this ppt has very detailed explanation of modeling and remodeling theory which we can use in patient care

1. PRESENTED BY
Monika
M.Sc. Nursing 2nd year
NINE, PGIMER, Chandigarh
Modeling And
Role Modeling
Theory
1

2. “Unconditional acceptance of the person as a
human in the process of Being and Becoming is
basic to the Modeling and Role-Modeling
paradigm. It is a prerequisite to facilitating holistic
growth …
2
Modeling and Role-Modeling enables nurses to care for and nurture each
client with an awareness of and respect for the individual's uniqueness.
This theory-based on clinical practice that focuses on the clients' needs
“In modeling nurse attempts
to view the patient’s situation
through the eyes of the
patient”

3. Overview
• Modeling and Role-Modeling theory is based in several nursing principles
that guide the assessment, intervention, and evaluation aspects of
practice.
• These principles reflected in the data collection categories are linked to
intervention aims and goals.
• Nursing interventions should have intent ; nurses should aim to make
something happen that facilitates health and healing when they interact
with clients
3

4. Introduction
• This theory was developed by Helen C. Erickson, E. M. Tomlin, and Mary
Ann P. Swain.
• In the mid of 1970s Helen C. Erickson met M. Tomlin, and it was their
discussions that began the research into the Modeling and Role modeling
theory of nursing.
• The theory was published in the book “Modeling and Role Modeling: A
Theory and the Paradigm for Nursing”, in 1983.
• The theory was republished in the book “Modeling and Role-Modeling: A
View from the Client’s Worldview”, in 2006.
4

5. 1. Theorist- Helen C. Erickson
• Was born in 1936.
• 1974 – B.Sc Nursing from The University of Michigan
• 1976 – M.Sc in Psychiatric and Medical-Surgical
Nursing from The University of Michigan
• 1984 – PhD in Educational psychology from
University of Michigan
• She currently lives in Texas, where she is a Professor
Emeritus at The University of Texas at Austin.
5

6. Clinical Background
• Emergency room and medical surgical nursing: Texas, Michigan
• Director of health services, Inter American University. San German,
Puerto Rico
• Independent Holistic Nurse Practitioner: Michigan, south Carolina, Texas
• Faculty/ Administrator: The University of Michigan, University of south
Carolina, The university of Texas
• Professor Emerita: The University of Texas at Austin
6

7. • Was born in 1929.
• She received her B.Sc Nursing from University of Southern
California
• M.Sc. Nursing in psychiatric nursing from the University of
Michigan in 1976.
• She began as a clinical instructor at Los Angeles County
General Hospital School of Nursing.
• She was among the first 16 nurses in the United States to be
certified by the American Association of Critical Care Nurses.
• She opened one of the first offices for independent nursing
practice in Michigan.
• She is on the board of directors and works as a volunteer at
Wayside Cross Ministries in Aurora.
2. Theorist- Evelyn M. Tomlin
7

8. • Was born in 1941.
• She received her bachelor of arts degree in psychology from
DePauw University in Greencastle, Indiana
• Her master of science and doctoral degrees from the
University of Michigan, both in the field of psychology.
• She is a member of the American Psychological Association
and an associate member of the Michigan Nurses Association.
• lecturer and Professor of Psychology and Nursing Research at
the University of Michigan.
3. Theorist- Mary Ann P. Swain
8

9. Aim of Theory
• The theory enables the nurse to care for and nurture each client with an
awareness of and respect for the individual’s uniqueness.
• It’s based on the client’s needs.
• Clients have the ability and knowledge to understand what has made them
sick.
• It empowers the client to grow to heal.
9

10. Modeling
• “Modeling” is to gain an understanding of the client’s world from the
client’s perspective. That is to build a “Model” of the client’s world view.
• Modeling occurs as the Nurse accepts and understands her clients
perspective.
• Modeling recognizes that each client has a unique perspective of his or
her world.
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11. 11
 The art of modeling is action taken by nurse
to develop and understanding of the client’s
perspective of the world.
 The science of modeling is data collection
and analysis from which a model of the
client’s world is constructed.
Modeling process involves assessment
of a client’s situation. It starts when we
initiate an interaction with an individual
and concludes with an understanding
of that person’s perspective of their
circumstances.

