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In the 1960s, Lydia Hall developed the Care, Cure, Core Theory that is still a valuable
tool for the nursing profession today. She also was the first to use the term of nursing
process in 1955 when she defined nursing as consisting of the three steps of observing,
providing care and validating.
Hall's nursing specialty was rehabilitative care, but she was also experienced in many
other areas including public health and psychiatry. She viewed patients holistically
and her theory is based on the belief that patients need nurturing care to allow them
to recover and to express their feelings. She stated that patients could either express
their feelings or repress them and become ill or psychotic. Her theory stresses that
professional nursing care provides the therapeutic atmosphere needed for the recovery
of the chronically ill patient. She was not a proponent of team nursing that was popular
in the 1960s, believing that professional nurses should be the only caregivers.
According to the Care, Cure, Core Theory that is sometimes called the Three Cs of
Lydia Hall, the patient is comprised of three interrelated parts. The core is the
person, the cure is the illness and treatment and the care is the body. The three
components are represented by interlocking circles that vary in size according to
the condition of the patient. During the acute phase of illness, the cure circle
will be larger while the care circle will be larger during rehabilitation and follow-up
phases.
Hall felt that care represented the nurturing influence of the professional nurse and
was exclusive to nursing. The core represents the healing use of self including personal
reflection, and the cure focuses on nursing interventions related to doctors' orders.
Concepts
- A patient is composed of body, illness and person. Patients set their own goals and are able to learn and grow.
- The environment should help bring about the fulfillment of the patients' goals.
- Health refers to the development of the ability to choose actions that lead to growth.
- Caring is nursing's most important function. Professional nursing is most important during the patient's recuperation.
Assumptions
- Nurses participate in all aspects of patient care, but care is the sole function of nursing. The core and cure are shared with other members of the health care team including physicians, psychologists, social workers and clergy.
- The main purpose of nursing care is to develop a relationship with the patient that will lead to the development of the core.
Theory Assertion
- Favorable patient outcomes are directly related to the therapeutic care given by professional nurses. Care should not be turned over to auxiliary personnel when patients are stabilized. The patient's recuperation depends on professional nursing.
Care
- Care is the exclusive function of nurses.
- The nurse-patient relationship is therapeutic in itself.
- The most important need for chronically ill patients is professional nursing care.
- Nurses nurture patients.
- Nurses provide comfort.
- Nurses help patients meet their needs when assistance is required.
- Teaching is a part of caring.
- Nurses form interpersonal relationships with patients.
- Hands on care creates an atmosphere of trust and open communication between patients and nurses.
Cure
- The cure process is shared with medicine.
- Nurses apply their knowledge of disease to assist with the medical plan of care and educate the patients and their families about the process of illness.
- Nurses assist doctors by performing medical tasks.
- Nurses help patients and their families adhere to and understand the treatment ordered by doctors.
- Nurses act as patient advocates.
- Nurses develop care plans that are in the best interests of patients.
Core
- The core is shared with other members of the health team including social workers, psychologists, clergy and the community.
- Nurses communicate with patients to help them understand their health conditions.
- Nurses help patients understand their roles in the rehabilitation process.
- Nurses act as sounding boards for patients to help them understand their lives.
The Care, Cure, Core Theory was the first to stress that the whole person needed care.
It also was the first one to specify that only professional nurses should give care
to patients. It included not only care of patients but also integrated care of the
families and advocated for community involvement. The establishment of the Loeb Center
for Nursing and Rehabilitation in New York City in 1963 allowed Lydia Hall to put her
nursing theory in practice. She proved that the nurse-centered care improved patient
outcomes and shortened rehabilitation time and lengths of stay. Since then, many other
rehabilitation centers across the United States and Canada have used these principles
to improve their patient outcomes as well.
Publications related to the Care, Cure, Core Nursing Theory
- Hall, Lydia E. Nursing: What is It?, The Canadian Nurse, 1964
- Hall, Lydia E. Core, Care and Cure Model, Nursing Outlook, 1963
- Anonuevo, et al. Theoretical Foundations of Nursing
- Fundamentals of Nursing, 8e
- Nursing Theorists and Their Work, 8e
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