Mabini Prefinal Lect. Theoretical Foundation of Nursing

THEORETICAL FOUNDATION OF NURSING (NCM) 100
1st Semester, Semi-Final Period
14 BASIC HUMAN NEEDS THEORY by

VIRGINIA HENDERSON
The nurse is temporarily the consciousness 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 mouthpiece for those too
weak or withdrawn to speak and so – on. “
BIOGRAPHY:
“First Lady of Nursing”

“First Truly International Nurse”
She began her career in Public Health Nursing (Henry St. Settlement and in the visiting Nurse Service in
Washington D.C )
She was the first full time instructor in nursing (Virginia)
She designed a plan to create district organizations within the state.
An early advocate for the introduction of Psychiatric Nursing in the curriculum and served on a committee to
develop such a course at Eastern State Hospital in Williamsburg Virginia in 1929
An outstanding teacher at Teachers College Columbia university.
At the age of 75, she directed her career to international teaching and speaking.
Honorary degree from thirteen universities.
American Nurses Association (ANA) Hall of fame and had a Sigma Theta Tau International Library named in her
honor.
Haloran,a nurse theorist wrote: “Henderson was to the Twentieth Century as Florence Nightingale was to the
Nineteenth.”
Died: March 19, 1996.
In 1939, she revised: Harmer’s classic textbook of nursing for its 4th edition, and later wrote the 5th; edition,
incorporating her personal definition of nursing (Henderson,1991)
METAPARADIGM;
PERSON – Referred to as a person as a patient who requires an assistance to achieve health and independence or in
some cases a peaceful death.
HEALTH – a quality of life and is very basic to function fully( requires health independence and interdependence ).
ENVIRONMENT – It is important to control, but as illness occurs, this ability is diminished or affected in caring for the
sick. It is the responsibility of the nurse to help the patient manage his surroundings to protect him from any harm or any
mechanical injury.
NURSING – The nurse must be knowledgeable in both biological and social sciences and must have the ability to
assess basic human needs as the signature of the profession that coincides with Henderson’s definition of nursing.
Nurses should function independently from the physician but they must promote the treatment plan prescribed by the
physician
14 BASIC NEEDS
• Breathe normally. Eat and drink adequately.

• Eliminate body wastes.
• Move and maintain desirable postures.
• Sleep and rest.
• Select suitable clothes-dress and undress.
• Maintain body temperature within normal range by adjusting clothing and modifying environment
• Keep the body clean and well-groomed and protect the integument
• Avoid dangers in the environment and avoid injuring others.
• Communicate with others in expressing emotions, needs, fears, or opinions.
• Worship according to one’s faith.
• Work in such a way that there is a sense of accomplishment.
• Play or participate in various forms of recreation.
• Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health
facilities.
The first 9 components are physiological. The tenth and fourteenth are psychological aspects of communicating and
learning. The eleventh component is spiritual and moral The twelfth and thirteenth components are sociologically
oriented to occupation and recreation
NURSES SPECIFIC ROLES AND RESPONSIBILIITIES
THE NURSE-PATIENT RELATIONSHIP
Nursing Process Henderson’s 14 components and definition of nursing

Nursing Assessment Henderson’s 14 component’s
Nursing Diagnosis Analysis: Compare data to knowledge base of health and disease
Nursing Plan Identify individual’s ability to meet own needs with or without assistance, taking into
consideration strength, will or knowledge
Nursing Implementation Document how the nurse can assist the individual, sick or well.
Assist the sick or well individual in to performance of activities in meeting human needs to
maintain health, recover from illness, or to aid in peaceful death.
Nursing Process Implementation based on the physiological principles, age, cultural background, emotional
balance, and physical and intellectual capacities.
Carry out treatment prescribed by the physician.
Nursing Evaluation Henderson’s 14 components and definition of nursing
Use the acceptable definition of nursing and appropriate laws related to the practice of
nursing.
The quality of care is drastically affected by the preparation and native ability of the nursing
personnel rather that the number of hours of care.
Successful outcomes of nursing care are based on the speed with which or degree to which
the patient performs independently the activities of daily living
Maslow’s Henderson
Physiological Needs Breathe normally
Eat and drink adequately Eliminate by all avenues of elimination
Move and maintain desirable posture
Sleep and rest Select suitable clothing
Maintain body temperature
Keep body clean and well-groomed and protect the integument
Safety Needs Avoid environmental dangers and avoid injuring other
Belongingness and Communicate with others
love needs worship according to one's faith
Work at something providing a sense of accomplishment
Esteem needs Play or participate in various forms of recreation
Learn, discover, or satisfy curiosity
ACCEPTANCE / CONTRIBUTIONS
PRACTICE
Nurses as direct caregiver help patients to become independent.
EDUCATION
Nurse’s education demands universal understanding of diverse human being.
Designed three phases of curriculum development
RESEARCH
Recommended library research.
Advocated research as a way to improve practice.
HEALTH PROMOTION MODEL by

Nola Pender
BIOGRAPHY
August 16, 1941 (age 81 years), Lansing, Michigan, United States
attended Michigan State University to earn her bachelor and master’s degrees in 1964 and 1965, respectively.
She earned her Ph.D. from Northwestern University in 1969
She received a Lifetime Achievement Award from the Midwest Nursing Research Society in 2005.
She was awarded an honorary doctorate of science degree in 1992 from Widener University.
She was given a Distinguished Alumni Award from the Michigan State University School of Nursing in 1972.
She has many publications in a variety of texts and journals, including sixth edition Health Promotion in Nursing
Practice
She received a Lifetime Achievement Award from the Midwest Nursing Research Society in 2005.
She was awarded an honorary doctorate of science degree in 1992 from Widener University.
She was given a Distinguished Alumni Award from the Michigan State University School of Nursing in 1972.
She has many publications in a variety of texts and journals, including sixth edition Health Promotion in Nursing
Practice
Introduction:
The health promotion model (HPM) proposed by Nola J Pender (1982; revised, 1996) was designed to be a
“complementary counterpart to models of health protection.”
It defines health as "a positive dynamic state not merely the absence of disease".
Health promotion is directed at increasing a client’s level of well-being.
The health promotion model describes the multi-dimensional nature of persons as they interact within their
environment to pursue health.
METAPARADIGM:
PERSON
is a biophysical organism shaped by the environment, but also seeks to create an environment in which
human potential can be fully expressed.
Because of this, the relationship between person and environment is reciprocal. Individual characteristics
and life experiences shape behaviors.
ENVIRONMENT
is described as the social, cultural, and physical context in which life unfolds. It can be manipulated by the
individual to create a positive context of cues and facilitators for health-enhancing behaviors.
NURSING
is a collaboration among patients, families, and communities to create the best conditions for the
expression of optimal health and high-level well-being.
HEALTH
is defined as the actualization of human potential through goal-directed behavior, self-care, and
relationships with others with necessary adjustments made to maintain relevant environments. Illnesses are
discrete events in the life that can hinder or facilitate the patient’s continuing quest for health.
The model focuses on three areas:
Individual characteristics and experiences
Behavior-specific cognitions and affect
Behavioral outcomes
❖ The health promotion model notes that each person has unique personal characteristics and experiences
that affect subsequent actions.
❖ The set of variables for behavioral specific knowledge and affect have important motivational significance.
❖ These variables can be modified through nursing actions.
❖ is a biophysical organism shaped by the environment, but also seeks to create an environment in which
human potential can be fully expressed.
❖ Because of this, the relationship between person and environment is reciprocal. Individual characteristics
and life experiences shape behaviors
Individual Characteristics and Experience

The first category explores the concept that each individual has his or her own set of characteristics and experiences,
which in turn help shape their actions. Pender emphasized that one’s past actions have a direct link to whether they
would partake in future health-promoting behaviors. Personal attributes and habits can also be a barrier to health-
promoting behaviors.
Behavior-specific Cognitions
The second category involves the behavior-specific cognitions and affect which have a direct impact on the
individual’s motivation for change. Nursing interventions can be tailored to these variables to assist in forming positive
changes. Variables include; the observed benefits and barriers to the action, self-worth, and the activity-related result.
Behavioral Outcomes
The third category is the behavioral outcome. The start of the outcome begins with the person committing to taking
the steps necessary to make a change. During this phase the individual must be supported with barriers addressed
in order to produce a positive health-promoting behavior. The goal of the health promotion model is to stimulate a
behavioral change that results in a positive health outcome.
MAJOR CONCEPTS AND DEFINITIONS

