Dorothea Orem’s Deficit of Care Theory


Patient education and awareness are crucial to the successful delivery of healthcare services. As long as a target demographic is capable of identifying a health threat and managing available resources, the possibility of complications or a rise in mortality rates drops significantly (Pelicand, Fournier, Le Rhun, & Aujoulat, 2015). The promotion of patient education, however, became possible only with the introduction of Dorothea Orem’s theory into the realm of nursing (Pelicand et al., 2015). Suggesting that patients should be educated about healthcare concerns and given enough independence to determine the presence of a threat and avoiding it, Orem’s Theory of Self-Care deficit allows determining the levels of awareness among patients and, thus, preventing further spread of a particular disease.

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Orem’s theoretic framework is composed of three key concepts, which are represented by three minor theories. The Theory of Self-Care implies that there are several universal principles, which people must follow in order to maintain good health. Known as the universal self-care requisites, the identified postulates set expectations for patients regarding their ability to define basic threats to their health and perform standard procedures for maintaining health (Pelicand et al., 2015). As a result, specific standards are set for patients to meet. The theory of Self-Care Deficit allows determining the presence of a gap in a patient’s knowledge, whereas the Theory of Nursing Systems unifies the previous two into a single entity. Each of the components complements the other two, thus, encouraging a nurse to educate patients about health issues.


Dorothea Orem’s Theory of Self-Care Deficit emerged during the time when patients were provided with little to no agency in managing their conditions. The lack of awareness regarding specific health issues was glaring among regular patients at the time, which led to numerous negative outcomes. The described deplorable situation convinced Dorothea Orem that changes had to be made to the very framework of delivering nursing services to patients. Thus, the creation of the Self-Deficit Theory was sparked.

While the change that Orem’s theory has caused in the nursing realm might seem minor, it, in fact, manifested a massive shift in the nursing care paradigm. Particularly, the significance of a patient’s participation and, therefore, a patient’s role in the nursing process have been acknowledged. As a result, the promotion of a patient-centered approach and the increase in the importance of a patient’s role became a possibility.

Orem also used several approaches to developing her theory, including a patient-centered one and the one focusing on patient-nurse communication. The specified method of theory design helped to improve the quality of the car significantly since it allowed preventing instances of miscommunication and misunderstandings between a nurse and a patient (Pelicand et al., 2015). Moreover, the foundation for a multicultural approach was built.

Because of the focus on patient education and a patient’s participation in the management of a disease or a disorder, Orem’s theory contributes to predicting outcomes with greater precision. As long as the nurse-patient communication remains consistent, a nurse can control the treatment process and, thus, understand possible outcomes better. For example, the theory can be deployed in the setting where patients suffer from STIs and need the education to prevent the contraction thereof. With the implementation of the theory, patients will develop an improved behavior that will help them prevent instances of STIs contraction.


The theory is extraordinarily useful in practice since it serves as the basis for improving the quality of patient-nurse communication. Furthermore, the framework encourages the acquisition of information and skills by nurses due to a high rate of diversity among patients. Therefore, the theory can be considered very practical and helpful for nurses. In addition to enhancing communication, it also provides an opportunity to predict outcomes and improve them significantly. Particularly, Orem’s theory helps avoid the scenarios in which the symptoms of a disease or a disorder are ignored until a patient develops a serious complication. Instead, the framework helps to locate a problem at the earliest stages of development. For example, in a case study conducted by Chang and Lo (2018), the framework is used to manage patient-related information and improving the communication process more effectively. According to the case study details, trans-institutional cooperation and interdisciplinary communication provide additional opportunities for patient education (Chang & Lo, 2018).

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The theory is testable since it can be easily applied to any healthcare setting. Furthermore, the framework can be deployed within a community to ensure a rise in patient education levels. Orem’s Self-Care Deficit Theory has generated further research, leading to the creation of multiple studies. Although the actual number of articles using the theory as the basis is difficult to calculate, the online search returns around 64,000 results. For instance, Didissen, Binay, and Yardimci (2017) use the theoretical framework designed by Orem to address the spread of pneumonia. The statements concerning patient education function as propositions.


Orem’s Self-Care Theory is comprehensive and specific since it allows encompassing the concept of nursing as a whole with the help of its Theory of Nursing Systems, at the same time focusing on the subject of patient education. The theory is general enough to be applied to any healthcare setting. Orem’s Self-Care framework helps to address the needs of patients belonging to any social or cultural background, which is an obvious strength. However, the Self-Care Theory does not allow addressing all aspects of care, which limits the range of its applicability. In my own advanced practice, I would use Orem’s theory to ensure that the quality of nurse-patient communication remains consistent.


Chung, F. I., & Lo, C. L. (2018). Service-Oriented Architecture Application in Long-Term Care Institution: A Case Study on an Information System Project Based on the Whole Person Concept in Taiwan. International Journal of Computing Sciences Research, 1(3), 17-37. Web.

Didisen, N. A., Binay, S., & Yardimci, F. (2017). Orem’s Self-care Deficit Theory and nursing care in relation to pneumonia: A case report. Studies on Ethno-Medicine, 11(4), 311-317. Web.

Pelicand, J., Fournier, C., Le Rhun, A., & Aujoulat, I. (2015). Self‐care support in paediatric patients with type 1 diabetes: bridging the gap between patient education and health promotion? A review. Health Expectations, 18(3), 303-311. Web.

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