Dorothea E. Orem's Self-Care Deficit Nursing Theory

Dorothea E. Orem's Self-Care Deficit Nursing Theory

The purpose of this paper is to inform the reader how Dorethea Orem’s nursing theory has been used in research. Orem begin developing her theory in the 1950’s, a time when most nursing conceptual models were based on other disciplines such as medicine, psychology and/or sociology (Fawcett, 2000). Orem’s theory is a three-part theory of self-care. The three theories that make up the general theory are: Self-Care, Self-Care Deficit, and Nursing Systems. The Self-Care theory states that adults deliberately learn and perform actions to direct their survival, quality of life, and well-being. Self-Care Deficit theory states that nursing is required because of the inability to perform self-care as the result of limitations. Nursing Systems theory is the product of nursing in nursing system(s) by which nurses use the nursing process to help individuals meet their self-care requisites and build their self-care or dependent-care capabilities. These three theories form the overall Self-Care Deficit Theory. (Alligood & Tomey, 2001)

Self-Care Deficit Nursing Theory (SCDNT) is an important component of nursing’s theoretical knowledge. It is a highly developed and formalized theoretical system that includes the philosophical foundation, the general theory of nursing with its constituent elements, and an expanding body of knowledge that includes empirical research. The conceptual structure of SCDNT is constituted from six core concepts (self-care, therapeutic self-care demand, self-care agency, self-care deficit, nursing agency, nursing system, and one peripheral concept -basic conditioning factors. (Taylor, Geden, Isaramalai &, Wongvatunyu, 104)

The capacity and ability of the individual to engage in self-care is termed self-care agency (SCA). The Therapeutic Self-Care Demand (TSCD) and SCA are influenced by a number of factors or variables referred to as basic conditioning factors (BCFs). The self-care system is an action system designed in response to the TSCD and is dependent on the quality of the individual’s self-care agency. (Geden & Taylor, 329)

The first article we reviewed was titled An Empirical Test of a Self-Care Model of Women’s Responses to Battering. Battering was conceptualized with Orem’s theory as a situation requiring therapeutic self-care. Based on Orem’s theory of self-care deficit a model of women’s responses to battering was constructed. This model proposes that age, education, income, and cultural orientation are BCFs that directly related to relational conflict. This conflict would be negatively related to self-care agency and indirectly related to both outcomes of health and well-being. The proposed model suggests that the degree of relational conflict experienced by a woman in a battering situation is directly related to her ability to care for herself.