Orem’s Self-Care Framework/Self-Care Deficit Theory of Nursing/The Self-Care Nursing Theory/A General Theory of Nursing

Contributor: Jacqueline Fawcett
August 30, 2018

Author – Dorothea E. Orem, RN, BS, MS

Year First Published – 1971

© 2018 Jacqueline Fawcett

Major Concepts

PATIENT

  • Individual
  • Multiperson Unit

THERAPEUTIC SELF-CARE DEMAND

  • Universal Self-Care Requisites
  • Developmental Self-Care Requisites
  • Health Deviation Self-Care Requisites

SELF-CARE
SELF-CARE AGENT
DEPENDENT- CARE
DEPENDENT-CARE AGENT
SELF-CARE AGENCY

  • Development
  • Operability
  • Adequacy

DEPENDENT-CARE AGENCY
BASIC CONDITIONING FACTORS
POWER COMPONENTS

  • Self-Care Agency Power Components
  • Nursing Agency Power Components

SELF-CARE DEFICIT
DEPENDENT-CARE DEFICIT
ENVIRONMENTAL FEATURES

  • Physical, Chemical, and Biologic Features
  • Socioeconomic-Cultural Features

HEALTH STATE
WELL-BEING
NURSING AGENCY

  • Social System
  • Interpersonal System
  • Professional-Technological System

PRACTICE METHODOLOGY: PROFESSIONAL-TECHNOLOGIC OPERATIONS OF NURSING PRACTICE

  • Case Management Operations
  • Diagnostic Operations
  • Prescriptive Operations
  • Regulatory Operations: Design of Nursing Systems for Performance of Regulatory Operations
  • Wholly Compensatory Nursing System
  • Partly Compensatory Nursing System
  • Supportive-Educative Nursing System
  • Methods of Helping
  • Regulatory Operations: Planning for Regulatory Operations
  • Regulatory Operations: Production of Regulatory Care
  • Control Operations
Typology

A conceptual model of nursing

Brief Description

“Orem’s work focuses on patients’ deliberate actions to meet their own and dependent others’ therapeutic self-care demands and nurses’ deliberate actions to implement nursing systems designed to assist individuals and multiperson units who have limitations in their abilities to provide continuing and therapeutic self-care or care of dependent others. . . . The goal of nursing agency is to compensate for or overcome known or emerging health-derived or health-associated limitations of legitimate patients for self-care or dependent-care” (Fawcett, J., & DeSanto-Madeya, S. (2013). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (3rd ed., pp. 179-180). Philadelphia, PA: F. A. Davis.)

See also Orem International Society

Primary Sources

Denyes, M.J., Orem, D.E., & Bekel, G. (2001). Self-care: A foundational science. Nursing Science Quarterly, 14, 48-54.

Nursing Development Conference Group. (1973). Concept formalization in nursing: Process and product. Boston< MA: Little, Brown.

Nursing Development Conference Group. (1979). Concept formalization in nursing: Process and product (2nd ed.). Boston, MA: Little, Brown.

Orem, D.E. (1956). Hospital nursing service: An analysis. Indianapolis, IN: Division of Hospital and Institutional Services of the Indiana State Board of Health.

Orem, D.E. (1959). Guides for developing curricula for the education of practical nurses. Washington, DC: US Government Printing Office.

Orem, D.E. (1971). Nursing: Concepts of practice. New York, NY: McGraw Hill.

Orem, D.E. (1980). Nursing: Concepts of practice (2nd ed.). New York, NY: McGraw-Hill.

Orem, D.E. (1981). Nursing: A triad of action systems. In G.E. Lasker (Ed.), Applied systems and cybernetics. Vol. IV. Systems research in health care, biocybernetics and ecology (pp. 1729–1733). New York, NY: Pergamon Press.

Orem, D.E. (1983). The self care deficit theory of nursing: A general theory. In I.W. Clements & F.B. Roberts (Eds.), Family health: A theoretical approach to nursing care (pp. 205–217). New York, NY: Wiley.

Orem, D.E. (1984). Orem’s conceptual model and community health nursing. In M.K. Asay & C.C. Ossler (Eds.), Conceptual models of nursing. Applications in community health nursing. Proceedings of the Eighth Annual Community Health Nursing Conference (pp. 35–50). Chapel Hill, NC: Department of Public Health Nursing, School of Public Health, University of North Carolina.

Orem, D.E. (1985). Nursing: Concepts of practice (3rd ed.). New York, NY: McGraw-Hill.

Orem, D.E. (1987). Orem’s general theory of nursing. In R.R. Parse (Ed.), Nursing science. Major paradigms, theories, and critiques (pp. 67–89). Philadelphia, PA: Saunders.

Orem, D.E. (1990). A nursing practice theory in three parts, 1956–1989. In M.E. Parker (Ed.), Nursing theories in practice (pp. 47–60). New York, NY: National League for Nursing.

Orem, D.E. (1991). Nursing: Concepts of practice (4th ed.). St. Louis, MO: Mosby.

Orem, D.E. (1995). Nursing: Concepts of practice (5th ed.). St. Louis: Mosby.

Orem, D.E. (1997). Views of human beings specific to nursing. Nursing Science Quarterly, 10, 26–31.

