1st theory

NANCY ROPER-WINIFRED LOGAN-ALISON TIERNEY'S MODEL OF NURSING BASED ON

ACTIVITIES OF LIVING
“Nursing is the practice of assisting patients live through life.”

(scenario:

✔ This model incorporates a life span approach wherein the characteristics of the person are considered
with respect
to prior development, current level of development, and likely future development.
✔ In conjunction with the life span approach an independence/dependence continuum is used. ✔ The
model then incorporates a set of 12 activities of living which represent those activities engaged in by
individuals whether sick or
well.

12 Activities of Living: together these elements are referred to as a <model of living=

1. Maintaining a Safe Environment:
● Maintaining a safe environment: Protecting the patient from harm and providing a
safe physical and emotional environment.
● Communicating: Facilitating effective communication between the patient and
healthcare providers.
2. Maintaining a Supply of Oxygen:
● Breathing: Ensuring the patient's respiratory system functions effectively.
3. Eating and Drinking:
● Eating and drinking: Providing nutrition and hydration to meet the patient's
physiological needs.
4. Eliminating Waste Products:
● Eliminating: Supporting the patient's ability to eliminate waste and toxins from the
body.
5.Maintaining Temperature: Ensuring the patient's body temperature remains within a
healthy range.
6. Mobilizing: Assisting the patient with mobility and physical activity.
7.Sleeping and Resting: Promoting healthy sleep patterns and providing opportunities for
rest and relaxation.
8. Expressing Sexuality: Addressing the patient's sexual health and emotional well-being.
9.Social Interaction: Supporting the patient's ability to engage in social activities and
maintain relationships.
10. Working and Playing: Encouraging the patient's ability to engage in meaningful work
and recreational activities.
11. Practicing Spirituality: Recognizing and respecting the patient's spiritual beliefs and
needs.
12. Dying: Providing appropriate care and support for patients at the end of life.
5 Main Factors that Influenced the ADLs:
▪ Biological
▪ Psychological
▪ Sociocultural
▪ Environmental
▪ Politico-economic

Characters:
● Alex p1(the person facing challenges)
● Dr. Barnes p2 (Biological)
● Sarah p3(Psychological)
● Carlos p4(Sociocultural)
● Maya p5(Environmental)
● Emily p6(Politico-economic)

Scene: The characters are seated, and Alex seems visibly stressed.
Alex: (Anxious) Thanks, everyone, for coming over. I've been struggling a lot lately, and I really
need your support.
Dr. Barnes: (Warmly) Of course, Alex. I'm Dr. Barnes, and I'll be representing the biological
aspect. Alex, tell us a bit about your physical health and how it's affecting your daily life.
Alex: (Nods) Well, I have a chronic illness that's causing pain and fatigue. It's been hard to do
even the simplest tasks lately.
Sarah: (Empathetic) I'm Sarah, and I'll be focusing on the psychological aspect. Alex, I
understand that dealing with your illness must also be taking a toll on your mental health. Can
you share how you've been feeling emotionally?
Alex: (Tearfully) It's been tough. I've been feeling anxious and depressed, and it's been hard to
stay motivated.
Carlos: (Introducing himself) Hi, Alex, I'm Carlos, representing the sociocultural factor. Your
cultural background and social circle play a significant role in how you cope with these
challenges. How has your cultural context influenced your experience?
Alex: (Reflecting) Well, my family has certain expectations, and sometimes it feels like I'm falling
short. They don't quite understand the extent of my illness.
Maya: (Introducing herself) I'm Maya, focusing on the environmental aspect. Alex, can you tell
us about your living environment? Is it accessible and supportive of your needs?
Alex: (Thoughtful) My apartment isn't very accessible. It's hard to move around, which makes
daily tasks like cooking and cleaning a real struggle.
Emily: (Last to introduce herself) I'm Emily, and I'll be discussing the politico-economic factor.
Alex, have you faced any challenges related to the cost of healthcare or support services?
Alex: (Sighs) Yes, Emily. The medical bills have been piling up, and I've had to make tough
financial decisions.
Dr. Barnes: (Summarizing) So, we've discussed how these five factors are influencing your
ability to carry out your daily activities, Alex. It's clear that they're interconnected and affecting
your overall well-being.
Sarah: (Supportive) Alex, it's essential to acknowledge these influences and seek support
where you can. It's okay to ask for help.
Carlos: (Encouraging) Your cultural background and social network can also be a source of
strength. Don't hesitate to lean on your friends and family for support.
Maya: (Practical) Consider making changes in your living environment that can improve your
accessibility and comfort. Small adjustments can make a big difference.
Emily: (Strategic) And let's explore options to manage the financial aspect. There might be
resources and assistance programs available to ease the financial burden.
Alex: (Grateful) Thank you all for being here and for your understanding. I'll take your advice to
heart, and I appreciate your support.
Dr. Barnes: (Assuring) Alex, we're here for you every step of the way. Together, we can work on
addressing these factors and improving your daily life.

Narrator: this demonstrates how five characters, each representing one of the five main factors
influencing Activities of Daily Living (Biological, Psychological, Sociocultural, Environmental, and
Politico-economic), come together to offer support and guidance to their friend, Alex, who is
facing challenges in his daily life.

▪ The model has been a significant guide towards advancing nursing practice, research, and
education in that it places great emphasis on the nurse’s ability to perform continuous patient
assessment, provide assistance in the performance of activities of living and individualizing
patient care.

