The model is based loosely upon the activities of daily living that evolved from the work of Virginia Henderson in 1966.
The latest book edited by these women 2001 is their culminating and completing work, in which they upgrade their model based on their view of societal needs.
The original purpose of the model was to be an assessment used throughout the patient's care, but it has become the norm in UK nursing to use it only as a checklist on admission.
For this reason, it is not recommended in the model that it be used as a checklist, but rather as Roper states "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 organisation of their care"[3] and that nurses in clinical practice deepen their knowledge and understanding of the model and its application; it is essential that those using such a widespread tool be competent in its correct application.
[4] Nancy Roper, when interviewed by members of the Royal College of Nursing's (RCN) Association of Nursing Students at RCN Congress in 2002 in Harrogate[5] stated that the greatest disappointment she held for the use of the model in the UK was the lack of application of the five factors listed below, citing that these are the factors which make the model holistic, and that failure to consider these factors means that the resulting assessment is both incomplete and flawed.
These modifications depend upon the institution or the nurse and often results from a lack of understanding of the application of, or the factors within, the model.
[5] For example, "sexuality" as an activity of daily living refers not only to the act of reproduction, but also to body image, self-esteem and gender-related beliefs, roles, values and practices, all issues that could have a high degree of relevance for the individual about to undergo surgery.