12.
Works in such a way that there is a sense of
VIRGINIA HENDERSON
(NEEDS THEORY)
 “The nurse is temporarily the conscious of the
unconscious, the love of life for the suicidal, the
leg of the amputee, the eyes of the newly blind,
a means of locomotion for the infant, knowledge
and confidence for the mother, the multipiece
for those too weak or withdrawn to speak and so
on”
 First lady of nursing
 First international nurse
 Full-time instructor in Virginia
 Advocate of the introduction of psychiatric
nursing
 Outstanding teacher
 Published a book: nature of nursing
 Selected as American nurse’s association hall
of fame the sigma theta tau library was
named after her
 One of the 51 pioneer nurses in Virginia
 Considered the 20th century nurse (19th is
nightingale)
THE METAPARADIGM IN NURSING
(the practice of nursing is independent from the practice
of physicians)
 NURSING
 Nurses must promote the treatment plan
prescribed by the physician. She must act
independently. Care must include all walks of
life, from well to sick, from the newborn to
dying. This definition was considered the
“signature” of nursing.
 PERSON
 The client that requires assistance to achieve
health and independence and in some cases, a
peaceful death. The person must function to the
utmost by maintaining physiological and
emotional balance.
 HEALTH
 Quality of life. it is influenced by external and
internal factors. Health promotion is more
important than the care of the sick.
 ENVIRONMENT
 Healthy individuals should control the
environment but if there is illness, this ability is
affected or diminished.
14 COMPONENTS OF VIRGINIA HENDERSON’S
NURSING NEED THEORY
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 a normal
range by adjusting clothing and modifying
the environment
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
accomplishment.
13. Play or participate in various forms of
recreations.
14. Learn, discover, or satisfy the curiosity that
leads to normal development and health and
use the available health facilities.
The Nurse-Patient Relationship
1. The nurse as a substitute for the client.
2. The nurse as a helper to the client
3. The nurse as a partner with the patient.
The Nurse-Physician Relationship
 Henderson asserts that nurses function
independently from physicians. She insisted that
nurses do not follow in a philosophy that allows
physicians to give orders to clients or HCT. She
said that many nursing roles and responsibilities
overlap with that those of the physicians.
Nurses as a member of healthcare team
 Henderson mentioned that every member must
work independently for the team to work in
harmony. The nurse should work and contribute
in carrying out the total program of care.
ACCEPTANCE BY THE NURSING COMMUNITY
 Practice
 Henderson’s approach focuses on decision
making and is deliberate in such a way that in
every step of the nursing process
 Assessment phase
 Planning phase
 Implementation phase
 Evaluation phase
 Education
 Henderson developed three phases of curriculum
development
 A. first phase – the emphasis is made
on helping the client perform activities
of daily living.
 B. Second Phase – importance is placed
on assisting clients to achieve their
needs in times of marked body
disturbances or illness. In here, the
students understand the rationale behind
the prescribed therapeutic plans made by
the physicians.
 C.Third phase – centered on the client
and his family together with the
dynamic affecting the relationship inside
the unit.
 Research
 she supported the use of research in improving
the practice of nursing. Various questions arise
commonly from her 14 basic needs.
 Accessibility
 Henderson’s theory is used in practice and the
concepts are clinically significant as they are
focused on assisting individuals to gain
independence in relations to the performance of
activities contributing to health or its recovery.
 Importance
 The perspective related to Henderson’s theory
opened doors for development by the upcoming
nursing theorists. Her definition of the unique
 function of a nurse has been widely read and
accepted.
JOYCE TRAVELBEE
(HUMAN TO HUMAN RELATIONSHIP MODEL)
 Psychiatric nurse
 She died at the age of 47 and was not able to
finish her doctorate degree.
