theory

1. Dr.Jean Watson
Theory of
Human Caring

2. Introduction:
• In the realm of the present times, improvements in healthy care
system have intensified nurse’s workload and responsibilities sad but
true, nurses in the present times often forget their caring attitudes
when they are faced with stressful and difficult situation.
• Despite of this, we nurses must learn how to deal with the
complexities arising in every patient situation and must find ways of
preserving their caring practice. One nursing theory has seemed
indespensable for this goal.
• Jean Watson view of caring is the most valuable attribute nursing has
to offer to humanity, yet caring has received less emphasis than
other aspects of the practice of nursing overtime.
• In Watson’s view disease might be cured but illness will remain
because without caring, health is not fully attained.

4. • Born in West Virginiamin July 21, 1940
• She was the youngest of eight children and was surrounded by an
extended family–community environment.
• She earned a B.S. in Nursing in 1964, MS in Psychiatric Nursing in 1966 and
Phd in Educational Psychology and Counseling in 1974.
• Founder of the center for Human Caring in Colorado.
• Distinguished Professor of Nursing and Chair in Caring Science at the
University of Colorado Health Sciences Center.
• Fellow of the American Academy of Nursing.
• Dean of Nursing at the University Health Sciences Center and President of
the National League for Nursing
• Undergraduate and graduate degrees in nursing and psychiatric-mental
health nursing and PhD in educational psychology and counseling.
• Six (6) Honorary Doctoral Degrees.
• In 1988, her theory was published in “nursing: human science and human
care”.

5. The Seven Assumptions
1. Caring can be effectively demonstrated and
practiced only interpersonally.
2. Caring consists of carative factors that result in
the satisfaction of certain human needs.
3. Effective caring promotes health and individual or
family growth.
4. Caring responses accept person not only as he or
she is now but as what he or she may become.

6. The Seven Assumptions
5. A caring environment is one that offers the
development of potential while allowing
the person to choose the best action for
himself or herself at a given point in time.
6. Caring is more “ healthogenic” than is
curing. A science of caring is
complementary to the science of curing.
7. The practice of caring is central to nursing.

7. The ten primary carative factors
1. The formation of a humanistic- altruistic
system of values.
2. The installation of faith-hope.
3. The cultivation of sensitivity to one’s self
and to others.
4. The development of a helping-trust
relationship
5. The promotion and acceptance of the
expression of positive and negative
feelings.

8. The ten primary carative factors
6. The systematic use of the scientific problem-
solving method for decision making
7. The promotion of interpersonal teaching-
learning.
8. The provision for a supportive, protective and /or
corrective mental, physical, socio-cultural and
spiritual environment.
9. Assistance with the gratification of human needs.
10.The allowance for existential-phenomenological
forces.

9. Major Elements of Watson’s
Theory of Human Caring
CURATIVE
CARE
TRANSPERSONAL
CARING
RELATIONSHIP
CARING
OCCASION/
CARING
MOVEMENTS
ELEMENTS

10. 1. The formation of a humanistic- altruistic
system of values
•Begins developmentally at an early age with
values shared with the parents.
•Mediated through ones own life experiences, the
learning one gains and exposure to the
humanities.
•Is perceived as necessary to the nurse’s own
maturation which then promotes altruistic
behavior towards others.

11. 2. Faith-hope
• Is essential to both the carative and the
curative processes.
• When modern science has nothing further
to offer the person, the nurse can continue
to use faith-hope to provide a sense of
well-being through beliefs which are
meaningful to the individual.

12. 3. Cultivation of sensitivity to one’s self and to others
• Explores the need of the nurse to begin to feel an
emotion as it presents itself.
• Development of one’s own feeling is needed to interact
genuinely and sensitively with others.
• Striving to become sensitive, makes the nurse more
authentic, which encourages self-growth and self-
actualization, in both the nurse and those with whom
the nurse interacts.
• The nurses promote health and higher level functioning
only when they form person to person relationship.

13. 4. Establishing a helping-trust relationship
• Strongest tool is the mode of communication, which
establishes rapport and caring.
• Characteristics needed to in the helping-trust relationship
are:
• Congruence
• Empathy
• Warmth
• Communication includes verbal, nonverbal and listening in
a manner which connotes empathetic understanding.

