As Hall (1965) says; “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.” Major Concepts
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 in Hall’s work. 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 a total person approach.
Health can be inferred to be a state of self-awareness with conscious selection of behaviors that are optimal 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.
The concept of society/environment is dealt with in relation to the individual. Hall is credited with developing the concept of Loeb Center because she assumed that the hospital environment during treatment of acute illness creates a difficult psychological experience for the ill individual (Bowar-Ferres, 1975). Loeb Center focuses on providing an environment that is conducive to self-development. In such a setting, the focus of the action of the nurses is the individual, so that any actions taken in relation to society or environment are for the purpose of assisting the individual in
attaining a personal goal.
Nursing is identified as consisting of participation in the care, core, and cure aspects of patient care.
The Care Circle
It represents the nurturing component of nursing and is exclusive to nursing. Nurturing involves using the factors that make up the concept of mothering (care and comfort of the person) and provide for teaching-learning activities.
The professional nurse provides bodily care for the patient and helps the patient complete such basic daily biological functions as eating, bathing, elimination, and dressing. When providing this care, the nurse’s goal is the comfort of the patient.
Providing care for a patient at the basic needs level presents the nurse and patient with an opportunity for closeness. As closeness develops, the patient can share and explore feelings with the nurse.
The Core Circle
It is based in the social sciences, involves the therapeutic use of self, and is shared with other members of the health team. The professional nurse, by developing an interpersonal relationship with the patient, is able to help the patient verbally express feelings regarding the disease process and its effects. Through such expression, the patient is able to gain self-identity and further develop maturity.
The professional nurse, by the use of reflective technique (acting as a mirror to the patient), helps the patient look at and explore 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 is now able to make conscious decisions based on understood and accepted feelings and motivation.
The Cure Circle
It is based in the pathological and therapeutic sciences and is shared with other members of the health team. During this aspect of nursing care, the nurse is an active advocate of the patient. Assumptions
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. Strengths/Weaknesses
The use of the terms care, core, and cure are unique to Hall.
Hall’s work appears to be completely and simply logical.
Hall’s work is simple in its presentation. However, the openness and flexibility required for its application may not be so simple for nurses whose personality, educational preparation, and experience have not prepared them to function with minimal structure. This and the self-imposed age and illness requirements limit the generalizability. Analysis
Hall imposed an age requirement for the application of her theory which is 16 years of age and above. This limits the theory since it cannot be disregarded that nurses are faced with pediatric clients every now and then. Even though Hall confined her concepts for that age bracket, the concepts of care, core and cure can still be applied to every age group but again, none was specified.
The only tool of therapeutic communication Hall discussed is reflection. By inference, all other techniques of therapeutic communication are eliminated. Reflection is not always the most effective technique to be used.
The concept of a patient aggregate such as having families and communities as the focus of nursing practice was not tackled. It is purely on the individual himself. Although, the role of the family or the community within the patient’s environment was modestly discussed.
In the focus of nursing care in Hall’s concepts, the individual must pass an acute stage of illness for you to successfully apply her theory. Therefore, this theory relates only to those who are ill. This indicates that no nursing contact with healthy individuals, families, or communities, and it negates the concept of health maintenance and disease prevention.