 Instructor in psychiatric nursing
 She published various articles and journals
 She published a book entitled “interpersonal
aspects of nursing 1996 and 1971”
METAPARADIGM IN NURSING
(Travelbee’s work is conceptual, and she wrote about
illness, suffering, pain, hopes, communication,
interaction, empathy, sympathy, rapport and therapeutic
use of self)
 NURSING
 An interpersonal process whereby the
professional nurse practitioner assists an
individual, family or community to prevent or
cope with the experience of illness and suffering
and to find meaning in these experiences.
 PERSON
 Defined as a human being (nurse and patient).
the human being is unique, an irreplaceable
individual who is in continuous process of
becoming, evolving, and changing.
 HEALTH
 It is measured by the subjective and objective
health. Subjective is the person’s wellbeing in
accord with self-appraisal of physical emotion –
spiritual status.
 ENVIRONMENT
 Was not clearly defined in her theory. Human
conditions and life experiences encountered by
all men as suffering, hope, pain and illness
which are all associated with the environment.
PATIENT AND NURSE INTERACTIONAL
PHASES
 Original Encounter – described as the 1st
impression by the nurse of the sick person and
vice versa. The nurse and the patient see each
other in stereotyped or traditional roles.
 Emerging identities – nurse and patients
perceive each other as unique individuals. This
time the relationship begins to form.
 Empathy- this the ability to share in the
persons’ experience. The result of this is ability
to expect the behavior of the individuals with
whom he or she emphasized.
 Sympathy- it happens when the nurse wants to
lessen the cause of the client’s sufferings.
 Rapport- nursing interventions that lessen the
client’s sufferings. The sick person shows trust
and confidence in the nurse.
ACCEPTANCE BY THE NURSING
COMMUNITY
 PRACTICE
 The hospice is one good example in which her
theory is applied. The hospice nurse attempts to
build rapport or a working relationship with the
client as well as her significant process.
 EDUCATION
 Her concepts served as better assistance for
nurses who help individuals understand the
meaning of illness and suffering.
 RESEARCH
 Numerous sources in research studies have cited
some aspects to one to one relationship
projected by travelbee.
THEORY ANALYSIS
 Clarity
 Her definitions are not consistent in clarity and
origin. Some of her definitions were lifted from
the standard sources. She also uses different
terms with the same definitions.
 Simplicity
 Her theory contains different variables, so her
theory is not simple.
 Generality
 Her theory has a wide scope of applications. It is
applicable whenever the nurse encounters clients
in distress and life changing events.
 Accessibility
 her theory appears to have a low measure of
empirical soundness, as it lacks simplicity.
 Importance
 It is useful because it can describe, explain,
predict, and control phenomena.
IDA JEAN ORLANDO PELLETIER
(DELIBERATIVE NURSING PROCESS THEORY)
 “nursing is responsible to individuals who suffer
or anticipate a sense of helplessness; it is
focused on the process of acre in an immediate
experience; it is concerned with providing direct
assistance to individuals in whatever setting they
are found, for the purpose avoiding, relieving,
diminishing or curing the individual’s sense of
helplessness.
 Associate professor
 Director of the graduate program in mental
health psychiatric nursing.
 Project investigator of a national mental
health psychiatric nursing
 Director of a research project
 Board member of Harvard community health
plan.

METAPARDIGM IN NURSING
 NURSING
- Unique and independent in its concerns for
an individual’s need for help in an
immediate situation.
 PERSON
 -
She used the concept of human or persons.
Human are the focus of nursing practice.
 HEALTH  DIAGNOSIS
- It is replaced by a sense of helplessness as - The nurse uses the nurse clinical judgement
the initiator of a necessity for nursing. She about health problems.
stated that nursing deals with individuals  PLANNING
who are in need of help. - It addresses each of the problems identified
 ENVIRONMENT in the diagnosis.
