PRESENTATION ON:

LYDIA E. HALLS THEORY

Presented by:
Soniyan
Sister Sheeeli

CREDENTIAL OF LYDIA E. HALL

Received her basic nursing education at New

York Hospital School of Nursing in NY,
Pennsylvania.
Both her Public Health Nursing and MA in
Teaching Natural Science from Teachers
College, Columbia University.
She was the 1st director of the Loeb Center for
Nursing and Rehabilitation and continued in
the same position until her death in 1969.
Her experience in nursing spans the clinical,
educational, research, and supervisory
components.
Her publications include several articles on the
definition of nursing and quality of care.
Lidya Hall put forth what she considered a
basic philosophy of nursing is Patient Care.

Born in New York City on

September 21, 1906.

LYDIA HALLS THEORY OF

NURSING

She presented her theory of nursing visually

by drawing three interlocking circles, each
circles presenting a particular aspect of
nursing.
The circles represent;
1. Care,
2. Core and
3. Cure

1. THE CARE CIRCLE

It represent the nurturing component of nursing and is

exclusive to nursing.
Nurturing involves using the factors that makes up the
concept of mothering and provides for teaching-learning
activities.
The professional nurse provides bodily care for the
patient and help to complete such basic daily biological
functions as eating, bathing and dressing.
The nurses goal is the comfort of patient.
It provides an opportunity for closeness.
When this is developed the fullest, the patient can share
and explore feelings with the nurse and provides her the
teaching-learning aspects of nurturing.

1. THE CARE CIRCLE (CONT.)

A strong theory base allows the nurse to maintain a

professional status rather than a mothering status, while
at the same time incorporating closeness and nurturance
in giving care.
The patient views the nurse as a potential comforter,
one who provides care and comfort.
The Body:
Natural and biological
sciences
Intimate bodily care
aspects of nursing
The Care

2. THE CORE CIRCLE

The core circle of patient care involves the therapeutic

use of self and is shared with other members of the
health team.
The nurse is able to help the patient verbally, expressing
feelings regarding the disease process.
Through such expression the patient is able to gain selfidentity and further develop towards maturity.
The nurse helps the patient look at and explore feelings
regarding his/her current health status and related
potential changes in lifestyle.
Helps the patient to bring into awareness the verbal and
nonverbal messages being sent to others.

2. THE CORE CIRCLE (CONT.)

The patient is now able to make conscious decisions

based on understood and accepted feelings and
motivations.
The motivation and energy necessary for healing exist
within the patient rather than the health care team.

The Person:
Social sciences
Therapeutic use of self
aspects of nursing
The Core

3. THE CURE CIRCLE

It is based in the pathological, therapeutic sciences and

is shared with other members of the health team.
The professional nurse help the patient and family
through the medical, surgical and rehabilitative
prescriptions made by the physicians.
During the aspect of nursing care, the nurse is an active
advocate of the patient.
The Disease:
Pathological and therapeutic
sciences
Seeing the patient and family
through the medical care
aspect of nursing
The Cure

LYDIA HALLS THEORY OF

NURSING
The Person
Therapeutic use of self

Core

The Body
Intimate bodily care

Care

The Disease
Seeing Patient & Family
through medical care

Cure

NURSING DIAGNOSIS

Patient Profile:
Patient Name: Mrs. Devi
Age: 24 years
Pain over the abdominal and perineum related
to involution of uterus and presence of
episiotomy.
Knowledge deficit related to lack of information
regarding to baby care and post natal
management.
Risk for infection related to episiotomy suture.
Risk for infection related to immature immune
system.

1. CORE CYCLE

A patient named Mrs. Devi, aged 24 years got

admitted to OBG ward with G3P1L1A1 at 38 weeks
of gestation.
She complained of recurring abdominal pain
since 2 am with increasing intensity and
frequency.
During admission time there is no history of
leaking and bleeding.
She delivered a girl baby, weight 2.9 Kg at 10
pm.
She was coming to St. John for antenatal
checkup

2. CARE CYCLE

Accessed mother and fetus condition during

labor by periodic monitoring vitals signs and
fetal heart sound.
Provided psychological support and
motivation to the patient and their family.
Encouraged her to take adequate nutritious
food to enhance the milk production.
Provided her with good environment and
ventilation.
Involved the family to provide support and
care to the patient.

3. CURE CYCLE
Diagnostic (Dx)

Type of Investigations:

Hemoglobin:

10.3

Albumin:

Nil
Sugar: Nil
HBA1C: 52
TSH: 20 mg/dm

Medication (Rx)

Capsule: Fefol OD
Tablet: Shelcal OD
Thyronorm: 50 mcg OD

Special investigation:
VDRL:

-ve
HIV: -ve
HBSAG: -ve

Ultrasound: 38 weeks 4 days, cephalic presentation,

liquid adequate, fetal weight 2.9

Core

A patient named Mrs. Devi, aged 24 years got

admitted to OBG ward with G3P1L1A1 at 38 weeks of
gestation.

