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Orem’s Self-Care Deficit Theory and Example


Orem’s Self-Care Deficit Theory mainly focuses on patients’ unique needs and the actions they initiate on their behalf to improve their quality of life. Orem also theorized that nursing practice encompasses deliberately directed actions executed by nurses to help people or groups under their care maintain an optimal state of health, change conditions in themselves or their environments or regain normal or near-usual health status in the event of illness or injury (Yip, 2021). The theory incorporates both clinicians’ and patients’ perspectives of the health situation. It comprises three interrelated concepts: self-care, self-care deficit, and nursing system theories.

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The Theory of Self-Care

Self-care can maintain life functioning and promote well-being. This theory incorporates self-care agency, the acquired power (capability) to engage in self-care (Gonzalo, 2021). Nevertheless, performing self-care is influenced by gender, age, developmental state, health status, and available resources. The theory also includes therapeutic self-care demand, which is the amount of intervention needed in a given period to meet an individual’s self-care requirements. Lastly, it also entails a self-care requisite, defined as an action directed towards self-care provision. There are three categories of self-care requisites, namely, health deviation self-care requisite, developmental self-care requisite, and universal self-care requisite.

Health Deviation Self-care

It is required if there is an injury or illness associated with genetic issues. It may address the problems that impede the diagnosis or treatment efforts (Gonzalo, 2021). An individual can learn to live with the consequences of pathologic conditions or seek appropriate medical assistance.

Developmental Self-care

It focuses on issues related to growth and development and life events, which can either be positive or negative. For instance, adjusting to the physical changes or a new job.

Universal Self-Care

It relates to basic activities or life processes performed to safeguard the integrity of human structure and functioning, such as sufficient water, air, and food intake, balancing between rest and activity, and promoting human function and growth through social interaction.

Theory of Self-Care Deficit

This concept specifies when nursing services are required. For instance, a professional healthcare intervention may be needed when an individual is incapable of performing their own continuous effective self-care and, thus, requires assistance (Smith & Parker, 2015). The theory provides means of assisting people in meeting self-care demands (Gonzalo, 2021). These include teaching, supporting, guiding, and acting for others and creating an environment that promotes personal development to address future care demands. In this case, a nurse needs to initiate a professional relationship with individuals, families, and groups to help coordinate care to address underlying health issues.

Theory of Nursing System

The system is required when a patient’s self-care needs surpass the available self-care agency and therapeutic self-care demand, leading to self-care deficits requiring effective nursing assistance. This model describes how a patient’s self-care demands will be addressed by a nurse, a patient, or both. The theorist identifies three categories of the nursing system; wholly compensatory system, which involves providing care to a patient who is entirely socially dependent on others. A partly compensatory system is where nurses and patients take an active role in the care process (Gonzalo, 2021). Conversely, a supportive-educative system trains patients to perform self-care through assistance from nursing staff.

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Current Nursing Example Based on Orem’s Theory

Ms. B is a 49-year-old hypertension patient. Applying the self-care theory, the patient can engage in physical activity (at least two hours of moderate-intense exercise) to maintain a healthy weight and lower blood pressure. However, if Ms. B is incapable of performing these self-care actions independently, nursing intervention can be secured. Nurses can monitor the patient’s blood pressure at intervals. Additionally, if Ms. B is on antihypertensive medication, her blood pressure is assessed to determine its effectiveness and identify changes in her symptoms. Regarding the theory of the nursing system, the nurse’s role in the supportive educational system may be considered when the patient is ready to learn but cannot do it without assistance (Khademian et al., 2020). Ms. B can enroll in a cardiac rehabilitation program to obtain lifestyle education.


Orem’s theory plays a significant role in healthcare provision because its key concept can be applied to a wide variety of patient settings, such as home, rehabilitation, and primary care. The self-care principle encourages patients to be independent by taking action to promote normal life functioning. Through their individual efforts, they can recover quickly and holistically by performing their own self-care as much as possible. In addition, the nursing systems and self-care deficit are also vital because they specify situations when professional nursing intervention is needed to help patients cope and manage their conditions.


Gonzalo, A. (2021). Dorothea Orem: Self-care deficit theory. Web.

Khademian, Z., Kazemi Ara, F., & Gholamzadeh, S. (2020). The effect of self care education based on Orem’s nursing theory on quality of life and self-efficacy in patients with hypertension: A quasi-experimental study. International Journal of Community Based Nursing and Midwifery, 8(2), 140–149. Web.

Smith, M., & Parker, M. (2015). Nursing theories and nursing practice. F. A. Davis Company.

Yip, J. (2021). Theory-based advanced nursing practice: A practice update on the application of Orem’s self-care deficit nursing theory. SAGE Open Nursing, 7, 23779608211011993. Web.

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