‘▪ Health is viewed as a reflection of the person’s ability to perform the activities of living in the
light of the five factors that influence its degree of performance and within the context of the
person’s developmental age. Major Concepts & Definitions:

▪ Individuality of living → the way in which the person attends to his activities of living with respect to
his developmental age or his place in the life span, on the dependence-independence continuum, and as
influenced by biological, psychological, environmental, and politico-economic factors

▪ The activities of living → describe the person in the complex process of living from the perspective of
an amalgam of activities

▪ Life span → refers to the concept of continuous change from birth until death and may refer to
developmental age

▪ The dependence-independence continuum → relates to the factors and activities of the person → the
continuum ranges from full incapacitation to having the ability to achieve activities of living → both
concepts occur at anticipated points across the lifespan and at unexpected times throughout life

Application of the Theory:

▪ The Theory of the Elements of Nursing: A Model Based on a Model of Living emphasizes the
importance of developmental assessment and of individualizing patient care.
▪ No two patients can have similar reactions to a particular disease condition or illness state
because of the concept of individuality of living.
▪ The first vital step towards high quality patient care is for the nurse to individualize patient care
and to make a thorough nursing and health assessment.

2nd theory
LYDIA HALL’S CARE, CURE, CORE THEORY OF NURSING
“Nursing is a distinct body of knowledge that provides nursing care to patients who are in
need of nursing care in support of medical interventions, in collaboration with other members
of the health team, or exclusively and independently by the nurse herself.”

Setting: A busy hospital emergency room.

Characters:
● Nurse Maria
● Dr. Anderson
● Patient Sarah
Scene:
Nurse Maria is on duty in the emergency room. The ER is bustling with activity, with medical
professionals rushing around attending to patients. Suddenly, the doors burst open, and Dr.
Anderson rushes in, pushing a gurney with Patient Sarah, who appears to be in distress.
Dr. Anderson: (Urgent) Maria, we have a critical case here. Patient Sarah is in respiratory
distress, and we need to act fast.
Nurse Maria: (Calm and focused) I'm ready, Doctor. Let's get her settled, and I'll start the initial
assessment.
Dr. Anderson and Nurse Maria work together efficiently to transfer Sarah onto a bed, connecting
her to vital sign monitors and oxygen. Sarah is struggling to breathe, and her distress is evident.
Nurse Maria: (While assessing Sarah) Dr. Anderson, it seems like her oxygen saturation is
dropping rapidly. I'll initiate high-flow oxygen therapy and prepare for arterial blood gas analysis.
Dr. Anderson: (Nods) Good call, Maria. We need to determine the severity of her respiratory
failure. I'll also order a chest X-ray and consult with the respiratory therapist.
Nurse Maria quickly administers high-flow oxygen to Sarah, ensuring her oxygen levels start to
improve. At the same time, she starts an IV line for medication administration and provides
reassurance to Sarah.
Nurse Maria: (Comforting Sarah) Sarah, we're here to help you breathe more comfortably.
We're working to find out what's causing this, and we'll do everything we can to make you feel
better.
While they wait for the respiratory therapist and additional test results, Nurse Maria continues to
monitor Sarah closely, making adjustments to her care as needed. Dr. Anderson consults with
the radiologist to expedite the chest X-ray.
Dr. Anderson: (Returning) Maria, the X-ray is on its way. Let's keep a close eye on her vital
signs and oxygen saturation while we wait.
Nurse Maria: (Acknowledging) Understood, Doctor. I'll continue to provide the best nursing care
possible to stabilize her condition.

Narrator: As the team works together seamlessly, Nurse Maria's distinct body of nursing
knowledge and expertise plays a crucial role in providing immediate care and support to Patient
Sarah, complementing the medical interventions led by Dr. Anderson. The collaborative effort of
the healthcare team ensures that Sarah receives the comprehensive care she urgently needs.
Theory Description:
✔ This theory defines 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.
✔ 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 behavior 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.”

Theory Assumptions: ▪ The motivation and energy necessary for healing exist within the patient,
rather than in the healthcare team. ▪ The three aspects of nursing should not be viewed as
functioning independently but as interrelated. ▪ The three aspects interact, and the circles
representing them change size, depending on the patient’s total course of progress.

How Do Nurses Relate? ▪ She proposed many ideas of professional practice, such as the
nursing process ▪ Improvement of nurses to meet the needs of the patient with better
professional nursing care ▪ Management of nursing care ▪ Establishment of nurse-patient
relationship ▪ Collaboration with other health professionals ▪ Deliverance of care to ill patients

Application of the Theory:

▪ Nurses are able to carry out nursing interventions independently, dependently, or
interdependently.
▪ The core aspect of the theory maintains that it is our responsibility to make sure that the
patient receives the highest level of care possible from all concerned health professions.
▪ The role of the nurse is in the collaboration, coordination, and cooperation with other members
of the health care team on matters that pertain to the patient’s welfare.
▪ The cure aspect of the theory clearly delineates nursing functions that are dependent on the
members of the medical profession.
▪ Examples of these include medication administration, performance of diagnostic procedures,
and some other interventions that need a written order from the doctor.
▪ The care domain of the theory refers to the independent roles and functions of the nurse
insofar as her knowledge and skills about the patient’s condition will allow her to carry on with
her responsibilities.

Conclusion:
▪ Hall believed patients should only receive care from professional nurses.
▪ Hall defined her philosophy on the basis of the patient.
▪ Hall believed that patients come to the hospital in a biological crisis (acute episode of a
disease) and that medicine does a great job at treating this crisis, but fails to treat the chronic
underlying disease. This is where she felt nursing could make a significant difference
. ▪ Hall felt that taking over this sub-acute phase was the way for nursing to legitimize itself into a
true profession.