She complained of recurring abdominal pain since 2

am with increasing intensity and frequency.

During admission time there is no history of leaking

and bleeding.

She delivered a girl baby, weight 2.9 Kg at 10 pm.

She was coming to St. John for antenatal checkup

Diagnostic (Dx)

Accessed mother and fetus condition during

labor by periodic monitoring vitals signs and
fetal heart sound.
Provided psychological support and
motivation to the patient and their family.

Encouraged her to take adequate nutritious

food to enhance the milk production.

Provided her with good environment and

ventilation.

Involved the family to provide support and

care to the patient.

Care

Type of Investigations:

Hemoglobin: 10.3

Albumin: Nil

Sugar: Nil

HBA1C: 52

Medication (Rx)

TSH: 20 mg/dm

Capsule: Fefol OD

Special investigation:

Tablet: Shelcal OD

VDRL: -ve

HIV: -ve

HBSAG: -ve

Thyronorm: 50 mcg OD

Ultrasound: 38 weeks 4 days, cephalic

presentation, liquid adequate, fetal
weight 2.9

Cure

SECTION -2

INTERACTIONS OF THE THREE

ASPECTS OF NURSING

Hall emphasizes the importance of a total

person approach, it is important that the
three aspects of nursing are not viewed
functioning independently but rater as
interrelated.

HALLS THREE ASPECTS OF

NURSING
THE PERSON
Therapeutic use of self
THE CORE

THE BODY
Intimate bodily care
THE CARE

THE DISEASE
Seeing the patient and
family through medical
care
THE CURE

The three aspects interact and the circles

representing them change size depending on
the patients total course of progress
The professional nurse functions most
therapeutically when patients have entered
the second stage of their hospital stay
During this recuperation stage, the care and
core aspects are the most prominent and the
cure aspect is less prominent.

The size of the circles represents the degree

to which the patient is progressing in each of
the three areas
The nurse at this time is able to help the
patient reach the core of his problem
through the closeness provided by the care
aspect of nursing

HALLS THREE ASPECTS OF

NURSING
THE CORE

THE CARE

THE CURE

HALLS THEORY AND THE FOUR

MAJOR CONCEPTS

Although concept of nursing is identified by

Hall, she does not speak directly to the three
concepts of human, health, society/
environment. However , interferences can be
made from her work.

THE INDIVIDUAL HUMAN

who is 16 years of age or older and past the
acute stage of a long term illness is the
focus of nursing care
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 total person approach

HEALTH
It can be inferred to be a state of selfawareness with conscious selection of
behaviors that are optimal for that individual
Hall stresses the need to help the person
explore the meaning of his/her behavior to
identify and overcome problems through
developing self-identity and maturity.

SOCIETY/ENVIRONENT
It is dealt with in relation to the individual
She assumed the hospital environment during
treatment of acute illness creates a difficult
psychological experience for the ill individual
She focuses on providing an environment that
is conducive to self development and the
individuals actions taken in relation to
society or environment would be for the
purpose of assisting the individual in
attaining a personal goal

NURSING
It is identified as consisting of participation
in the care, core and cure aspects of patient
care
Care is the sole function of nurses, whereas
core and cure are shared with other
members of the health care team
The major purpose of care is to achieve an
interpersonal relationship with the individual
that will facilitate the development of core.
Ex.the development of self-identity and selfdirection by the patient

APPLICATION AND LIMITATION

OF THE THEORY
In reviewing Halls theory of nursing there
are several areas that limit its application to
patient care.
1. It is the stage of illness. Hall applies her
ideas of nursing to a patient who has
passed the acute stage of biological stress.
Ex.The patient who is experiencing the acute
stage of illness is not included in Halls
approach to nursing care. Whereas they need
the basic care.

2. A second limiting factor is age.

Hall refers to only aadult patients in the
second stage of their illness. This eliminates
all younger patients less than 16 years old.
However, it would be possible to apply Halls
theory with younger individuals.
Certainly adolescents younger than 16 are
capable of seeking self idendity.

3. Description of how to help a person toward

self-awareness. The only tool of therapeutic
communication discussed is reflection.
By inference, all other techniques of
therapeutic communication are eliminated.
Active listening and nonverbal support may
be used to facilitate the self development of
self-identity.

4. The family is mentioned in the cure circle.

The family is used only in regard to patiens
medical care.
It does not allow for helping a family
increase awareness of the familys self.

5. Halls theory relates only to those who are

ill.
This would indicate no nursing contact with
healthy individuals, families or communities
and it negates the concept of health
maintenance and health care to prevent
illness.

