Roper Logan and Tierney Model of Reflection
Introduction
The Roper Logan model was named after the author of the model, Nancy Roper, Logan and Tierney. It was first developed in 1980 based upon the work by Nancy Roper in 1976. The model is based on the 12 activities of living in order to live.
The purpose of the Roper Logan theory is as an assessment used throughout the patient’s care. As a nurse you should use the model to assess the patient’s relative independence and potential for independence in the activities of daily living. The patient’s independence is looked at on a continuum that ranges from complete dependence to complete independence. This helps to determine what interventions will lead to increased independence as well as what ongoing support is needed to offset any dependency that still exists.
The 12 Activities of Daily Living
Roper states that the twelve activities of daily living should be viewed “As a cognitive approach to the
assessment and care of the patient, not on paper as a list of boxes, but in the nurse’s approach to and
organization of her care,” and that nurses deepen their understanding of the model and its application.
The patient should be assessed on admission, and his or her dependence and independence should be
reviewed throughout the care plan and evaluation. By looking at changes in the dependence-independence
continuum, the nurse can see whether the patient is improving or not, and make changes to the care
provided based on the evidence presented.
The 12 activities of living listed in the Roper-Logan-Tierney Model of Nursing are:
- maintaining a safe environment
- communication
- breathing
- eating and drinking
- elimination
- washing and dressing
- controlling temperature
- mobilization
- working and playing
- expressing sexuality
- sleeping
- death
Factors influencing activities of living
The Roper Logan model also considers the five factors listed below, these are the factors which make the model holistic, Roper believes that failure to consider these factors means that the resulting assessment is both incomplete and flawed. Therefore it is recommended that nurses make use of the model through promoting an understanding of these factors as an element of the model.
The following variables are factors that impact on the individual and affect their levels of dependence / independence.
- Biological: The biological factor addresses the impact of the overall health, of current injury and illness, and the scope of the patient’s anatomy and physiology.
- Physiological: The psychological factor addresses the impact of emotion, cognition, spiritual beliefs, and the ability to understand. According to Roper, this is about “knowing, thinking, hoping, feeling and believing.”
- Socio-cultural: The sociocultural factor is the impact of society and culture as experienced by the individual patient. This includes expectations and values based on class and status, and culture within the sociocultural factor relates to the beliefs, expectations, and values held by the individual patient for him or herself, as well as by others pertaining to independence in and ability to carry out the activities of daily living.
- Environmental: The model recommends consideration of not only the impact of the environment on the activities of daily living, but also the impact of the individual's ALs on the environment.
- Politico-economic: this is the impact of government, politics and the economy on ALs. Issues such as funding, government policies and programmes, state of war or violent conflict, availability and access to benefits, political reforms and government targets, interest rates and availability of fundings (both public and private) all are considered under this factor.
Evaluation of the Roper, Logan and Tierney Model
The Roper, Logan and Tierney model is widely used in nursing practice in both the UK and Ireland. The patient is assessed on his or her or her ability to perform the 12 activities of living in relation to his position on the lifespan, and his or her level on the dependence/independence continuum and aims in care are identified. The goals of the care plan are mutually agreed between the nurse and patient and the family. Finally, evaluation of care determines whether or not the goals of care have been achieved, or if they need to be revised. The model provides a systematic and logical means of delivering care, encouraging team participation leading to primary care and continuity of care.
