Orem*s Self-Care Deficit Nursing Theory
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Transcript Orem*s Self-Care Deficit Nursing Theory
Orem’s Self-Care Deficit
Nursing Theory
Orem’s Self-Care Deficit Nursing
Theory (SCDNT)
Original Source
Impetus was to define content for practical nursing
curricula for Department of Health, Education, and
Welfare
References Parson’s structure of social action and von
Bertalanfy’s system theory
Ontology
moderate realism
Focus
person as agent
Source: McEwen & Wills (2007)
SCDNT Paradigmatic Origins
Needs Theory (Henderson, 1966)
Functional Theory (Abdellah, Beland, Martin, & Matheney,
1961)
Uniqueness of Orem’s theory – individual is capable of
engaging in own self-care
Orem credits reflection on own practice & others for theory
beginnings
Source: Meleis (1997)
SCDNT Overview
“Relationship between self-care agency and therapeutic
self-care demands, distinguishing self-care deficit from
dependent care” (Romeo & Devereaux, 2006)
Composed of 3 nested theories:
Self-care
Self-care deficit
Nursing systems
Relationship between the 3 theories:
“The theory nursing systems subsumes the theory of self-care
deficit, which subsumes the theory of self-care” (Orem, 1991,
p. 66)
SCDNT Overview
Based on 4 concepts
Self-care
Activities an individual performs independently throughout life to
promote & maintain well-being
Self-care agency
Individual’s ability to perform self-care activities
Self-care requisites
Measures or actions to provide self-care
Therapeutic self-care demand
Self-care activities required to meet self-care requisites
Source: Berman, Snyder, Kozier & Erb (2008)
SCDNT Overview
Self-care deficit results when the self-care agency can not
meet self-care demands
Explains when nursing care is needed
Explains how people can be assisted through 5 methods of
helping:
Acting or doing for
Guiding
Teaching
Supporting
Providing an environment to promote the person’s abilities to
meet current & future demands
Orem’s 3 Types of Nursing Systems
Wholly compensatory
Required when one cannot control/monitor their environment
Nurse accomplishes patient’s therapeutic self-care
Partly compensatory
Required when one is unable to perform some but not all self-care
activities
Nurse and patient work together to meet patient’s self-care needs
Supportive-educative
Required when one needs to learn to perform self-care activities &
needs assistance to do so
Patient provides necessary self-care and nurse supports/educates client
in development of self-care agency
Sources: Berman, Snyder, Kozier & Erb (2008)
Meleis (1997)
SCDNT and Research
Jenny, J. (1991). Self-care deficit theory and nursing
diagnosis: A test of conceptual fit. Journal of Nursing
Education, 30(5), 227-232.
Kumar, C. P. (2007). Application of Orem’s self-care
deficit theory and standardized nursing languages in a
case study of a woman with diabetes. International
Journal of Nursing Terminologies and Classifications,
18(3), 103- 110.
Moore, J. B. (1993). Predictors of children’s self-care
performance: Testing the theory of self-care deficit.
Scholarly Inquiry for Nursing Practice, 7(3), 199-212.
SCDNT Applied to Nursing Practice
Burks, K. J. (1999). A nursing practice model for chronic
illness. Rehabilitation Nursing, 24(5), 197-200.
Frey, M. A. & Fox, M. A. (1990). Assessing and teaching
self-care to youths with diabetes mellitus. Pediatric
Nursing, 16, 597-800.
Geden, E. A., Sang-Arun, I., & Taylor, S. (2001). Self-care
deficit nursing theory and the nurse practitioner’s practice.
Nursing Science Quarterly, 14(1), 29.
Harrison-Raines, K. (1993). Nursing and self-care theory
applied to utilization review: Concepts and cases. American
Journal of Medical Quality, 8(4), 197-199.
Application of SCDNT To My
Practice
As a nurse educator, I can use SCDNT to help students
identify when patients should receive help to meet
their heath care needs. In addition, this theory
identifies to what degree the client needs help. I
believe in allowing an individual to do what they can
for themselves and to support those efforts the best I
can. Finally, SCDNT identifies the concept of
educating clients, an important role of the
professional nurse.