Roper–Logan–Tierney model of nursing

The Roper-Logan-Tierney model of nursing is a method of assessing how an illness or injury is affecting the patient’s overall life. It is often abbreviated as the R-L-T model or simply RLT. The model takes into account what the person’s life was like before the illness or injury, the patient’s status at the time of the assessment, and the most likely impact of the illness or injury on the person in the future. Using a list of activities that most people conduct in daily living as a guide, the nurse looks for areas that can be addressed to restore maximum functionality.

Background

The Roper-Logan-Tierney (RLT) model was developed in the 1970s by British nurse and nurse educator Nancy Roper. After training as a nurse, Roper became a teacher at the request of the British Army in the 1940s. When she later returned to school to complete her graduate studies in Scotland, Roper conducted research that ultimately recognized that every patient had factors in common that needed to be addressed if they were to maintain or recover the greatest possible functionality. She laid out her theory in 1976 in the journal Clinical Experience in Nursing Education.

Roper’s theory was based on the earlier work of Virginia Henderson. The American-born Henderson was a nurse, educator, and researcher who authored the most significant texts on nursing since the earliest accepted nursing practices were established in the 1860s by Florence Nightingale. Roper built on Henderson’s premise that nurses are crucial to providing the life skills assessment, education, and encouragement their patients need to ensure the best possible long-term health outcomes.

Fellow nursing educators Winifred Logan and Alison J. Tierney expanded on Roper’s research. In the 1980s, the three collaborated on a revised model that included an emphasis on psychological, social, economic, and spiritual factors in identifying potential issues for a person’s recovery. Their model was published as The Roper-Logan-Tierney Model of Nursing Based on Activities of Living in 2000.

Overview

A nurse caring for a patient follows a specific process called a care plan to determine a patient’s status, progress, and potential for full recovery. There are a number of different models for care plans used by nurses, but the goal of each is the same: to help the patient achieve the highest possible level of health and function. The main steps in any of the processes include assessment, diagnosis, planning, intervention, and evaluation. By working through the entire process to determine what care the patient needs to recover from the illness or injury then establishing a plan to achieve this, the nurse can help facilitate the patient’s recovery.

Since it was created in the 1980s, the Roper-Logan-Tierney model has been among the most popular nursing care planning formats. It is called a holistic model because it addresses the five broad factors that are considered important to a person enjoying a full life. It takes into account how the person’s illness or injury affects living from a physical/biological perspective and how the person is affected psychologically. In addition, a holistic model looks at how the patient is affected in several other ways and how these other ways affect the patient’s health and recovery potential.

The model looks at the sociocultural aspects, or how the person’s social, cultural, and spiritual circumstances affect their condition and recovery. This factor includes such things as what kind of support the person has from family and friends and what cultural rules or taboos or religious requirements might need to be considered in a treatment plan.

The model also considers environmental aspects, or what factors in the person’s living environment might need to be addressed. For instance, a person recovering from knee surgery might need to temporarily sleep in a different room to avoid stairs.

Politicoeconomic aspects, or factors such as government regulations or financial restrictions, also need to be addressed. One of the most significant aspects of this a nurse might help with would be a patient’s ability to afford the care needed. A nurse might direct the patient to programs that can help with funding or arrange for the physician to consider less expensive alternative treatments.

The Roper-Logan-Tierney nursing model focuses the care process on ten specific activities of living (ADLs). These are functions that everyone—healthy or ill—engages in on a regular basis. They are considered essential to a person’s ability to live and function independently. They can, therefore, be used as guides for establishing a plan of recovery and a method of measuring the patient’s progress and ultimate outcomes.

The ten primary activities of daily living include the abilities to:

• maintain a safe environment
• communicate
• breathe
• eat and drink
• perform bodily functions such as elimination
• tend to personal care needs such as washing and dressing
• regulate body temperature
• walk or otherwise move around
• work or play
• sleep

The revised version of the RLT model included the addition of the patient’s ability to function sexually and the ability to deal with end-of-life issues, or issues related to dying. These ADLs are sometimes left off the main list of assessments because they are only considered when relevant. For example, a person who is dealing with a non-life-threatening condition such as a broken foot might not need to address end-of-life issues, and a nurse caring for a toddler would most likely not deal with sexuality issues.

Using the RLT model ensures that the nurse is giving the patient individualized care that addresses the needs of that patient. It takes into account where the patient would be in life without the health condition and what steps can be taken to reduce the impact of the condition on the patient’s lifestyle and life span. The model can serve to make the nurse more effective in identifying problems and solutions as well as establishing goals and helping the patient meet the goals to enjoy the best possible health outcomes for a full life.

Bibliography

“Nancy Roper – Developed Daily Living Theory and Influenced Generations of Nurses.” Nursing Times, 2004, www.nursingtimes.net/nancy-roper-developed-daily-living-theory-and-influenced-generations-of-nurses/5012108.article. Accessed 15 Dec. 2018.

“Roper-Logan-Tierney's Model for Nursing Based on a Model of Living.” Nursing Theory, www.nursing-theory.org/theories-and-models/roper-model-for-nursing-based-on-a-model-of-living.php. Accessed 15 Dec. 2018.

“Roper-Logan-Tierney Model of Nursing.” Current Nursing, 12 May 2020, currentnursing.com/theory/Roper–Logan–Tierney‗model‗of‗nursing.html. Accessed 6 Jan. 2025.

“Virginia A. Henderson.” American Association for the History of Nursing, www.aahn.org/henderson. Accessed 6 Jan. 2025.

"What Is the Roper Logan and Tierney Model of Reflection?" Care Learning, 13 Oct. 2024, carelearning.org.uk/blog/nursing/what-is-the-roper-logan-and-tierney-model-of-reflection/. Accessed 6 Jan. 2025.

Williams, Bridgette C. “The Roper-Logan-Tierney Model of Nursing: A Framework to Complement the Nursing Process.” Nursing 2015, vol. 45, no. 3, Mar. 2015, journals.lww.com/nursing/fulltext/2015/03000/The‗Roper‗Logan‗Tierney‗model‗of‗nursing‗‗A.9.aspx. Accessed 15 Dec. 2018.