Individual Characteristics and Experience
Prior related behavior
Frequency of the similar behavior in the past. Direct and indirect effects on the likelihood of engaging in
health promoting behaviors.
PERSONAL FACTORS
Personal factors categorized as biological, psychological and socio-cultural.
These factors are predictive of a given behavior and shaped by the nature of the target behavior being
considered.
▪ Personal biological factors - include variable such as age gender body mass index pubertal status,
aerobic capacity, strength, agility, or balance.
▪ Personal psychological factors - include variables such as self esteem, self motivation, personal
competence perceived health status and definition of health.
▪ Personal socio-cultural factors - include variables such as race ethnicity, acculturation, education and
socioeconomic status.
PERCEIVED BENEFITS OF ACTION
• Anticipated positive outcomes that will occur from health behavior.
PERCEIVED BARRIERS TO ACTION
• Anticipated, imagined or real blocks and personal costs of understanding a given behavior
PERCEIVED SELF EFFICACY
• Judgment of personal capability to organize and execute a health-promoting behavior.
• Perceived self-efficacy influences perceived barriers to action so higher efficacy result in lowered
perceptions of barriers to the performance of the behavior.
ACTIVITY RELATED AFFECT
• Subjective positive or negative feeling that occur before, during and following behavior based on the
stimulus properties of the behavior itself.
• Activity-related affect influences perceived self-efficacy, which means the more positive the subjective
feeling, the greater the feeling of efficacy. In turn, increased feelings of efficacy can generate further
positive affect.
INTERPERSONAL INFLUENCES
• Cognition concerning behaviors, beliefs, or attitudes of the others. Interpersonal influences include: norms
(expectations of significant others), social support (instrumental and emotional encouragement) and
modelling (vicarious learning through observing others engaged in a particular behavior).
• Primary sources of interpersonal influences are families, peers, and healthcare providers.
SITUATIONAL INFLUENCES
• Personal perceptions and cognitions of any given situation or context that can facilitate or impede behavior.
• Situational influences may have direct or indirect influences on health behavior.
Behavioral Outcome
COMMITMENT TO PLAN OF ACTION
• The concept of intention and identification of a planned strategy leads to implementation of health
behaviour.
IMMEDIATE COMPETING DEMANDS AND PREFERENCES
•Competing demands are those alternative behaviour over which individuals have low control because there
are environmental contingencies such as work or family care responsibilities.
• Competing preferences are alternative behaviour over which individuals exert relatively high control, such
as choice of ice cream or apple for a snack
HEALTH PROMOTING BEHAVIOUR
• Endpoint or action outcome directed toward attaining positive health outcome such as optimal well-
being, personal fulfillment, and productive living
THEORY OF CULTURE CARE AND DIVERSITY by

Madeleine Leininger
‘”Care is the heart of nursing. Care is power. Care is essential to healing. Care is curing and Care is the central and
dominant focus of nursing and transcultural nursing decisions and actions.”
BIOGRAPHY:
She is considered as the founder of the theory of transcultural nursing.

She obtained her basic nursing education at St. Anthony School of Nursing, Denver, Colorado and graduated in
1948.
She merited her Bachelor of Science degree from Benedictine College Atchison,Kansas in 1953.
Obtained her masters of Science (Doctor of Philosophy) in Anthropology from the University of Washington,Seattle.
One of the first nursing theorist and transcultural global nursing consultants.
Developed the concept of transcultural nursing and the ethno nursing research model.
Her theory has now developed as a discipline in nursing.
Evolution of her theory can be understood from her books:
a. Culture Care Diversity and Universality (1991)
b. Transcultural nursing theory is also known as Culture Care theory.
c. Theoretical framework is depicted in her model called the Sunrise Model (1997)
METAPARADIGM
PERSON–Humans are thus believed to be caring and capable of being concerned about the desires, welfare and
continued existence of others. Human care is collective .(culture dependent)
ENVIRONMENT – The totality of an event, situation or experience. Her description of culture centers on a particular
group (society) and the patterning of actions, thoughts and decisions that occurs as the result of learned, shared and
transmitted values, norms, beliefs and lifeways.
HEALTH –Health is universal. Discussed components: Health systems, health care practices, changing health patterns,
health promotions and health maintenance.
NURSING – Showed her concern to nurses who do not have sufficient preparation for a transcultural perspective. For
that reason, they will not value nor practice such viewpoint to the fullest extent possible.
Transcultural Nursing
-Transcultural nursing is a comparative study of cultures to understand similarities (culture universal) and difference
(culture-specific) across human groups (Leininger, 1991).
Culture
-Set of values, beliefs and traditions, that are held by a specific group of people and handed down from generation to
generation.
-Culture is also beliefs, habits, likes, dislikes, customs and rituals learn from one’s family.
-Culture is the learned, shared and transmitted values, beliefs, norms and life way practices of a particular group that
guide thinking, decisions, and actions in patterned ways.
-Culture is learned by each generation through both formal and informal life experiences.
-Language is primary through means of transmitting culture.
-The practices of particular culture often arise because of the group's social and physical environment.
-Culture practice and beliefs are adapted over time but they mainly remain constant as long as they satisfy needs.
* A key component of Leininger’s theory is that of refers to cultural diversity this the differences or variations that
can be found both between end among different cultures. By recognizing the variations, the nurse can avoid the
problem of stereotyping
(using general standards) and assuming that all people will reach to the same nursing care. A similar concept
is that of culture universality , the opposite of diversity, which refers to the commonalities that exist in different
culture. These ideas have led to an important achievement of the theory – that is” to discover similarities and
differences about care and it’s impact on the health and well being of groups.
Religion Is a set of belief in a divine or super human power (or powers) to be obeyed and worshipped as the creator and
ruler of the universe.
Ethnic refers to a group of people who share a common and distinctive culture and who are members of a specific group.
Ethnicity a consciousness of belonging to a group.
Cultural -Identify the sense of being part of an ethnic group or culture
Culture-universals commonalities of values, norms of behaviour, and life patterns that are similar among different
cultures.
Culture-specifies values, beliefs, and patterns of behaviour that tend to be unique to a designate culture.
Material culture refers to objects (dress, art, religious arti1acts)
Non-material culture refers to beliefs customs, languages, social institutions.
Subculture composed of people who have a distinct identity but are related to a larger cultural group.
Bicultural a person who crosses two cultures, lifestyles, and sets of values.
Diversity refers to the fact or state of being different. Diversity can occur between cultures and within a cultural group.
Acculturation People of a minority group tend to assume the attitudes, values, beliefs, find practices of the dominant
society resulting in a blended cultural pattern.
Cultural shock the state of being disoriented or unable to respond to a different cultural environment because of its
sudden strangeness, unfamiliarity, and incompatibility to the stranger's perceptions and expectations at is
differentiated from others by symbolic markers (cultures, biology, territory, religion).
Ethnic groups share a common social and cultural heritage that is passed on to successive generations.,
Ethnic identity refers to a subjective perspective of the person's heritage and to a sense of belonging to a group that
is distinguishable from other groups.
Race the classification of people according to shared biologic characteristics, genetic markers, or features. Not all
people of the same race have the same culture.
Cultural awareness It is an in-depth self-examination of one's own background, recognizing biases and prejudices
and assumptions about other people.
Culturally congruent care Care that fits the people's valued life patterns and set of meanings -which is generated
from the people themselves, rather than based on predetermined criteria.
Culturally competent care is the ability of the practitioner to bridge cultural gaps in caring, work with cultural
differences and enable clients and families to achieve meaningful and supportive caring.
Nursing Decisions
Leininger (1991) identified three nursing decision and action modes to achieve culturally congruent care.
Cultural preservation or maintenance.
Cultural care accommodation or negotiation.
Cultural care repatterning or restructuring.
MAJOR CONCEPTS AND DEFINITIONS

