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1. THEORIST THEORY/CONCEPTS/COMPONENTS METAPARADIGM
Hildegard Peplau
- “Psychiatric Nurse of
the Century”
- First Book:
Interpersonal
Relations in Nursing
INTERPERSONAL RELATIONS THEORY
• The nurse-patient relationship was described as a
four-phase phenomenon:
a. Orientation
- Initial interaction between nurse and patient
- Nurse assists the patient in recognizing and
understanding the patient experience
b. Identification
- Patient and nurse explore the experience and
needs of patient
c. Exploitation
- Patient shift from dependent role to independent
role
- New goals are projected, but power is shifted to
the patient
d. Resolution
- Patient earns independence over care
- Patient puts goals aside and formulates a new one
• Psychological Mothering:
a. Patient is accepted unconditionally as a
participant
b. Recognition and response to patient’s readiness
for growth
c. Power shifts to the patient
• Nursing Roles:
a. Stranger
- The nurse attempts to know the patient better
- The nurse treats the patient with outmost
courtesy
- Occurs during the Identification Phase
b. Resource Person
- Nurse provides specific answers to questions
- Nurse must change response to patient’s level of
understanding
c. Teacher
- Determines how the patient understands the plan
of care
d. Leader
- The nurse must act in behalf of the patient’s
interest and at the same time enable him to make
decisions over own care
- Achieved through cooperation and active
participation
e. Surrogate
- Temporary care giver
f. Counselor
- The nurse becomes a listening friend
- The nurse gives sound empathic advises
Person:
• A man who is an organism that
lives in an unstable balance of a
given system
Health:
• For health to be achieved and
maintained, needs must be met
(physiological demands and
interpersonal conditions)
Environment:
• Forces outside the organism
Nursing:
• Nursing is a significant,
therapeutic interpersonal
process
Ida Jean Orlando NURSING PROCESS THEORY
• Focus: Reciprocal relationship between nurse
and patient
• The nurse uses the standard nursing process in
Orlando’s Nursing Process Discipline Theory,
which follows:
A – ssessment
D – iagnosis
P – lanning
I – mplementation
E – valuation
Person:
• Humans in need are the focus of
nursing practice
Health:
• Health is a sense of helplessness
as an initiator for necessity for
nursing
Environment:
• Orlando disregarded
environment in her theory
Nursing:

2. • Nursing is unique and
independent for individual’s
need for help
Joyce Travelbee HUMAN-TO-HUMAN RELATIONSHIP MODEL
• The nurse and patient undergo series of
interactional phases:
a. Original Encounter
- First impression of the nurse and patient to each
other
b. Emerging Identities
- Nurse and patient perceiving each other as
unique individuals
- Link of relationship begins to form
a. c. Empathy
- Ability to share the person’s experience
d. Sympathy
- Nurse wants to lessen the cause of suffering
- It goes beyond empathy
b. e. Rapport
- Nursing interventions that lessen cause of
suffering
- The patient shows trust and confidence to the
nurse
Person:
• Human being is a unique,
irreplaceable individual
Health:
• Health is measured subjectively
and objectively.
Environment:
• Human conditions and life
experiences encountered by
men as suffering, hope, pain and
illness
Nursing:
• Nursing is an interpersonal
process whereby the nurse
assists individual, family,
community
Lydia Hall CARE, CORE, CURE
• Three components:
a. Care
- “The Body”
- “Intimate bodily care”
- Represents the nurses’ roles and focused on
performing task to nurture patients
b. Core
- “The Person”
- “Therapeutic Use of Self”
- Represents the patient receiving nursing care
- Involves therapeutic use of self
- Emphasizes patient’s social, emotional,
intellectual, spiritual needs
- The nurse uses reflective technique
c. Cure
- “The Disease”
- “Seeing the patient and family through medical
care”
- Represents nursing
- Represents interventions geared towards treating
the patient
- The nurse shares with other health care
professionals
Person:
• Source of energy and motivation
for healing
Health:
• Health is a state of self-
awareness
Environment:
• Environment should be
conducive for self-development
Nursing:
• Nursing is participating in the
care, core, cure aspects of
nursing caring
Faye Abdellah
- “First woman to serve
as Deputy Surgeon
General of the United
States”
TWENTY-ONE NURSING PROBLEMS
• Focus of theory: it is nursing-centered rather
than patient-centered
• Main Goal: Improvement of nursing education
• Impact to nursing practice: helped transform
focus of profession from disease-centered to
patient-centered
• Three chief components:
a. Health
b. Nursing problems
c. Problem solving
• Health needs are seen as:
a. Overt – can-be-seen condition
b. Covert – unseen or masked one
Person:
• Beneficiary of care
Health:
• Center and purpose of nursing
services
Environment:
• Apex of nursing service is the
individual
Nursing:
• Nursing is an all-inclusive service

