5 - Lydia Eloise Hall Nursing Theory-1

Prepared By:
Surrya Shahid
Senior Nursing Instructor
Shalamar Nursing College, Lahore
Contents
1. Background
2. Description
3. Assumptions
4. Major Concepts
o Individual
o Health
o Society and Environment
o Nursing
Contents
4. Sub concepts
oThe Care Circle
o The Core Circle
oThe Cure Circle
5. Strengths
6. Weaknesses
7. Conclusion
BACKGROUND
 Lydia Hall began her prestigious career in nursing as
a graduate of the York Hospital School of Nursing in
York, Pennsylvania.
o She earned B.S. and M.A. degrees from Teachers
College, Columbia University, in New York.
o Had faculty position at the York Hospital School of
Nursing and Fordham Hospital School of Nursing
o Became consultant in Nursing Education to the
Nursing Faculty at the State University of New York,
Upstate Medical Center. She also was an instructor of
nursing education at Teachers College.
BACKGROUND
o Career Interests: Public Health Nursing, cardiovascular
nursing, pediatric cardiology and nursing of long term
illness.
o Authored 21 publications and the bulk of the articles and
addresses regarding her nursing theory were published
in in the early to middle 1960s.
o In the 1967, she received the award for Distinguished
Achievement in Nursing Practice from Columbia
University.
BACKGROUND
 Greatest Achievements:
o Hall design and develop Loeb Center for Nursing at
Montefiore Hospital in New York City and apply her
theory to nursing practice. Opened at January 1963.
o A 80 bed capacity for persons aged 16 years or older who
were no longer having acute biological disturbances.
o Patients were recommended by their physicians and had
favourable potential for recovery and subsequent return
to their community.
o Hall served as administrative director of the Loeb Center
for Nursing for from its opening until her death in
February 1969.
About Lydia Eloise Hall
• Lydia Eloise Hall (September 21,
1906 – February 27, 1969) was a
Nursing Theorist who developed the
Care, Cure, Core model of nursing.
Her theory defined Nursing as “a
participation in care, core and cure
aspects of patient care, where CARE
is the sole function of nurses,
whereas the CORE and CURE are
shared with other members of the
health team.”
About Lydia Eloise Hall
• She was an innovator, motivator,
and mentor to nurses in all
phases of their careers and an
advocate for chronically ill
patients and worked to involve
the community in public health
issues as well.
Description
• Nursing theory in line with Lydia Hall is nothing short of
revolutionary. In the 1960s, she put down in her own
simple words, her thoughts about nursing. She did not
consider herself a nurse theorist, but instead talked about
her transparent thoughts and remarkable ideas of nursing
care as she learned it over the years. These lead to the
development of her “Care, Cure, Core Theory,” also known
as the “Three Cs of Lydia Hall.”
Description
 Hall’s theory define Nursing as the “participation in
care, core and cure aspects of patient care, where
CARE is the sole function of nurses, whereas the
CORE and CURE are shared with other members of
the health team.” The major purpose of care is to
achieve an interpersonal relationship with the
individual that will facilitate the development of the
core.
Description
 As Hall says; “To look at and listen to self is often too
difficult without the help of a significant figure (nurturer)
who has learned how to hold up a mirror and sounding
board to invite the behaver to look and listen to himself.
 If he accepts the invitation, he will explore the concerns
in his acts and as he listens to his exploration through
the reflection of the nurse, he may uncover in sequence
his difficulties, the problem area, his problem, and
eventually the threat which is dictating his out-of-control
behavior.”
Assumptions
 The assumptions of Hall’s Care, Cure, Core
Theory are as follows:
– (1) The motivation and energy necessary for healing
exist within the patient, rather than in the healthcare
team.
– (2) The three aspects of nursing should not be viewed as
functioning independently but as interrelated. And lastly,
– (3) The three aspects interact, and the circles
representing them change size, depending on the
patient’s total course of progress.