CONCEPTUAL FRAMEWORK
CORE
-Mrs. Rekha, 33 years old female got admitted to OBG ward with
G5A4 at 36 weeks of gestation

She came with complaints of decreased fetal movement since

2 days

She complaints of low back ache and has fear of loosing this
baby also

She has a bad obstetric history of four spontaneous abortions

in the past between 11/2 months to 3 months.

Her blood group is B negative and her husbands is O

positive.

CARE
-Assessed the condition of the mother by checking vital signs. Temp-Normal,Pulse80b/mt,
Bp-100/60mmHg.
-FHS checked daily.
-NST done daily. 17/10/16 FHS-146/mt, 18/10/16 FHS 144/mt, 19/10/16 FHS 140/mt
-Mother was asked to count the fetal movement daily and report
-Provided psychological support to Mrs.Rekha
-Encouraged her to talk to baby in the womb
-Informed her about the treatment and the condition of the baby
-Encouraged her to take nutritious food
-Provided good environment
-Encouraged her to ventilate her feelings and talk to other patients
-Involved the family to provide support and care to Mrs.Rekha

Cure
Investigations:
Blood ICT Negative
Urine C/S- No pus cells, no bcteria
NST- daily
Downs scan- Lower risk
USG SLF 36+3 weeks, ceph ,PLC anterior, liquid adequate,EFW2.7kg,single loop of cord, adjacent to neck,AFI-9.5cm, PlacentaFundal present
Treatment
Cap. Fefol OD
Tab.Shelcal OD
Arginine sachet OD

ASSESSMENT

Mrs. Rekha ,33 years old female had the obstretric score
of G5A4.

She had given up hope to have child.

She conceived spontaneously and at present 36 weeks of

gestation

She came with the complaints of decreased fetal

movement 4-5 movements per day.

She felt lack of support from the family since she didnt
have child for 15years

She is worried what baby she will deliver because her inlaws want a male baby.

CONCEPT IN RELATION TO
PATIENT
The Human:
-Mrs.Rekha is a 33 years old female.
-She has had 4 abortions in the past and at present came
with decreased fetal movement. At present for safe delivery
she is kept in the hospital
-Now she believes that she is capable of bearing a child and
she can live in the family and society with dignity.
-She believes that she is capable of taking care oneself and
the baby
-she is a calm,cheerful and cooperative person

HEALTH
Mrs.Rekhas

gestation is G5A4 .
She got admitted with decreased fetal movement
Physical examination:
-Height -153cm
-Weight -69 kg
-Temp- 98.4`F
-PP -80/mt
-RR -20/mt
-BP -100/60mmHg
General appearanceShe is moderately built, maintains hygiene by daily bath , changing clothes and
grooming hair.

Nutrition:- She takes three meals per day and takes non
vegetarian food twice a week.
Abdominal examination:
Abdominal girth -168 cm
Fundal height

- 37 wks,34 cm

Linea nigra

- present

Striae gravida

-Lightly present

Psychological assessment:
Mrs.Rekha didnt receive any psychological support from her
family since she didnt have child for 15 years. Whereas her
sister-in-law has three children.

SOCIETY/ENVIRONMENT

She lives in a joint family

.Total of 9 members (3

children).
They have pakka house with two rooms, one kitchen, one
hall and a bath room outside.
Her husband and her father-in-law are the earning
members in the family doing small business
Her brother-in-law whatever earns, he spends all the
money for drinking.
Her experience of the hospital in the past was not a
positive experience
She had four abortions ad Dilatation and evacuation was
done after each abortions.
She has received Inj. Anti D after each abortion.

NURSING

Developed interpersonal relationship

Provided her psychological support as she was worried about her baby

Assisted her in meeting ADL.

Adviced her to eat healthy food on time and take small and frequent
food.

Provided her fruits, snacks and milk in between the meals.

Informed her about the condition of the baby daily

Asked her to count the fetal movement daily

Built the confidence in her that she and her baby are doing well, not to
worry so much

Taught her about the normal process of labour and care of new born

Health education given on breast feeding

Advised her to prevent infection by personal hygiene and care of baby

Advised her to have positive thought about herself

NURSING DIAGNOSIS
1.Anxiety related to safe delivery and wellness of the baby
2.Knowledge deficit regarding the process of labour and care
of new born
3.Imbalanced nutrition less than body requirement related to
less food intake and increased calorie requirement
4.Altered sleeping pattern related to hospitalization and
discomfort experienced by the mother
5.Fatigue related to metabolic changes in prenancy
6.Risk for complications related to bad obstetric history and
decreased fetal movement
7.Disturbed body image related to change of appearance
with pregnancy

Assessm Nursing
ent
diagnosis
Subjecti
ve data

Goal

Planning Implementation Evaluation