Dorothea Orem: Self-Care Deficit Theory

Dorothea Orem: Self-Care Deficit Theory of Nursing

Credentials and Background

Dorothea Elizabeth Orem was born in 1914 in Baltimore, Maryland. She graduated Seton High School in Baltimore in 1931and graduated from the Providence Hospital School of Nursing in Washington, D.C in 1934. Orem continued her education at the Catholic University of America to earn her bachelors in Nursing Education in 1939, and a Masters in Nursing Education in 1945 (Medical Archives, 2018).

Orem’s nursing career consisted of a variety of titles, positions, and facilities. She gained experience in various departments such as pediatrics, adult medical-surgical units, emergency departments, operating rooms and private duties. After earning her advanced degrees,

More specifically, the person is under nursing care with potential certain limitations and a variable degree of self-care. Additionally, Orem and Taylor (2011) mention four concepts directly related to the major concept of person, consisting of self-care agent, self-care agency, self-care limitations, and the self as self-care agent (p. 39). According to Masters (2015), self-care agency is a learned behavior with the goal to control one’s own development and daily activities necessary to meet personal needs. Self-care agency contains three parts. The first fragment includes the “operational capabilities for persons’ deliberate engagement in self care”, the second requires the identification of capabilities a person needs to engage in self care, and the third one includes the understanding of “the foundational capabilities and dispositions needed for the engagement in any and all forms of deliberate action (Orem & Taylor, 2011, p. 39). Additionally, Orem and Taylor (2011) mention basic conditioning factors affecting personal and environmental aspects. According to Orem and Taylor (2011), the factors include demographics like age, gender, developmental and health state, sociocultural orientation, family system factors, patterns of living, environmental factors, and resource availability and adequacy (p.

154). Orem’s self-care deficit theory is applicable to nursing today as it encompasses the modern holistic view of patient care (Masters, 2015). An example of modern day nursing practice utilizing Orem’s theory is with renal patients. With an ever-increasing elderly population, renal care is one of the prominent current nursing focused issues (O’Shaughnessy, 2014). O’Shaughnessy, 2014, wrote a continuing nursing education article on the importance of Orem’s theory in relation to elderly patients performing peritoneal dialysis. The examination was of elderly patient’s self-care abilities and the success of nursing staff allowing patients to do as much individual care as possible. “Orem’s theory postulates that people have a natural ability for self-care, and nursing should focus on identifying these deficit areas” (O’Shaughnessy, 2014, p. 496). The argument proposed is that peritoneal dialysis at home allows the elderly patient to maintain life closer to their previous life pre-dialysis. In order for the patients to be successful with their home peritoneal dialysis nurses have to assess the gaps in care that need to be addressed. The gaps in self-care can be corrected through education, demonstration, teach-back, and evaluation of meeting expected outcomes (O’Shaughnessy, 2014). This example