3. • Problem-solving process includes:
a. Identify the problem
b. Select relevant data
c. Devise hypotheses
d. Test hypotheses through assortment of data
e. Revise hypotheses
• 21 NURSING PROBLEMS:
A. BASIC TO ALL PATIENTS
1. To maintain good hygiene and physical comfort
2. To promote optimal activity: exercise, rest and
sleep
3. To promote safety through the prevention of
accidents, injury, or other trauma and through the
prevention of the spread of infection
4. To maintain good body mechanics and prevent
and correct deformity
B. SUSTENAL CARE NEEDS
5. To facilitate the maintenance of a supply of oxygen
to all body cells
6. To facilitate the maintenance of nutrition of all
body cells
7. To facilitate the maintenance of elimination
8. To facilitate the maintenance of fluid and
electrolyte balance
9. To recognize the physiological responses of the
body to disease conditions
10. To facilitate the maintenance of regulatory
mechanisms and functions
11. To facilitate the maintenance of sensory function.
C. REMEDIAL CARE NEEDS
12. To identify and accept positive and negative
expressions, feelings, and reactions
13. To identify and accept the interrelatedness of
emotions and organic illness
14. To facilitate the maintenance of effective verbal
and non-verbal communication
15. To promote the development of productive
interpersonal relationships
16. To facilitate progress toward achievement of
personal spiritual goals
17. To create and / or maintain a therapeutic
environment
18. To facilitate awareness of self as an individual with
varying physical, emotional, and developmental
needs
D. RESTORATIVE CARE NEEDS
19. To accept the optimum possible goals in the light
of limitations, physical and emotional
20. To use community resources as an aid in resolving
problems arising from illness
21. To understand the role of social problems as
influencing factors in the case of illness
Virginia Henderson
- “First Lady of
Nursing”
- “First Truly
International Nurse”
14 BASIC HUMAN NEEDS
1. Breathe normally.
2. Eat and drink adequately.
3. Eliminate body wastes.
4. Move and maintain desirable postures.
5. Sleep and rest.
6. Select suitable clothes-dress and undress.
7. Maintain body temperature within normal range
by adjusting clothing and modifying environment
Person:
• Person is an individual who
requires assistance to achieve
health and independence
Health:
• Health is a quality of life and
basic for human to function fully
Environment:
• The nurse must be educated
about safety

