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.
Application of SCDNT to my
nursing profession
 As a Registered Nurse Case Manager is use Orem’s Self
Care Deficit Nursing Theory while assisting patients
and families in discharge planning. I am able to
provide education and the tools needed to allow the
patient to care for themselves. Families are
incorporated in the teaching and are willing to learn
how to assist or allow the patient to care for
themselves. SCDNT describes the professional nurse
as an educator but also how to provide the knowledge
that will allow the patient to care for themselves.