Self-Care Deficit Theory by Dorothea Orem


In modern nursing, there are many theories with the help of which practitioners redefine their working approaches and gain a better understanding of care. At the same time, attention should be paid to the possibilities of patients and their responsibilities in healthcare facilities. Dorothea Orem is a famous nursing theorist of the 20th century, whose theory of self-care deficit will be analyzed in this paper.


Each individual can perform self-care for maintaining well-being and health. However, in the majority of cases, patients believe that it is the responsibility of the medical staff to provide care and associated interventions. Orem aims to improve the quality of care by combing patients’ and nurses’ roles. The main assumptions of her self-care deficit theory are that people are self-reliant and distinct individuals who should use knowledge of health problems and nursing assistance to promote self-care (“Orem’s self-care deficit nursing theory,” 2016).

There are three parts (self-care, self-care deficit, and nursing systems) in terms of which the concepts of health, person, environment, and nursing are elaborated. Health is a state of wholeness when a person, as an independent individual, performs beneficial actions in the environment created by nurses to support and promote personal development. The relationship between the concepts of the theory is close because Orem identified self-care deficits, relying on both nursing and patient demands.

Origins of the Theory

In the middle of the 1900s, Orem recognized the need to develop new nursing knowledge. It was not enough to consider nursing as a field of knowledge or a field of practice only (Berbiglia & Banfield, 2018). She used her experience as the primary source to identify the needs of late-20th-century patients. To create the theory of self-care deficit, Orem was motivated by the current state of affairs. At that moment, American society had already survived two world wars, and the field of nursing needed specific improvements. Nurses did not know how to talk to patients or share their knowledge with families who expected support and understanding.

Therefore, Orem studied the works created by (but not limited to) Nightingale, Abdellah, Orlando, and Roy (Berbiglia & Banfield, 2018). Her comprehensive approach included the philosophical systems and epistemological underpinnings to clarify the nature of reality and the environment where patients and nurses cooperate (Berbiglia & Banfield, 2018). The combination of patient teaching and care in nursing practice turned out to be a new theoretical vision.


Orem’s self-care deficit theory is a critical element in understanding patients’ needs and expectations. The quality of nursing was not perfect at the moment, and the usefulness of this theory was the possibility of creating a specific environment for patients and nurses. In practice, Orem’s work is effective in managing pain as it promotes self-care behaviors in patients (Saeedifar, Memarian, Fatahi, & Ghelichkhani, 2018).

In nursing, the theory helps to determine the elements that connect nurses and patients. It also contributes to understanding patient outcomes because people participate in care and recognize what they want and can achieve. The example of rheumatoid arthritis patients and the application of Orem’s model shows how patients could carry out their daily activities and establish non-dependence, dealing with pain and other complications (Saeedifar et al., 2018). However, it is not the only way to use this theory, and it may be successfully applied in controlling vital signs, preventing falls, or predicting cardiac problems.


The chosen theory is testable in empirical studies by comparing the results before and after its intervention. However, Orem did not use other studies to prove her position because her knowledge and vision were the only primary resources. It is a grand nursing theory where general concepts and propositions were developed. Although the whole theory can hardly be tested, its concepts like self-care deficit may be designed for testing. The already mentioned study by Saeedifar et al. (2018) was done based on Orem’s ideas to prove that positive health outcomes could be achieved if patients’ needs are understood by family members. As soon as patients demonstrate their independence and readiness to care for themselves, their well-being is easily achieved under appropriate nursing control.

Overall Evaluation

Orem’s theory of self-care deficit is comprehensive and specific to nursing because it indicates the steps of nurses and patients. Although it is general in terms of its main assumptions like patient’s self-reliance, dependent care, and self-care within a socio-cultural context, its strengths cannot be ignored. This theory may be applied to a variety of nursing specialties and care units. It is not easy to understand and implement for coordinating patients and nurses. Still, it is time-consuming for many nurses because of its multilevel nature. However, patients should know their roles in care, and this theory is one of the best options for nurses to teach families how to improve their health and enhance recovery.


In general, Orem developed a comprehensive approach to understanding the nature of the relationships patients and nurses develop in healthcare facilities. Self-care deficit theory has several strong and weak aspects, but its usefulness prevails over its limitations, and many modern nurses find it necessary to develop similar concepts. Human actions cannot be ignored in health promotion, and nurses should use their connection with patients to guide and support their independence.


Berbiglia, V. A., & Banfield, B. (2018). Self-care deficit theory of nursing. In M. R. Alligood (Ed.), Nursing theorists and their work (9th ed.) (pp. 198-212). St. Louis, MO: Elsevier.

Orem’s self-care deficit nursing theory. (2016). Web.

Saeedifar, E. S., Memarian, R., Fatahi, S., & Ghelichkhani, F. (2018). Use of the Orem self-care model on pain relief in women with rheumatoid arthritis: A randomized trial. Electronic Physician, 10(6), 6884-6891.

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NursingBird. (2023, August 15). Self-Care Deficit Theory by Dorothea Orem. Retrieved from


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NursingBird. (2023) 'Self-Care Deficit Theory by Dorothea Orem'. 15 August.


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NursingBird. "Self-Care Deficit Theory by Dorothea Orem." August 15, 2023.