14. 5. The expression of feelings, both positive
and negative
• “Feelings alter thoughts and behavior, and they
need to be considered and allowed for in a caring
relationship”.
• Awareness of the feelings helps to understand the
behavior it engenders.

15. 6. The systematic use of the scientific
problem-solving method for decision making
•The scientific problem- solving method
is the only method that allows for control and
prediction, and that permits self-correction.
•The science of caring should not be always
neutral and objective.

16. 7. Promotion of interpersonal
teaching-learning
•The caring nurse must focus on the learning
process as much as the teaching process.
•Understanding the person’s perception of
the situation assist the nurse to prepare a
cognitive plan.

17. 8. Provision for a supportive, protective and /or
corrective mental, physical, socio-cultural and
spiritual environment
• Watson divides these into eternal and internal
variables, which the nurse manipulates in order to
provide support and protection for the person’s
mental and physical well-being.
• The external and internal environments are
interdependent.
• Nurse must provide comfort, privacy and safety as a
part of this carative factor.

18. 9. Assistance with the gratification of
human needs
•It is based on a hierarchy of need similar to
that of the Maslow’s.
•Each need is equally important for quality
nursing care and the promotion of optimal
health.
•All the needs deserve to be attended to and
valued.

19. Watson’s ordering of needs
Lower order needs
Biophysical needs
Psychophysical needs
Higher order needs
Psychosocial needs
Intrapersonal-interpersonal
need
The need for food and fluid
The need for elimination
The need for ventilation
The need for activity-inactivity
The need for sexuality
The need for achievement
The need for affiliation
The need for self-actualization

20. 10. Allowance for existential-
phenomenological forces
• Phenomenology is a way of understanding people from
the way things appear to them, from their frame of
reference.
• Existential psychology is the study of human existence
using phenomenological analysis.
• This factor helps the nurse to reconcile and mediate the
incongruity of viewing the person holistically while at the
same time attending to the hierarchical ordering of
needs.
• Thus the nurse assists the person to find the strength or
courage to confront life or death.

21. Transpersonal
• Is concerned with the inner life world and what we
believe the meaning of another person is.
• It recognizes the power of love, faith, compasion,
caring, consiousness and the access to deeper/higher
energy source
• GOD is extremely importnat to Healing !

22. Transpersonal Caring
•This involves a human to human
connectedness.
•The nurse and the patient are touched by
the soul of the other

23. Transpersonal Caring-Healing
•Involves a person to move beyond the
ego self in order for the spiritual and
cosmic concern and connections to
help reach the healing possibilities and
potentials.

24. Watson’s nursing goals were to promote health, restore health, and
prevent illness from reoccuring
1. Caring
• The ethical and moral idea of nursing that has interpersonal and
humanistic qualities.
• It is s complex concept involving development of a range of
knowledge and expertise encompassing holism, empathy,
communication, clinical competence, technical proficiency, and
interpersonal skills.
2. Person
• A person is unique and not predictable. They have certain needs
that be valued, cared for, respected, nuurtured, understood and
assisted.
• “ We are not human being having a spiritual experience. We are
spiritual beings having a human experience.”

25. 3. Environment
• Extremely important in healing a person’s mental, physical,
social, emotional, spiritual, developmental, and protective
supporting environment for a patient’s health and well
being.
4. Health
• Defined as the unity and harmony within the body, mind
and soul. It associates with the congruence between how
we perceive ourselves and what we experience.
• Watson views health and illness fuctioning simultanueosly
as a way to stabilize and balance ones life.

27. Nursing theorist in focus…
A first-generation American of Italian descent
Birth date :
Birthplace :
Husband :
Death date :

28. 1947 - Diploma in Nursing, New
York Medical College
1951 - B.S. in Public Health
Nursing, St. John's University,
Brooklyn, New York
1954 - M.A. in mental health
consultation, Columbia
University, New York

29. • Staff nurse, varied specialties (OB, MS, ER)
• Supervisor in a General Hospital
• Research Associate & Principal Investigator of a Federal Project entitled
“Integration of Mental Health Concepts in a Basic Curriculum” at Yale University
in New Haven, Connecticut (1954-1961)
• Clinical Nursing Consultant in Mental Health, McLean Hospital in Belmont,
Massachusetts (1962-1972)
• Served on various committees at Harvard Community Health Plan in Boston,
Massachusetts since 1972
• Nurse Educator for Metropolitan State Hospital in Waltham, Massachusetts in
1981
• Assistant Director of Nursing for Education and Research at Metropolitan State
Hospital (September1987)
• Retired in 1992

