Orem：自理理论

§3 General Theory of Nursing

Orem (2001) : The condition that validates the existence of a requirement for nursing in an adult is the health-
associated absence of the ability to maintain continuously that amount and quality of self-care that is therapeutic in sustaining life and health, in recovering from disease or injury, or in coping with their effects.
formalization in nursing: Process an product .
1971, published Nursing: concepts
of practice
In 1980,1985,1991,1995,2001, the second, third, fourth, fifth and sixth editions of this book were published.
这些能力包括： （1）重视和警惕危害因素的能力
（2）控制和利用体能的能力 （3）控制体位的能力 （4）认识疾病和预防复发的能力
（5）动机 （6）对健康问题的判断能力 （7）学习和运用与疾病治疗和康复相关的知识和 技能的能力 （8）与医护人员有效沟通，配和治疗和护理的能 力 （9）安排自我照顾行为的能力 （10）从个人、家庭、社区和社会各方面寻求支 持和帮助的能力 The basic conditioning factors is composed of: Age




Orem’s concept of nursing as the provision of self-care was first published in 1959. 1965, Nursing Model Committee was formed. 1968, Nursing Development Conference Group (NDCG) was formed. 1973, the NDCG published Concept
No.1 Theory of Self-Care

1.Self -care（include dependent care ） : is the performance or practice of activities that individuals initiate and perform on their own behalf to maintain life, health, and well-being.
自护模式的假设



人具有得到照顾和照顾他人的需要 人的行为能力在自我照顾、照顾他人和满足需 要中得到锻炼和提高 人都会经历自护活动受限或生活承受力和功能 调节力的缺乏，此时即产生自护能力的不足， 需要他人的照顾 人可以发现、发展和传递满足不同需要的途径 社会团体有义务和责任为自护不足的人提供照 顾





ห้องสมุดไป่ตู้
The maintenance of a sufficient of intake of water The maintenance of a sufficient of intake of food The provision of care associated with elimination processes and excrements. The maintenance of a balance between activity and rest The maintenance of a balance between solitude and social interaction
Dorotheae .Orem： Self-Care Deficit Theory of Nursing (S-CDTN)
Chen Huizhen Saturday, July 13, 2013
＄1.Introduction of Orem:
Education: She was born in 1914 in Baltimore , Maryland, America. She began her nursing education at Providence Hospital School of Nursing in Washington.DC. And received her diploma in the early 1930s.

Health care system factors (i.e., diagnostic and treatment modalities)

3.The therapeutic self-care demand : is the totality of “care measures necessary at specific times or over a duration of time for meeting an individual’s selfcare requisites by using appropriate methods and related sets operations and actions.


She earned her Bachelor of Science in Nursing Education in 1939 and her Mastrerof Science in Nursing Education in 1945 from the Catholic University of America. She has received several honorary degrees including a Doctor of Science from Georgetown University in 1976; Doctor of Science from the Incarnate World College, San Antonio, Texas, in 1980,and Doctor of Humane Letters from Illinois Western University, Bloomington,in 1988.
4.Self-care requisites (or requirements) Self-care can be defined as ―the reasons for which self-care is undertaken; they express the intended or desired results(Orem, 2001) *Orem presents three categories of self-care requisites: universal ; developmental and health deviation
2.Self-care agency （ include dependent care agency): is the human’s required ability or power to engage in self-care. This ability to engage in self-care in affected by basic conditioning factors.
自理需求
一 般 的 自 理 需 求
成 长 的 自 理 需 求
健 康 欠 佳 的 自 理 需 求
4.1 Universal self-care requisites


Universal self-care requisites are associated with life processes, the maintenance of the integrity human structure and functioning, and with general well-being(2001) . Orem identifies self-care requisites as follows: The maintenance of a sufficient of intake of air

With children, the condition is the
inability of the parent (or guardian) associated with the child’s health state to maintain continuously for the child the amount and quality of care that is therapeutic.



Self-care Deficit Theory of Nursing (her General Theory ) is composed of three interrelated theories: The theory of self-care The theory of self-care dificit The theory of nursing systems Incorporated within these three theory are six central concepts and one peripheral concept. J:\护理理论\Relationship of Orem's three theories.doc




Gender Developmental state Health state Sociocultural factors Patterns of living(e.g., activities regularly engaged in) Environmental factors Family system factors, Resource adequacy and availability