WRITTEN REPORT:

Lydia Hall: Care, Cure, Core

Nursing Theory

BSN 1-5

GROUP 1:
Lapid, Alexandra D.G
Mendoza, Janella Rose D.
Ramirez, Rovina Victoria S.
 TABLE OF CONTENTS:

Life History of Lydia Hall

Biography 1

Early life of Lydia Hall 1

Education 1

Career 2

Works of Lydia Hall 2

Awards and Honors of Lydia Hall 2

Presentation of Concepts, Relationships, Model and Paradigm

Introduction of Care, Core, Cure Model/Theory 3

Definition of The Four Metaparadigms in Nursing 3

Major Concepts of Care, Core, Cure Theory 4-5

Relationship of the Concepts of Care, Cure, and Core Theory 5-6

Conclusion 6

Lydia Hall’s Theoretical Assumptions 7

Application of the Theory in the Fields of Practice and Research

Nursing Practice 7-8

Research 8-9

References 10
LIFE HISTORY OF LYDIA ELOISE WILLIAMS HALL

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Biography
Lydia Eloise Hall (September 21, 1906 – February 27, 1969) was a nursing theorist who
developed the Care, Cure, Core model of nursing. Her nursing experience was in clinical
nursing, nursing education, research, and in a supervisory role. She was an innovator, motivator,
mentor to nurses in all phases of their careers and an advocate for chronically ill patients.

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

Early Life
Lydia Hall was born on September 21, 1906, in New York City. She was the eldest child
of Louis V. Williams and Anna Ketterman Williams. At a young age, her family moved to York,
Pennsylvania, where her father was a physician.

Education
Lydia Hall graduated from York Hospital School of Nursing in 1927 with a diploma in
nursing. After several years in clinical practice, she resumed her education and earned a Bachelor
Science degree in Public Health Nursing in 1932. Later, she pursued a doctorate and completed
all of the requirements except for the dissertation.

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Career
Lydia Hall's nursing experience was functional, proficient, and 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
wherein she became a staff nurse with the Visiting Nurses Association of New York and stayed
there until 1947. And in 1950, she became a professor at the Teacher’s College at Columbia,
where she 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 the professional nurse played in its recovery and welfare. She
founded the Loeb Center for Nursing and Rehabilitation at Montefiore Medical Center in Bronx,
New York. Through her leadership, the nursing-centered care reduced rehabilitation time and
length of stay by up to one-third.

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 many articles regarding the Loeb Center and her
long-term care and chronic disease control theories. 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 to provide 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.” During her time there, Hall authored 21
publications and bulk of articles and addresses regarding her theory.

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 was their Nursing Hall of
Fame inductee. In 1984, she was inducted into the American Nurses Association (ANA) Hall of
Fame.

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PRESENTATION OF CONCEPTS, RELATIONSHIPS MODEL AND NURSING
PARADIGM

Introduction of Care, Core, Cure Model/Theory

Lydia Hall was described as a visionary, risk-taker, and extremely skilled professional.
She was remembered by her colleagues for her extreme passion for nursing. She inspired
commitment and dedication through her unique conceptual framework for nursing practice that
viewed professional nursing as the key to the care and rehabilitation of patients. In the late
1960s, Hall’s interest and research in the field of rehabilitation of chronically ill patients brought
her to the formulation and development of her now-famous Care, Core, Cure Theory of Nursing
with also the use of her knowledge of psychiatry and nursing experiences in the Loeb Center.

Definition of The Four Metaparadigms in Nursing

The four metaparadigms of nursing include person, environment, health, and nursing.
Hall's theory defines 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.” Hall stipulated that patients should be cared for only by
professional nurses who can take total responsibility for the care and teaching of their patients.
The next metaparadigm is the Individual/Patient who is 16 years of age or older and past the
acute stage of long-term illness focuses on nursing care in Hall’s work. 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. Hall also viewed
a patient as composed of these three aspects: body, pathology and person. She emphasized the
individual’s importance as unique, capable of growth and learning, and requiring a total person
approach. With this, patients were able to achieve their maximal potential through the learning
process. That is why the chief therapy they need is teaching. The next metaparadigm according
to Hall is Health which can be inferred as a state of self-awareness with a conscious selection of
optimal behaviors 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. Lastly, The concept of society or environment according to Hall is
dealt with concerning the individual. Hall is credited with developing Loeb Center’s concept
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 nurses’
action is the individual. Any actions taken concerning society or the environment are to assist the
individual in attaining a personal goal.

