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The Modeling and Role Modeling Theory was developed by Helen Erickson, Evelyn M. Tomlin, and
Mary Anne P. Swain. It was first published in 1983 in their book Modeling and Role Modeling: A
Theory and Paradigm for Nursing . The theory enables nurses to care for and nurture each patient
with an awareness of and respect for the individual patient's uniqueness. This exemplifies theory-
based clinical practice that focuses on the patient's needs.
The theory draws concepts from a variety of sources. Included in the sources are Maslow's Theory
of Hierarchy of Needs, Erikson's Theory of Psychosocial Stages, Piaget's Theory of Cognitive
Development, and Seyle and Lazarus's General Adaptation Syndrome.
The Modeling and Role Modeling Theory explains some commonalities and differences among
people.
Holism, which is the belief that people are more than the sum of their parts. Instead, mind,
body, emotion, and spirit function as one unit, affecting and controlling the parts in dynamic
interaction with one another. This means conscious and unconscious processes are equally
important.
Basic needs, which drive behavior. Basic needs are only met when the patient perceives
they are met. According to Maslow, whose hierarchical ordering of basic and growth needs is
the basis for basic needs in the Modeling and Role Modeling Theory, when a need is met, it
no longer exists, and growth can occur. When needs are left unmet, a situation may be
perceived as a threat, leading to distress and illness. Lack of growth-need satisfaction
usually provides challenging anxiety and stimulates growth. Need to know and fear of
knowing are associated with meeting safety and security needs.
Affiliated Individuation is a concept unique to the Modeling and Role Modeling Theory, based
on the belief that all people have an instinctual drive to be accepted and dependent on
support systems throughout life, while also maintaining a sense of independence and
freedom. This differs from the concept of interdependence.
Attachment and Loss addresses the idea that people have an innate drive to attach to
objects that meet their needs repeatedly. They also grieve the loss of any of these objects.
The loss can be real, as well as perceived or threatened. Unresolved loss leads to a lack of
resources to cope with daily stressors, which results in morbid grief and chronic need
deficits.
Psychosocial Stages, based on Erikson's theory, say that task resolution depends on the
degree of need satisfaction. Resolution of stage-critical tasks lead to growth-promoting or
growth-impeding residual attributes that affect one's ability to be fully functional and able to
respond in a healthy way to daily stressors. As each age-specific task is negotiated, the
person gains enduring character-building strengths and virtues.
Cognitive Stages are based on Piaget's theory, and are the thinking abilities that develop in a
sequential order. It is useful to understand the stages to determine what developmental
stage the patient may have had difficulty with.
Inherent Endowment, which is genetic as well as prenatal and perinatal influences that affect
health status.
Model of the World is the patient's perspective of his or her own environment based on past
experiences, knowledge, state in life, etc.
Adaptation is the way a patient responds to stressors that are health- and growth-directed.
Adaptation Potential is the individual patient's ability to cope with a stressor. This can be
predicted with an assessment model that delineates three categories of coping: arousal,
equilibrium, and impoverishment.
Self-Care is the process of managing responses to stressors. It includes what the patient
knows about him or herself, his or her resources, and his or her behaviors.
Self-Care Knowledge is the information about the self that a person has concerning what
promotes or interferes with his or her own health, growth, and development. This includes
mind-body data.
Self-Care Resources are internal and external sources of help for coping with stressors.
They develop over time as basic needs are met and developmental tasks are achieved.
Self-Care Action is the development and utilization of self-care knowledge and resources to
promote optimum health. This includes all conscious and unconscious behaviors directed
toward health, growth, development, and adaptation.
In the theory, modeling is the process by which the nurse seeks to know and understand the
patient's personal model of his or her own world, as well as learns to appreciate its value and
significance. Modeling recognizes that each patient has a unique perspective of his or her own
world. These perspectives are called models. The nurse uses the process to develop an image and
understanding of the patient's world from that patient's unique perspective.
Role modeling is the process by which the nurse facilitates and nurtures the individual in attaining,
maintaining, and promoting health. It accepts the patient as he or she is unconditionally, and allows
the planning of unique interventions. According to this concept, the patient is the expert in his or her
own care, and knows best how he or she needs to be helped.
This model gives the nurse three main roles. They are facilitation, nurturance, and unconditional
acceptance. As a facilitator, the nurse helps the patient take steps toward health, including providing
necessary resources and information. As a nurturer, the nurse provides care and comfort to the
patient. In unconditional acceptance, the nurse accepts each patient just as he or she is without any
conditions.
The basic theoretical linkages used in nursing practice for this model are: developmental task
resolution (residual) and need satisfaction are related; basic need status, object attachment and
loss, growth and development are all interrelated; and adaptive potential and need status are
related.
According to the theory, the five goals of nursing intervention are to build trust, promote the patient's
positive orientation, promote the patient's control, affirm and promote the patient's strengths, and set
mutual, health-directed goals.
Modeling refers to the development of an understanding of the patient's world, while role modeling is
the nursing intervention, or nurturance, that requires unconditional acceptance. This model
considers nursing as a self-care model based on the patient's perception of the world, as well as his
or her adaptation to stressors.
When it comes to research, the following are some theoretical propositions presented by the model:
The individual's ability to contend with new stressors is directly related to the ability to
mobilize resources needed.
The individual's ability to mobilize resources is directly related to their need deficits and
assets.
Objects that repeatedly facilitate the individual patient in need take on significance for that
individual patient. When this occurs, attachment to the significant object occurs.
Real, threatened, or perceived loss of the attachment object results in morbid grief.
An adequate alternative object must be perceived as available in order for the patient to
resolve his or her grief process.
Unmet basic and growth needs interfere with growth processes for the patient.
Introduction
Major Concepts
Holism
Basic Needs
Affiliated-Individuation
Psychosocial Stages
Cognitive Stages
Adaptation
Adaptation Potential
Stress
Self-Care
Self-Care Knowledge
Self-Care Resources
Self-Care Action
Modeling
Role Modeling
According to this concept, the client is the expert in his or her own
care and knows best how he or she needs to be helped.
Application of the theory
Facilitation
Nurturance
Unconditional Acceptance
Build trust
Conclusion
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