History of Self Care Deficit Theory - Dorothea Elizabeth Orem

Self Care Deficit Theory - Dorothea Elizabeth Orem

Dorothe Orem was born in Baltimore, Maryland in 1914. Dorothe Orem attended Seton High School in Baltimore, and graduated in 1931. She received a diploma from the Providence Hospital School of Nursing in Washington, D.C. in 1934 and went on to the Catholic University of America to earn a B.S. in Nursing Education in 1939, and an M.S. in Nursing Education in 1945.

Dorothea Orem was a nursing theorist and creator of the self-care deficit nursing theory, also known as the Orem model of nursing.

She studied Diploma in Nursing in early 1930’s at the Providence Hospital School og Nursing In Washington D.C.,

In 139 and 1945 she finished B.S. Nursing Education ( BSN Ed.) and MSN Ed successively in Catholic University of America, Washington D.C.

1976 She become Honorary Doctorates: Doctors of Science from Georgetown University and Incarnate word college in San Antonio in Texas in 1980.

In 1988 she finished Doctor of Humane Letters from Illinois Wesleyan University in Bloomington, Illinois.
1988 She Graduated from University of Missouri in Columbia, Doctor Honoris Causae.

In 1971 Orem published Nursing: Concepts of Practice, the work in which she outlines her theory of nursing, the Self-care Deficit Theory of Nursing. The success of this work and the theory it presents established Orem as a leading theorist of nursing practice and education.

A Glimpse of Orem’s Accomplishments and Contributions:
  • Dorothea Orem as a member of a curriculum subcommittee at Catholic University recognized the need to continue in developing a conceptualization of nursing.
  • Orem’s Nursing: Concept of Practice was first published in 1971 and subsequently in 1980, 1985, 1991, 1995, and 2001.
  • Nursing: Concepts of Practice was the original publication of the conceptual framework (Orem, 1971)
  • 1949-1957 Orem worked for the Division of Hospital and Institutional Services of the Indiana State Board of Health. Her objective was to improve the quality of nursing in general hospitals and she was able develop the definition of nursing by this time
  • 1958-1960 she help publish "Guidelines for Developing Curricula for the Education of Practical Nurses" in 1959.
  • Washington D.C. in 1957, Orem further developed her ideas, first as a consultant in the Office of Education where her task was to improve the nursing component of a vocational nursing curriculum.
  • Orem’s ideas were further formalized after her participation in the Nursing Development Conference Group (NDCG), the two were committed to the development of structured nursing knowledge and to nursing as a practice discipline” (Hartweg, 1995)
  • Continues to develop her theory after her retirement in 1984
  • Dr. Orem continues to be active in theory development. She completed the 6th edition of Nursing: Concepts of Practice, published by Mosby in January 2001.

  • Self-care: which is the practice of activities that an individual initiates and performs on his or her own behalf to maintain life, health, and well-being.
  • Self-care agency: which is a human ability that is "the ability for engaging in self-care," conditioned by age, developmental state, life experience, socio-cultural orientation, health, and available resources.
  • Therapeutic self-care demand: which is the total self-care actions to be performed over a specific duration to meet self-care requisites by using valid methods and related sets of operations and actions.
  • Self-care requisites: which include the categories of universal, developmental, and health deviation self-care requisites.


1. Universal self care requisites

Associated with life processes and the maintenance of the integrity of human structure and functioning
Common to all , ADL
Identifies these requisites as:
  • Maintenance of sufficient intake of air ,water, food
  • Provision of care assoc with elimination process
  • Balance between activity and rest, between solitude and social interaction
  • Prevention of hazards to human life well being and
  • Promotion of human functioning

2. Developmental self care requisites

Associated with developmental processes/ derived from a condition…. Or associated with an event
  • E.g. adjusting to a new job
  • adjusting to body changes

3. Health deviation self care

Required in conditions of illness, injury, or disease .these include:--
Seeking and securing appropriate medical assistance
Being aware of and attending to the effects and results of pathologic conditions
Effectively carrying out medically prescribed measures
Modifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health care
Learning to live with effects of pathologic conditions


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