30. Books Published:
 1961 - “The Dynamic Nurse-Patient Relationship: Function, Process
and Principles”
 1967 - “The Patients Predicament and Nursing Function ” an
issue of Psychiatric Opinion
 1972 - “The Discipline and Teaching of Nursing Process : An
Evaluative Study”
• Conducted Training Programs at McLean Hospital
• Managed 60 workshops about her theory in USA
and Canada (1972-1981)
• Outstanding Nurse in the Hall of Fame of
Massachusetts Nurse’s Association in 2001

31. Mrs. So: “Nurse, can you give me my morphine!”
Nurse: “Can you tell how painful it is using the 0 ‐10 pain scale, where 0 being not painful and 10
being severely painful?
Mrs.So: “Ummm... I think it’s about 7. Can I have my morphine now?”
Nurse: “Mrs. So, I think something is bothering you besides your pain. Am I correct?”
Mrs. So (crying): “I can’t help it. I’m so worried about my 3 boys. I’m not sure how they are or who’s
been taking care of them. They’re still so young to be left alone. My husband is in Yemen right
now and he won’t be back until next month.”
Nurse: “Why don’t we make a phone call to your house so you could check out on your boys?”
Mrs. So called up his sons. After the phone call.
Mrs. So: “Thank you nurse. I don’t think I still need that morphine.
My boys are fine. Our neighbour, Mrs. Yee, she’s watching over my boys right now.”
CASE SCENARIO

32. ORLANDO
PERSON
unique and developmental beings with needs,
individuals have their own subjective perceptions and
feelings that may not be observable directly
NURSING
providing direct assistance to
individuals in whatever setting for the
purpose of avoiding, relieving,
diminishing, or curing the person’s
sense of helplessness
HEALTH
is not well-defined but assumed
as “freedom from mental or
physical discomfort and feelings
of adequacy and well-being ”
ENVIRONMENT
is not clearly defined as well but assumed as a nursing situation
when there is a nurse-patient contact and that both nurse and
patient perceive, think, feel, and act in the immediate situation

33. • In the late 1950s, Orlando developed her theory inductively through an
empirical study of nursing practice.
• For 3 years, she recorded 2000 observations between a nurse and patient
interactions.
• She was only able to categorize the records as "good" or "bad" nursing.
According to records:
*Good Nursing – nurse’s focus was on the patient’s immediate verbal and nonverbal
behaviour from the beginning through the end of the contact
*Bad Nursing – nurse’s focus was on a prescribed activity or something that had nothing
to do with the patient’s behaviour
Development of Theory

34. •From these observations, she formulated the “Deliberative
Nursing Process” which was published in 1961.
•Conducted research at McLean Hospital through
continuous tape recording of nurses with patients and
other health care members
•Based on this research, her formulations were validated,
thus she extended her theory to include the entire nursing
practice system which then evolved as “Nursing Process
Discipline”
Development of Theory

35. •Orlando's theory remains one the of the most effective
practice theories available.
•Many theory scholars utilized her concept as basis for their
further studies.
•Her work has been translated into six languages and was
contained in the international section.
•A web page about her theory, developed by Schmieding in
1999, is updated periodically and contains extensive
references.
Development of Theory

36. Assumptions about Nurses:
• “The nurse’s reaction to each patient
is unique”
• “Nurses should not add to the patient’s
distress”
• “The nurse’s mind is the major tool for
helping patients”
• “The nurse’s use of automatic responses
prevents the responsibility of nursing
from being fulfilled”
• “Nurse’s practice is improved through
self-reflection”
Assumptions about Patients:
• “Patients’ needs for help are unique”
• “Patients have an initial ability to
communicate their needs for help”
• “When patients cannot meet their
own needs they become distressed”
• “The patient’s behaviour is
meaningful”
• “Patients are able and willing to
communicate verbally (and non-
verbally when unable to
communicate verbally)”

