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CHAPTER 14 Dorothea E. Orem 247

MAJOR CONCEPTS & DEFINITIONS—cont’d
Basic Conditioning Factors n Developmental state
Basic conditioning factors condition or affect the n Health state
value of the therapeutic self-care demand and/or the n Pattern of living
self-care agency of an individual at particular times n Health care system factors
and under specific circumstances. The following ten n Family system factors
factors have been identified: n Socio-cultural factors
n Age n Availability of resources
n Gender n External environmental factors

Use of Empirical Evidence knowledge” (p. 50). Since the SCDNT was first pub-
As a practical science, nursing knowledge is devel- lished, extensive empirical evidence has contributed
oped to inform nursing practice. Orem (2001) stated to the development of theoretical knowledge. Much
that, “nursing is practical endeavor, but it is practical of this is incorporated into continuing refinement of
endeavor engaged in by persons who have special- the theory; however, the basics of the theory remain
ized theoretic nursing knowledge with developed unchanged. The theory of dependent care represents
capabilities to put this knowledge to work in concrete a major advancement in terms of the development
situations of nursing practice” (p. 161). The provision of the SCDNT. “The increased need in societies for
of nursing care occurs in concrete situations. As dependent-care indicates the importance for nurses of
nurses enter into nursing practice situations, they understanding dependent-care and their relationships
use their knowledge of nursing science to assign to dependent-care agents” (Orem, 2001, p. 286).
meaning to the features of the situation, to make
judgments about what can and should be done, and
to design and implement systems of nursing care. Major Assumptions
From the perspective of the SCDNT, desired nursing Assumptions basic to the general theory were formal-
outcomes include meeting the patient’s therapeutic ized during the early 1970s and were first presented at
self-care demand and/or regulating and developing Marquette University School of Nursing in 1973.
the patient’s self-care agency. Orem (2001) identifies the following five premises
The conceptual elements and the specific theories of underlying the general theory of nursing:
the SCDNT are abstractions about the features com- 1. Human beings require continuous, deliberate
mon to all nursing practice situations. The SCDNT was inputs to themselves and their environments to
developed and refined through the use of intellectual remain alive and function in accordance with
processes that focused on nursing practice situations. natural human endowments.
For example, Orem reflected on her nursing practice 2. Human agency, the power to act deliberately, is
experiences to identify the proper object of nursing. exercised in the form of care for self and others in
In their work related to the SCDNT, the Nursing identifying needs and making needed inputs.
Development Conference Group (1979) engaged in 3. Mature human beings experience privations in the
analysis of nursing cases and in processes of analogical form of limitations for action in care for self and
reasoning. In a tribute to Orem, Allison (2008) talks others involving making of life-sustaining and
about the Nursing Development Conference Group, function-regulating inputs.
saying that “these nurses came together because they 4. Human agency is exercised in discovering, devel-
were interested in and willing to commit themselves to oping, and transmitting ways and means to identify
examining nursing situations in order to formalize needs and make inputs to self and others.
ways of thinking about nursing that they felt were de- 5. Groups of human beings with structured relation-
scriptive of nursing and would contribute to nursing ships cluster tasks and allocate responsibilities for