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Dorothea Orem’s Self-Care Deficit Theory in Nursing


The contemporary society is focused on the cultivation of humanistic values, which also presupposes the gradual improvement of the state of the health of the nation. Due to this fact, nursing plays a critical role in the evolution of communities and the increase in the quality of people’s lives. This fact results in the increased attention to the nursing theory as one of the potent tools to assist patients in their recovery and meet the diversified requirements of all people who might need medical assistance and care. At the same time, the sphere has entered the stage of its rapid development due to the extensive use of innovative technologies.

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It results in the emergence of new ways to perform traditional tasks and improve the quality of care. However, the issues that have been topical for decades also remain relevant. For this reason, it is critical to achieving an improved understanding of the nursing theory as one of the necessities to align the connection between the past and the future.


The given paper revolves around Orem’s self-care deficit theory as one of the pillars of modern nursing. It rests on the central idea that an individual is an independent and powerful creature that possesses the ability to adapt to any environment if there is a critical need for it (Orem, 2001).

The main reason Dorothea Orem introduced her theory was the desire to improve the quality of nursing in hospitals. In such a way, she offered a simple though effective paradigm assuming that there should be another perspective on the provision of care to patients that is focused on the necessity to create conditions beneficial for the emergence of the interest for self-care and engagement in similar activities that can help to avoid further complications and attain significant success (Orem, 2011). The importance of the given theory can be evidenced by the fact that it remains relevant to modern nursing and numerous specialists take it as the guide for their actions.

It can be defined as the approach promoting the improved self-care or the practice of activities a patient should initiate on his/her desire to improve the quality of life, maintain his/her health, and attain better treatment results. The ability to engage in self-care might vary in different individuals depending on their age, culture, life experience, social background, level of knowledge, and available resources (Orem, 2001).

However, regardless of these showings, a nurse should be ready to create the atmosphere and conditions beneficial for an individual and his/her engagement in self-care activities that will improve outcomes and teach a patient how to remain healthy and achieve a better quality of life. The outlined paradigm formulates the major assumptions that should regulate the work of a nurse and result in the significant improvement of the results of care, patient-nurse cooperation, and individuals’ ability to perform needed activities.

In the course of the theory’s evolution, Orem formulated several ideas that contributed to the creation of a theoretical framework of the self-care deficit theory and promoted its increased effectiveness. The first one states that all individuals engaged in the treatment process should be self-reliant and responsible for both their and close people’s care as it will help to achieve better outcomes (Orem, 2001). Another one assumes that all people are distinct individuals with their needs and demands that should be considered while delivering care. (Orem, 2001).

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Orem (2001) also wants to attract specialists’ attention to the idea that nursing is the act of interaction between two and more people, which should be considered while organizing cooperation between them. This cooperation should also rest on the idea that fulfillment of universal and development self-care requisites is a fundamental element of primary care prevention and health improvement.

Finally, every individual should be interested in the acquisition and promotion of appropriate self-care behaviors that should help to avoid the emergence of new health issues or deterioration of the state of health (Malekzadeh, Amouzeshi, & Mazlom, 2018). Finally, all these actions and incentives should be learned through the prism of socio-cultural context, which is an important part of the work of any nurse. Observation of these basic principles will help to attain better results and cultivate a new health culture.


Like any other nursing theories, Orem’s self-deficit framework presupposes the existence of the four basic meta paradigms that include the definition of nursing, person, environment, and health. These are the fundamentals of nursing that are introduced specialists in the enhancement of their knowledge related to a particular theory. At the same time, these conceptions ensure that the essential domains of nursing will be considered while creating an approach or working with clients. Orem’s nursing theory introduces its own definitions of these meta paradigms.

The concept of nursing is determined as art and helping service that should be focused on the attainment of appropriate results. All nurses should select their actions regarding their impact on the maintenance of health and the provision of care that can change conditions for more beneficial ones (Orem, 2001). Only if this requirement is met can specialists achieve a particular success while working with patients.

At the same time, one of the important aspects of Orem’s definition includes the creation of a unity consisting of the patient’s perspective on health, physician and nurses’ approaches, and the existing theoretical framework with the pivotal aim to guarantee the provision of the needed care and improved results of treatment. In accordance with the given model, the central goal of nursing is to ensure that patients and their close people can engage in self-care activities and fulfill their specific health needs. It will help to maintain their quality of life and health at the appropriate level.

The second meta paradigm found in any nursing theory is health. Orem accepts the fundamental importance of the given aspect and assumes that the term healthy should be used to describe the normal state of individuals when they are structurally and functionally sound and are able to perform their traditional activities (Orem, 2001). In such a way, the fundamental task of any nurse is to try to achieve the integrity that makes a person a human being and helps him/her to enjoy life.

In accordance with the given framework, self-care is the critical element of health as it is one of the main guarantees that a patient will be able to care for himself/herself and acquire the demanded results through the performance of activities that will have a beneficial impact on the state of his/her body both and physiological and psychological levels. The creation of these mechanisms and their explanation to patients can be considered one of the main activities needed to promote health.

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The metaparadigm of the environment also plays a critical role in Orem’s conception. In accordance with the framework created by her, all components of a set play an important role in the provision of care as they precondition results and impact the way patients feel (Orem, 2001).