Care refers to abstract and concrete phenomena related to assisting, supporting or enabling experiences or
behaviours toward or for others with evident or anticipated to ameliorate or improve a human condition or lifeway.
Caring refers to actions and activities directed toward assisting, supporting, or enabling another individual or group with
evident or anticipated needs to ameliorate or improve a human condition or lifeway, or to face death
Culture refers to the learned, shared and transmitted values, beliefs, norms and lifeways of a particular group that
guides their thinking, decisions and actions in patterned ways
Cultural care refers to the subjectively and objectively learned and transmitted values, beliefs and patterned lifeways
that assist, support, facilitate, or enable another individual or group to maintain their well-being, health, to improve their
human condition and lifeway, or to deal with illness, handicaps, or death
Cultural care diversity refers to the variabilities and/ or differences in meanings, patterns, values, lifeways, or symbols
of care within or between collectivities that are related to assistive, supportive or enabling human care expressions
Nursing refers to a learned humanistic and scientific profession and discipline which is focused on human care
phenomena and activities in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their
well-being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death
Worldview refers to the way people tend to look out on the world or their universe to form a picture or a value stance
about their life or world around them
Cultural and social structure dimensions refers to the dynamic patterns and features of interrelated structural and
organizational factors of a particular culture (subculture or society) which includes religious, kinship (social), political (and
legal), economic, educational, technologic and cultural values and ethnohistorical factors, and how these factors may be
interrelated and function to influence human behavior in different environmental contexts
Environmental context refers to the totality of an event, situation or particular experiences that give meaning to human
expressions, interpretations, and social interactions in particular physical, ecological, socio-political and/ or cultural
settings.
Ethnohistory refers to those past facts, events, instances and experiences of individual, groups, cultures and institutions
that are primarily people-centered (ethno) and that describe, explain, and interpret human lifeways within particular
cultural contexts and over short or long periods of time
Generic (folk or lay) care system refer to culturally learned and transmitted, indigenous (or traditional ), folk (home
based) knowledge and skills used to provide assistive, supportive, enabling or facilitative acts toward or for another
individual, group or institution with evident or anticipated needs to ameliorate or improve a human lifeway or health
condition (or well-being) or to deal with handicaps and death situations
Professional care system(s) refers to formally taught, learned and transmitted professional care, health, illness,
wellness and related knowledge and practice skills that prevail in professional institutions usually with multidisciplinary
personnel to serve consumers.
Health refers to a state of well-being that is culturally defined, valued and practiced, and that reflects the ability of
individuals (or groups) to perform their daily role activities in culturally expressed, beneficial, and patterned lifeways
Cultural care preservation or maintenance refers to those assistive, supporting, facilitative or enabling professional
actions and decisions that help people of a particular culture to retain and/or preserve relevant care values so that
they can maintain their well-being, recover from illness, or face handicaps and/or death
Cultural care accommodation or negotiation refers to those assistive, supporting, facilitate creative professional
actions and decisions that help people of a designated culture to adapt to, or negotiate with others for a beneficial or
satisfying health outcomes with professional care providers.
Cultural care repatterning or restructuring refers to those assistive, supportive, facilitative or enabling professional
actions and decisions that help clients reorder, change or greatly modify their life ways for new, different and beneficial
health acre pattern while respecting the client’s cultural values and beliefs and still providing a beneficial, healthier
lifeway than before the changes were co-established with the client
Cultural congruent (nursing) care refers to those cognitively based assistive, supportive, facilitative, or enabling
acts or decisions that are tailor made to fit the individual, group or institutional cultural values, beliefs and life ways in
order to provide or support meaningful beneficial and satisfying health care or well-being services.
APPLICATIONS / CONTRIBUTIONS
PRACTICE
Prepares nurses to prevent culture shock and conflicts as they practice in different places with different
cultures.
Provides human care and health behaviours as background knowledge to understand nursing phenomena
EDUCATION
Helps produced a well-qualified faculty prepared in Transcultural Nursing to teach and guide students.
Educator in transcultural Nursing leads to culturally competent nursing care.
RESEARCH
Focused on culture care
With research method of (ethnonursing) to examine theories.
Cultural care preservation or maintenance refers to those assistive, supporting, facilitative or enabling professional
actions and decisions that help people of a particular culture to retain and/or preserve relevant care values so that
they can maintain their well-being, recover from illness, or face handicaps and/or death
Cultural care accommodation or negotiation refers to those assistive, supporting, facilitative or enabling creative
professional actions and decisions that help people of a designated culture to adapt to, or to negotiate with,
others for a beneficial or satisfying health outcome with professional care providers
Cultural care repatterning or restructuring refers to those assistive, supportive, facilitative or enabling professional
actions and decisions that help clients reorder, change or greatly modify their life ways for new, different and
beneficial health care pattern while respecting the client’s cultural values and beliefs and still providing a beneficial,
healthier lifeway than before the changes were co-established with the client
Cultural congruent (nursing) care refers to those cognitively based assistive, supportive, facilitative, or enabling
acts or decisions that are tailor made to fit the individual, group or institutional cultural values, beliefs and life ways in order
to provide or support meaningful beneficial and satisfying health care or well-being services.
MAJOR CONCEPTS [Leininger (1991)]
Illness and wellness are shaped by a various factors including perception and coping skills, as well as the social
level of the patient.
Cultural competence is an important component of nursing.
Culture influences all spheres of human life. It defines health, illness, and the search for relief from disease or
distress.
Religious and Cultural knowledge is an important ingredient in health care.
The health concepts held by many cultural groups may result in people choosing not to seek modern medical
treatment procedures.
Health care provider need to be flexible in the design of programs, policies, and services to meet the needs and
concerns of the culturally diverse population, groups that are likely to be encountered.
Most cases of lay illness have multiple causalities and may require several different approaches to diagnosis,
treatment, and cure including folk and Western medical interventions.
The use of traditional or alternate models of health care delivery is widely varied and may come into conflict with
Western models of health care practice.
Culture guides behavior into acceptable ways for the people in a specific group as such culture originates and
develops within the social structure through inter personal interactions.
For a nurse to successfully provide care for a client of a different cultural or ethnic to background, effective
intercultural communication must take place.
APPLICATION TO NURSING
To develop understanding, respect and appreciation for the individuality and diversity of patients beliefs, values,
spirituality and culture regarding illness, its meaning, cause, treatment, and outcome.
To encourage in developing and maintaining a program of physical, emotional and spiritual self-care introduce
therapies such as ayurveda and pancha karma.
HEALTH PRACTICES IN DIFFERENT CULTURES

Use of Protective Objects
Protective objects can be worn or carried or hung in the home- charms worn on a string or chain around the neck,
wrist, or waist to protect the wearer from the evil eye or evil spirits.
Use of Substances.
It is believed that certain food substances can be ingested to prevent illness.
E.g. eating raw garlic or onion to prevent illness or wear them on the body or hang them in the home.
Religious Practices
Burning of candles, rituals of redemption etc.
Traditional Remedies
The use of folk or traditional medicine is seen among people from all walks of life and cultural ethnic back ground.
Healers
Within a given community, specific people are known to have the power to heal.
Immigration
Immigrant groups have their own cultural attitudes ranging beliefs and practices regarding these areas
Gender Roles
In many cultures, the male is dominant figure and often they take decisions related to health practices and
treatment. In some other cultures females are dominant.
In some cultures, women are discriminated in providing proper treatment for illness.
Beliefs about mental health
Mental illnesses are caused by a lack of harmony of emotions or by evil spirits.
Problems in this life are most likely related to transgressions committed in a past life.
Economic Factors
Factors such as unemployment, underemployment, homelessness, lack of health insurance poverty prevent people
from entering the health care system.
Time orientation
It is varies for different cultures groups.
Personal Space
Respect the client's personal space when performing nursing procedures.
The nurse should also welcome visiting members of the family and extended family.
NURSING PROCESS AND ROLE OF NURSE
Determine the client's cultural heritage and language skills.

Determine if any of his health beliefs relate to the cause of the illness or to the problem.
Collect information that any home remedies the person is taking to treat the symptoms.
Nurses should evaluate their attitudes toward ethnic nursing care.
Self-evaluation helps the nurse to become more comfortable when providing care to clients from diverse backgrounds
Understand the influence of culture, race &ethnicity on the development of social emotional relationship, child rearing
practices & attitude toward health.
Collect information about the socioeconomic status of the family and its influence on their health promotion and
wellness
Identify the religious practices of the family and their influence on health promotion belief in families.
Understanding of the general characteristics of the major ethnic groups, but always individualize care.
The nursing diagnosis for clients should include potential problems in their interaction with the health care system
and problems involving the effects of culture.
The planning and implementation of nursing interventions should be adapted as much as possible to the client's
cultural background.
Evaluation should include the nurse's self-evaluation of attitudes and emotions toward providing nursing care to
clients from diverse sociocultural backgrounds.
Self-evaluation by the nurse is crucial as he or she increases skills for interaction.
CONCLUSION
Nurses need to be aware of and sensitive to the cultural needs of clients.
The practice of nursing today demands that the nurse identify and meet the cultural needs of diverse groups,
understand the social and cultural reality of the client, family, and community, develop expertise to implement
culturally acceptable strategies to provide nursing care, and identify and use resources acceptable to the client
(Andrews & Boyle, 2002).
HEALTH AS EXPANDING CONCIOUSNESS by

Margareth Newman
“Health is the expansion of consciousness.” - Newman, 1983
INTRODUCTION
The theory of health as expanding consciousness stems from Rogers' theory of unitary human beings.
The theory of health as expanding consciousness was stimulated by concern for those for whom health as the
absence of disease or disability is not possible, (Newman, 2010).
The theory has progressed to include the health of all persons regardless of the presence or absence of disease,
(Newman, 2010).
The theory asserts that every person in every situation, no matter how disordered and hopeless it may seem, is part
of the universal process of expanding consciousness – a process of becoming more of oneself, of finding greater
meaning in life, and of reaching new dimensions of connectedness with other people and the world, (Newman,
2010).
BACKGROUND OF THE THEORIST