Major Concepts
o Individual
o Health
o Society and Environment
o Nursing
Individual
 The individual human who is 16 years of
age or older and past the acute stage of
a long-term illness is the focus of nursing
care in Hall’s work.
 The source of energy and motivation for
healing is the individual care recipient,
not the health care provider.
 Hall emphasizes the importance of the
individual as unique, capable of growth
and learning, and requiring a total
person approach.
Health
 Health can be inferred to be a
state of self-awareness with
conscious selection of behaviors
that are optimal for that
individual. Hall stresses the need
to help the person explore the
meaning of his or her behavior to
identify and overcome problems
through developing self-identity
and maturity.
Society and Environment
o The concept of society or environment is
dealt with in relation to the individual.
Hall is credited with developing the
concept of Loeb Center because she
assumed that the hospital environment
during treatment of acute illness creates
a difficult psychological experience for
the ill individual. Loeb Center focuses on
providing an environment that is
conducive to self-development.
Society and Environment
In such a setting, the focus
of the action of the nurses is
the individual, so that any
actions taken in relation to
society or environment are
for the purpose of assisting
the individual in attaining a
personal goal.
Nursing
Nursing is
identified as
consisting of
participation in the
care, core, and cure
aspects of patient
care.
Subconcepts
 Hall’s theory has three
components which are
represented by three
independent but
interconnected circles. The
three circles are: the core, the
care, and the cure. The size of
each circle constantly varies
and depends on the state of
the patient.
The Care Circle
 According to the theory, nurses are focused on
performing the noble task of nurturing patients.
• Nurturing component of care
• It is exclusive to nursing
• “Mothering”
• Provides teaching
o This circle solely represents the role of nurses, and is focused

on performing the task of nurturing patients. Nurturing
involves using the factors that make up the concept of
mothering (care and comfort of the person) and provide for
teaching-learning activities.
The Care Circle
and learning activities
o Nurses goal is to “comfort” the patient
o Patient may explore and share feelings with
nurse
o Nurse is concerned with intimate bodily care
o Nurse applies knowledge of natuaral and
biological sciences
o Nurse act as potential comforter
The Care Circle
The care circle defines the primary role of a
professional nurse such as providing bodily
care for the patient and helping the patient
complete such basic daily biological functions
as eating, bathing, elimination, and dressing.
When providing this care, the nurse’s goal is
the comfort of the patient.
The Care Circle
Moreover, the role of the nurse also includes
educating patients, and helping a patient meet
any needs he or she is unable to meet alone.
This presents the nurse and patient with an
opportunity for closeness. As closeness
develops, the patient can share and explore
feelings with the nurse.
The Core Circle
The core, according to Hall’s theory, is the
patient receiving nursing care. The core has
goals set by him or herself rather than by any
other person, and behaves according to his or
her feelings and values. This involves the
therapeutic use of self, and is shared with
other members of the health team.
The Core Circle
Core involves the therapeutic use of self in
communicating with the patient. The nurse
through the use of reflective technique helps
the patient clarify motives and goals,
facilitating the process of increasing the
patients self awareness. The social sciences
(the person).
The Core Circle
o Patient care is based on social sciences
o Therapeutic use of self
o Helps patient learn their role is in the healing process
o Patient is able to maintain who they are
o Patient able to develop a maturity level when nurse
listens to them and acts as sounding board
o Patient able to make informed decisions
o Emphasis on social,emotional,spiritual and intellectual
needs
o Patient makes more rapid progress towards recovery
and rehabilitation
The Core Circle
This area emphasizes the social, emotional,
spiritual, and intellectual needs of the patient
in relation to family, institution, community
and the world. This is able to help the patient
verbally express feelings regarding the disease
process and its effects by the use of reflective
technique. Through such expression, the
patient is able to gain self-identity and further
develop maturity.
The Core Circle
• Reflective technique is used by the
professional nurse in a way the he or she acts
as a mirror to the patient to help the latter
explore his or her own feelings regarding his
or her current health status and related
potential changes in lifestyle.
