Self-Care Deficit Theory by Dorothea Orem


The selected nursing theorist is Dorothea Orem who came up with the theory of self-care deficit. Dorothea Orem was born in Baltimore, the United States of America, where she undertook and earned her nursing diploma at Providence Hospital Nursing School in Washington DC. She pursued Bachelor of Science degree in nursing at the Catholic University of America in 1939. Dorothea further advanced her studies and earned her Master of Science degree in nursing education in 1945. Professionally, Orem worked as a staff nurse, private duty nurse, nurse educator, administrator, and a nurse consultant where she acquired relevant firsthand experience in nursing practice. Moreover, due to her strong desire to advance knowledge of nursing practice, she received honorary doctoral degree awards from three education institutions, namely, Incarnate Word College, Georgetown University, and Illinois Wesleyan University. Development and incorporation of Orem’s theory to enhance nursing knowledge and care delivery took place in 1959 to1985 (Queiros, Vidinha, & Filho, 2014). Orem developed self-care deficit theory with the objective of improving the quality of hospital nursing care.

Analysis of Basic Components

The theory encompasses three major interrelated components essential in achieving improved nursing practice. The three components enable nurses to assess and identify the diverse patient needs and provide observable measures that restore the patients self-care abilities. The components include nursing agency, self-care, and self-care deficit. Self-care describes the body’s ability to conduct normal body functions in full potential to achieve the good status of development and wellness for good quality life. Queiros, Vidinha and Filho (2014) state that the body purposefully regulates its functional mechanism to achieve and maintain normal processes. The self-care concept provides nurses with an understanding of the normal body conditions essential for individual self-care ability. Self-care deficit indicates limited abilities of an individual to provide care for oneself, either on a partial level or a complete level. According to O’shaughnessy (2014), limited inner body potential limits an individual’s ability to provide own self-care. Therefore, self-care deficit is an important concept of detecting deficit on individual functional ability and enhances customized nursing services.

The aim of the nursing care is to enhance patient’s quality of life. Nurses, therefore, assess the patient self-care ability, identify the deficit, and customize the nursing care to fit the needs of the individual. Nurses agency refer to the body of trained nurses with the practical and professional knowledge to provide therapeutic self-care needs to patients through the adoption of best practices and customized patient self-care services. O’shaughnessy (2014) explains that nurses provide nursing care to enhance achievement of individual maximum self-care potential. Hence, nurses intervene to provide supportive measures to improve individual self-care.

The three components interrelate in nursing practice to promote the quality of care of a patient. Nurses working as components of nursing agency engage in assessing patients’ self-care potential and determine a suitable care specific for each patient while continually observing the patient’s recovery process to ascertain the impact of self-care. Self-care requires nursing actions that provide understanding of individual patient self-care needs and procedures to meet the patient’s care demands (Afrasiabifar, Mehri, Sadat, & Shirazi, 2016). Assessment of inner abilities enhances understanding of patients’ diverse needs for different nursing care.

Relevance of the theory

Personal Relevance of Theorist to Theory

The extensive experience of Dorothea Orem in nursing is relevant to the theory because it boosts its validity, reliability, and application in nursing. The self-care deficit theory equips nurses with the relevant knowledge required in their daily care delivery. According to Hashemi et al. (2014), self-care deficit concept is essential to nurses in examining the diverse needs of different patients depending on their innate abilities. The Self-care deficit theory provides nurses with structured steps, which identify patient needs and customizations of self-care interventions. Orem’s theory of self-care deficit is relevant to nursing as it equips nurses with a practical model of designing and developing a progressive care plan tailored to meet unique needs of patients.

Relevance to Healthcare

The three basic components of Orem’s theory enhance its relevance to health care practice. The self-care concept is essential in determining a patient’s innate ability to provide self-care for a particular health requirement. O’shaughnessy (2014) argues that self-care deficit theory acts as a structured component for assessment of patient needs and proper determination of the specific required care intervention. Self-care deficit concept is important in health care determination of patient limited innate ability to achieve the deliberate condition of maintaining a health functional status. The knowledge of the deficit informs nurses to design customized patient self-care intervention and enable patients to achieve quality services of self-care. A nursing agency then provides the trained healthcare providers who assess patient needs, determine a customized self-care for particular patients, and deliver a continued refined self-care through monitoring of patient progress to attain independent self-care. The theory, therefore, promotes self-care delivery in nursing practice through proper identification of the patient’s self-care abilities and the deficit of the individual innate ability to provide independent self-care.

Application to Research and Practice

Orem’s theory is applicable in research and nursing practice as it acts as a model of research to the diverse healthcare problems and needs. According to Gatlin and Insel (2015), Orem’s theory acts as a model that provides a conceptual framework for research and enhances understanding of nursing needs of patients. The test of the theory in health care research enhances understanding of the three major concepts that form the fundamental units of self-care delivery. In nursing practice, self-care deficit theory offers a structured approach for assessing innate abilities and determination of a tailored care intervention with continued monitoring of progress to attain independent self-care. Conclusively, self-care deficit theory acts as a conceptual structure for the advancement of healthcare knowledge through research and the delivery of quality self-care to the needy patients in nursing practice.



Orem’s theory is applicable in the entire nursing practice. The conceptual framework is relevant for practice both in research and nursing practice at all levels. The theory provides only three major concepts of self-care, self-care deficit, and nursing agency, which are testable in nursing research for improved delivery of quality self-care. The concepts are easy to understand and provide three simple intervention systems, which include supportive education and wholly and partial compensations, describing the relevant action requirements for attaining patient self-care recovery. Moreover, the theory describes the specific point of need of nursing care and the processes of self-care delivery as patient needs assessment, tailored self-care intervention, and continued monitoring of progress.


The theory fails to describe the multifaceted external effects of the nurse-patient relationship. The environmental influence on the nurse-patient relationship is fundamental in the delivery of self-care. Conducive environmental conditions enhance optimum attainment and recovery of individuals as self-care is dependent on the patient needs. Gatlin and Insel (2015) describe the external environment as the conditioning factor necessary for improved quality of life among patients. Therefore, to achieve enhanced patient quality of life requires consideration of the external factors. Additionally, the theory relies excessively on ideal healthcare model and depicts a patient’s condition to be explicitly dependent on nursing care.


Afrasiabifar, A., Mehri, Z., Sadat, S., & Shirazi, H. (2016). The effects of Orem’s self-care model on fatigue in patients with multiple sclerosis: A single blind randomized clinical trial study. Iran Red Crescent Medical Journal, 18(8), 1-8. Web.

Gatlin, P., & Insel, C. (2015). Severity of type 2 diabetes, cognitive function, and self-care. Biological Research in Nursing, 17(5), 540-548. Web.

Hashemi, F., Dolatabad, F., Yektatalab, S., Ayaz, M., Zare, N., & Mansouri, P. (2014).

Effect of Orem self-care program on the life of quality of burn patients referred to Ghotb-al-Dine-Shirazi Burn Center, Shiraz, Iran: A randomized control trial. International Journal of Community Based Nursing and Midwifery, 2(1), 40-50.

O’shaughnessy, M. (2014). Application of Dorothea Orem’s theory of self-care to the elderly patient on peritoneal dialysis. Nephrology Nursing Journal, 41(5), 495-498.

Queiros, P., Vidinha, T., & Filho, A. (2014). Self-care: Orem’s theoretical contribution of the nursing discipline and profession. Reference Journal of Nursing, 4(3), 157-173. Web.

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