Running head: Theory Evaluation

Dorothea Orems Self-Care Theory

Bosede Adedire, BSN, RN
Coppin State University
Theoretical Foundations for the Practice of Nursing
Nurs 620
Dr. Johnson
January 20, 2013

Theory evaluation

Dorothea Orems self-care deficit nursing theory (SCDNT) describes concepts that
have wide adaptability in health practice situations. The theory describes useful concepts for
initiating care implementation, and views an individual as a primary advocate in their own care
towards maintaining health, and prevention of illness. Alligood & Tomey (2010) explains that
the self-care deficit nursing theory represents a general theory of nursing expressed in three
theories: self-care theory, self-care deficit theory and nursing theory (pg. 273). These concepts
are person centered and explains that individuals as independent being have a world that exist
outside of what they know, and explains how a nurse as health care professional could build on a
patients knowledge of independent self-care foster the patients independence, however such
teachings should not in any way undermine the patients position as an individual capable of
making their own decisions. That is, in essence the nurse-patient relationship should be one that
is beneficial to the patient by empowering them in the process of their own care. The theory of
self-care deficit explains the benefits of nursing services in planning care and also develops
motives for identified concepts to guide practical health care management. The primary motive
for SCDNT is to explain that an individual as an independent being is capable of achieving
maximal health with or without physical or health limitations. The theory builds on different
concepts within its framework to achieve this purpose, emphasis were placed on different
criterion to assessing healthy living and the importance of practicing healthy lifestyle. Several
concepts were developed from its theories; however, the nursing system theory embodies the
other two concepts: self-care and self-care deficit while other concepts described in the theory
can be expressed through these three theories: Nursing Theory, Self-Care Theory and Self-Care
deficit Theory.

Theory evaluation

Orems quest to find out what the subject matter of nursing was stimulated the concept
of self-care deficit theory. The concept of SCDNT originated when Orem recognized that for
nursing to advance as a field of knowledge and practice, a structured organized body of nursing
knowledge was needed(Alligood & Tomey, 2010, pg. 266) to achieve this purpose. To achieve
this purpose, Orem integrated her background as a practical nurse and her experience as
administrative personnel in nursing education curriculum development to initiate an idea for her
proposal. In the development of the theory, Orem uses different concepts and influence from
other disciplines to build her theory, the theory blossoms with more ideas gathered from Orems
discussion with other practicing nurses and her colleagues in health services. The theory emerged
from collaborative efforts of other members of Orems team, with Orem providing direction for
the theory through leadership. Orems self-care theory as a general theory embodies three cogent
theories with other concepts derived from these three major theories.
Orems Major Theories
Self-Care theory is a major component of Orems theory, the idea deals with healthful
lifestyle practices that individuals need to cultivate independently to promote well-being and to
continue to grow in their personal lives.
Self-Care deficit theory shows a persons need for assistive care when there are certain aspect
of personal care needs that the individual is unable to meet independently to continue purposive
functioning.
Nursing Systems theory is an idea developed to promote nurse-patient collaboration by
involving the patient in their own care so as to foster patients self-development and
empowerment to promote continued development of self (Alligoog & Tomey, pg. 269).

Theory evaluation

Main Concepts in Model

Dependent Care is care provided to a person that is not able to provide independent selfcare due to any form of limitations.
Concept of self-care requisite builds and identifies the criterion that needs to be met for an
individual to be seen as being able to achieve optimal self-care without assistance.
Universal Self-Care Requisite concept is applicable to individuals that are dependent for
self-care and those that are independent. The goal of this concept (as cited by Alligood & Tomey,
2010) is to establish if individuals are able to meet or achieve basic things that they need at
various stages of development, for instance, air, food, water, elimination, balance between
activities and rest, balance between solitude and social interaction, prevention of disease, and
promotion of health.
Nursing Agency comprises of developed abilities of professional nurses that empower
them to practice as nurses and to provide therapeutic nursing care to individuals that are in need
of nursing services. Helping method concept of Orems theory can be view through the Nursing
Agency concept, the two concepts are similar.
Nursing design creates a concept that guide health care provider to plan patient care for
identified nursing diagnosis and at risk situations by using practical nursing judgments about
situations to provide efficient care for effective outcome that is logical.
Basic Conditioning Factors refer to those factors that condition or affect the value of
therapeutic self-care agency of an individual at a particular time under specific circumstance:
age, gender, health state, lifestyle, resource availability, environmental factors (Alligoog &
Tomey, pg. 272).