37. Assumptions about the
nurse-patient situation:
• “The nurse-patient situation
is a dynamic whole”
• “The phenomenon of the
nurse- patient encounter
represents a major source of
nursing knowledge”
Assumptions about Nursing:
• “Nursing is a distinct profession
separate from other disciplines”
• “Professional nursing has a
distinct function and product
(outcome)”
• “There is a difference between lay
and professional nursing”
• “Nursing is aligned with medicine”

38. "I can't move, I can't speak, I need help..."
Introduction to the Theory
Nurse Action
Nurse Reaction
Patient Behavior

39. A) The nursing process is set in motion by the Patient Behaviour
- All patient behaviour:
a) verbal ( a patient’s use of language )
b) non-verbal ( includes physiological symptoms, motor activity, and
nonverbal communication)
c) physical forms (vital signs)
- Must be considered an expression of a need for help and has to be validated .
- Ineffective assessment by the nurse leads nurse-patient relationship failure.
- Communication process is vital to acquire patient’s cooperation in achieving
health.
Remember: When a patient’s need for help is not resolved even with the help
of another, will result to sense of helplessness.

40. B) The Patient Behaviour stimulates a Nurse Reaction
- Nurse-patient relationship takes place.
- Correct evaluation of patient’s behaviour by using the nurse reactions steps yields
positive feedback response from the patient.
The steps are as follows:
1) The nurse perceives behaviour through any of the senses
2) The perception leads to automatic thought
3) The thought produces an automatic feeling
4) The nurse shares reactions with the patient to ascertain whether perceptions are
accurate or inaccurate
5) The nurse consciously deliberates about personal reactions and patient input in order
to produce professional deliberative actions based on mindful assessment rather than
automatic reactions.
Remember : Exploration with the patient helps validate the patient’s behaviour.

41. Automatic Reaction (Non-Deliberative)
 stem from nursing behaviours that are performed to satisfy a directive
other than the patient’s need for help.
Example: The nurse who gives a sleeping pill to a patient every evening
because it is ordered by the physician, without first discussing the need
for the medication with the patient.
Rationale : Giving of the pill has more to do with following medical orders
(automatically) than with the patient’s immediate expressed need for
help.
C) Critically considering one or two ways in implementing Nurse Action

42. Deliberative Reaction
 is a “disciplined professional response”, that all nursing actions are meant to help
the client and should be considered deliberative.
 The following criteria should be considered.
Deliberative actions result from the correct identification of patient needs by
validation of the nurses’ reaction to patient behaviour.
The nurse explores the meaning of the action with the patient and its relevance to
meeting his need.
The nurse validates the action’s effectiveness immediately after compelling it.
The nurse is free of stimuli unrelated to the patient’s need (when action is taken).
Remember : For an action to have been truly deliberative, it must undergo reflective
evaluation to determine if the action helped the client by addressing the need as
determined by the nurse and the client in the immediate situation.
C) Critically considering one or two ways in implementing Nurse Action

43. The role of the nurse is to find out and meet the patient's
immediate need for help.
The patient's presenting behaviour may be a plea for help,
however, the help needed may not be what it appears to be.
Therefore, nurses need to use their perception, thoughts
about the perception, or the feeling engendered from their
thoughts to explore with patients the meaning of their
behaviour.
This process helps nurse find out the nature of the distress and
what help the patient needs.
Orlando’s Nursing Process Discipline

44. MAJOR DIMENSIONS OF THE THEORY
Function of Professional Nursing - Organizing Principle
Presenting Behaviour - Problematic Situation
Immediate Reaction - Internal Response
Nursing Process Discipline – Investigation
Improvement - Resolution
Orlando’s Nursing Process Discipline

45. FUNCTIONS OF PROFESSIONAL NURSING - ORGANIZING PRINCIPLE
Finding out and meeting the patients immediate needs for help
• Nursing….is responsive to individuals who suffer or anticipate a sense of
helplessness, it is focused on the process of care in an immediate experience, it is
concerned with providing direct assistance to individuals in whatever setting they
are found for the purpose of avoiding, relieving, diminishing or curing the
individuals sense of helplessness
• The purpose of nursing is to supply the help a patient requires for his needs to
be met
• Nursing thought - Does the patient have an immediate need for help or not?
• If the patient has an immediate need for help and the nurse finds out and
meets that need ,the function of professional nursing is achieved .
MAJOR DIMENSIONS OF THE THEORY

