Lydia Hall Core Care Cure Model by Joany Rabilas

Lydia Hall

• born September 21, 1906 in New York City
• grew up in Pennsylvania
• with flamboyant personality & passion for nursing according to colleagues
• died of heart attack in February 27, 1969

• 1927: York Hospital School of Nursing
• 1932: Bachelors in Public Health Nursing
• 1942: Master of Arts Degree at Teacher's College Columbia University

Work experience

• Research Analyst, U.S. Public Health
• Project Director, Public Health System
• Director, Loeb Center (Bronx, New York, USA)

Achievements

• published more than 20 articles about Loeb Center in early 1960's
• 1964: "Nursing: What is it?" in The Canadian Nurse
• 1969: "The Loeb Center for Nursing and Rehabilitation"in the International Journal of Nursing Studies
• =>1975: evaluation of Loeb Center revealed that those admitted in the unit were readmitted less often, more independent, had higher post- discharge quality of life, more satisfied with hospital experience

“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.”

~ Hall (1965)

Care, Core, Cure Model

• Health can be inferred to be a state of self-awareness with conscious selection of behaviors that are optimal for that individual.
• The concept of society/environment is dealt with in relation to the individual.
• Nursing is identified as consisting of participation in the aspects of patient care.

Exploring the aspects of patient care...

CARE

"... make a distinction between trade & profession... laying hands to wash the body is an activity. It is trade. .. look beyond it for opportunities that activity opens up something more enriching in growth... is a profession."

• represents the nurturing component of nursing and is exclusive to nursing
• concept of mothering (care and comfort of the person) and provide for teaching-learning activities
• an opportunity for closeness -> share and explore feelings

CORE

"Nurses must work with patient professionally, rather than for him technically, or at him vocationally.

• based in the social sciences, involves the therapeutic use of self
• developing an interpersonal relationship with the patient
• patient is able to gain self-identity and further develop maturity
• use of reflective technique : process of bringing into awareness the feelings being experienced

CURE

• based in the pathological and therapeutic sciences
• nurse is an active advocate of the patient

"... patients receive second class doctoring from professional nurses and second class nursing from practical nurses

• The motivation and energy necessary for healing exist within the patient, rather than in the health care 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.

Journals Using Model

• Lyon, JC. (1993). Models of nursing care delivery and case management: Clarification of terms. Nursing Economic$, Vol. 11. Issue 3, pp. 163-169.

• Rigby A.; Leach C.; Greasley P. (2001). Primary nursing: Staff perception of changes in ward atmosphere and role. Journal of Psychiatric & Mental Health Nursing, Vol. 8, Issue 6, pp. 525-532.

• Hilton, PA. (1997). Theoretical perspectives of nursing: A review of the literature. Journal of Advanced Nursing, Vol. 26, Issue 6, pp. 1211-1120.

• Dabney, Beverly Waller ; Huey-Ming Tzeng. (2013). Service Quality and Patient-Centered Care. MEDSURG Nursing, Vol. 22, Issue 6, pp. 359-364.

• Adrian, ML; Andaya, JEMR; Andrade, PAP; Cabiles, RD; Cabrera, SFA; Concepcion, MJM; Kim, EYC; Maren, AIG; Morento, KAG; Paraiso, AJS; Samaniego, JAB; Supetran, CEC; Villa, PJI. (2013). Lydia Hall's Care, core and cure level of orientation of Nursing students of Manila Tytana Colleges. 6th National Nursing Research Conference: Adventures of Nursing research, Poster presentation, The Crown Legacy Hotel, Baguio City: Philippine Nursing Research Society, Inc.

Case application

• During the acute phase of illness, the cure circle will be largest.
• During the evaluation & follow- up visits, care circle is the biggest.
• During long term care, core circle should be largest.

• Mental health patients

• Community based clients

• Chronically ill clients

• Palliative patients

• Patients with language barriers

• Young pediatric patients

Strengths

• stressed autonomous function of nursing: professional nursing care
• use of the terms care, core, and cure are unique to Hall => philosophy of nursing
• "Nursing was raised to a high therapeutic level." ~ Genrose Alfano, 1999
• work appears to be completely and simply logical

Weaknesses

• excludes illness prevention & health maintenance
• application may not be so simple for nurses whose personality, educational preparation, and experience have not prepared them to function with minimal structure
• self-imposed age and illness requirements limit the generalizability
• only tool of therapeutic communication Hall discussed is reflection
• concept of a patient aggregate such as having families and communities as the focus of nursing practice was not tackled

Lydia Hall: Care, Core, Cure Model

The Body

The Person

Assumptions

Profile

"The CARE"

"The CORE"

SOCIAL SCIENCES

NATURAL & BIOLOGICAL SCIENCES

Education

The Disease

"The CURE"

PATHOLOGICAL & THERAPEUTIC SCIENCES

The CORE

Aspects of Patient Care

The Care

The CURE

Montefiore Medical Center : Loeb Center

• 1947: Dr. Martin Cherkasky was Director of new hospital based home care division
• 1950: Cherkasky was appointed Director of Montefiore Medical Center
• Convalescent treatment was undergoing rapid change due largely to medical advances, new pharmaceuticals & technological discoveries.
• Cherkasky & Hall collaborated in convincing board for the establishment of Loeb Center -> 5 years of planning & construction under Hall's direction (1957)
• 1963: Loeb Center for Nursing & Rehabilitation

The CARE

The CURE

Immediate post- acute care

Long term care

Major Concepts:

The Person

Therapeutic use of self

"The CORE"

by Joany Rabilas

The disease

The Body

Intimate bodily care

Seeing the patient

& family

through

medical care

"The CARE"

"The CURE"

Aspects of Patient Care