12. Purpose of Modeling
12
1- Learn how that individual describes the situation.
2- What he or she expects will happen.
3- His or her perceived resources and life goals.
4- Modeling is use to build a mirror image of an individual’s worldview.
This worldview helps us understand what that person perceives to be important,
what has caused his or her problems, what will help, and how he or she wants to
relate to others.

13. Role Modeling
• Role modeling occurs when nurse plan and implement interventions that
are unique for the client.
• The nurse facilitates and nurtures the individual in attaining, maintain, or
promoting health through purposeful interventions is called as “role
modeling”.
• Role-modeling starts when the nurse moves from the analysis phase of the
nursing process to the planning of nursing interventions.
13
 The art of role modeling involves planning and implementing care based on
the data analysis. The planned and implemented care will be different for
each client because each individual is unique.
 The science of role modeling involves using knowledge of theory to plan and
implement care.
 Together art and science of role modeling will result in assisting” the
individual in attaining, maintaining or promoting health through purposeful
interventions”

14. Theoretical Sources
The concepts of this theory were drawn from the work of:
 Maslow’s theory of hierarchy of needs
 Piaget’s theory of cognitive development
 Erikson’s theory of psychosocial stages
 General Adaptation syndrome (GAS) by Selye and Lazarus
14

15. Maslow’s Theory of Hierarchy Of Needs
15

16. Piaget’s Theory of Cognitive Development
16

17. Erikson’s Theory of Psychosocial Stages
17

18. General Adaptation Syndrome (GAS) By
Selye And Lazarus
18

19. Theoretical Underpinnings
The basic theoretical linkages used in nursing practice for this model are:
1. There is a relationship between adaptive potential and needs
satisfaction.
2. There is a relationship between developmental task resolution and needs
satisfaction.
3. There is a relationship between developmental residual and self-care
resources.
4. There is a relationship among basic needs satisfaction, growth, and
development.
19

20. METAPARADIGM
Person
Environment
Health
Nurses
20

21. Person
• Human beings are holistic persons with interacting subsystems
(biophysical, psychological, social and cognitive) and inherent genetics
bases and spiritual drive.
• Patient is given treatment and instructions; a client participates in his or
her own care. “our goal is for nurse to work with clients”.
21

22. Environment
• Environment is not identified in the theory as an entity of its own.
• The interaction between self and others both cultural and individual.
• Internal and external stressors and resources for adapting to stressors.
22

23. Health
• Health is a state of physical, mental, and social well being and not merely
the absence of disease or infirmity.
• It indicate a state of dynamic equilibrium among the various subsystems of
a holistic person.
23

24. Nursing
• Nurse is a facilitator, not an effector.
• Nurse client relationship is an interactive and interpersonal process that
aids the individual to identify, mobilize and develop his or her own
strengths.
• In the process of assisting client to achieve holistic health, the nurse must
nurtures the client; facilitate and accept the client unconditionally.
24

25. 25
Major Concepts of
Modeling And Role-modeling
Theory

26. 26
Major
Concepts
Commonalities Differences

27. Commonalities
Basic
needs
Holism
People
are like
becaus
e of
their
Affiliated-
Individua
tion
Attachm
-ent and
Loss
Psychoso
-cial
Stages
Cognitive
Stages
27

28. 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 action.
• This means conscious and unconscious processes
are equally important.
28

29. Basic Needs
• According to Maslow, whose hierarchical ordering of basic and growth
needs is the basic needs .
• 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.
29