46. PRESENTING BEHAVIOR – PROBLEMATIC SITUATION
To find out the immediate need for help the nurse must first
recognize the situation as problematic
• The presenting behaviour of the patient, regardless of the
form in which it appears, may represent a plea for help
• The presenting behaviour of the patient, the stimulus,
causes an automatic internal response in the nurse, and
the nurses behaviour causes a response in the patient
MAJOR DIMENSIONS OF THE THEORY

47. IMMEDIATE REACTION –INTERNAL RESPONSE
• Person perceives with any one of his five sense organs an
object or objects
• The perceptions stimulate automatic thought
• Each thought stimulates an automatic feeling
• Then the person acts
• The first three items taken together are defined as the
person’s immediate reaction
• Reflects how the nurse experiences her or his participation
in the nurse patient situation

48. NURSING PROCESS DISCIPLINE - INVESTIGATION
• Any observation shared and explored with the patient is immediately useful in
ascertaining and meeting his need or finding out that he is not in need at that
time
• The nurse does not assume that any aspect of her reaction to the patient is
correct, helpful or appropriate until she checks the validity of it in exploration
with the patient
• The nurse initiates a process of exploration to ascertain how the patient is
affected by what she says or does
• Automatic reactions are not effective because the nurses action is decided upon
for reasons other than the meaning of the patients behaviour or the patients
immediate need for help
• When the nurse does not explore with the patient her reaction it seems
reasonably certain that clear communication between them stops

49. IMPROVEMENT - RESOLUTION
•It is not the nurses activity that is evaluated but rather
its result : whether the activity serves to help the
patient communicate her or his need for help and how
it is met
•In each contact the nurse repeats a process of learning
how to help the individual patient.
•Her own individuality and that of the patient requires
that she go through this each time she is called upon
to render service to those who need her

50. Distinguish the Theory Analyze the Theory
CONCEPTUAL FRAMEWORK

51. RESEARCH
The diversity of the research using the theory
attests to its breadth of application. It also
indicates its utility for application of the
findings in:
• Perioperative Nursing
•Studying Nurse-Patient Relationships
•Advanced-Nursing Practice and
Administrations
•Responses to distressed patients
•Mental Illnesses
•Positive Patient-Centered Outcomes
ACCEPTANCE by the NursingCommunity:

52. EDUCATION
Orlando’s nursing process theory
was recommended for teaching
BSN students and conceptualize
BSN curriculums which has an
emphasis on the interaction
process and its goal on
communication and psychosocial
foundations which may translate
into more effective exploratory
skills in the students.
ACCEPTANCE by the NursingCommunity:

53. PRACTICE
Orlando’s nursing process discipline reflects the elements of
the therapeutic relationships which include expression of
empathy, warmth, and genuineness that would increase the
therapeutic effectiveness of nursing having applied
throughout various nursing departments: Operating Rooms,
Mental Health Units, Administrations and Public Health
departments
Use in Clinical Practice: Nursing care plan, Case studies,
Progressive patient care settings
Nursing process: A-D-P-I-E
ACCEPTANCE by the NursingCommunity:

54. ANALYSIS/ CRITIQUE:
CLARITY
•Presents concepts clearly and consistently uses the same words for her major components and processes.
The writing style involves defining concepts minimally at first and then developing them throughout the
book.
SIMPLICITY
•Theory is considered simple yet elegant and has benefited research applications. It was also used as an
example of grand nursing theory and described as a practice theory.
GENERALITY
•Conceivably, the theory could be adapted to other nursing situation and other professional fields whose
focus is on identifying and finding out patient’s immediate need for help.
EMPIRICAL PRECISION
• Orlando used a qualitative method to obtain data from which she developed
her theory. She also utilized field methodology before it became a world view
in research.
DERIVABLE CONSEQUENCES
• The nursing process discipline allows the nurses to view the patient from a medical disease orientation.
The use of Orlando’s theory benefits the patient, enhances the nurse’s professional identity, and helps to
advance the nursing profession.