4. 8. Keep the body clean and well-groomed and
protect the integument
9. Avoid dangers in the environment and avoid
injuring others.
10. Communicate with others in expressing
emotions, needs, fears, or opinions.
11. Worship according to one’s faith.
12. Work in such a way that there is a sense of
accomplishment.
13. Play or participate in various forms of recreation.
14. Learn, discover, or satisfy the curiosity that leads
to normal development and health and use the
available health facilities.
• Emphasis: view the patient and family as a single
unit
• Three levels in nurse-patient relationship:
a. Nurse as a substitute for the patient
- The nurse serves as a substitute to what the
patient lacks
b. Nurse as a helper to the patient
- Nurse focus on assisting the patient to meet needs
c. Nurse as a partner with the patient
- The nurse and patient formulate plan together
- The nurse empowers the patient to make effective
decisions regarding care plans
Nursing:
• Nurse functions independently
from the physician
• Nurse must help both sick and
well individual
Nola Pender HEALTH PROMOTION MODEL
• Each person has unique characteristics and
experiences
• This are desired behavioral outcome that should
result in improved health, enhanced functional
ability, and better quality of life
• Examples of health promoting behaviors:
- Healthy diet
- Exercise
- Managing stress
- Gain adequate rest and spiritual growth
- Building positive relationships
• Variables that influence individual to engage in
health-promoting behaviors:
a. Activity-related affect
b. Commitment to a plan of action
c. Immediate competing demand and
preferences
Person:
• Individuals, family, community
as active participants for the
promotion of health
Health:
• Focus on health promotion and
disease prevention
Environment:
• Environment wellness is
manifested with balance
between human beings and
surroundings
Nursing:
• Helping individuals understand
and perform health promoting
behaviors
Madeleine Leininger
- “Culture Care or
Culture Care Diversity
and Universality”
TRANCULTURAL NURSING
• Culture
- Learned, shared, and transmitted values, beliefs,
norms, and lifeways of a particular group
• Key component: Cultural Diversity (differences or
variations that can be found in different cultures)
Person:
• Humans are caring and capable
of being concerned about
desires, welfare, and continued
existence
Health:
• Health is universal and diverse
Environment:
• Environment as being the
totality of an event, situation, or
experience
Nursing:
• Three types of nursing actions:
a. Cultural care
preservation/maintenance
b. Cultural care
accommodation/negotiation

5. c. Cultural care
repatterning/restructuring
Margaret Newman HEALTH AS EXPANDING CONSCIOUSNESS
• Focus: Health as expansion of consciousness
• Goal: not to make people well, or to prevent their
getting sick, but to assist people to utilize the
power that is within them as they evolve toward
higher levels of consciousness
• Must include health of all persons regardless of
presence or absence of disease
• Health is the central of the theory and seen as the
process of developing awareness for self and
environment
• Consciousness – manifestation of an evolving
pattern of person-environment interaction
Person:
• Patients are viewed as
participants in transformative
process
• Humans are unitary and cannot
be divided into parts
Health:
• Pattern of the whole
• Fusion of disease and non-
disease
• Health and illness are a unitary
process
Environment:
• Interaction between human and
environment as key process to
create unique configurations for
each individual
• Viewed as a universe of open
systems
Nursing:
• The focus of nursing is the
primacy of relationships
• The nurse must get in touch with
the meaning of life through
identification of meaning
• Nursing is caring in the human
health experience
Rosemarie Parse HUMAN BECOMING THEORY
• Purpose: Guide nurses in practice to focus on
quality of life
• The human becoming theory posits quality of life
from person’s own perspective as the goal of
nursing practice
• Man Living Health
o 2 paradigms (worldview of nursing)
a. Totality Paradigm
- Man is a combination of biological, psychological,
sociological, spiritual factors
b. Simultaneity Paradigm
- Man is a unitary being in continuous, mutual
interaction with environment
• Three Principles:
1. Structuring meaning multidimensionality
- Cocreating reality through the Languaging of
valuing and imaging
- SCENARIO:
▪ Imaging: an infertile couple believes there are
many children in need of homes and plan to
adopt
▪ Valuing: an older woman putting her health
first as all her children moved out of the
house
▪ Languaging: a man diagnosed with terminal
illness finds words and strength to talk about
it to his family
2. Cocreating rhythmical patterns of relating
- Living the paradoxical unity of revealing-
concealing and enabling-limiting while
connecting-separating
Person:
• Open being who is more than
and different from the sum of
the parts
Health:
• Open process of being and
becoming.
• Involves synthesis of values
Environment:
• Everything in the person and his
experiences
• Inseparable, complimentary to
and evolving with
Nursing:
• A human science and art that
uses an abstract body of
knowledge to serve people

6. - SCENARIO:
▪ Revealing-Concealing: a pregnant teenager
must reveal the truth to her parents
▪ Enabling-Limiting: a patient chose to refuse a
treatment
▪ Connecting-Separating: parents want more
aggressive treatment for child; the husband
disagrees causing a strain in the relationship
3. Contranscending with the possible
- Powering the unique ways of originating in the
process of transforming
- SCENARIO:
▪ Powering: parents learn to be strong and
move on with the death of their child
▪ Originating: a woman raises money for
cancer research in honor of her mother
▪ Transforming: an elderly man accepts help as
he is unable to care for his wife