Born on October 10, 1933.
Bachelor’s degree - University of Tennessee in 1962
Master’s degree - University of California in 1964
Doctorate - New York University in 1971
She has worked in - University of Tennessee, New York University, Pennsylvania State University, University of
Minnesota, University of Minnesota
THEORY DEVELOPMENT
She was influenced by following theorists:
• Martha Rogers
o Martha Roger’s theory of Unitary Human Beings was the main basis of the development of her theory,
Health as Expanding Consciousness
• Itzhak Bentov – The concept of evolution of consciousness
• Arthur Young – The Theory of Process
• David Bohm – The Theory of Implicate
ASSUMPTIONS
1. Health encompasses conditions heretofore described as illness, or, in medical terms, pathology
2. These pathological conditions can be considered a manifestation of the total pattern of the individual
3. The pattern of the individual that eventually manifests itself as pathology is primary and exists prior to structural or
functional changes
4. Removal of the pathology in itself will not change the pattern of the indivdual
5. If becoming ill is the only way an individual's pattern can manifest itself, then that is health for that person
6. Health is an expansion of consciousness.
DESCRIPTION OF THE THEORY
“The theory of health as expanding consciousness (HEC) was stimulated by concern for those for whom health as the
absence of disease or disability is not possible. Nurses often relate to such people: people facing the uncertainty,
debilitation, loss and eventual death associated with chronicillness. The theory has progressed to include the health of all
persons regardless of the presence or absence of disease. The theory asserts that every person in every situation, no
matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness – a process
of becoming more of oneself, of finding greater meaning in life, and of reaching new dimensions of connectedness with
other people and the world” (Newman, 2010).
• Humans are open to the whole energy system of the universe and constantly interacting with the energy. With this
process of interaction humans are evolving their individual pattern of whole.
• According to Newman understanding the pattern is essential. The expanding consciousness is the pattern
recognition.
• The manifestation of disease depends on the pattern of individual so the pathology of the diseases exists before the
symptoms appear so removal of disease symptoms does not change the individual structure.
• Newman also redefines nursing according to her nursing is the process of recognizing the individual in relation to
environment and it is the process of understanding of consciousness.
• The nurse helps to understand people to use the power within to develop the higher level of consciousness.
• Thus it helps to realize the disease process, its recovery and prevention.
• Newman also explains the interrelatedness of time, space and movement.
• Time and space are the temporal pattern of the individual, both have complementary relationship.
• Humans are constantly changing through time and space and it shows unique pattern of reality.
NURSING PARADIGMS
Health
“Health and illness are synthesized as health - the fusion on one state of being (disease) with its opposite (non-
disease) results in what can be regarded as health”.
Nursing
Nursing is “caring in the human health experience”.
Nursing is seen as a partnership between the nurse and client, with both grow in the “sense of higher levels of
consciousness”
Human
“The human is unitary, that is cannot be divided into parts, and is inseparable from the larger unitary field”
“Persons as individuals, and human beings as a species are identified by their patterns of consciousness”…
“The person does not possess consciousness-the person is consciousness”.
Persons are “centers of consciousness” within an overall pattern of expanding consciousness”
Environment
Environment is described as a “universe of open systems”
“Consciousness is a manifestation of an evolving pattern of person-environment interaction”

THEORY OF HUMAN BECOMING by

Rosemarie Parse
INTRODUCTION
The Parse theory of human becoming guides nurses In their practice to focus on quality of life as it is described and
lived (Karen &Melnechenko, 1995).
The human becoming theory of nursing presents an alternative to both the conventional bio-medical approach and
the bio-psycho-social-spiritual (but still normative) approach of most other theories of nursing.(ICPS)
The human becoming theory posits quality of life from each person's own perspective as the goal of nursing
practice.(ICPS)
Rosemarie Rizzo Parse first published the theory in 1981 as the "Man-living-health" theory (ICPS)
The name was officially changed to "the human becoming theory" in 1992 to remove the term "man," after the
change in the dictionary definition of the word from its former meaning of "humankind."
BIOGRAPHY
Educated at Duquesne University, Pittsburgh
MSN and Ph.D. from University of Pittsburgh
Published her theory of nursing, Man-Living-Health in 1981
Name changed to Theory of Human Becoming in 1992
Editor and Founder, Nursing Science Quarterly
Has published eight books and hundreds of articles about Human Becoming Theory
Professor and Niehoff Chair at Loyola University, Chicago
THEORY DEVELOPMENT
• The human becoming theory was developed as a human science nursing theory in the tradition of Dilthey,
Heidegger, Sartre, Merleau-Ponty, and Gadamer and Science of Unitary Human Beings by Martha Rogers .
• The assumptions underpinning the theory were synthesized from works by the European philosophers, Heidegger,
Sartre, and Merleau-Ponty, along with works by the pioneer American nurse theorist, Martha Rogers.
• The theory is structured around three abiding themes: meaning, rhythmicity, and transcendence.
ASSUMPTIONS
About man
The human is coexisting while constituting rhythmical patterns with the universe
The human is open, freely choosing meaning in situation, bearing responsibility for decisions.
The human is unitary, continuously constituting patterns of relating.
The human is transcending multidimensionally with the possible
About Becoming
Becoming is unitary human-living-health.
Becoming is a rhythmically constituting human-universe process.
Becoming is the human’s patterns of relating value priorities.
Becoming is an intersubjective process of transcending with the possible.
Becoming is unitary human’s emerging
Three Major Assumptions of Human Becoming
• Meaning
o Human Becoming is freely choosing personal meaning in situations in the intersubjective process of living
value priorities.
o Man’s reality is given meaning through lived experiences
o Man and environment cocreate
• Rhythmicity
o Human Becoming is cocreating rhythmical patterns of relating in mutual process with the universe.
o Man and environment cocreate ( imaging, valuing, languaging) in rhythmical patterns
• Transcendence
o Human Becoming is transcending multidimensionally with emerging possibles.
o Refers to reaching out and beyond the limits that a person sets
o One constantly transforms
SUMMARY OF THE THEORY
• Human Becoming Theory includes Totality Paradigm

o Man is a combination of biological, psychological, sociological and spiritual factors
• Simultaneity Paradigm
o Man is a unitary being in continuous, mutual interaction with environment
• Originally Man-Living-Health Theory
NURSING PARADIGMS AND PARSE'S THEORY
Person
Open being who is more than and different from the sum of the parts
Environment
Everything in the person and his experiences
Inseparable, complimentary to and evolving with
Health
Open process of being and becoming. Involves synthesis of values
Nursing
A human science and art that uses an abstract body of knowledge to serve people
SYMBOL OF HUMAN BECOMING THEORY
• Black and white = opposite paradox significant to ontology of human becoming and green is hope
• Center joined =co created mutual human universe process at the ontological level & nurse-person process
• Green and black swirls intertwining = human-universe co creation as an ongoing process of becoming
APPLICATION OF THE THEORY
Nursing Practice
• A transformative approach to all levels of nursing

• Differs from the traditional nursing process, particularly in that it does not seek to “fix” problems
• Ability to see patients perspective allows nurse to “be with” patient and guide them toward desired health outcomes
• Nurse-person relationship cocreates changing health patterns
Research
• Enhances understanding of human lived experience, health, quality of life and quality of nursing practice
• Expands the theory of human becoming
• Builds new nursing knowledge about universal lived experiences which may ultimately contribute to health and
quality of life
CRITIQUE
• Congruence with personal values

o Nurse must subscribe to this world view to truly use it
• Congruence with other professional values
o Complements and competes with other health care professionals’ values
o Exoteric foundations
o Esoteric utility
• Congruence with social values
o Fulfills society’s expectations of nursing role
• Social Significance
o Makes a substantial difference in the lives of clients and nurses
NURSING PROCESS THEORY by

IDA ORLANDO
BIOGRAPHY
Ida Jean Orlando - born in 1926.
wrote about the nursing process.
Nursing diploma - New York Medical College
BS in public health nursing - St. John's University, NY,
MA in mental health nursing - Columbia University, New York.
Associate Professor at Yale School of Nursing and Director of the Graduate Program in Mental Health Psychiatric Nursing.
Project investigator of a National Institute of Mental Health grant entitled: Integration of Mental Health Concepts in a Basic
Nursing Curriculum.
published in her 1961 book, The Dynamic Nurse-Patient Relationship and revised 1972 book: The Discipline and Teaching of
Nursing Processes
A board member of Harvard Community Health Plan.
Major Dimensions
The role of the nurse is to find out and meet the patient's immediate need for help.
The patient's presenting behavior 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 behavior.
This process helps nurse find out the nature of the distress and what help the patient needs.
METAPARADIGM
PERSON
Human being – developmental beings with needs, individuals have their own subjective perceptions and feelings that may
not be observable directly.
ENVIRONMENT
not defined directly but implicitly in the immediate context for a patient.
NURSING
is responsive to individuals who suffer or anticipate a sense of helplessness.
Goal:
increased sense of well-being, increase in ability, adequacy in better care of self and improvement in patients behavior.
HEALTH
Sense of adequacy or well being
Fulfilled needs.
Sense of comfort
TERMS
Distress is the experience of a patient whose need has not been met.
Nursing role is to discover and meet the patient’s immediate need for help.
Patient’s behavior may not represent the true need.
The nurse validates his/her understanding of the need with the patient.
Nursing actions directly or indirectly provide for the patient’s immediate need.
An outcome is a change in the behavior of the patient indicating either a relief from distress or an unmet need.
Observable verbally and nonverbally.
CONCEPTS
Function of professional nursing - organizing principle
Presenting behavior - problematic situation
Immediate reaction - internal response
Nursing process discipline – investigation
Improvement – resolution
Function 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." – Orlando
Presenting Behaviour – Problematic Situation

