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 OriginsNeeds 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-careSelf-care deficitNursing 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 conceptsSelf-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 OverviewSelf-care deficit results when the self-care agency

can not meet self-care demandsExplains when nursing care is neededExplains how people can be assisted through 5

methods of helping:Acting or doing forGuidingTeachingSupportingProviding 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 PracticeBurks, 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 PracticeAs 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 professionAs 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.