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I. Lydia E. Halls Core, Care and Cure Model

Halls three aspects of nursing


Care should be the primary focus and that nurses were the most qualified to provide the type of care that would enable patients to achieve their maximum potential. The focus of nursing is the provision of intimate bodily care and the nurse must know how to modify the care depending on the pathology and treatment while considering the patients unique needs and personality.

Nursing as having three aspects, like care, core and cure. The individual, as unique, capable of growth and learning and requiring a total person approach. Environment to be conducive for the patients self development.

The major purpose of care is to achieve an inter-personal relationship with the individual that will facilitate the development of core (i.e., the development of self-identity and selfdirection by the patient.

This theory will be applicable in assessment, planning and implementation of the patient care. Three interlocking circles, presenting a particular aspect of nursing like care, core and cure. So, the patient whoever comes to hospital will be considered as a Body, person and disease. The nurse who is providing care to the patient should meet all his bodily care like bathing, eating, elimination and dressing thereby meeting his comfort.

During care, the nurse should develop an interpersonal relationship and consider the patient as a person to provide him a way to express his feelings and emotions to gain self-identity. After developing an interpersonal relationship, the nurse should see patient and family through medical care and consider him as a diseased person and act an advocate to cure his condition.


Major concepts identified in the model are; Client Variables Environment Stressors Wellness & Nursing Interventions

Clients are viewed as wholes whose parts are in dynamic interaction. Variables are those which simultaneously affecting the client system. They are, Physiological, psychological, socio-cultural, developmental and spiritual.
Environment is defined as being all the internal and external factors that surround and interact with person and client. There are three relevant environments: Internal, External and Created.

Stressors (intrapersonal, interpersonal, extra personal) are significant to the concept of environment and are described as environmental forces that interact with and potentially alter system stability.
Wellness is a condition where all the subsystems are in balance and harmony with the whole of the client and is balanced on the actual or potential effort that environment stressors have on the energy level of the system.

Nursing interventions are described by using the term prevention. There are three types of prevention: Primary, Secondary, and Tertiary.

The Neuman Systems Model (Conceptual Model)

Application This conceptual model will be applicable for: Assessment of the client system Utilization of the nursing process (Planning) Implementation of preventive interventions

Application of Betty Neumans Systems Model for the Patient with Diabetes Mellitus



The four phases of the nurse-patient relationship are; Orientation, Identification, Exploitation and Resolution.
On admission During intensive treatment period Convalescence and Rehabilitation
Orientation Identification



Overlapping phases in Nurse-patient relationships


She proposed and described six nursing roles like: Stranger, Resource person, Teacher, Leader, Surrogate, and Counselor.

Factors influencing the blending of the nurse-patient relationship


This theory will be applicable in Assessment Planning Implementation and Evaluation of patient care Also, allows nursing to move away from doing to to doing with clients.




Health Nursing Problems and Problem Solving

Health may be defined as the dynamic pattern of functioning whereby there is a continued interaction with external and internal forces that result in the optimal use of the wellness.

Nursing Problems: The clients health needs can be viewed as problems which may be overt as an apparent condition, or covert as a hidden or concealed one.

Problem-solving process involves, identifying the problem, selecting pertinent data, formulating hypothesis, testing hypothesis through the collection of data and revising the hypothesis when necessary on the basis of conclusion obtained from the data.

Nursing Centered Client centered

Disease centered

The focus of care pendulum

Abdellahs Twenty-one Nursing problems

It can be classified under four areas like, i. Physiological needs ii. Safety needs iii. Belonging and love needs iv. Esteem needs

I. Physiological needs include

To maintain good hygiene and physical comfort. To promote optimal activity: exercise, rest, and sleep. To maintain good body mechanics, prevent and correct deformities. To facilitate the maintenance of: - a supply of oxygen to all the body cells, - nutrition of all body cells. - elimination, - fluid and electrolyte balance

II. Safety needs include

To promote safety through the prevention of accidents, injury, or other trauma and through the prevention of spread of infection.
To facilitate the maintenance of sensory function.

III. Belonging and love needs include

To facilitate the maintenance of effective verbal and non-verbal communication. To promote the development of productive inter-personal relationships.

To facilitate progress towards achievement of personal spiritual goals.

IV. Esteem needs include

To recognize the physiological response of the body to disease conditions pathological, physiological, and compensatory. To identify and accept positive and negative expressions, feelings and reactions, the interrelatedness of emotions and organic illness. To create and/or maintain a therapeutic environment.

To facilitate awareness of self as an individual with varying physical, emotional and developmental needs.
To accept the optimum possible goals in the light of limitations, physical and emotional To use community resource as an aid in resolving problems arising from illness. To understand the role of social problems as influential factors in the case of illness.

This theory is mainly applicable for assessment and identification of nursing problems with nurse-centered orientation. For e.g. If we take patient with Severe crushing chest pain Shortness of breath Tachycardia and Profuse diaphoresis

Assessment includes

Physiological needs and Esteem Needs

The patients physiological needs include

Hygiene and physical comfort Exercise, rest and sleep Maintenance of good body mechanics thereby deformity will be prevented Oxygen supply to be administered Nutrition to be met Elimination needs to be taken care Fluid and electrolyte balance to be maintained

The patients Esteem needs include The nurse should;

Recognize the abnormal signs and symptoms of heart problem Identify his emotional status towards disease condition Provide therapeutic environment Facilitate self-awareness

Make him to understand the optimum way of living and achieving goals Advice him about availability of community resources to resolve complications Make him to understand the social factors which will influence his disease condition

Thank You !!!