30. Affiliated Individuation
• Individuals have an instinctual need for affiliated-individuation.
• They need to be able to dependent on support systems while
simultaneously maintaining independence from these support systems.
• They need to feel a deep sense of both the “I” and the “we” states of being,
and to perceive freedom and acceptance in both state.
30

31. 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.
31

32. Psychosocial Stages
• Based on Erikson’s theory, say that task resolution depends on the
degree of need satisfaction.
• Each stage represents a developmental task or encounter resulting in a
turning point, a moment of decision between alternative basic attitudes.
• As a maturing individual negotiates or resolves each age-specific crisis or
task, the individual gains enduring strengths and attitudes that contribute
to the character and health of the individual’s personality in his or her
culture.
32

33. Cognitive Stages
• 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 client may have had difficulty with.
33

34. Differences
People are
different
because
of their:
Inherent
endowment
Adaptation
Adaptation potential
• Self-care
• Self-care resources
• Self-care action
34
People
are
different
because
of their:

35. Inherent Endowment
• Genetic as well as prenatal and perinatal influences that affect health
status.
35
 Each individual is born with a set of genes that will to some
extent predetermine appearance, growth, development, and
responses to life events Clearly.
 both genetic makeup and inherited characteristics influence
growth and development.
 They make individuals different from one another, each unique
in his or her own way

36. Adaptation
• Adaptation is the way a patient responds to stressors that are health- and
growth-directed.
36

37. Adaptation Potential
• 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.
37

38. Self-Care
• Self -Care is reflected in the assumption that clients have a basic
understanding of what has made them sick and what will help to improve
their health.
• 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.
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39. Self-Care Resources
• 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.
39

40. Self-Care Action
• 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.
40

41. Nursing Actions
• Nurse help patients, to facilitate their own health by guiding them to
identify and develop their own strengths to improve health.
• The nurse nurtures the patient by supporting him or her to integrate all
physical, psychological and spiritual systems in the process toward health.
• The nurse accepts each patient as a worthwhile person.
41

42. Nurse Three Main Roles
• Facilitation
• Nurturance
• Unconditional acceptance
42

43. facilitation
• As a facilitator, the nurse helps the patient
take steps toward health, including
providing necessary resources and
information.
43

44. Nurturer
• As a nurturer, the nurse provides care and
comfort to the patient.
44

45. Unconditional Acceptance
• In unconditional acceptance, the nurse
accepts each patient just as he or she is
without any conditions.
• Nurse’s use empathy helps the individual
learn that the nurse accepts and respects
him or her as is.
45

46. 5 Goal of Nursing Interventions
• The theory states five goals of nursing
interventions as:
1. Build trust
2. Promote hope and positive self-esteem
3. Promote client’s perception of control
4. Assisting client to identify and use their
own strengths
5. Set mutual health promoting goals and
meet basic needs.
46
 Meeting these goals allows
clients to take control of their
health care, move toward
health at their own pace, and
approach life in their own
unique way.
 This theory especially useful
in reaching home care’s
ultimate goal: for the patient
to achieve appropriate self-
care.

47. Application and framework in different
situations
47
Patient care
Mentor and mentee
Nurse’s self-care with external sources

48. Patient care
48

49. Mentor - Mentee
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50. Nurse’s self-care with external sources
• Self care concept is applies for both patient and nurses.
• Nurses practice self care need must be met before the needs of
patient are met.
• To practice self care, it is necessary to obtain self-care
resources.
• Self care resources can be external and internal.
50
Internal resources are
reside within each
person.
(hope, optimistic
view)
External resources
are those people
and things that
provide support.