55. Use of her theory assures
that patient will be treated as
individuals and that they will
have active and constant
input into their own care .
Prevents inaccurate diagnosis
or ineffective plans because
the nurse has to constantly
explore her reactions with
the patient
Assertion of nursing’s
independence as a profession
and her belief that this
independence must be based
on a sound theoretical frame
work
Nursing can pursue
Orlando's work for
retesting and further
developing her work
Make evaluation a less time
consuming and more
deliberate function, the results
of which would be
documented in patients charts
Guides the nurse to
evaluate her care in
terms of objectively
observable patient
outcomes
Limitations
Highly interactive nature
Orlando's theory makes it hard
to include the highly technical
and physical care that nurses
give in certain settings
Her theory struggles with
the authority derived from
the function of profession
and that of the employing
institution’s commitment
to the public

56. 1. Guiding Principle
Finding out and meeting the
patient’s immediate need for
help
2. Problematic situation and
immediate reaction(s)
3. Inquiry-Problem Determination
4. Identifying specific plans for each
problem
5. Implement
6. Improvement
Assessing a Patient by using Orlando’s Theory to guide the Nurse’s Process
The nurse’s focus is on the patient and free of distracting thoughts
-The nurse recognizes cues that a patient problem may exist before the next step in the process.
-The nurse identifies his or her immediate perception, thoughts, feelings (Immediate reaction)
-The nurse uses terms the patient can understand and explores immediate reactions with the patient to
discover physical/nonphysical problems. As the problem is identified, the nurse asks the patient to
confirm or refute its accuracy.
-The nurse explores the disagreement to determine its basis
-With the patient, the nurse determines action(s) needed and develops plans for each problem.
-The nurse explores whether the patient agrees with or refutes the plan. The nurse explores and
resolves the basis of disagreement. The patient verbally or nonverbally agrees. If not, the nurse
continues the inquiry for the basis.
-If the patient is unable, the nurse implements the plan and asks the patient whether the action is
helpful. If it is not, the nurse explores the basis .
-The nurse helps the patient if he or she is unable to do it alone and explores whether the patient was
helped. The nurse inquires about his or her results.
The nurse asks the patient whether the action helped and observes the patient’s verbal and nonverbal
behavior. If he or she has improved, the need for help was mer. If not, the nurse continues to use the
content of immediate reaction to explore with the patient until a positive change is evident.

57. 1. Guiding Principle
Finding out and meeting the
patient’s immediate
need for help
2. Problematic situation
and immediate
reaction(s)
3. Inquiry-Problem
Determination
Assessing a Patient by using Orlando’s Theory to guide the Nurse’s Process
The nurse’s focus is on the patient and
free of distracting thoughts
-The nurse recognizes cues that a patient problem may
exist before the next step in the process.
-The nurse identifies his or her immediate perception,
thoughts, feelings (Immediate reaction)
-The nurse uses terms the patient can understand and
explores immediate reactions with the patient to discover
physical/nonphysical problems. As the problem is identified,
the nurse asks the patient to confirm or refute its accuracy.
-The nurse explores the disagreement to determine its basis

58. 4. Identifying specific
plans for each
problem
5. Implement
6. Improvement
Assessing a Patient by using Orlando’s Theory to guide the Nurse’s Process
-With the patient, the nurse determines action(s) needed and
develops plans for each problem.
-The nurse explores whether the patient agrees with or
refutes the plan. The nurse explores and resolves the basis of
disagreement. The patient verbally or nonverbally agrees. If
not, the nurse continues the inquiry for the basis.
-If the patient is unable, the nurse implements the plan and
asks the patient whether the action is helpful. If it is not, the
nurse explores the basis .
-The nurse helps the patient if he or she is unable to do it
alone and explores whether the patient was helped. The
nurse inquires about his or her results.
The nurse asks the patient whether the action helped and observes
the patient’s verbal and nonverbal behaviour. If he or she has
improved, the need for help was mer. If not, the nurse continues to
use the content of immediate reaction to explore with the patient
until a positive change is evident.

59. HUMAN-TO-HUMAN RELATIONSHIP MODEL

60. “The nurse is responsible for helping the
patient avoid and alleviate the distress of
unmet needs.”
- Travelbee
HUMAN-TO-HUMAN RELATIONSHIP MODEL

61. INTRODUCTION
•Joyce Travelbee (1926-1973) developed the
Human-to-Human Relationship Model presented
in her book Interpersonal Aspects of Nursing
(1966, 1971).
• She dealt with the interpersonal aspects of
nursing.