To find out the immediate need for help the nurse must first recognize the situation as problematic
The presenting behavior of the patient, regardless of the form in which it appears, may represent a plea for help
The presenting behavior of the patient, the stimulus, causes an automatic internal response in the nurse, and the
nurses behavior causes a response in the patient
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
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 .
When the nurse does not explore with the patient her reaction it seems reasonably certain that clear communication
between them stops
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 patien
DOMAIN CONCEPTS
Process of care in an immediate experience…. for avoiding, relieving, diminishing or curing the individuals sense of
helplessness. Finding out meeting the patients immediate need for help.
Nursing client – patients who are under medical care and who cannot deal with their needs or who cannot carry out
medical treatment alone
Nursing problem – distress due to unmet needs due to physical limitations, adverse reactions to the setting or
experiences which prevent the patient from communicating his needs
Nursing process – the interaction of 1)the behavior of the patient, 2) the reaction of the nurse and 3)the nursing
actions which are assigned for the patients benefit.
Nurse – patient relations – central in theory and not differentiated from nursing therapeutics or nursing process
Nursing therapeutics – Direct function : initiates a process of helping the patient express the specific meaning of his
behavior in order to ascertain his distress and helps the patient explore the distress in order to ascertain the help he
requires so that his distress may be relieved.
Indirect function – calling for help of others , whatever help the patient may require for his need to be met
Nursing therapeutics - Disciplined and professional activities – automatic activities plus matching of verbal and
nonverbal responses, validation of perceptions, matching of thoughts and feelings with action
Automatic activities – perception by five senses, automatic thoughts, automatic feeling, action.
LECTURE;
Medical Diagnosis e.g. Hypertension, Pneumonia, COPD

s/s
Nursing Diagnosis:
e.g. Difficulty of breathing, on and off fever, presence of lymph nodes
NURSING DIAGNOSIS; NANDA
Actual action: TSB tepid sponge bath
Potential
High risk
Wellness
Syndrome (Clustering)
Basic 1 part,2parts,3parts
Alteration in body temperature (Problem)
Alteration in body temperature(problem) related to presence of infection (etiology)
Alteration in body temperature (problem) related to presence of infection(etiology) as
manifested/as evidenced by (s/s) body temperature of 39 degrees centigrade
SMART= SPECIFIC, MEASURABLE, ATTAINABLE, REALISTIC AND TIME BOUND
TECHNOLOGICAL COMPETENCY AS CARING by

Rozzano Locsin
BIOGRAPHY:
1976-BSN & 1978-MAN-Siliman University of the Philippines
1988- PhD (Doctorate degree) – University of the Philippines
1991 – Professor – Christine E. Lynn College of Nursing, Florida Atlantic University
Program pf Research:” Life transitions in the health-illness experience”
Knowing persons is a process of nursing that allows for continuous appreciation of persons moment to moment
(Locsin,2005).
Technology is use to now wholeness of persons moment to moment (Locsin,2004).
To illustrate the harmonious co-existence between technology and caring in nursing.

To place nursing in the context of modern healthcare
Technology & brings the patient closer to the nurse. Conversely, technology can also increase the gap & between
the NURSE & and the NURSED.
The Process of Nursing
A. KNOWING
B. DESIGNING
C. PARTICIPATION IN APPRECIATION
D. VERIFYING KNOWLEDGE
METAPARADIGM
PERSON
Patients seen as “participants in their care rather than object of nurse care” (Locsin,20-7).
ENVIRONMENT
Technological world in which we live
NURSING
“Nurses value technological competency as an expression of caring in nursing” (Locsin, 2013)
HEALTH
o Humanity is preserved by technology.
o “An experience that is often expressed in terms of wellness and illness, and may occur in the presence or
absence of disease” (Nursing Scope and Standards of Practice, 2010, p. 65)
HUMAN NEEDS THEORY by

Abraham Maslow
BIOGRAPHY:
Born April 1, 1908 in Brooklyn, New York
He first studied law at the City College of New York (CCNY) and after three semesters, he transferred to Cornell,
and then back to CCNY
He received his BA in 1930, his MA in 1931, and his PhD in 1934, all in psychology, all from the University of
Wisconsin
He began teaching full time at Brooklyn College.
Maslow served as the chair of the psychology department at Brandeis from 1951 to 1969.
He met Kurt Goldstein, who had originated the idea of self-actualization in his famous book, The Organism (1934).
He spends his final years in semi-retirement in California, until, on June 8 1970, he died of a heart attack after years
of ill health.
ASSUMPTIONS
People’s behavior
r is based on their needs
A satisfied need does not motivate
A satisfied need can no longer motivate a person
As one need is satisfied, another replaces it.
Physiological needs - these are biological requirements for human survival, oxygen, food, water, shelter, clothing,
sleep.
Safety needs– security, stability, order, and physical safety.
Love and belonging– affection, identification, companionship.
Esteem needs- classified into two categories:
(i) esteem for oneself (dignity, achievement, mastery, independence) and
(ii) the desire for reputation or respect from others (e.g., status, prestige).
Self-actualization needs are the highest level in Maslow's hierarchy, and refer to the realization of a person's
potential, self-fulfillment, seeking personal growth and peak experiences.
Behaviors leading to self-actualization:

(a) Experiencing life like a child, with full absorption and concentration;
(b) Trying new things instead of sticking to safe paths;
(c) Listening to your own feelings in evaluating experiences instead of the voice of tradition, authority or the
majority;
(d) Avoiding pretense ('game playing') and being honest;
(e) Being prepared to be unpopular if your views do not coincide with those of the majority;
(f) Taking responsibility and working hard;
(g) Trying to identify your defenses and having the courage to give them up.
Characteristics of Self Actualizers

1. They perceive reality efficiently and can tolerate uncertainty;
2. Accept themselves and others for what they are;
3. Spontaneous in thought and action;
4. Problem-centered (not self-centered);
5. Unusual sense of humor
6. Able to look at life objectively;
7. Highly creative;
8. Resistant to enculturation, but not purposely unconventional;
9. Concerned for the welfare of humanity;
10. Capable of deep appreciation of basic life-experience;
11. Establish deep satisfying interpersonal relationships with a few people;
12. Peak experiences;
13. Need for privacy;
14. Democratic attitudes;
15. Strong moral/ethical standards.
Deficiency Needs vs. Growth Needs

This five-stage model can be divided into deficiency needs and growth needs. The first four levels are often referred
to as deficiency needs (D-needs), and the top level is known as growth or being needs (B-needs).
Deficiency needs arise due to deprivation and are said to motivate people when they are unmet. Also, the
motivation to fulfil such needs will become stronger the longer the duration they are denied. For example, the longer
a person goes without food, the hungrier they will become.
Maslow termed the highest level of the pyramid as growth needs.
Growth needs do not stem from a lack of something, but rather from a desire to grow as a person. Once these
growth needs have been reasonably satisfied, one may be able to reach the highest level called self-actualization.
SUMMARY
(a) human beings are motivated by a hierarchy of needs.

(b) needs are organized in a hierarchy of prepotency in which more basic needs must be more or less met (rather
than all or none) prior to higher needs.
(c) the order of needs is not rigid but instead may be flexible based on external circumstances or individual
differences.
(d) most behavior is multi-motivated, that is, simultaneously determined by more than one basic need.
TRANSACTIONAL ANALYSIS by
HARRY STACK SULLIVAN
BIOGRAPHY
Born Feb. 21, 1892

Oldest existing son of poor Irish Catholic parents Lonely childhood existence
Poor relationship with father.
Close friendship with Clarence Bellinger.
Academically gifted.
Poor academic performance in freshman year at Cornell.
Suffered a schizophrenic breakdown.
Enrolled for Medicine, received degree 2 yrs after graduation.
Work with William Alanson WhitePrivate practice in New York Zodiac Group
His therapy was neither psychoanalytic nor neoFreudian.
Died of Cerebral Hemorrhage on Jan. 14, 1949.
Rumors of homosexuality
Overview:
People develop their personality within a social context. Without other people, humans would have no personality.
Development rests on the individual’s ability to establish intimacy with another person. Anxiety can interfere with
satisfying interpersonal relations.
Healthy development entails experiencing intimacy and lust toward another same person.
▪ Personality is an energy system.
▪ Tension potentiality for action
▪ Energy Transformations actions themselves
▪ Tensions brought about by a biological imbalance between the person and environment. Episodic Biological
component and interpersonal relations.
▪ Zonal Needs arises from a specific body part.
▪ General Needs over all well-being of a person.
▪ Tenderness is a basic interpersonal need.
TRANSACTIONAL ANALYSIS
is a method of understanding people’s behavior by analyzing the transactions or interactions which transpire
between people. • Transactional analysis is a social psychology and a method to improve communication.
GOAL:
Make yourself aware of your triadic personality structure.
Increase awareness of your own ego state and the ego states of others.
Be aware of both social and psychological messages which exist within communication transactions.
Increase the chance for complementary transaction.
Berne defined an ego state as
“ a consistent pattern of feeling and experience directly related to a corresponding consistent pattern of behavior” .
❖ Only 7% of the meaning is in the words spoken

