Lydia E. Hall’s Care, Cure, Core Theory

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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.

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

Individual

The individual human who is 16 years of age or older and past the acute stage of 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 a 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

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. 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.

Lydia Hall's Three Aspects of Nursing
Lydia Hall’s Three Aspects of Nursing

The Care Circle

According to the theory, nurses are focused on performing the noble task of nurturing patients. 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 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.

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.

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 the reflective technique. Through such expression, the patient is able to gain self-identity and further develop maturity.

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.

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.

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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.

Hall's Diagram
Hall’s diagram showing interlocking circles that may change in size and overlap

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.

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.

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.

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.

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.

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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.

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.

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.

See Also

References

  1. Alligood, M., & Tomey, A. (2010). Nursing theorists and their work, seventh edition (No ed.). Maryland Heights: Mosby-Elsevier.
  2. Hall, L. (1965) Another view of nursing care and quality. Address given at Catholic University Workshop, Washington, D.C. In George, J. (Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange.
  3. George, J.B.; Nursing Theories: The Base for Professional Nursing Practice; 2000.

Further Reading

With contributions by Wayne, G., Ramirez, Q.

Last updated on
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Angelo Gonzalo, BSN, RN
Angelo Gonzalo earned his Nursing degree in the year 2010 and continued his studies at St. Paul University Manila taking up Masters of Arts in Nursing Major in Clinical Management. He worked as an intensive care nurse for more than six years. He advocates for proper training and development of new nurses, quality assurance and compassionate care. He has also been involved in community development for 10 years steering programs on good governance, health, sports, and education. Angelo aims to build a good foundation for aspiring nurses. He would like to impart the importance of understanding nursing theories that he hopes to be translated successfully to practice.

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