62. • A psychiatric nurse, educator and writer born in 1926.
• 1956, she completed her BSN degree at Louisiana State
University
• 1959, she completed her Master of Science Degree in Nursing at
Yale University.
• 1952, Psychiatric Nursing Instructor at Depaul Hospital Affilliate
School, New Orleans.
• Later in Charity Hospital School of Nursing in Louisiana State
University, New York University and University of Mississippi.
• Travelbee died at age 47
ABOUT THE THEORIST

63. • Travelbee based the assumptions of her theory on the concepts of
existentialism by Soren Kierkegaard and logotherapy by Viktor
Frankl.
• Existential theory believes that that humans are constantly faced
choices and conflicts and is accountable to the choices we make in
life
• Logotherapy theory was first proposed by Viktor Frankel, a
survivor of Auschwitz, in his book Man's Search for Meaning
(1963).
DEVELOPMENT OF THE THEORY

64. SUFFERING
"An experience that varies in intensity, duration and depth ... a feeling of
unease, ranging from mild, transient mental, physical or mental discomfort to
extreme pain and extreme tortured ..."
MEANING
Meaning is the reason as oneself attributes
NURSING
is to help man to find meaning in the experience of illness and suffering has a
responsibility to help individuals and their families to find meaning. The nurses'
spiritual and ethical choices, and perceptions of illness and suffering, is crucial
to helping to find meaning.
BASIC CONCEPTS

65. HOPE
• Nurse's job is to help the patient to maintain hope
and avoid hopelessness.
• Hope is a faith that can and will be change that
would bring something better with it.
• Hope's core lies in a fundamental trust the outside
world, and a belief that others will help someone
when you need it.
BASIC CONCEPTS

66. Six important factors characteristics of hope are:
1. It is strongly associated with dependence on other people.
2. It is future oriented.
3. It is linked to elections from several alternatives or escape
routes out of its situation.
4. The desire to possess any object or condition, to complete a
task or have an experience.
5. Confidence that others will be there for one when you need
them.
6. The hoping person is in possession of courage to be able to
acknowledge its shortcomings and fears and go forward
towards its goal.

67. •COMMUNICATIONS
• "a strict necessity for good nursing care"
•USING HIMSELF THERAPEUTIC
• " one is able to use itself therapeutic."
• Self-awareness and self-understanding, understanding
of human behavior, the ability to predict one's own and
others' behavior are important in this process.
•TARGETED INTELLECTUAL APPROACH
• Nurse must have a systematic intellectual approach to
the patient's situation.

68. NURSING METAPARADIGMS
• • PERSON •
• Person is defined as a human being. • Both the nurse and the
patient are human beings.
• • HEALTH •
• Health is subjective and objective.
• • Subjective health is an individually defined state of well being in
accord with self-appraisal of physical-emotional-spiritual status.
• • Objective health is an absence of discernible disease, disability
of defect as measured by physical examination, laboratory tests
and assessment by spiritual director or psychological counselor.

69. NURSING METAPARADIGMS
•• ENVIRONMENT •
• Environment is not clearly defined.
•• NURSING •
• "an interpersonal process whereby the
professional nurse practitioner assists an
individual, family or community to prevent or cope
with experience or illness and suffering, and if
necessary to find meaning in these experiences.”

70. •Travelbee believed nursing is accomplished
through human-to-human relationships that
begin with the original encounter and then
progress through stages of emerging
identities, developing feelings of empathy,
and later feelings of sympathy.
DESCRIPTION OF THE THEORY

71. • The nurse and patient attain a rapport in the
final stage. For meeting the goals of nursing it
is a prerequisite to achieving a genuine
human-to-human relationships.
•This relationship can only be established by an
interaction process.
DESCRIPTION OF THE THEORY

72. •It has five phases.
 The inaugural meeting or original encounter
 Visibility of personal identities/ emerging
identities.
 Empathy
 Sympathy
 Establishing mutual understanding and
contact/ rapport
DESCRIPTION OF THE THEORY

73. CONCLUSION
Travelbee's theory has significantly
influenced nursing and health care.
 Travelbee's ideas have greatly influenced
the hospice movement in the west

74. THANK YOU
and
GOOD NIGHT!