Question
How can the Roper Logan and Tierney model be used to assess a COPD patient?
Answer
Chronic Obstructive Pulmonary Disease (COPD) is a slow progressive airway obstruction disease that is a leading cause of global morbidity and mortality (Kara, 2007). In the USA, it is estimated that approximately 14 million people experience COPD (Kara, 2007), and in the UK, COPD is the fifth most prevalent cause of death and disability (Elsherif and Noble, 2011). The disease is a life-long chronic illness, which can impede many areas of daily functioning, impacting upon relationships, emotions, employment, socializing and maintaining independence (Elsherif and Noble, 2011).
Ensuring individuals’ holistic needs with COPD are met requires, as Holland (2008) describes, a nursing process that utilises problem solving strategies to identify patients’ problems and needs. The Roper, Logan and Tierney (1990) model is evidenced to be effective in providing nurses with a structured assessment process, to aid care planning, through focusing upon 12 activities of living (ALs). The model identifies the individual’s ability to gain, maintain and restore the utmost independence in these ALs, or to adjust with increasing dependence on others where necessary (Kara, 2007).
This model guides COPD assessment practices through a holistic information gathering approach, considering physiological, sociological and psychological aspects within the 12 activities of living. This enables the identification of individual needs that can be linked with particular interventions to support the individual in the AL areas. The 12 areas include: maintaining a safe environment; communication; eating and drinking; breathing; elimination; personal grooming; controlling body temperature; mobilising; work and play; expressing sexuality; sleeping and dying. Research indicates that the model is effective in improving the health outcomes of people with COPD in activities of living areas such as enhancing respiratory functions and self-management, although further high quality research is needed (Kara, 2007).
References
Elsherif, M., and Noble, H., (2011). Management of COPD using the Roper-Logan-Tierney framework. British Journal of Nursing, 20(1), 1346-1351.
Holland, K., (2008). Applying the Roper-Logan-Tierney model in practice. London: Elsevier Health Sciences.
Kara, M., (2007). Using the Roper, Logan and Tierney model in care of people with COPD. Journal of Clinical Nursing, 16(7b), 223-233.
Roper, N., Logan, W.W., & Tierney, A.J. (1990) The Elements of Nursing: A Model for Nursing Based on a Model of Living, 4th edn. London: Churchill Livingstone.