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Major Concepts of Care, Core, Cure Theory

https://nursologycom.files.wordpress.com/2018/08/halls-three-aspects.png?w=584&h=584

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. In this theory, Hall enumerated
three aspects of the person as a patient: the person, the body, and the disease. She believed that
this model reflected the nature of nursing as a professional interpersonal process. Her “Core,
Cure, Care” Nursing theory identifies the nurse-to-patient relationship as central to healing for
those who are chronically ill. This nursing-centered care model reduced rehabilitation time and
length of stay by up to one-half to one-third. Hall visualized each of the three overlapping circles
as an “aspect of the nursing process related to the patient, to the supporting sciences and to the
underlying philosophical dynamics” (Hall, 1958, p. 1).
The care circle is Hall’s explanation of the role of nurses in her model. Hall suggested
that the part of nursing that is concerned with intimate bodily care (e.g., bathing, feeding,
toileting, positioning, moving, dressing, undressing, and maintaining a healthful environment)
belongs exclusively to nursing. That is why 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 that will educate and help a patient meet any needs he or she is
unable to meet alone. This aspect provided the opportunity for closeness and required seeing the
process as an interpersonal relationship (Hall, 1958). As closeness develops, the patient can share
and explore feelings with the nurse.
The second aspect of the nursing process is shared with medicine and is labeled the
“cure.” The nurse may assume medical functions, or help the patient with these through
comforting and nurturing. Hall (1958) comments on the two ways that this medical aspect of
nursing may be viewed. First, it may be viewed as the nurse assisting the doctor by assuming
medical tasks or functions, then the other view of this aspect of nursing is to see the nurse

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helping the patient through his or her medical, surgical, and rehabilitative care in the role of
comforter and nurturer. 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.
The third area that nursing shares with all of the helping professions is that of using
relationships for therapeutic effect—the core. According to Hall’s theory, It is the patient
receiving nursing care. He or she has goals set by him or herself rather than by any other person
and behaves according to their 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 (Hall, 1955, 1958, 1965). Knowledge and skills are important for the nurse to be able
to use self therapeutically including knowing self and learning interpersonal skills. The goals of
the interpersonal process are to help patients to understand themselves as they participate in
problem focusing and problem solving. This can help the patient verbally express feelings
regarding the disease process and its effects by using the reflective technique. Through such
expression, the patient can gain self-identity and further develop maturity. The professional nurse
uses the reflective technique to act 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 can now make conscious decisions based on
understood and accepted feelings and motivation. Hall believed that through this process, the
patient would emerge as a whole person.

Relationship of the Concepts of Care, Cure, and Core Theory

https://nurseslabs.com/wp-content/uploads/2014/08/Halls-Diagram.png.webp
As seen in the figure above, There is an emphasis put on all three aspects of the theory
(care, cure, and core circles) functioning together. The circles overlap and change in size as the
patient progresses through a medical crisis to the rehabilitative phase of the illness. A nurse also
functions in all three circles but to different degrees. In the acute (severe) care phase, the CURE

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circle is the largest. During the evaluation and follow-up phase, the CARE circle is predominant.
(Chinn & Jacobs, 1987; Marriner-Tomey, Peskoe, & Gumm, 1989; Stevens-Barnum, 1990).

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.
Nursing functions in all three of the circles but shares them to different degrees with other
disciplines. The core is the patient. 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. The cure refers to the medical and nursing interventions,
and the care is the nurturing provided by nurses. Hall clearly stated that the focus of nursing is
the provision of intimate bodily care. Being expert in the area of the body involved more than
simply knowing how to provide intimate bodily care. To be an expert, the nurse must know how
to modify the care depending on the pathology and treatment while considering the unique needs
and personality of the patient.
This theory emphasizes the importance of the total patient rather than looking at one part
or aspect. Hall believed that the role of professional nursing was enacted through the provision of
care that facilitates the interpersonal process and invited the patient to learn to get at the core of
his difficulties while seeing him through the cure that is possible. Through the professional
nursing process, the patient has the opportunity of making the illness a learning experience from
which he may emerge even healthier than before his illness (Hall, 1965).

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THEORETICAL ASSUMPTIONS
According to Hall’s Care, Cure, Core Theory, assumptions 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 the size, depending
on the patient’s total course of progress.

