General Theory of Nursing
• Theory of self care
• Theory of self care deficit
• Theory of nursing system
Dorothea Orem (1914-2007)
Born in Baltimore, Maryland
Education
 Earned her diploma at Providence Hospital
School of Nursing in 1930’s
 Earned her BSN at Catholic University of
America in 1939
 Earned her MSN at Catholic University of
America in 1945
 Received an honorary Doctor of Science degree
from Georgetown University in 1976
 Doctor of Nursing Honoris Causae from the
 University of Missouri in 1998
A Brief Timeline of Accomplishments
Early Experience included nursing in the operating room, private
duty nursing, pediatric and adult med/surg nursing, evening
supervisor in the emergency department, and biological science
technician
1940-1949 Dorothea Orem held directorship of both nursing school
and department of nursing at Providence Hospital in Detroit
1949-1957 Dorothea Orem worked at the Indiana State Board of
Health where her goal was to upgrade the quality of nursing care
throughout the state. It was during this time she began working on her
definitions of nursing and related concepts
1959 Dorothea Orem worked for the US Department of Health where
she helped publish Guidelines for Developing Curricula for the
Education of Practical Nurses
1971 Her theory was first published in Nursing: Concepts of Practice.
The theory was revised in 1980, 1985, 1991, 1995, and 2001
The Core Beliefs of Dorothea Orem
 People should be self-reliant and responsible for their
own care and others in their family needing care
 People are distinct individuals
 Nursing is a form of action
 Successfully meeting universal and development selfcare requisites is an important component of primary
care prevention and ill health
 A person’s knowledge of potential health problems is
necessary for promoting self-care behaviors
 Self-care and dependent-care are behaviors learned
within a socio-cultural context
The Core Beliefs of Dorothea Orem
 People should be self-reliant and responsible for
their own care and others in their family needing care
 People are distinct individuals
 Nursing is a form of action
 Successfully meeting universal and development
self-care requisites is an important component of
primary care prevention and ill health
 A person’s knowledge of potential health problems
is necessary for promoting self-care behaviors
 Self-care and dependent-care are behaviors learned
within a socio-cultural context
Dorothea Orem’s Nursing Metaparadigm
(Person/Environment/Nursing/Health)
Orem’s Nursing Metaparadigm: PERSON
 The recipient of nursing care
 Someone that functions biologically, symbolically, and socially
 Has the potential for learning & development
 Is subject to the forces of nature
 Has a capacity for self-knowledge
 Can engage in deliberate actions, interpret experiences, and perform
beneficial actions
 Can learn to meet self-care needs (requisites)
 Human beings are distinguished from other living beings by their capacity
to:
 Reflect upon themselves and their environment
 Symbolize what they experience
 Use symbolic creations in thinking, communicating, and guiding efforts
to make things that are beneficial for themselves and for others
Orem’s Nursing Metaparadigm: ENVIRONMENT
 Environmental conditions can be external and/or
psychosocial surroundings
 Developmental environments promote goal achievement
 The quality of an environment can positively or negatively
impact a person’s ability to provide self-care
Orem’s Nursing Metaparadigm: NURSING
 A service geared towards helping the self and others
 Is required when self-care demands exceed a patient’s self-care
ability (agency)
 Promotes the patient as a
self-care agent
 Comprised of several components
Components of NURSING
 NURSING ART: The theoretical base of nursing. Describes
what it “ought” to do.
 NURSING PRUDENCE: Enables the nurse to seek advice in
new or difficult situations, to make correct judgments, and to
decide to act in a particular manner.
 NURSING SERVICE: An assistive service
 NURSING AGENCY: The competency of the RN
 ROLE THEORY: The role of the nurse & patient are
complementary as they work together to achieve self-care
 SPECIAL TECHNOLOGIES:
 Social & Interpersonal technologies: Involve communicating,
coordinating, establishing & maintaining therapeutic relations
and providing help
 Regulatory technologies: Involve maintaining and promoting
life processes, growth/development, and psycho-physiological
modes of functioning