Orem’s Self-Care Deficit Nursing Theory

1. Orem’s Self-Care Deficit Nursing Theory

2. 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)

3. 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)

4. 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)

5. 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)

6. 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

7. 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)

8. 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.

9. 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.

10. 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.