❖ 38% of meaning is paralinguistic (the way that the words are said)
❖ 55 % is in facial expression
INTERPERSONAL TRANSACTIONS
▪ Reciprocal/complementary
Example 1
A: have you been able to write the report?(adult to adult)
B :“yes I m about to email it to you.” (adult to adult)
Example 2
A: “would you like to skip this meeting and go watch a film with me instead?”(child to child)
B: “I’d love to – I don’t want to work anymore, what should we go and see?” (child to child)
▪ Crossed Transactions
Example 1
A: have you been able to write the report?(adult to adult) •
B: “ will you stop hassling me? I ‘ll do it eventually”(child to parent)
▪ Duplex or Covet Transactions

There are two different levels in transaction. One of them is a surface level or social level and the second
one is a hidden level or a psychological level.
“In a class room the teacher played some video clips to give a presentation on Marxist ideology. Two of the
students started discussing topics related to Marxist ideology which were not discussed in the class before. Now
apparently, or on surface, the two students were having an adult-to-adult transaction. But covertly, that
transaction was a child-to-child transaction as the two were trying to tell the rest of the class, ‘Look! We’ve more
knowledge about the topic”.
FOUR LIFE POSITIONS
1. I AM NOT O.K YOU ARE O.K

Lack of self-respect and self confidence
Feeling of inferiority and negative approval.
Lack motivation and strive to progress.
Dominated by situations and lack initiative.
2. I AM NOT O.K YOU ARE NOT O.K

Low opinion and lack of self-confidence.
No trust in others, rather always suspicious.
Negative feeling of thought of self and others.
Not straight forward.
3. I AM OK YOU ARE NOT OK

Lack of trust and confidence in colleagues.
Feeling of superiority and power
Blaming his colleagues for any failure.
No interest in feedback.
4. I AM O.K YOU ARE O.K

Respect for self and others- high self-esteem.
Interested to provide democratic leadership.
Honest and sincere in both his work and with colleague
POSITIVE STROKES
A positive stroke is any recognition that is direct, appropriate, and relevant .
Positive strokes leaves the other person feeling alive, alert, and significant
Positive strokes may be . . .
❖ Complimentary
❖ Affectionate
Positive Unconditional Strokes

Example :
“I really liked the way you handled the meeting.”
“You really know how to close a sale.”
Positive Conditional Strokes

Example:
“If you keep that up, you will get a big bonus.”
“When you work like that you really contribute to the team.”
NEGATIVE STROKES
Strokes can also be negative
A put down
An insult Laughing at someone
Transactional Analysis as a Tool in building Interpersonal Relationship
❖ Knowing and trusting each other is essential, self disclosure, self awareness and self- trust are also very important.
❖ Communicating with each other accurately and in clear words and actions.
❖ Accepting and supporting each other’s positive and negative strokes. Accept the person as he is and then change
him once the rapport is established.
❖ Resolving conflicts and relationship problem constructively.
ROLE OF TRANSACTIONAL ANALYSIS IN NURSING PROFESSION
TA enables the managers and educators to aware about their ego states for the first time.
Based on this awareness, they do feel the need for shifting ego states as per the demand of the situations.
It helps them to become aware of the effects of their communication(transactions) with others and why and how it
breaks or builds.
They become aware of the need and efficacy of positive strokes and dysfunctional effects of negative strokes
TA concepts help them to reduce work tension and increase harmony in working with people.
TA develops capacities of awareness, spontaneity and intimacy.
Knowledge of transactional analysis enables a manager and educator to modify the behavior of coworkers, thereby
improving communication and increasing productivity.
An understanding of ego state is necessary for the manager to interpret and modify her own responses to patient
and coworker.
EDUCATION
Transactional analysis is a practical educational psychology that offers a way of transforming educational
philosophy and principle into everyday practice.
TA concept provide a flexible and creative approach to understand how people function and to the connection
between the human behavior ,learning and empowerment, enhancing effective methods of interaction and mutual
recognition.
Educational TA is both preventive and restorative . the aim is to increase personal autonomy , to support people in
developing their own personal and professional philosophies and to enable optimum psychological health and
growth.
ORGANIZATIONAL CHANGE
TA to enhance job performance develop more effective management, leadership skills, and greater organizational
teamwork. TA support organizational goals and helps to solve management employee problems or conflicts in order
to promote healthier and more productive business, government and social organization.
PERSONAL CHANGE
TA to help achieve your personal goals. You can use it to break free of negative life script and become more
autonomous.
TA has significant role in resolving conflicts and building interpersonal relationship. It can bridge the difference and
cement interpersonal relationship by knowing and trusting each other by self-disclosure, self-awareness and self-
trust
Communicating each other accurately • Accepting and supporting each other’s positive and negative strokes
SOCIAL CHANGE
TA can be used to promote healthy and productive social institutions. It can raise awareness of social inequities and
promote ok- ok relations between diverse cultural group. TA can be used by both informal and formal social leaders
and their followers to support basic human rights in line with the goal of creating more harmony in society.
SYSTEM THEORY by
VON BERTALANFFY
THE SYSTEM THEORY
❖ The system theory is the transdisciplinary study of the abstract organization of phenomena, independent of their
substance, type, or spatial or temporal scale of existence.
❖ It is also a management methodology as it is a way of analyzing and thinking about organizations and also an
alternative approach Simpler definition says, A theory that sees an organization as a set of interrelated and
interdependent parts.
❖ The systems theory focuses on understanding the organization as an open system that transforms inputs into
outputs.
❖ This theory is based on the work of a biologist, Ludwig von Bertalanffy, who believed that a general systems model
could be used to unite science. Early contributors to this theory included Kenneth Boulding, Richard Johnson,
Fremont Kast, and James Rosenzweig.
❖ The systems theory began to have a strong impact on management thought in the 1960s as a way of thinking about
managing techniques that would allow managers to relate different specialties and parts of the company to one
another, as well as to external environmental factors.
❖ The systems theory focuses on the organization as a whole, its interaction with the environment, and its need to
achieve equilibrium.
THE PREMISES OF THE SYSTEM THEORY
The systems theory puts forth the premise that organizations, like living organisms, are made up of numerous
component subsystems that must work together in harmony for the larger system to succeed. Systems theory states
that organizational success relies on synergy, interrelations and interdependence between different subsystems. As
arguably the most valuable component of a company, employees make up various vital subsystems within an
organization. Departments, work groups, business units, facilities and individual employees can all be considered
component systems of the organizations.
ENVIRONMENT
SYSTEM
TRANFORMATION OUTPUT
INPUT
WORKER’S PRODUCT &
PHYSICAL ACTIVITY SERVICES
HUMAN TECHNOLOGY
FINANCIAL ADMINISTRATION FINANCIAL
INFORMATION SYSTEM HUMAN RESULT
CONTROL SYSTEM
FEEDBACK
ENVIRONMENT
WORKERS ACTIVITY TECHOLOGY ADMINSTRATION SYSTEM CONTROL SYSTEM ENVIRONMENT SYSTEM

FEEDBACK TRANSFORMATION OUTPUT
IMPORTANT VIEW POINTS ON ORGANIZATION
❖ Open Systems
❖ Closed System
❖ Subsystem
❖ Synergy
❖ Entropy
CHARACTERISTICS/FEACTURES OF THE SYSTEMS THEORY
Communication
Communication mechanisms must be put in place for organizational systems to exchange relevant information with its
environment.
Communication provides for the flow of information among the subsystems.
Systems, subsystems and supersystem

Systems are a set interrelated part that turn inputs to outputs through processing.
Subsystems is the step that does the processing of the objectives within an organization.
Super systems are other systems in environment of which the survival of the focal system is dependent.
Boundaries
The part of the system that separates it from its environment.
The four types of boundaries involved in the process are physical, linguistical, systematic and psychological
boundaries.
Goal-directedness
systems are goal oriented and engage in feedback in order to meet the goals of the organization. Also, every part
of the system is interdependent with each other working together towards the goal.
ADVANTAGES OF THE SYSTEMS THEORY

It focuses on the environment and how changes can impact the organization.
Broadens the theoretical aspects for viewing the behaviour of organizations.
It is designed to deal with complex tasks It aims in meaningful analysis of organization and their management.
Facilitates interaction between organization and environment.
DISADVANTAGES OF THE SYSTEMS THEORY