51. The Modeling and Role Modeling (MRM)
Logo
• The original logo of MRM, designed in 1981 by
consensus among Erickson, Tomlin and Swain,
shows nurse and client in an environment that
exists in the universe, allowing for future growth
and expansion of the paradigm.
51

52. The MRM Logo Meaning
• The two persons, arms interconnected, represent the
human need for mutuality and reciprocity, or in simple
language, connections with others without losing one's
self (this is affiliated-individuation [A-I]).
• The hand represents the nurse's (or care provider's)
role as a facilitator not a regulator. The nurse’s job is to
help people heal and grow at their own rate and in their
own time.
• The arm represents the ability to facilitate another
person across time and space. When we work with
people, as described in MRM, we often "seed" growth
that is not immediately observed; however, change may
occur as a result of something we communicate. Thus,
our ability to affect another person's life over time and
space is extremely important. 52

53. When it comes to research, the following are
some theoretical propositions presented by the
theory:
• 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.
• Distresses are unmet basic needs; stressors are unmet growth.
53

54. Theoretical Propositions Cont…
• Secure attachment produces feelings of worthiness.
• Feelings of worthiness result in a sense of futurity.
• Unmet basic and growth needs interfere with growth processes for the
patient.
• Real, threatened, or perceived loss of the attachment object results in
morbid grief.
• Basic need deficits co-exist with the grief process.
54

55. Theoretical Propositions Cont…
• An adequate alternative object must be perceived as available in order for
the patient to resolve his or her grief process.
• Prolonged grief due to an unavailable or inadequate object results in morbid
grief.
• Repeated satisfaction of basic needs is a prerequisite to working through
developmental tasks and resolution of related developmental crises.
• Morbid grief is always related to need deficits.
55

56. Case Study
Robert, a 75-year-old rancher with a history of chronic obstructive pulmonary
disease (COPD), is admitted with (unmet physiological needs). It is his fourth
admission in 6 months (he is having difficulty adapting to stressors in his life). The
nurse introduces herself in a quiet, calm voice (interventions designed to establish
trust and a sense of safety and security and to facilitate a sense of connectedness)
" After he is stabilized (physiological needs are met, so the nurse can focus on his
other needs. Why do you think you are here today?" (The nurse seeks information
from the client who is the primary data source and facilitates a sense of client
control.)
He replies, "My wife of 49 years died a few months ago; she took care of me, and
my heart is broken. My life no longer has meaning." (He is experiencing unmet
needs, is having problems with the developmental stage of generativity, and is
grieving the loss of his wife.)
56

57. Case Study Cont…
• The nurse asks him what he needs to feel better and to help him get through the
next few weeks (promoting positive future orientation). He replies, "I need to be
closer to my friends and the hospital. I am so lonely and afraid out there by
myself" (unmet love and belonging and safety and security needs).
• The nurse is facilitating client control, affirming his strengths and his self-care
knowledge that he knows what will make him heal, together they are setting
mutual goals. Robert calls and speaks to his son, who plans to visit (this action
facilitates his sense of perceived support and Al). His minister is called, and grief
counseling is arranged (support is perceived, facilitation of grief resolution is
initiated, and the client is facilitated in being future-focused).
57

58. Case Study Cont…
• Robert decides that he will move to town into a senior citizen apartment that
provides meals and other services, and arrangements are made for him to
have help with the moving process. He will be closer to the hospital and other
people it he needs them (this will help him feel safer and more secure).
• He can then choose when to visit with friends or participate in social activities
that are offered at the complex this love and belonging needs can be met,
and this facilitates his sense of control. He can also receive assistance with
basic physiological needs when needed (meals, housekeeping services).
• After he is settled into his new home, the nurse provides him with her
telephone number, so he can call if he needs anything or if he just wants to
check in (support and love and be longing needs are met). This action
facilitates trust, his safety and security and love and belonging and Al needs
are met.
58

59. Research Studies Related To Modeling
And Role-modeling Theory
59

60. Conclusion: According to the study findings, the modeling and role-modeling
theory plays a major role in improving the body image among the patients with
colorectal cancer. The theory offered a practical framework for the self-care
process in these patients and proposed that a comprehensive examination of
patients in terms of self-care, self-care knowledge, and self-care resources
significantly improves the self-care performance.
60

