The Self-Care Deficit Nursing Theory

The Self-Care Deficit Nursing Theory (SCDNT) was conceived and developed during a time when Nursing lacked definition and identity within the medical community. This theory, not only, helped to move nursing from vocation to profession, it “is one of the most commonly used in practice” (Alligood, 2010, p 261). The SCDNT has “four structured cognitive operations: diagnostic, prescriptive, regulatory, and control” (Alligood, 2010, p 266). In the simplest terms this theory states that a nurse should establish the nurse-client relationship, determining what the client’s self-care requisites are (Diagnostic Operations).
Then determine, based on the clients personal characteristics which self-care deficits exist (Prescriptive Operations). With the self-care deficits established, both the client’s, client’s caretaker’s, and nurse’s roles can be established. Develop the plan for self-care, designing learning into the system (Regulatory Operations). As the plan is executed, continuing evaluation is required to make any changes so the client’s self-care is at its optimum (Control Operations).
The nurse is not limited to executing these operations in this order. Their sequence is interchangeable as the evaluations may dictate (Alligood, 2010). The SCDNT was developed by Dr. Dorothea Orem. Dr. Orem was born in Baltimore, Maryland in 1914 and lived 93 years, until her death in Savannah, Georgia on June 22, 2007 (DeLorme, 2007, para 1 &2). In 1934, “Orem arrived on the [Nursing] scene when the image of nurses still lacked major definition” (DeLorme, 2007, para 2), and this continued for decades.

According to Sarah E. Allison in an article she co-authored in Nursing Science Quarterly, “From the late 1950s to the 1970s, Orem was deeply concerned that nursing had no clear sense of direction in terms of purpose or focus – no clear concept about its domain of practice” (Clarke, 2009, para 4). Orem’s career began as an operating room nurse; a tested time she refers to as “a post-graduate course in operating room” (DeLorme, 2007, para 3). It is this time that Dr. Orem states that allowed her “’to see the whole picture’ in terms of organization and administration in the nursing field” (DeLorme, 2007, para 3).