APPLICATION OF THE THEORY IN THE FIELDS OF PRACTICE AND RESEARCH

Nursing Practice:
The core, cure, and care theory of Lydia Hall are simple to apply in practice. Her theory's
central concept outlines the person for whom nursing care is intended, as well as the individual's
behavior as a result of their feelings and value system.
This theory of Lydia Hall can be used in the assessment, planning, and implementation of
patient care.
The assessment part which is the first step in the nursing process. The nurse gets
information regarding the patient's psychological, physiological, sociological, and spiritual status
throughout this phase. This information can be gathered in a number of ways. A patient
interview is usually conducted by nurses. Physical examinations, a patient's medical history, a
patient's family history, and general observation can all be utilized to collect evaluation data.
During this evaluative phase, patient interaction is usually the most intense and this is where the
core circle of Hall’s theory can be used. This section focuses on the patient's and using the
reflective method, the patient can vocally convey thoughts about the illness process and its
repercussions. The patient can achieve self-identity and maturity by expressing themselves in
this way.
Next is the planning. The nurse makes an educated judgment regarding a potential or
actual health condition with a patient. These evaluations include not just a description of the
problem, but also whether or not the patient is at risk of developing further issues. A plan of
action can be created after the patient and nurse agree on the diagnosis. If there are numerous
diagnoses to be treated, the head nurse will prioritize each evaluation and focus on severe
symptoms and high risk factors. Nurses typically use the Nursing Outcome Classification for this
phase, which is a collection of defined words and metrics for measuring patient health. This goes
in the cure circle of Hall’s theory. Hall explains in the model that the nurse shares the cure circle
with other health professionals, such as physicians or physical therapists.
The nurse's job in the implementation phase is to carry out the plan of action that has
been chosen. This strategy is tailored to each patient's needs and focuses on attainable goals.
Monitoring the patient for signs of change or improvement, directly caring for the patient or
performing necessary medical tasks, educating and instructing the patient about further health
management, and referring or contacting the patient for follow-up are all actions included in a
nursing care plan. This phase goes in the care circle where nurses are focused on the important
duty of caring for patients. This circle symbolizes the job of nurses only, and it is exclusively
focused on completing the mission. The nurse and patient will also have an opportunity for
closeness and as closeness develops, the patient can share and explore feelings with the nurse.

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 For example, there is a patient that is a post-stroke, 59 years old male with left sided
hemiparesis and dysarthria. The nursing interventions used the Core, Care and Cure theory of
Hall. In the core which is the therapeutic use of self, nurses help patients to set realistic goals,
provide emotional support and encouragement, this is because the motivation and energy
necessary for healing exists with the patient rather than with the health care team. In addition,
nurses reinforce structured training programs and observe the performance and progress of the
patient. They can also give positive feedback to the patients to encourage him to restore his
mobility and functional independence as possible. For the care circle which is intimate bodily
care, nursing interventions can be by correcting positioning to prevent complications and to
provide a full range of motions to maintain joint mobility. Lastly, in the cure circle which is the
medical care aspect, nursing interventions are as follows; administration of the physician’s
prescribed medicine and the collaboration with other health professionals like physiotherapist,
occupational therapist, and speech and language therapist.

Research:
Growing research needs more information, and the necessity for a successful nursing
practice system. Nursing is a complicated field that necessitates theoretical explanations and
descriptions of nursing phenomena. Thus in using Hall’s Theory on where she utilized the use of
well-defined terminology that was consistent throughout the theory. It can be used in research. It
also maintains consistency in terms of content, beginning with the identification of assumptions
and the meticulous characterization of ideas, which she defined as the interconnected rings of
care, cure, and core. She also created an overlapping circle graphic to show how the three
components of nursing intervention may be used to achieve the objective of wellbeing. The
principles are basic yet logical, and nurses may quickly comprehend their meaning and apply it
to patient care or future research in the nursing plan. The theory may be used for all elements of
nursing care methods. Hall’s Theory also emphasizes the nurse's, patient's, and other health
providers' interconnectedness in achieving health. It opens the way for more trials and research
to improve the quality of care.
For example, a study applies Lydia E. Hall's theory to the treatment of a patient with a
cerebrovascular accident. The Medical Ward of the Las Pinas General Hospital Center and
Satellite Center was used for this research. The researcher worked for 8 hours every day for 15
days, caring for a CVA patient. During the patient's confinement days, 19 nursing diagnoses were
made, and 19 nursing care plans were created. According to the theory, therapeutic use of self
was classified under the core element, intimate body care was classified under the care aspect,
and aiding with the medical plan was classified under the cure aspect. The three interconnected
components of the theory were shown to be useful and efficient in enhancing the quality of
nursing care for a patient with a cerebrovascular accident, according to the study. The actual
inclusion of the three components in carrying out activities or nursing interventions for the
patient's care enhanced patient care.
In conclusion, The theory by Lydia Hall on the three interrelated aspects of nursing as
"the core, care, and cure" proved to be effective and efficient in improving the quality of nursing
care for a patient with cerebrovascular accident. Hall's theory was utilized in the different phases
of the nursing process to care for a patient with cerebrovascular accident. Her theory on the
three-fold aspect of nursing was best described during the implementation phase where nursing
actions are categorized based on the therapeutic use of self (core), intimate bodily care (care),
and assisting in the medical plan (cure). A case study method was employed in the conduct of the