61. 61

62. Conclusion: the authors explore the experiences of a young women with
diabetes mellitus and demonstrate how nursing care based on theory of
modeling and role modeling enabled the client to recognize and develop
strengths and empowered her to begin the healing process.
62

63. 63
Conclusion: In Mrs. P’s case, the Modeling and Role-Modeling Theory helped to
understand Mrs. P.’s world and connect with her on biological, psychological,
sociocultural, and spiritual levels. (Mrs. P. exercised a sense of control by
choosing visit times and by participating in wound care as she helped lift up the
panniculus so Mariah (nurse) could dress the wound. They also discussed future
healthcare goals, including the panniculectomy, which gave Mrs. P. a sense of
hope) Nursing theory can help move practice away from the medical model and
recognize that people are more than just problems in certain systems or body
parts.

64. 64
Conclusion: The nurses in this study described how they experienced
spirituality or found meaning and purpose through the work they performed as
a nurse, such as through their nurse-patient relationships and the caring
moments during patient care. The importance of establishing relationships
with patients, caring for patients rather than just performing technical skills,
and the interactions with patients are the activities that bring meaning and
purpose in the work of the staff nurse. Nurses also suggested more chaplain
support as ways to provide more spiritual support to them.

65. Thesis
Patricia Darlene (2005) A descriptive exploratory study
“application of the modeling and role-modeling theory to
mentoring in nursing”
• Purpose: The purpose was to explore the applicability of the MRM Theory
to the relationship of nursing educators as mentors and students as
mentees.
• An exploratory study aims were to
1) determine if the theory’s concepts were considered realistic to nursing
faculty and nursing students
65
Conclusion: None of the participants felt any concepts were missing or
should be included in the MRM model. However, some participants suggested
that rewording the descriptions of the concepts of nurturance, unconditional
acceptance, and modeling would lend to a greater acceptance of those
concepts.

66. 66

67. Summary
• Helen Erickson, Evelyn Tomlin and Mary Ann Swain developed the
Modeling and Role modeling theory.
• The view nursing as self-care model based on the clients perception of the
world and adaptations to stressors.
• They asserted that each individual is unique and has some self-care
knowledge and needs.
• Nurses in this theory, facilitate, nurture and accept the person
unconditionally.
• The nurse model (assesses), role models (plans), and intervenes in this
interpersonal and interactive theory.
• The focus of this theory is on the person.
67

68. Conclusion
• Modeling refers to the development of an understanding of the client’s
world.
• Role modeling is the nursing intervention, or nurturance, that requires
unconditional acceptance.
• This model considers nursing as self-care model based on the client’s
perception of the world and adaptations to stressors.
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69. References
1. https://nursing-theory.org/nursing-theorists/Helen-C-Erickson.php
2. https://nursing-theory.org/theories-and-models/erickson-modeling-and-role-modeling-theory.php
3. https://www.mrmnursingtheory.org/
4. https://www.slideshare.net/MuhammadShaikh10/modeling-and-rm-theory
5. https://www.worldcat.org/title/nursing-theorists-and-their-work/oclc/623178231
6. file:///C:/Users/monic/Downloads/089801019601400205%20(1)%20(1).pdf
7. file:///C:/Users/monic/Downloads/The_Effect_of_Self_Care_Program_Based_on_Modeling.3.pdf
8. https://nursology.net/wp-content/uploads/2019/05/handout-mrm-for-casewestern.pdf
9. https://www.researchgate.net/publication/7734750_A_Case_Study_Applying_the_Modeling_and_
Role-Modeling_Theory_to_Morbid_Obesity
10. https://scholarworks.montana.edu/xmlui/bitstream/handle/1/1693/LambP0805.pdf?sequence=1
11. https://oce.ovid.com/article/00004650-201301000-00007/HTML
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