Further development of conceptual elements of the theory of self-care, one of the three constituent theories of Orem's self-care deficit theory of nursing, is reported. Five content areas of a practical science of self-care are identified; one content area, self-care requisites, is refined and developed. The nature of self-care requisites is reformulated; guides and standards for the expression of self-care requisites, examples of expressed self-care requisites, and a self-care practice guide are described. These developments are illustrated using the example of the requisite to maintain an adequate fluid intake.

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Orem's theories of self-care and self-care deficit contain several propositions important to health promotion. This article presents results of tests of these relationships, which indicated partial support for the model. In an aggregate sample of 369 adolescents, self-care and self-care agency were significant predictors of health. This relationship held when health was defined as a general positive state of integrity and soundness, but not when it was considered as merely the absence of disease.

Orem's theory suggests that different self-care actions are necessary to meet requisites related to health (universal self-care) and illness (health-deviation self-care). The authors differentiate these types of self-care, propose hypotheses relating these concepts to other concepts in Orem's theory, and test them in a sample of adolescents with diabetes mellitus. As predicted, universal self-care is significantly related to a measure of the global health state, and health-deviation self-care is related to control of pathology. The findings provide direction for additional research and theory development.