Joan Riehl-Sisca's Symbolic Interactionism Nursing Model
This paper examines the nursing theory developed by Joan Riehl-Sisca, introduced in the 1980 text co-authored with Sister Callista Roy. Grounded in symbolic interactionism, Riehl-Sisca's model emphasizes the nurse's role in assessing and interpreting patient behavior to plan effective individual and family interventions. The paper outlines the model's core concepts—people, association, social acts, and inter-linkages—and explains how nurses can apply them to understand patient self-concept, support family members, and develop targeted care plans. The discussion draws on foundational nursing theory texts and concludes with a brief reflection on applying the model in clinical practice.
- Introduction to Riehl-Sisca's Nursing Theory: Origins and core purpose of Riehl-Sisca's nursing model
- Symbolic Interactionism and Nursing Assessment: How symbolic interactionism shapes nurse-patient interpretation
- The Self-Concept Module and Nursing Diagnosis: Self-concept module and its role in nursing diagnosis
- Planning Interventions for Patients and Families: Developing care plans for patients and family members
- Core Concepts of the Riehl Model: People, association, social acts, and inter-linkages defined
- Applying the Riehl Model in Practice: First-person reflection on clinical application of the model
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What makes this paper effective
- The paper grounds a specific nursing theory in a broader behavioral framework—symbolic interactionism—giving readers a conceptual anchor before introducing model-specific terminology.
- It moves logically from theory to application, explaining the model's core concepts before describing how a nurse would implement them with patients and families.
- The first-person reflection at the end demonstrates practical engagement with the theoretical content, connecting abstract concepts to real clinical scenarios.
Key academic technique demonstrated
The paper demonstrates concept mapping: each major component of the Riehl model (people, association, social acts, inter-linkages) is defined and then linked to a concrete nursing behavior. This approach transforms a theoretical framework into an actionable clinical toolkit, which is a useful technique for nursing theory papers at the undergraduate level.
Structure breakdown
The paper opens by contextualizing Riehl-Sisca's work within a broader nursing concern—how to care for conscious, interactive patients. It then explains symbolic interactionism as the theoretical foundation, describes the self-concept module drawn from Nursing Theorists and Their Works, and outlines care-planning and evaluation. A bulleted breakdown of the model's four core concepts follows, and the paper closes with a first-person clinical application paragraph and a reference list.
Introduction to Riehl-Sisca's Nursing Theory
In 1980, a book by Joan Riehl and Sister Callista Roy titled Conceptual Models for Nursing made a significant impact on the professions of medicine and nursing. The book introduced a new theory of nursing that addressed a fundamental challenge faced by nurses and medical or psychological helpers: how to care for patients who are conscious and interactive. When a patient is unconscious, a nurse need only provide physical care; conscious interaction is not required. However, when a patient is suffering and yet remains conscious, the nurse's role expands considerably, requiring far more than physical assistance.
Most nursing theorists recognize the importance of the interpersonal dimension of nursing. They argue that some form of personal interaction between nurses and patients is necessary for faster and more complete recovery (O'Brien, 2009). In general, a competent nurse must be able to assess the patient's ability to engage in activities of daily living and provide assistance whenever and in whatever manner it is required. The nurse is considered responsible for creating and maintaining a therapeutic environment for the patient—one that includes proper mental as well as physical care (O'Brien, 2009).
Symbolic Interactionism and Nursing Assessment
According to symbolic interactionism, people interpret the actions of others based on the meaning they attach to those actions, and only then do they respond. This makes the relationship between stimulus and response a continuous, interpretive process. Riehl-Sisca's suggestions emphasize the proper assessment and accurate interpretation of patient actions by the observing nurse. The nurse is then required to assess and predict the nature of the patient and his or her behavior. Such interactive interpretation is especially necessary in cases of individual therapy and family therapy. Every nurse remains attentive to the role of family in the treatment and recovery of the patient ("Riehl, Sisca, Joan," 2010).
The assessment and interpretation of patient actions are carried out in order to plan appropriate interventions with both the patient and the patient's family. According to Riehl-Sisca, the nurse and patient engage in an active exchange of information that the nurse collects and uses to promote the patient's mental and physical health. The nurse may draw on this information to employ multiple theories, therapies, and allied health disciplines, and may also develop a plan for family members to participate constructively in the patient's health improvement ("Riehl, Sisca, Joan," 2010).
The Self-Concept Module and Nursing Diagnosis
The process of learning and assessing the patient's self-concept—and helping the patient through an understanding of his or her concept of various familial and social roles—is a cornerstone of what are known as the conceptual models of nursing practice. Both the nurse and family members must accept and engage with these roles as part of the therapeutic process (Walker & Neuman, 1996).
In Nursing Theorists and Their Works, Marriner-Tomey and Alligood describe the self-concept module of nursing proposed by Riehl-Sisca by noting that a nurse must assess the individual patient's actions and attempt to view those actions in the same way the patient perceives them. Through both implicit and explicit role-playing, the nurse develops an understanding of why a patient performs certain actions and under what conditions. This knowledge helps the nurse identify the precise source of the patient's difficulty and provides a foundation for nursing diagnosis (Marriner-Tomey & Alligood, 2006).
References
Marriner-Tomey, A., & Alligood, M. R. (2006). Nursing theorists and their work. Elsevier Health Sciences.
N.A. (2010). "Riehl, Sisca, Joan." Free Dictionary. Retrieved 6 August 2010 from http://medical-dictionary.thefreedictionary.com/Riehl-Sisca
O'Brien, P. G. (2009). Psychiatric mental health nursing: An introduction to theory and practice. Jones and Bartlett Publishers.
Walker, P. H., & Neuman, B. M. (1996). Blueprint for use of nursing models: Education, research, practice, and administration. Jones & Bartlett Learning.
Wood, L. (2001). Joan Riehl-Sisca. Retrieved 6 August 2010 from http://nursing.clayton.edu/eichelberger/theory/Joan%20Riehl.doc
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