Dorothea Orem and the theory of Self Care Essay

Dorothea is one of the leading nursing theorists, and was an important influence in service, practice and education in nursing. In this paper, the focus will not be on who Dorothea was, but on the theory of Self Care and how it was formulated explicated in the professional field. The four main stages of the paper will involve steps in which theorizing occurs, syntax is developed, the theory is tested and lastly evaluation.

Stage One: Theorizing

The self-care theory is development at an early stage of a nurse’s career. When an individual is working at an administrative capacity in state health board, their thinking is most likely aligned to finding a solution to the changing needs of the state’s hospitals (Orem, 1991). The changing needs can be met through proper definition of nursing practice and self-care. The concept is developed in line with what is seen to be important elements of self-care.

Stage Two: Development of Syntax

At this stage, the most important thing that is done is definition of concepts that are very critical to the theory. The most critical question that comes to one’s mind is related to definition of nursing (Taylor, 2006). Orem defined nursing as an act, which involves the process of assisting others in management and provision of self-care to improve the functioning of human at the level of being effective at home.

Another important concept that has to be defined in this case is the self-care. It is described as the practice and performance of certain activities initiated by an individual on their own behalf to ensure that they maintain proper life and health. The concept of nursing and self-care are about the existence of human beings (Orem, 1991). In the case of these theory human beings are defined as those with the ability to use and reflect on the symbols. The human is viewed as a total being that has developmental and universal needs and has the capacity to uphold self-care.

Third Stage: Theory Testing

The concept of nursing as defined by Orem has been split into three other important elements that include self-care, self-care deficit and theory of nursing system. Under the theory of self-care there is the understanding of what self-care means. The definition is that activity with is initiated by an individual in performing their own wellbeing and maintenance of life. The human ability to engage in self-care is what has been defined as the self-care agency. Such ability is conditioned through other elements such as state of development, age and life experience on sociocultural orientation and use of resources that are made available. The therapeutic self-care demand means the totality of self-care actions that are carried out for a given period of time to meet the requirements of self-care for a certain period of time and is related to a given set of actions and operations (Taylor, 2006). The self-care requisites make up part of the theory, and it means the actions that are carried out and directed towards giving of self-care.

The development of the theory also does involve making of certain assumptions that are very critical. The main assumption is that people are required to be self-responsible and reliant for their own health care and for the care of their family. In the theory, it is further assumed that the people are distinct individuals (Orem, 1991). Nursing is also defined through a given assumption which looks at the practice as a form of action that involves interaction between more than one individual. Meeting the needs of self-care is an important part of primary care and most importantly looks at prevention of ill health.

Fourth Stage: Evaluation

In the evaluation of the theory is a philosophical debate about how the theory is implemented. In this case the theory is looked at in terms of its strength and weaknesses when applied in nursing practice (George, 2012). The main strength is that it is a theory that offers comprehensive basis under which nursing practice is carried out. It provides utility for professional nursing in form of education, administration in nursing (Whelan, 2014). It is a theory that is contemporary and in line with the contemporary ideas of health maintenance and promotion.

The limitations to the theory also explain a better part of the philosophical application. The main shortcoming is based on the fact that health in most cases is seen as a dynamic and ever-changing concept. It cannot be viewed as a single element but as a whole with several parts. In general view, the theory can be said to be simple but it can be applied to variety of patients (Tomey & Alligood, 2002). It does provide an explanation of what nursing systems entail deficits in self-care and the terms under self-care. The theory is also an indication that patients are in need of taking care of themselves and that they are at a better position of getting better if they perform their personal self-care.




George B. J. (2012). Nursing Theories- The base for professional Nursing Practice, 3rd ed. Norwalk, Appleton & Lange.

Orem, D.E. (1991). Nursing: Concepts of practice (4th ed.). St. Louis, MO: Mosby-Year Book Inc.

Taylor, S.G. (2006). Dorthea E. Orem: Self-care deficit theory of nursing. In A.M.

Tomey, A. & Alligood, M. (2002). Significance of theory for nursing as a discipline and profession. Nursing Theorists and their work. Mosby, St. Louis, Missouri, United States of America.

Whelan, E. G. (2014). Analysis and application of Dorothea Orem’s Self-care Practice Model.





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