The systems theory doesn’t focus on specific task functions
Over conceptual
Unpractical i.e it can’t be easily & directly applied to practical problems.
The theory changes in environment directly affect the structure and function of the organization
Doesn’t directly explore the impact of interpersonal relationships, type of interaction, interdependencies and loyalty
on productivity.
WAYS SYSTEM THEORY IS USED IN MORDERN ORGANIZATION
System theory is used to measure performance, control and compute the interactions among individuals in
each department of the organization. When the system theory is presented in an organization this helps in growth
and development. If a typical managerial leader has any knowledge of the system theory it is easier to manage the
mechanisms of products and services leaving the organization.
SUMMARY
Systems advocates envision the organization as being made up of interdependent factors including individuals’
groups attitudes, motives, formal structure, interactions goals, status & authority if all parts of the organization are not
coordinated internally then organization goals cannot be achieved.
Again, open system approach recognized that org. are not self-content they rely on their environment for essential
inputs as a source to absorbs their outputs.
So, system approach is very crucial for organizations for its existence in business scenario and economic
environment, in order to face all cyclic circumstances and move step ahead to achieve organizational goal.
CHANGE THEORY by
KURT LEWINS
Force Field Analysis: Driving Forces
Driving Forces are forces that push in a direction that causes change to occur.
They cause a shift in the equilibrium towards change.
i.e. A married couple who has to get ready for a party, the husband is on the couch watching the football game. The
wife encourages her husband to get ready because there is going to be free beer at the party. The husband starts
to get ready in a hurry. The driving forces are: The wife encouraging the husband & The incentive of free alcohol at
the party.
Force Field Analysis: Restraining Forces
Restraining forces are forces that counter driving forces. They oppose change.
Restraining forces cause a shift in the equilibrium which opposes change
i.e.In the case of the husband and wife getting ready for the party. Present at the party is going to be the husbands
cousin whom he despises. The cousin and the husband have not got along for many years and if the husband was
to go, there surely would be a fight. The husband also finds out that the beer is non-alcoholic.
Force Field Analysis: Equilibrium
Equilibrium is a state of being where driving forces equal restraining forces and no change occurs
Equilibrium can be raised or lowered by changes that occur between the driving and restraining forces
Consists of three distinct and vital stages:
“Unfreezing”
Involves finding a method of making it possible for people to let go of an old pattern that was counterproductive in
some way
“Moving to a new level or Changing”
Involves a process of change in thoughts, feeling, behavior, or all three, that is in some way more liberating or more
productive
“Refreezing”
Is establishing the change as a new habit, so that it now becomes the “standard operating procedure.” Without this
stage of refreezing, it is easy to backslide into the old ways.
STAGES OF PSYCHOSOCIAL DEVELOPMENT by

Erik Homburger Erikson’s
BIOGRAPHY
• Father of Psychosocial Development
• His theory, Post-Freudian Theory
• Coined the term identity crises, (a turning point in one’s life that may either strengthen or weaken one’s
personality.)
• ]A world fame Psychoanalyst, Anthropologist, Psychohistorian and a Medical School Professor. Yet he had no
college degree of any kind.
• Intended his theory of personality to extend rather than repudiate Freud’s Psychoanalysis and to offer a new “way
of looking things
• Regards his theory as the extension of Freud’s Psychoanalysis
• His theory is a reflection of his own background, that consist of arts, extensive travels, experiences with varied
culture and a lifelong search for his own identity.
Introduction
An understanding of Erikson’s eight stages of psychosocial development requires awareness of several basic points.
The word Psychosocial Psycho relates to mind, brain and personality. Social which means the external relationships
and environment. Bio psychosocial, in which Bio refers to life as in biological.
The theory is a basis for broad or complex discussion and analysis of personality and behavior, and also facilitating
personal development – of self and others. Why? Because, this can help the teacher in becoming more knowledgeable
and at the same time understanding of the various environmental factors that affect his own and his student’s personality
and behavior.
Growth takes place according to epigenetic principle, which states that a person's development is predetermined. Also,
in every stage of life there is an interaction of opposites, a conflict between;
Syntonic- A harmonious element (e.g., Trust) &
Dystonic- A disruptive element. (e.g., Mistrust)
Erikson conditioned that people must have these two experiences in order to grow. At each stage of conflict between
the two elements, a person develops an ego quality or strength or basic strength (e.g., develops hope, behind conflicts)
that allows a person to move to the next stage. In dealing with the conflicts, each stage has also a core pathology in
which a person has a tendency to develop the opposite strength (e.g., develops withdrawal).
Erikson’s eight stages of development never lose the sight to biological aspect of human development, he believes that
events in the earlier stage but ego is shape by the multiplicity of conflicts and events (past, present and future) that
causes an individual to experience identity crises, and this is not a catastrophic event but rather an opportunity to
maladaptive or adaptive adjustment.
STAGE 1 Infancy Oral-sensory (0-1 year old) Trust vs. Mistrust

Psychosocial Crisis: The first stage is infancy, is approximately the first year or year and a half of life. The goal is
to develop trust without completely eliminating the capacity for mistrust. If the primary caregivers, like the parents
can give the baby a sense of familiarity, consistency, and continuity, then the baby will develop the feeling that the world
is a safe place to be, that people are reliable and loving.
Maladaptation Malignancy
Sensory Maladjustment: Overly trusting, even gullible, this person cannot believe anyone would mean them harm, and will
use all the defenses at their command to find an explanation or excuse for the person who did him wrong. Withdrawal:
characterized by depression, paranoia, and possibly psychosis.
If the proper balance is achieved, the child will develop the virtue of Hope. Basic Strength
STAGE 2 Early Childhood Muscular-Anal (2-3 years old) Autonomy vs. Doubt
He begins to make choices and express his will. If encouraged, he develops a sense of autonomy and independence. In this
stage Erikson believes that the child may develops a sense of doubt and shame manifested in feelings of worthless and
incompetence. We should keep in mind that even something as innocent as laughing at the toddler’s efforts can lead the child
to feel deeply ashamed and to doubt his or her abilities.
Basic Strength: If you get the proper, positive balance of autonomy and shame and doubt, you will develop the virtue
of willpower or determination.
Impulsiveness – a sort of shameless willfulness that leads you, in a later childhood and even adulthood, to jump into things
without proper consideration of your abilities.
Maladaptation vs. Malignancy
Compulsiveness – feels as if their entire being rides on everything they do, and so everything must be done perfectly.
STAGE 3 Play Age Locomotor-Genital (4-5 years old) Initiative vs. Guilt
Psychosocial crisis:
Child begins to explore his social and physical worlds discovering what he can accomplish. Erikson refers to this as a
time for developing a sense of initiative or a positive attitude of personal accomplishment. At this time, the child
gradually becomes aware of the various social roles presented by his environment. In Erikson’s view, the basic
influence during this period is the child’s families who can help him learn to be responsible for his behavior and actions.
Ruthlessness – to be heartless or unfeeling or be “without mercy”.

Inhibition - the inhibited person will not try things because “nothing ventured, nothing lost” and, particularly,
nothing to feel guilty about.
Basic Strength A good balance leads to the psychosocial strengths of purpose.
STAGE 4 School Age Latency (6-11 years old) Industry vs. Inferiority
Psychosocial Crisis:
the child’s world broadens technical skills are learned and feelings of competence, enlarged. Children enter new world of the
neighborhood and the school. In Erikson’s view, when children come to believe that they cannot achieve according to them
school, family, or peers, their sense of mastery will give way to personal inferiority. Thus, they become incapable of facing the
transitory adolescent years which lie directly ahead. Parents must encourage, teachers must care, peers must accept.
Narrow Virtuosity: we see this in children who aren’t allowed to “be children” the ones that parents or teachers push
into one area of competence, without allowing the development of broader interests.
Inertia: this includes all of us who suffer from the “inferiority complexes” Alfred Adler talked about.
Virtue
A happier thing is to develop the right balance of industry and inferiority a– that is, mostly industry with just a touch of
inferiority to keep us sensibly humble. Then we have the virtue called competency.
STAGE 5 Adolescence (12-18 years old) Identity vs. Role confusion
Psychosocial Crisis: According to Erikson, is characterized by an identity – formation crisis. The question “Who am I and what
can I do when I become an adult?” confronts the adolescent. His struggle is based not only on societal demands as an emerging
adult, but also on the pubescent age. Since an adolescent spends more time with his friend, the peer group now becomes an
essential source of general rules of behavior.
Maladaptation Malignancy Fanaticism believes that his way is the only way.
Repudiation – they reject them membership in the world of adults and, even more, they reject their need for an identity.
Virtue If you successfully negotiate this stage, you will have the virtue Erikson called fidelity.
STAGE 6 Young Adulthood (19-40 years old) Intimacy vs. Isolation
In this stage the individual develops a warm and intimate relationship with another person. If such sense of intimacy is not
acquired during this time of life, a sense of isolation develops instead. Such attitude is reflected in the ability to trust others in a
close and intimate manner.
Maladaptation Malignancy Promiscuity
referring particularly to the tendency to become intimate too freely, too easily, and without any depth to you
intimacy.
Exclusion
which refers to the tendency to isolate oneself from love, friendship, and community, and to develop a certain
hatefulness in compensation.
Virtue If you successfully negotiate this stage, you will instead carry with you for the rest of your life the virtue Erikson calls love.
STAGE 7 Adulthood (40-60 years old) Generativity vs. Stagnation
The middle years of stage comprise the productive years of adulthood. In this stage, the individual’s productivity is
gauged by his contributions to his family and to society. According to Erikson, the person who fails to develop this sense
of generativity becomes preoccupied instead with his personal needs and interests with his personal needs and interests
or both with a sense of self-absorption.
Overextension
illustrates the problem. Some people try to be so generative that they no longer allow time for themselves, for rest
and relaxation.
Rejectivity – too little generativity and too much stagnation and you are no longer participating in or contributing to
society.
Virtue But if you are successfully at this stage, you will have a capacity for caring that will serve you through the rest
of your life.
STAGE 8 Old Age/Maturity (60-death) Ego integrity vs. Despair
In the last stage, a person comes to terms with the temporal limits of his life. It is the fulfillment and culmination. In
Erikson’s view it as the achievement of a sense of integrity resulting from identification with mankind. If a person,
however, develops an attitude of regret and fear of the end of life, then a sense of despair emerges instead.
Presumption
this is what happens when a person “presumes” ego integrity without actually facing the difficulties of old age.
Disdain
by which Erikson means a contempt of life, one’s own or anyone’s.
Virtue
Someone who approaches death without fear has the strength Erikson calls wisdom.
MORAL DEVELOPMENT THEORY by

