Lydia Hall: Care, Cure, Core Nursing Theory

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Lydia Hall Nursing Theory

Learn about Lydia Hall and her nursing theory “Care, Cure, Core” model in this nursing theories study guide. Get to know Lydia Hall’s biography, career as a nurse, and an in-depth discussion of her nursing theory where we tackle the major concepts, assumptions, and its application to nursing.

Biography of Lydia E. 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.”

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.

Early Life of Lydia Hall

Lydia Eloise Williams Hall
Lydia Eloise Williams Hall

Lydia Hall was born on September 21, 1906 in New York City as Lydia Eloise Williams. She was the eldest child of Louis V. Williams and Anna Ketterman Williams and was named after her maternal grandmother. Her brother, Henry, was several years younger. At a young age, her family decided to move to York, Pennsylvania, where her father was a physician in general practice.

Education

Lydia Hall graduated from York Hospital School of Nursing in 1927 with a diploma in nursing. However, she felt as if she needed more education. She entered Teacher’s College at Columbia University in New York and earned a Bachelor of Science degree in public health nursing in 1932. After a number of years in clinical practice, she resumed her education and received a master’s degree in the teaching of natural life sciences from Columbia University in 1942. Later, she pursued a doctorate and completed all of the requirements except for the dissertation.

In 1945, she married Reginald A. Hall who was a native of England.

Career and Appointments

Just like any other nurses who have passion in their craft, Lydia Hall’s nursing experience was functional, proficient as well as hypothetical. She spent her early years as a registered nurse working for the Life Extension Institute of the Metropolitan Life Insurance Company in Pennsylvania and New York where the main focus was on preventative health. She also had the opportunity to work for the New York Heart Association from 1935 to 1940. In 1941, she became a staff nurse with the Visiting Nurses Association of New York and stayed there until 1947. Hall also managed to be an advocate of community involvement in public health issues. And in 1950, she became a professor at Teacher’s College at Columbia, where taught nursing students to function as medical consultants. She was also a research analyst in the field of cardiovascular disease.

Hall’s interest and research in the field of rehabilitation of chronically ill patients brought her to develop her now-famous Care, Cure, Core Theory. She was always interested in rehabilitative nursing and the role that the professional nurse played in the patient’s recovery and welfare. With these, she became involved in the establishment of the Loeb Center for Nursing and Rehabilitation at the Montefiore Medical Center (MMC) in the Bronx, New York. The Solomon and Betty Loeb Memorial Home for Convalescents had provided community services at Montefiore Hospital since 1905. In 1957, the Board of Trustees decided to expand the services and entered into a partnership with the hospital to construct a new facility. Dr. Martin Cherkasky, director of the hospital, contacted Hall to lead the venture, and she worked from 1957 to 1962 on all aspects of the project including construction and administration. As the founder and the first director, she was determined that nurses were in charge of everyday activities and transactions.

Hall then worked as the first director of the Loeb Center for Nursing. Her nursing experience was in clinical nursing, nursing education, research, and in a supervisory role. Through her leadership, the nursing-centered care reduced rehabilitation time and length of stay by up to one-half to one-third. The center became a prime example of nursing-led care, and many centers in the United States and Canada followed its principles. During her time there, Hall authored 21 publications and a bulk of articles and addresses regarding her theory.

Care, Cure, Core Theory

Lydia Hall used her knowledge of psychiatry and nursing experiences in the Loeb Center as a framework for formulating her theory. Also known as “the Three Cs of Lydia Hall,” it contains three independent but interconnected circles: the core, the care, and the cure.

The core 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.

The cure is the attention given to patients by medical professionals. Hall explains in the model that the cure circle is shared by the nurse with other health professionals, such as physicians or physical therapists. These are the interventions or actions geared toward treating the patient for whatever illness or disease he or she is suffering from.

The care circle addresses the role of nurses, and is focused on performing the task of nurturing patients. This means the “motherly” care provided by nurses, which may include comfort measures, patient instruction, and helping the patient meet his or her needs when help is needed.

Hall’s theory emphasizes the total patient rather than looking at just one part and depends on all three components of the theory working together.

Works of Lydia Hall

Aside from being a nurse, Lydia Hall also managed to balance her time in writing.  In the 1960s, she authored 21 publications and a bulk of articles regarding the Loeb Center and her theories of long-term care and chronic disease control. Her work was presented in “Nursing: What Is It?” in The Canadian Nurse. In 1969, it was discussed in “The Loeb Center for Nursing and Rehabilitation” in the International Journal of Nursing Studies. In her innovative work at the Loeb Center, Hall argued that a need exists in society for the provision of hospital beds grouped into units that focus on the delivery of therapeutic nursing. The Loeb plan has been seen in many ways as similar to what later emerged as “primary nursing.”

Awards and Honors of Lydia Hall

In 1967, Lydia Hall received the Teacher’s College Nursing Education Alumni Association (TCNEAA) Achievement in Nursing Practice Award and also was their Nursing Hall of Fame inductee. In 1984, she was inducted into the American Nurses Association (ANA) Hall of Fame.

Death

In memory of Lydia Hall, Louis Williams (father), and Henry Williams (brother)
In memory of Lydia Hall, Louis Williams (father), and Henry Williams (brother)

Hall died on February 27, 1969, at Queens Hospital in New York. Genrose Alfano continued her work at the Loeb Center until the focus of the center was changed to that of custodial care in 1985.

Lydia Hall’s: Care, Core, Cure

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

Lydia 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 of Care, Core, Cure

The following the the major concepts of Lydia Hall’s Care, Core, Cure nursing theory including their definitions.

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

Lydia 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. 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.

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

Lydia 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

Lydia 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

Lydia 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.

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

You may also like the following nursing theories study guides: 

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.

External Links

Further Reading

With contributions by Wayne, G. (Biography), Vera, M. Ramirez, Q.

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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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