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study. A researcher-made assessment tool based on Lydia Hall's theory on three interlocking
aspects of nursing was utilized during the investigation and observation of the patient. The
researcher went on an intensive 8 hour per day duty caring for a patient with CVA from
admission until discharge for a total of 15 days. Nineteen nursing diagnoses were formulated
based on identified patient needs and nineteen nursing care plans were implemented to address
these problems.
Another example of the Application of Hall’s theory in research is on a study about the
Provider-type and Heart Failure Hospitalizations which uses Hall’s Theory to differentiate the
approach the nurses take in caring for their patients through Lydia Hall’s Care, Cure, Core
Theory. The theory shows the importance of nursing interventions – in this case, advanced
practice nursing, on the care of heart failure patients. In conclusion, nurses use Lydia Hall's Care,
Cure, and Core Model to offer care that supports the patient in learning to reach the core of his or
her issues and seeing him or her through the cure (Parker & Smith, 2010). The patient has the
ability to learn from his or her sickness via this nursing process, and may even emerge healthier
than before (Parker & Smith, 2010). Nurse practitioners' unconscious implementation of the
nursing process as defined in Lydia Hall's Care, Cure, and Core Model helps to bring their
quality of care up to par with physicians' despite disparities in schooling and training.
In this research study a non-experimental, retrospective longitudinal study will be
completed on outpatient care encounter data. A follow-up study as a type of longitudinal design
is preferred, because clinical data will be collected at more than one point in time over an
extended period on the same patients (Polit & Beck, 2012, p. 187). Data Collection Process
through chart reviews of the patients’ electronic health records will provide the data necessary
for this study. As stated before, data will be collected retrospectively, and will follow individual
patients’ records from their first heart failure exacerbation to their most recent. In order to collect
the most recent and relevant information, quota sampling will occur in a reverse chronological
order – meaning that data will be collected starting at the current time and going backward. A
two-tailed independent t test will be performed, in order to compare the means of the
grouping/independent variables, outpatient care of heart failure patients by physicians vs. nurses,
and to detect any differences between the two.

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References:
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● Parker, M. E. (2001), Nursing Theories and Nursing Practice (1st Edition). F. A. Davis
Company.
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Retrieved October 9, 2021, from Herdin ph:
http://www.herdin.ph/index.php/partners?view=research cid=52012
● Chinn, / P. (2018, June 2). Lydia Hall (1906 – 1969). NurseManifest. Retrieved October
16, 2021, from https://nursemanifest.com/2018/07/27/lydia-hall-1906-1969/.
● Jamito M. C. (2017). Provider-type and Heart Failure Hospitalizations. ScholarWorks.
Retrieved October 9, 2021, from
https://scholarworks.calstate.edu/concern/theses/f4752h309?locale=zh
● JaypeeSidon. (1970, January 1). Lydia E. Hall: Core, care and cure model. Lydia E. Hall:
Core, Care and Cure Model. Retrieved October 16, 2021, from
http://tfnursing.blogspot.com/2014/06/lydia-e-hall.html .
● Nursing Process Steps. (n.d.). Retrieved October 9, 2021, from
https://www.nursingprocess.org/Nursing-Process-Steps.html
● Revilla, A. (2021, March 5). Lydia Hall: Care, cure, core nursing theory. Nurseslabs.
Retrieved October 9, 2021, from
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