Orem, D.E. (2001). Dorothea E. Orem: The self-care deficit nursing theory. In M.E. Parker (Ed.), Nursing theories and nursing practice (pp. 171-178). Philadelphia, PA: F.A. Davis.

Orem, D.E. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby.

Orem, D.E. (2004). Reflections on nursing practice science: The nature, the structure, and the foundation of nursing science. Self-Care, Dependent-Care, and Nursing, 12(3), 4-11.

Orem, D. (2004). Reflections on nursing practice science: The nature, the structure and the foundation of nursing sciences. Self-Care, Dependent-Care, and Nursing, 12, 4-11.

Orem, D.E. (2006). Part One: Dorothea E. Orem’s self-care deficit nursing theory. In M.E. Parker, Nursing theories and nursing practice (2nd ed., pp. 141-149). Philadelphia, PA: F.A. Davis.

Orem, D.E., & Parker, K.S. (Eds.) (1963). Nurse education workshop proceedings. Washington, DC: Catholic University of America.

Orem, D.E., & Taylor, S.G. (1986). Orem’s general theory of nursing. In P. Winstead Fry (Ed.), Case studies in nursing theory (pp. 37–71). New York, NY: National League for Nursing.

Orem, D.E., & Taylor, S.G. (2011). Reflections on nursing practice science: The nature, the structure, and the foundation of nursing sciences. Nursing Science Quarterly, 24, 35-41.

Orem, D.E., & Vardiman, E.M. (1995). Orem’s nursing theory and positive mental health: Practical considerations. Nursing Science Quarterly, 8, 165–173.

Renpenning, K.M., SozWiss, G.B., Denyes, M.J., Orem, D.E., & Taylor, S.G. (2011). Explication of the nature and meaning of nursing diagnosis. Nursing Science Quarterly, 24, 130-136.

Renpenning, K.M., & Taylor, S.G. (Eds.). (2003). Self-care theory in nursing: Selected papers of Dorothea Orem. New York, NY: Springer.

Taylor, S.G. (2007). Tribute to the theorists. Dorothea Orem over the years. Nursing Science Quarterly, 20, 106.

Theories Derived from Orem’s Self-Care Framework

Theory of Self-Care

Orem, D.E. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby.

Theory of Self-Care Deficit

Orem, D.E. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby.

Theory of Nursing System

Orem, D.E. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby.

General Theory of Nursing Administration

Orem, D.E. (1989). Theories and hypotheses for nursing administration. In B. Henry, M. DiVincenti, C. Arndt, & A. Marriner (Eds.), Dimensions of nursing administration. Theory, research, education and practice (pp. 55–62). Boston, MA: Blackwell Scientific.

Theory of Dependent-Care.

Arndt, M.J., & Horodynski, M.A.O. (2004). Theory of dependent-care in research with parents of toddlers: The NEAT project. Nursing Science Quarterly, 17, 345-350.

Taylor, S.G., Renpenning, K.E., Geden, E.Z., Neuman, B.M., & Hart, M.A. (2001). A theory of dependent-care: A corollary theory to Orem’s theory of self-care. Nursing Science Quarterly, 14, 39–47.

Theory of Diabetes Self-Care Management

Sousa, V.D., & Zauszniewski, J.A. (2005). Toward a theory of diabetes self-care management. Journal of Theory Construction & Testing, 9, 61-67.

Theory of Keeping Vigil Over the Patient

Schreiber, R. & MacDonald, M. (2010). Keeping vigil over the patient: A grounded theory of nurse anaesthesia practice. Journal of Advanced Nursing, 66, 552-561.

Theory of Sensing Presence and Sensing Space

Orticio, L.P. (2007). Sensing presence and sensing space: A middle-range theory of nursing. Insight: The Journal of the American Society of Ophthalmic Registered Nurses, 32(4), 7-11.

Theory of Taking Care of Oneself in a High-Risk Environment

Rew, L. (2003). A theory of taking care of oneself grounded in experiences of homeless youth. Nursing Research, 52, 234-241.

Theory of Testicular Self-Examination

Fessenden, C.C. (2003). Adoption of testicular self-examination. Dissertation Abstracts International, 63, 5157B.

Author

Dorothea E. Orem (1914-2007)

Dorothea Elizabeth Orem received her diploma in nursing from Providence Hospital School of Nursing in Washington, D.C. She earned a BS in Nursing Education (1939) and an MS in Nursing Education (1946) from Catholic University of America. She held various staff nursing, private duty nursing, and supervisor positions early in her career. She was the Director of the nursing school and the hospital department of nursing at Providence Hospital in Detroit, MI (1940-1949), and went on to work in the Division of Hospital and Institutional Services of the Indiana State Board of Health (1949-1957). She served as a curriculum consultant to the United Stated Department of Health, Education, and Welfare Office of Education (1957-1960). She held faculty and administration positions at Catholic University of America (1960-1970) and then formed her own consulting firm in 1970. Although she retired in 1984, she continued to work on refining her self-care framework alone and with colleagues. (From Berbiglia, V. A., & Banfield, B. (2010). Self-care deficit theory of nursing. In M..R. Alligood & A. M. Tomey (Eds.) Nursing theorists and their work (7th ed., pp. 265-285). St. Louis, MO: Mosby Elsevier.)