LAWRENCE KOHLBERG
Kohlberg’s Moral Development
Lawrence Kohlberg, an American psychologist, was among the pioneers of moral development research. Building on
from the original propositions of Jean Piaget, Kohlberg theorised that humans develop their moral judgements in 6
stages. To confirm his theory, Kohlberg interviewed boys between the ages of 10 and 16. He then analyzed how they
would justify their decision when confronted with different hypothetical moral dilemmas. Superimposing the participants’
argumentation onto their cognitive development, Kohlberg postulated, that humans progress through the stages in a
hierarchical order, as their cognitive abilities develop.
Lawrence Kohlberg’s theory claims that our development of moral reasoning happens in six stages. The stages
themselves are structured in three levels: Pre-Conventional, Conventional and Post-Conventional. To understand this
better, imagine a conflict at school.
There is a fight in the schoolyard. Two ninth-graders are beating up Tom. Those who watch the fight are at different
stages of moral development. Let’s see what they do and how they justify their behavior.
Pre-conventional
STAGE 1: OBEDIENCE AND PUNISHMENT

At stage one, we make moral judgments based on obedience and punishment. Mark’s sense of good and bad is directly
linked to whether he gets punished or not. Marcus sees what is happening to his friend and wants to help. He doesn’t,
however, because he is afraid the teacher may punish him if he gets caught fighting. He asks himself; how can I avoid
punishment?
STAGE 2: SELF-INTEREST
At stage two, we are motivated by self-interest. Mary decides to intervene and help Tom. She knows that she might get
punished, but she also knows that she could become a victim herself, someday. If she helps Tom now, he might help her
in the future. She is asking herself: What’s in it for me?
Conventional
STAGE 3: INTERPERSONAL ACCORD AND CONFORMITY

At stage three, interpersonal accord and conformity guide our moral judgments. Beth sees the fight and wants to
intervene, but when she realizes that all the others are just watching, she decides not to get involved. She wants others
to see that she is a good girl, who is conforming with the ethics of the community. She asks herself: What do others think
of me?
STAGE 4: AUTHORITY AND MAINTAINING SOCIAL ORDER

At stage four, we value authority and want to maintain social-order. When the teacher sees the group fighting, he
immediately steps in and shouts: “Stop, fighting at school is forbidden!”. He feels that, above all, it is important to follow
the rules, otherwise chaos breaks out and that it is his duty to uphold the rules that sustain a functioning society. The
teacher at that moment asks himself: How can I maintain law and order?
Post conventional
STAGE 5: SOCIAL CONTRACT

At stage five, we understand rules as a social contract as opposed to a strict order. Jessy, who watches from
afar, is not sure is not sure how she feels about this. To her, rules make sense only if they serve the right purpose.
Obviously, the school rules prohibit fighting, but maybe Tom deserves to finally learnt his lesson. Just yesterday he
punched a young girl from grade one. She asks herself: Does a rule truly serve all members of the community?
STAGE 6: UNIVERSAL ETHICAL PRINCIPLES

At stage six, we are guided by universal ethical principles. All those involved now have to face the headmaster. He first
explains the school rules, and why they exist. He then clarifies that rules are valid only if they are grounded in justice. The
commitment to justice carries with it an obligation to disobey unjust rules. The headmaster’s highest moral principle is
compassion. He believes that all people should learn to understand each other’s viewpoints and that they don’t feel alone
with their feelings. He asks: What are the abstract ethical principles that serve my understandings of justice?
PRE-CONVENTIONAL LEVEL
At the pre-conventional level, Mark is driven by fear and Mary by self-interest. Both judge what is right or wrong by the
direct consequences they expect for themselves, and not by social norms. This form of reasoning is common among
children.
CONVENTIONAL LEVEL
At the conventional level, Beth responds to peer pressure, and the teacher follows the rules. Their morality is centered
around what society regards as right. At this level, the fairness of rules is seldom questioned. It is common to think like this
during adolescence and adulthood.
POST-CONVENTIONAL LEVEL
At the post-conventional level, Jessy knows that things are complicated because individuals may disobey rules inconsistent
with their own morality. The headmaster follows a universal ethical idea, at complete disconnect with what society thinks
or the rules say. To him everything is solved through compassion. The right behavior in his opinion, is therefore never a
means to an end, but always an end in itself. Not every person reaches this level.
PRE-FINAL PERIOD COVERAGE
A. Nursing Theories
1. Henderson’s Need Theory

2. Pender’s Health Promotion Model: Nursing Theories
3. Leininger Theory of Culture Care Diversity & Universality
4. Newman’s Theory of Health as Expanding Consciousness
5. Parse’s Theory of Human Becoming
6. Watson’s Theory of Human Caring
7. Orlando’s Nursing Process
8. Locsin’s Technological Competency as Caring
B. Theories Relevant to Nursing Practice

1. Maslow’s Human Needs Theory
2. Sullivan’s Transactional Analysis
3. Von Bertalanffy’s General System Theory
4. Lewin’s Change Theory
5. Erikson’s Psychosocial Development
6. Kohlberg’s Moral Development
Prepared by:
Maria Haydi P. Medina, MAN, RN
Clinical Instructor

Mabini Prefinal Lect. Theoretical Foundation of Nursing

Uploaded by

Copyright:

Available Formats

You might also like

Mabini Prefinal Lect. Theoretical Foundation of Nursing

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Mabini Prefinal Lect. Theoretical Foundation of Nursing

Uploaded by

Copyright:

Available Formats

THEORETICAL FOUNDATION OF NURSING (NCM) 100

1st Semester, Semi-Final Period

14 BASIC HUMAN NEEDS THEORY by

“First Lady of Nursing”

• Breathe normally. Eat and drink adequately.

NURSES SPECIFIC ROLES AND RESPONSIBILIITIES

THE NURSE-PATIENT RELATIONSHIP

Nursing Process Henderson’s 14 components and definition of nursing

HEALTH PROMOTION MODEL by

Individual Characteristics and Experience

MAJOR CONCEPTS AND DEFINITIONS

THEORY OF CULTURE CARE AND DIVERSITY by

She is considered as the founder of the theory of transcultural nursing.

MAJOR CONCEPTS AND DEFINITIONS

HEALTH PRACTICES IN DIFFERENT CULTURES

NURSING PROCESS AND ROLE OF NURSE

Determine the client's cultural heritage and language skills.

HEALTH AS EXPANDING CONCIOUSNESS by

BACKGROUND OF THE THEORIST

DESCRIPTION OF THE THEORY

“Consciousness is a manifestation of an evolving pattern of person-environment interaction”

THEORY OF HUMAN BECOMING by

Three Major Assumptions of Human Becoming

SUMMARY OF THE THEORY

• Human Becoming Theory includes Totality Paradigm

NURSING PARADIGMS AND PARSE'S THEORY

SYMBOL OF HUMAN BECOMING THEORY

APPLICATION OF THE THEORY

• A transformative approach to all levels of nursing

• Congruence with personal values

NURSING PROCESS THEORY by

Function of Professional Nursing- Organizing Principle

Presenting Behaviour – Problematic Situation

Immediate Reaction – Internal response

NURSING PROCESS DISCIPLINE - INVESTIGATION

Medical Diagnosis e.g. Hypertension, Pneumonia, COPD

TECHNOLOGICAL COMPETENCY AS CARING by

Technology is use to now wholeness of persons moment to moment (Locsin,2004).

To illustrate the harmonious co-existence between technology and caring in nursing.

The Process of Nursing

HUMAN NEEDS THEORY by

Behaviors leading to self-actualization:

Characteristics of Self Actualizers

Deficiency Needs vs. Growth Needs

(a) human beings are motivated by a hierarchy of needs.

Born Feb. 21, 1892

Berne defined an ego state as

❖ Only 7% of the meaning is in the words spoken

▪ Duplex or Covet Transactions

1. I AM NOT O.K YOU ARE O.K

2. I AM NOT O.K YOU ARE NOT O.K

3. I AM OK YOU ARE NOT OK

4. I AM O.K YOU ARE O.K

Positive Unconditional Strokes

Positive Conditional Strokes

Transactional Analysis as a Tool in building Interpersonal Relationship

ROLE OF TRANSACTIONAL ANALYSIS IN NURSING PROFESSION

THE PREMISES OF THE SYSTEM THEORY