Overview of Dorothea Orem’s Self-Care Theory for Nurses
At its core, Dorothea Orem’s self-care theory proposes that patients have the innate ability and responsibility to care for themselves. A nurse’s role goes beyond tending to patients’ physical needs; it involves supporting them on their journey to regain independence. This approach not only meets patients’ immediate needs but also helps them restore their confidence and well-being.
Interested in empowering your patients to foster inner strength and healing? Delve into Orem’s self-care deficit nursing theory and uncover actionable strategies to boost your nursing practice.
Dorothea Orem. Source: Chesney Archives.
What Is Orem’s Self-Care Theory?
Orem’s self-care nursing theory proposes that caring for oneself is essential for maintaining optimal health and well-being. While self-care includes basic tasks like hygiene and nutrition, Orem expands this concept to include activities that not only help us stay alive, but also nurture our sense of overall well-being.
Wondering about the famous nurse behind the theory? Self-care deficit theory was created by Dorothea Orem (1914–2007). After earning her nursing diploma from the Providence Hospital School of Nursing, she later earned her master’s of science in nursing from the Catholic University of America.
Orem started her career in clinical care and later transitioned into teaching and administrative roles. She has authored several influential books, including Nursing: Concepts of Practice, which has had a profound impact on nursing education and practice worldwide.
Orem’s Self-Care Theory Explained
Central to Orem’s theory of self-care are three interrelated concepts: self-care requisites, self-care deficits, and nursing systems.
There are two more important terms in Orem’s theory — self-care agent and self-care agency. A self-care agent is an individual capable of performing self-care activities, while self-care agency refers to a person’s ability and willingness to engage in behaviors that foster their physical and mental well-being.
Let’s take a deeper look at the three concepts that make up Orem’s theory.
1. Self-Care Requisites
Self-care requisites are the essential needs that people must meet to stay alive and build a meaningful life. Orem categorizes these requisites into three groups:
- Universal self-care requisites: Fundamental needs that are universal to all people, such as air and water.
- Developmental self-care requisites: Specialized needs to maintain a sense of well-being, such as a safe environment and the ability to pursue personal goals and maintain a sense of purpose in life. This requisite is also tied to different life stages or developmental milestones, such as those related to aging.
- Health deviation self-care requisites: Needs that arise when a person’s health deviates from the norm, such as managing symptoms of illness or injury.
2. Self-Care Deficits
According to Dorothea Orem’s self-care theory, self-care deficit refers to situations where people are unable to meet their self-care needs adequately. This inability may arise due to illnesses, physical limitations, cognitive issues, or situational constraints.
When a person is dealing with a self-care deficit, they need external help, such as registered nurses, nurse practitioners, and other healthcare professionals, depending on the situation they are facing.
3. Nursing Systems
Nursing systems are the strategies nurses use to assist patients in meeting their self-care needs when they are unable to do so independently. These systems are designed to provide varying levels of support based on the patient’s capabilities and specific needs. There are three main types of nursing systems:
- Wholly compensatory system: This system is used when patients are unable to perform any aspect of self-care on their own. In this case, nurses take full responsibility for meeting the patient’s needs and performing tasks such as bathing, feeding, and medication administration.
- Partially compensatory system: This system is used when patients are capable of performing some self-care activities but need help with others. In this case, nurses provide partial assistance to ensure all patient’s needs are met, balancing autonomy with support.
- Supportive-educative system: This system focuses on empowering patients to become self-reliant in meeting their self-care needs. Here, nurses provide education, guidance, and emotional support to help patients build the skills necessary for effective self-care management.
Orem’s Self-Care Theory in Practice
Now, you may be wondering how to apply Orem’s theory of self-care in your workplace. Let’s take a look at the examples of Orem’s theory in nursing practice.
- Nurses in neurological settings can guide post-stroke patients through exercises to regain independence in activities of daily living, such as dressing and grooming.
- Nurses working in home health care settings can assess clients’ self-care abilities and develop personalized care plans that empower them to perform certain tasks independently by using assistive devices if needed.
- Nurses working in psychiatric facilities can teach patients coping skills and self-management strategies to enhance their mental well-being and promote recovery.
- Nurses working in labor and delivery units can prepare expectant mothers for childbirth and parenting.
- Nurses in long-term care facilities can promote residents’ autonomy and self-care abilities, while also providing necessary assistance to meet their needs for activities such as bathing, toileting, and mobility.
Orem’s Self-Care Theory: Frequently Asked Questions
What are universal self-care requisites in Orem’s theory?
Universal self-care requisites in Orem’s theory are basic needs that every individual must fulfill to maintain their health and well-being. They are essential for sustaining life and health. They include the following:
- Air
- Water
- Food
- Elimination
- Activity and rest
- Solitude and social interaction
- Hazard prevention
Can Orem’s theory be applied to different populations?
Yes, Orem’s theory can be applied to different patient populations across various age groups, including pediatric and geriatric patients. It also can be applied to people of all cultures. Its flexible framework allows for adaptation to the unique needs and circumstances of diverse individuals.
What research evidence supports the effectiveness of the theory?
Research studies have applied Orem’s self-care theory conceptual framework to explore its effectiveness. Studies consistently show positive outcomes in patient self-care abilities, health promotion, and disease management when interventions based on Orem’s theory are applied. Moreover, research findings show improvements in patient autonomy, self-efficacy, and overall well-being.
What is the difference between self-care agency and self-care requisites?
Self-care agency refers to a person’s ability and willingness to engage in self-care activities, while self-care requisites are the specific requirements for health maintenance. In other words, self-care agency is about a person’s capabilities, while self-care requisites are the things they need to do to stay healthy.
What are the limitations or criticisms of Orem’s theory?
Some critics argue that Orem’s theory neglects to consider the dynamic nature of healthcare. Additionally, some literature suggests that Orem’s presentation of the nursing system implies three static conditions of health, rather than recognizing its evolving nature.
What role do soft skills play in Orem’s theory?
In this theory, soft skills such as empathy, active listening, and compassion are key to understanding patients’ self-care needs. These skills help build therapeutic relationships, enabling care that’s not only clinically effective but also empathetic and patient-centered.
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