- She disregarded this in her theory  IMPLEMENTATION
- The nurse uses the nursing care plan
DELIBERATIVE NURSING THEORY  EVALUATION
- Nurse should converse with the client and - The nurse investigates the progress of the
let them know what the plan of care for the client towards the goals set in the nursing
day is going to be. care plans
- However, regardless of how will thought out
a nursing care plan is for a client, ACCEPTANCE BY THE COMMUNITY
unexpected problems to the client’s recovery  PRACTICE
may arise at any time. - Very easy to understand, easy to use, and
- With these, the job of the nurse is to know focuses on the client.
how to deal with those problems so the  EDUCATION
client can continue to get back and reclaim - Her process of recording has made a
his or her wellbeing. significant contribution to facilitating self-
evaluation.
 RESEARCH
 RECIPROCAL RELATIONSHIP - Her theory has been applied in various
BETWEEN THE NURSE AND THE research settings. She focused on how to
PATIENT IS VERY IMPORTANT. produce improvement in client’s behavior.
 CLIENT’S PARTICIPATION IN THE
NURSING PROCESS IS VERY THEORY ANALYSIS
IMPORTANT  CLARITY
 NURSING IS VERY DISTINCT FROM - Clear as it involves defining concepts
MEDICINE minimally
- Patients have their own meanings and  SIMPLICITY
interpretations of situations and therefore - Simple as it can predict statements as
nurses must validate their inferences and opposed to description and explanation.
analyses with patients before drawing  GENERALITY
conclusions. - Focuses on limited situations
 ACCESSABILITY
- It benefited research application
ASSUMPTIONS OF IDA JUAN ORLANDO  IMPORTANCE
- Beneficial in achieving valued outcomes

STAGES OF THE DELIBERATIVE NURSING

PROCESS
 ASSESSMENT
- The nurse completes a holistic assessment of
the client’s needs. She uses objective and
subjective data.

FAYE GLENN ABDELLAH
(TWENTY-ONE NURSING PROBLEMS)
- “I never wanted to be a medical doctor because I could
do all I wanted to do in nursing, which is caring
profession.”
- first woman and first nurse to serve as DEPUTY
SURGEON GENERAL of the US.
- inducted into the Us national woman’s hall of fame
- fellow, American Academy of Nursing
- she contributed 100 applications related to nursing
care, education, nursing research, and advance
nursing practice.
- promoted client-centered all-inclusive nursing care
making nursing a true humanitarian service of
individuals.
 The concept of nursing as an art and science
mold the attitude, intellectual competencies,
and technical skills of the individuals’ nurse
into the desire and ability to help individuals
cope with their needs.
AS A COMPLETE HUMANITARIAN SERVICE,
NURSING INCLUDES THE FF.:
 Be acquainted with the nursing problems of the
client.
 Choose the definite courses of action to make in
the scope of relevant nursing principles.
 Make available continuous care of the
individual’s entire health needs.
 Give continuous to relieve pain and discomfort
and provide immediate security for the
individual
 Regulate the total nursing care plan to meet the
client’s entire health needs.
 Serving the individuals to become more self-
determining in achieving maintaining a healthy
state of mind and body.
 Informing the nursing personnel, family and
support system to provide the individuals act for
oneself within perceived limitations.
 Facilitate the individuals to adapt to limits and
emotional problems.
 Team up with different allied health professions
in working with the diagram for optimum health
on local, state, national, and international levels.
 Engaging in non-stop evaluation and research to
develop nursing techniques and create new
techniques to serve the health needs of different
people.
METAPARADIGM IN NURSING
 Nursing
- The concept of nursing in this theory is
generally grouped into 21 problems areas for
nurses to work out their judgement and
appropriate.
 Person
- She classifies the beneficiary of care as
individuals. However, she does not set
standard limits on the nature and essence of
human beings.
 Health
- It is defined as the center and purpose of
nursing services. She does not give a
definition of health; she speaks to “total
health needs” and a “healthy state of mind
and body” in her description of nursing as
comprehensive service.