Theory evaluation

Orems theory has a general concept that is applicable in all types of health care
services (Alligood & Tomey, 2010, p. 262). The theory is applicable in practice for patient
empowerment and care implementation. The ability to adapt the concept of the nursing systems
to practice foster nurse-patient collaboration by involving the patient in their own care as much
as possible to encourage a positive care outcome and promote patient compliance. The concept
of nursing systems makes the patient their own advocate in their care which invariably boost the
patients ego and self-worth that leads towards continuing patient personal development.
Similarly, the concept of nursing design from Orems theory can be adapted to refine nursing
practice and care delivery. The ability of health care professionals to be able to apply practical
judgment in patient care process assist to create pertinent nursing diagnosis that puts into
consideration at risk diagnosis of patient situation to manage known conditions and to prevent
undesirable change or untoward progression of patients status.
Likewise, Orems theory can be used in research to select study sample by using Orems
basic conditioning factors or universal self-care requisite concepts. These concepts can assist
researchers to make selections from their target population by using criteria listed for Orems
concepts, for instance, classifying population by age, economic stability, resource availability
and more. These concepts can be used in and outside of nursing field and can be used to guide
research and to direct the study. Further use of the concept in research would be to define
different concepts relevant to health care services. The concepts can give a reason or provide a
basis for a research study to refine nursing practice. Orems theory can be used to explain the
reason for a research study to find out if practice is in line with what theory states.
Moreover, Orems theory can be used in education to prepare nursing school curriculum
and also to prepare prospective nurses as leaders in their field. The concept of nursing design can

Theory evaluation

be adapted to teach nursing students about critical thinking and nursing judgment in real life
practice. The concept of nursing design can be adapted purposefully especially from theory
(classroom teachings) to practical use in clinical rotations to refine student thought pattern and
how to organize their reasoning when it comes to patient care. Further, this theory can be used in
continuing education classes to reinforce what is already known about the concepts of self-care
theory to improve health care quality and delivery system.
There are several research studies that have explored Orems theory to pilot their studies,
considering that the Self Care theory emphasizes patient empowerment; a research article
describes possible outcomes that could result from using this model in hemodialysis setting. The
study explores the adaptation of Orems Self Care theory in hemodialysis patients to help
promote quality of life in this population by using the strategy provided by Orems SCDNT to
maximize patient outcome through patient teachings and empowerment to build patient selfindependence. Simmons (2009) found out that healthcare specialists can foster positive
behaviors in hemodialysis patients by giving them required training and showing them
approaches that would increase self-care agency, thus improving their quality of life (para.6).
Another article used Orems theory in research to identify common nursing diagnosis in
people with diabetes mellitus to help create an organized care path towards care management.
Eighteen diagnoses from the research findings were related to Orems universal self-care
requirements. Teixeria, Zanetti & Pereira (2009) in their research study concluded that knowing
common diagnosis in diabetic patients can guide in fostering the development of independent
self-care and promote diabetic care management (para.2).

Theory evaluation

References
Alligood, M., R. & Tomey, A. (2010). Nursing theorists and their work. 7th ed.
Mosby Elsevier.
Simmons. L. (2009). Dorothea Orem's self-care theory as related to nursing practice in
hemodialysis. American Journal of Nursing 36(4):419-21.
doi: 10.1097/01.NAJ.8800422170.06154.cb
Teixeria. C., Zanetti. M., Pereira. M. (2009) Nursing diagnoses in people with diabetes mellitus
according to Orems theory of self-care. American Journal of Nursing
22 (4): 385-91