requisites, and universal self-care, can be very
confusing to the reader.
Orem’s definition of health was confined to three static conditions,
which she refers to as a “concrete nursing system,” which connotes
rigidity.
Throughout her work, there is a limited acknowledgment of the
individual’s emotional needs.
Health is often viewed as dynamic and ever-changing.
Wellness Model
The Healthy Campus Initiative has adopted an eight-dimension model of wellness
to illustrate the interconnectedness of the many aspects of living and how,
together, they contribute to a healthy existence. The National Wellness Institute
notes that applying a wellness approach can be useful in nearly every human
endeavor as a pathway to optimal living. The eight dimensions of the wellness
model are: emotional, environmental, financial, intellectual, occupational, physical,
social and spiritual. Consistent consideration and use of this model helps
streamline intervention efforts and evaluative measures.
HIGH LEVEL WELLNESS MODEL:
h
By Dunn (1961): this model recognizes health as an ongoing process towa person's highest potential of
functioning. This process involves the person f and the community. He describes high-level wellness as"
the experience of person alive with the glow of good health, alive to the tips of their fingers wit energy
to burn, tingling with vitality at times like this the world is a glorious The wellness-illness continuum
(Travis and Ryan 1988) is a visual comp hea
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high-level wellness and traditional medicine's view of wellness
High level wellness according to Ardell (1977) is a lifestyle focused appr which you design for the
purpose of pursuing the highest level of health your capability.