In such a way, conditions and other factors emerging during the cooperation between a health worker and an individual should be given attention to avoid the emergence of discomfort and decreased ability to engage in self-care activities. Moreover, the theory emphasizes the fact that the environment can promote better results of the outlined actions by affecting patients in beneficial ways and contributing to the spark of their interest in care (Mahmoudzadeh-Zarandi, Hamedanizadeh, Ebadi, &, Raiesifar, 2016). In such a way, the creation of the appropriate environment acquires the top priority for all specialists engaged in the work of the health care sector.

Finally, the metaparadigm of a person is defined by Orem in a specific way. The self-care nursing theory considers every patient a human being with universal, developmental needs for self-care and continuous development. It means that to remain sound, a person should be able to perform all activities essential for the preservation of his/her quality of life at a high level. It will contribute to the achievement of soundness and better outcomes of treatment.

Orem emphasizes the fact that all clients have unique needs that should be analyzed and fulfilled to ensure that they are satisfied and have a stable interest in the self-care activities that are central to their soundness (2001). The physiological and psychological health of a person can be cultivated through a set of multiple acts aimed at the promotion of a specific environment and the achievement of a final goal.

Research Study

The importance and relevance of the selected theory can be proved by the fact that it is highly applicable in the modern setting can be used to assist patients with various health issues in their recovery. For instance, the research study by Ali outlines the way self-care deficit can be used when organizing care for a psychiatric patient. The central problem is that the person had suicidal attempts in the past, and the current state remains unsatisfactory.

There is a critical need to organize care in a way that excludes the risk of new problems. Applying the given concept, the patient should be provided with the mechanisms effective in the creation of the appropriate environment and engagement in self-care activities that will help to avoid depressive behaviors and thoughts (Ali, 2018). At the same time, it will provide the patient with a certain purpose that will help to minimize the risk of new attempts.

Theories in the Real World

In such a way, the factors mentioned above evidence that nursing theories remain useful in the real world. First of all, they describe the basic peculiarities of human beings that should be considered while delivering care and improving the quality of patients’ lives. Moreover, these specific frameworks contribute to the improved understanding of the major pillars of nursing (Khatiban, Shirani, Oshvandi, Soltanian, & Ebrahimian, 2018).

It helps to achieve better results and higher satisfaction levels among patients. Utilization of the theories can also help to select the most appropriate approach regarding the current clients’ needs and their demands. That is why, despite the fact that some of the nursing theories emerged in the past century, their usefulness in the modern healthcare setting remains undoubted. All nurses working with individuals should be ready to apply metapardigms outlined by theorists to guarantee that beneficial results will be achieved.

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Speaking about Orem’s theory, its relevance to nursing homes from the universal character of the discussed concepts and patients’ demands. Today, the healthcare sector is focused on the creation of continuity of care, meaning that all individuals should be provided with assistance at different periods of their lives to minimize the development of undesired conditions and poor outcomes (Bagnasco et al., 2017).

The given model also presupposes that there is a need for prophylactic, preliminary work, and special education for people to be able to monitor the state of their health. It coincides with the major Orem’s assumptions about the necessity of self-care activities as one of the factors guaranteeing positive results in populations and the decreased level of new problematic issues (Weiss & Tappen, 2014). For this reason, the theory remains applicable in the current healthcare settings.


Altogether, Orem’s self-care deficit theory remains topical for the modern health care sector. It emphasizes the importance of patients’ focus on the promotion of their health via a set of activities that have a beneficial impact on their bodies. At the same time, a nurse should be able to create conditions that promote interest in this sort of action. Moreover, being one of the central agents who provide individuals with all needed services, health workers should be ready to assess the unique peculiarities of every person and select a self-care approach that fits the best. Only under these conditions can success be achieved, and patients will remain satisfied with the quality of provided care.


Ali, B. (2018). Application of Orem self care deficit theory on psychiatric patient. Annals of Nursing Practice, 5(1). Web.

Bagnasco, A., Watson, R., Zanini, M., Catania, G., Aleo, G., & Sasso, L. (2017). Developing a stoma acceptance questionnaire to improve motivation to adhere to enterostoma self-care. Journal of Preventive Medicine and Hygiene, 58(2). Web.

Khatiban, M., Shirani, F., Oshvandi, K., Soltanian, A., & Ebrahimian, R. (2018). Orem’s self-care model with trauma patients: A quasi-experimental study. Nursing Science Quarterly, 31(3), 272-278. Web.

Mahmoudzadeh-Zarandi, F., Hamedanizadeh, F., Ebadi, A., &, Raiesifar, A. (2016). The effectiveness of Orem’s self-care program on headache-related disability in migraine patients. Iran Journal of Neurology, 15(4). Web.

Malekzadeh, J., Amouzeshi, Z., & Mazlom, S. (2018). A quasi-experimental study of the effect of teaching Orem’s self-care model on nursing students’ clinical performance and patient satisfaction. Nursing Open, 5(3), 370-375. Web.

Orem, D. (2001). Nursing concepts of practice. St. Louis, MO: Mosby.

Weiss, S., & Tappen, R. (2014). Essentials of nursing leadership & management (6th ed.). Philadelphia, PA: F.A. Davis Company.

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