Nursing: Concepts of Practice (Orem, 2001) is organized with two foci: nursing as a unique field of knowledge and nursing as practical science.

Nursing: Concepts of Practice (Orem, 2001) is organized with two foci: nursing as a unique field of knowledge and nursing as practical science.

Theory of self-care deficit

The central idea of the theory of self-care deficit is that the requirements of persons for nursing are associated with the subjectivity of mature and maturing persons to health-related or health care–related action limitations.

These limitations render them completely or partially unable to know existent and emerging requisites for regulatory care for themselves or their dependents.

They also limit the ability to engage in the continuing performance of care measures to control or in some way manage factors that are regulatory of their own or their dependent’s functioning and development

Theory of self-care

Self-care is a human regulatory function that individuals must, with deliberation, perform themselves or must have performed for them to maintain life, health, development, and well-being.

Self-care is an action system. Elaboration of the concepts of self-care, self-care demand, and self-care agency provides the foundation for understanding the action requirements and action limitations of persons who may benefit from nursing.

Theory of dependent-care

The theory of dependent-care “explains how the self-care system is modified when it is directed toward a person who is socially dependent and needs assistance in meeting his or her self-care requisites” (Taylor & Renpenning, 2011, p. 24).

For persons who are socially dependent and unable to meet their therapeutic self-care demand, assistance from other persons is necessary.

Logical form

Orem’s insight led to her initial formalization and subsequent expression of a general concept of nursing. This generalization then made possible inductive and deductive thinking about nursing.

Acceptance by the nursing community

Orem’s SCDNT has achieved a significant level of acceptance by the international nursing community, as evidenced by the magnitude of published material and presentations at the International Orem Society World Congresses (2008, 2011, and 2012).

In research using the SCDNT or components, Biggs (2008) found more than 800 references. Berbiglia (2014) identified selected practice settings and SCDNT conceptual foci from a review of more than 3 decades of use of the SCDNT in practice and research and publicized selected international SCDNT practice models for the 21st century.

Further development

From the time of publication of the first edition of Nursing: Concepts of Practice in 1971, Orem was engaged in continual development of her conceptualizations. She worked by herself and with colleagues.

The sixth and final edition was published in 2001. Her work with a group of scholars, known as the Orem Study Group, further developed the various conceptualizations and structured nursing knowledge using elements of the theory.

Nursing: Concepts of Practice (Orem, 2001) is organized with two foci: nursing as a unique field of knowledge and nursing as practical science.



The terms Orem used are defined precisely.

The language of the theory is consistent with the 21st-century language used in action theory and philosophy.

The terminology of the theory is congruent throughout.

The term self-care has multiple meanings across disciplines; Orem defined the term and elaborated the substantive structure of the concept in a way that is unique but also congruent with other interpretations.


Orem’s theory is expressed in a limited number of terms. These terms are defined and used consistently in the expression of the theory. Orem’s general theory, the SCDNT, comprises four constituent theories: self-care, dependent-care, self-care deficit, and nursing systems.

The SCDNT is a synthesis of knowledge about eight entities, which include self-care (and dependent-care), self-care agency (and dependent-care agency), therapeutic self-care demand, self-care deficit, nursing agency, and nursing system. Development


Orem commented on the generality, or universality, of the theory as follows: “The self-care deficit theory of nursing is not an explanation of the individuality of a particular concrete nursing practice situation, but rather the expression of a singular combination of conceptualized properties or features common to all instances of nursing. As a general theory, it serves nurses engaged in nursing practice, in development and validation of nursing knowledge, and in teaching and learning nursing.” (1995, pp. 166–167)


As a general theory, the SCDNT provides a descriptive explanation of why persons require nursing and what processes are needed for the production of required nursing care. The concepts of the theory are abstractions of the entities that represent the proper object of nurses in concrete nursing practice situations. Self-care, dependent-care, and nursing care all are forms of deliberate action engaged in to achieve a particular purpose. The concepts of therapeutic self-care demand, self-care agency, dependent-care agency, and nursing agency refer to properties of persons. Self-care deficit and dependent-care deficit refer to relationships between properties of persons. Self-care system, dependent-care system, and nursing system are systems of care that are designed and implemented to achieve desired outcomes.


The SCDNT differentiates the focus of nursing from other disciplines. Although other disciplines find the theory of self-care helpful and contribute to its development, the theory of nursing systems provides a unique focus for nursing. The significance of Orem’s work extends far beyond the development of the SCDNT. In her works, she provided expression of the form of nursing science as practical science, along with a structure for ongoing development of nursing knowledge in the stages of theory development.


The critical question—What is the condition that indicates that a person needs nursing care?—was the starting point for the development of the SCDNT. Orem noted that it was the inability of persons to maintain on a continuous basis their own care or the care of dependents. From this observation, she began the process of formalizing knowledge about what persons need to do or have done for themselves to maintain health and well-being. When a person needs assistance, what are the appropriate nursing assistive actions? The theory of self-care describes what a person requires and what actions need to be taken to meet those requirements.

Place Your Order Here!

Leave a Comment

Your email address will not be published. Required fields are marked *