The Core Circle
• Motivations are discovered through the
process of bringing into awareness the
feelings being experienced. With this
awareness, the patient is now able to make
conscious decisions based on understood and
accepted feelings and motivation.
The Cure Circle
The cure as explained in this theory is the aspect of
nursing which involves the administration of medications
and treatments. Hall explains in the model that the cure
circle is shared by the nurse with other health
professionals, such as physicians or physical therapists.
• In short, these are the interventions or actions geared
toward treating the patient for whatever illness or
disease he or she is suffering from. During this aspect of
nursing care, the nurse is an active advocate of the
patient.
The Cure Circle
Cure is the aspect of nursing involved with the
administration of medications and treatments.
The nurse functions in his role as an investigator
and potential cause of pain related to skills such
as injections and dressing changes. Seeing the
patient and family through the medical care
aspect of nursing. The pathological and
therapeutic sciences (the disease).
The Cure Circle
o Care based on pathological and therapeutic
sciences
o Application of medical knowledge by nurses
o Nurse assisting the doctor in performing tasks
o Nurse is patient advocate in this area
o Nurse is a patient advocate
o Nurses role changes from positive quality to
negative quality
o Medical surgical and rehabilitative care
o COPERATE WITH FAMILIES OR CARE GIVERS
The Cure Circle
As seen in the figure above, the three interlocking circles
may change in size and overlap in relation to the patient’s
phase in the disease process. A nurse functions in all three
circles but to different degrees.
• For example, in the care phase, the nurse gives hands-on
bodily care to the patient in relation in relation to the
activities of daily living such as toileting and bathing. In the
cure phase, the nurse applies medical knowledge to
treatment of the person, and in the core phase, the nurse
addresses the social and emotional needs of the patient for
effective communication and a comfortable environment.
Strengths
Hall’s model appears to be completely and
simply logical. Her work may be viewed as the
philosophy of nursing.
o The three Cs (care, core and cure) in this
theory were unique. In all the circles of the
model, the nurse is present, although focus of
the nurse’s role is on the care circle.
Weaknesses
Hall’s model is considered to be plain and
simple in its presentation. However, the
receptiveness and resilience necessary for its
utilization and function may not be so simple
for nurses whose personality, educational
preparation, and experience have not
prepared them to function with minimal
structure. This and the self-imposed age and
illness requirements limit the generalizability.
Weaknesses
The age requirement for the application of her
theory which is 16 years of age and above limits the
theory since it cannot be disregarded that nurses are
faced with pediatric clients every now and then.
o The concept of a patient aggregate such as having
families and communities as the focus of nursing
practice was not tackled. It is purely on the individual
himself. Although, the role of the family or the
community within the patient’s environment was
modestly discussed.
Conclusion
 Hall used her knowledge of
psychiatry and nursing
experiences in the Loeb
Center as a framework for
formulating the Care, Core
and Cure Theory. Her model
contains three independent
but interconnected circles.
The three circles are: the core,
the care, and the cure.
Conclusion
o The core is the patient, the
cure refers to the medical
and nursing interventions
and the care is the nurturing
provided by nurses. Nursing
functions in all three of the
circles but shares them to
different degrees with other
disciplines.
Conclusion
o Even though Hall confined her
concepts for patients with the age
of 16 years and above, the
concepts of care, core and cure can
still be applied to every age group
but again, none was specified.
o This theory puts emphasis on the
importance of the total patient
rather than looking at one part or
aspect. There is also emphasis put
on all three aspects of the theory,
the three Cs, functioning together.
Conclusion
o And for a nurse to successfully
apply Hall’s theory, the
individual must pass an acute
stage of illness. In this theory,
no nursing contact with
healthy individuals, families,
or communities, contradicts
the concept of health
maintenance and disease
prevention.
References
• Alligood, M., & Tomey, A. (2010). Nursing theorists
and their work, seventh edition (No ed.). Maryland
Heights: Mosby-Elsevier.
• George, J.B.; Nursing Theories: The Base for
Professional Nursing Practice; 2000.

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o This circle solely represents the role of nurses, and is focused

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