 Environment
- The ideas of environment are addressed by
abdellah and is included in “planning for
optimum health on local, state, national, and
international levels,
ABDELLAH’S TYPOLOGY OF 21 NURSING
PROBLEMS
(SA BABA)
THE PROBLEM-SOLVING APPROACH
1. Identifying the problem
2. Selecting the relevant data
3. Devising hypothesis
4. Testing hypotheses through the assortment of
data
5. Revising hypotheses when necessary, on the
basis of conclusions obtained from the data.
ACCEPTANCE BY THE NURSING COMMUNITY
 PRACTICE
- The typology of 21 nursing problems helps
nurses and nursing students perform in
scientific and systematic way.
 EDUCATION
- the typology of 21 nursing problems has the
most potent effect in the educational system.
 RESEARCH
- the typology of 21 nursing problems
produced through research therefore, it is
expected that more research followed after
its introduction to the academic world.
THEORY ANALYSIS
 CLARITY
- All terms are consistent and easy to
understand and are all nursing related.
 SIMPLICITY
- The typology is straightforward and is
practical to use among clients.
 GENERALITY
- The typology of 21 nursing problems is
collective and associated with time and
environment.
 ACCESSIBILITY
- the concepts are very exact with empirical
referents that are easily recognizable.
 IMPORTANCE
- The importance in problem-solving is not
restricted by time or space and gives a way
for continual growth and change in the
service of nursing care.

MARGARET JEAN WATSON
( )
 Noted herself that her ideas of her theory is
concerned with spirit than matter, flux rather
than form, inner knowledge and power rather
than circumstance.
 She moved beyond contemporary nursing to a
view that is rooted in nightingale’s vision.
 She reflects, “it is both theoretical and beyond
theory”
 Transpersonal caring relationship is foundation
of her theory. It is a special kind of human care
relationship a union with another person high
regard for the whole person and their being in
the world.
METAPARADIGM IN NURSING
 NURSING
- She sees nursing as having to move
educationally in the two areas of stress and
developmental conflicts to provide holistic
care, which she believes is central to the
practice of caring in nursing.
- A human science of people and human
health-illness experiences that are mediated
by professional, personal, scientific,
aesthetic, and ethical human care
transactions.
 PERSON
- Is valued person in and of him to be cared
for, respected, nurtured, understood, and
assisted. A fully functional integrated self.
She said human is grated than and different
from, the sum of his parts.
 HEALTH
- Unity and harmony within the mind, body,
and soul associated with the degree of
congruence between self as perceived and as
experienced.
 ENVIRONMENT
- Provides the values that determine how one
should behave and what goals one should
strive toward.
ASSUMPTIONS
1. Caring can be effectively demonstrated
and practiced only interpersonally.
2. Effective caring promotes health and
individuals or family growth.
3. Caring responses accept a person not
only as he is now bur as what as she
may become.
4. A caring environment is one that offers
the development of potential while
allow the person to choose the best
action for himself or herself at a given
point in time.
5. Caring is more “healthogenic” than
curing. A science of caring is therefore
complementary to the science of curing.
6. The practice of caring is central of
nursing.
10 CARAIVE FACTORS
THE CARITAS PROCESSES
ACCEPTANCE BY THE NURSING COMMUNITY
 PRACTICE
- Watson is optimist. Her writing encourages
explorations of questions such as “what is
the root of my response?”, “how will I
respond?”, “why do I respond?”, “when is it
hard to care?”, how will I sustain and
nurture my caring consciousness?” who will
care for me?
 EDUCATION
- It leads the reader through an inspiring
experience emphasizing deep inner
reflection and personal growth,
communication skills, use of self
transpersonal growth, attention both nurse
and patient, and the human caring process
that potentiates human health and healing.
 RESEARCH
- Client outcomes in caring transactions are a
potential area for studies. Research and
practice should focus both on the subjective
and objective patient outcomes whether
caring is indeed the truest essence of
nursing.

THEORY ANALYSIS
 CLARITY- her concepts are concise and precise
to be used and understood. Concepts were
outlined and used and understood
 SIMPLICITY – she used sophisticated words in
her theory. So we need to read in between the
lines.
 GENERALITY- her theory provides the moral
and philosophical basis of nursing. The scope of
her framework encompasses all aspects of
health-illness continuum.
 ACCESSABILITY- she draws heavily on
widely accepted work from other disciplines.
This solid foundation strengthens her views.
 IMPORTANCE- her concepts such as the use of
self, patient-identified needs, the caring process,
and the spiritual sense of human being, may help
nurses and their patients and harmony in a
period of increasing complexity.

JOSEPHINE PATERSON & LORETTA ZDERAD
(HUMANISTIC NURSING THEORY)
- “nursing occurs within the context of relationship. It is
nurturing response of one person to another in time of
need that aims toward the development of well-being
and more being.”
DR. JOSEPHINE PATERSON
- Finished doctor of nursing science
specializing in mental health and
psychiatric nursing.
- Conceptualized and taught humanistic
nursing to graduate students and faculty
and staff in a variety of settings.
- Clinical nurse specialist in the north point
veteran’s administration medical center.
DR. LORETTA ZDERAD
- Finished doctor of philosophy
- Taught in several universities and has
lead groups on humanistic nursing
- Associate chief for nursing education
METAPARADIGM IN NURSING
 NURSING
- Viewed as transactions between persons.
Transactional whose meaningless demands
conceptualization founded on a nurse’s
existential awareness of self and other.
 PERSON
- A unique human with their own gestalt, an
organized whole that is perceived as more
than the sum of its parts. Person is viewed as
an incomate being, always becoming in
relation with man and things in a world of
time and space. The person has the
capability of self-reflection.
 HEALTH
- Wellbeing and more being, conceptualize as
somewhat more than that the freedom from
diseases. They are it as a resource that the
client can use to help realize their own
potential.
 EMVIRONMENT
- Considered environment in terms of
objective world. environment is other human
-
-
beings, the immediate surrounding, the clients and
family.
HUMANISTIC NURSING MODEL
- It is nursing practice that is derived from
lived experiences of the nurses and the
person receiving care
- It is the articulated vision of the experience
- Concerned with phenomenological
experiences of individuals and the
exploration of human experiences.
- Nurses need to fully appreciate the value,
biases, myths and expectations other bring
to the nursing experience.
 The practice of humanistic nursing is rooted
from:
- EXISTENTIALISM –a philosophical
approach to understanding life, individuals
are faced with possibilities when making
choices. These choices determine the
direction meaning one’s life.
- PHENOMENOLOGY – the study of the
meaning of a phenomenon to a particular
individual.
HUMANISTIC NURSING
- Is an existential phenomological humanistic
approach referring to a reverence for life
that values the need for human interaction in
order to determine the meaning that comes
from the individual’s unique way of
experiencing the world.
ACCEPTANCE BY THE NURSING COMMUNITY
 PRACTICE
- The theory applies the basic foundation of
human relationship in nursing. It is
commonly used in palliative care,
 spirituality in nursing and patient
participation and communication.
 EDUACTION
-they believe that nursing education should be
founded in experience and that a nurse’s training
should focus as much on the nurse’s ability to
relate and interact with clients with scientific
and medical background.
 RESEARCH
- It has been applied in research regarding
hospice and palliative care.

THEORY ANALYSIS
 CLARITY
- Comprehensive and broad enough to include
many areas of nursing practice and provide
guidelines for research and education.
 GENERALITY
- It can be applied to different scenarios
giving rise to more specific theories.
 ACCESSABILITY
- The concepts are abstract and
multidimensional. However, the main idea
of this theory is concrete and clinically
relevant.
 IMPORTANCE
- It strongly emphasizes the nurses-client
relationship. Trust between the nurse and the
client builds a string basis for a positive
nurse-patient relationship.