OUR LADY OF FATIMA UNIVERSITY

QUEZON CITY

NCMA110

Theoretical
Foundation of
Nursing

Fatima Aira S. Legaspi

ACADEMICIAN
 FINALS
Week 15

Local Theories:
Divinagracia & Kuan
Week 13

Non-Nursing Theories
Relevant to Nursing
Practice
Week 16

Local Theories:
Abaquin & Laurente
Week 14

Local Theories:
Agravante & Locsin
Week 17

Synchronicity in Human-
Space-Time Theory of
Nursing Management

Fatima Aira S. Legaspi

ACADEMICIAN
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice
THEORIES RELEVANT TO THE NURSING
PRACTICE
Maslow's Hierarchy
of Needs
Maslow's hierarchy of needs is a theory of
motivation which states that five categories of
human needs dictate an individual's behavior.
Those needs are physiological needs, safety
needs, love and belonging needs, esteem
needs, and self-actualization needs
Maslow (1943) initially stated that
individuals must satisfy lower level
deficit needs before progressing on to
meet higher level growth needs.
However, he later clarified that
satisfaction of a needs is not an “all-or-
none” phenomenon, admitting that his
earlier statements may have given “the
false impression that a need must be
satisfied 100 percent before the next
need emerges..”
1.Physiological Needs
- these are biological requirements for
human survival, e.g. air, food, drink, shelter,
clothing, warmth, sex, sleep.
- Maslow considered physiological needs
the most important as all the other needs
become secondary until these needs are met.
Fatima Aira Legaspi
ACADEMICIAN
2.Safety Needs
- Once an individual’s physiological
needs are satisfied, the needs for security
and safety become salient. People want to
experience order, predictability and
control in their lives. These needs can be
fulfilled by the family and society (e.g.
police, schools, business and medical
care).
- e.g. emotional security, financial
security, law & order, freedom from fear,
social stability, property, health and well-
being.
3.Love and Belongingness Needs
- The need for interpersonal
relationships motivates behavior.
- e.g. friendship, intimacy, trust, and
acceptance, receiving and giving
affection and love, and affiliating-being
part of a group like family, work, etc.
4.Esteem Needs
- Maslow 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).
5.Self-actualization Needs
- 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.
- Maslow (1943) describes this level
as the desire to accomplish
everything that one can, to
become the most that one
can be.
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice
Interpersonal Theory of
Personality
This theory was proposed by Harry Stack
Sullivan.
The theory further states that the
purpose of all behavior is to get needs
met through interpersonal interactions
and decrease or avoid anxiety.
Three Types of Self: (According to Sulivan)
Good Me: represents what people like
about themselves and is willing to share
with others
Bad Me: what people don’t like about
themselves and are not willing to share.
Develops in response to negative
feedback with feelings of discomfort,
displeasure, and distress. The “Bad Me”
creates anxiety.
Not Me: the aspects of self that are so
anxiety-provoking that the person does
not consider them a part of the person. It
contains feelings of horror, dread, dread.
This part of the self is primarily
unconscious (dissociative coping).
Fatima Aira Legaspi
ACADEMICIAN
Sullivan's theory explains about anxiety,
self-system and self-esteem:
Anxiety - the “main disruptive force” in
interpersonal relations
Security operations –those measures that
the individual employs to reduce anxiety
and enhance security.
Self-system – all of the security
operations an individual uses to defend
against anxiety and ensure self esteem.
APPLICATION:
Sullivan's interpersonal theory provides the
theoretical basis for interpersonal
psychotherapy (IPT) for depression and
schizophrenia.
Interpersonal theory proposes that
depression develops most often in the
context of adverse events, particularly
interpersonal loss. (Tasman 2008)
 He also wrote on techniques and
approaches on psychiatric interview.
This theory of personality by Sulivan is based
on the belief that people’s interactions with
other people, especially significant others,
determine their sense of security, sense of self,
and the dynamisms that motivate their
behavior.
For Sullivan, personality is the product of a
long series of stages in which the individual
gradually develops “good feeling” toward
others and a sense of a good me
toward himself or herself.
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice
Change Theory
This theory was developed by Kurt Lewin,
the father of social psychology.
The theory enveloped a change model
involving three steps: unfreezing,
changing and refreezing.
For Lewin, the process of change entails
creating the perception that a change is
needed, then moving toward the new,
desired level of behavior and finally,
solidifying that the new behavior as the
norm.
Three Major Concepts of Change Theory
Driving Forces
Restraining Forces
Equilibrium
1. Driving Forces - are those that push in
a direction that causes change to occur.
They facilitate change because they
push the patient in a desired direction.
They cause a shift in the equilibrium
towards change.
2. Restraining Forces - are those forces
that counter the driving forces. They
Hinder change because they push the
patient in the opposite direction. The
equilibrium that opposes change.
3. Equilibrium - is a state of being where
driving forces equal restraining
forces,and no change occurs. It can be
raised or lowered by changes that occur
between the driving and restraining
forces.
Fatima Aira Legaspi
ACADEMICIAN
Three Stages of Change Theory
1. Unfreezing is the process which involves
finding a method of making it possible for
people to let go of an old pattern that was
somehow counterproductive.
Three Methods : Achievement of unfreezing
1. Increase the driving forces that direct
behavior away from the existing situation or
status quo
2. Decrease the restraining forces that
negatively affect the movement from the
existing equilibrium.
3. Finding a combination of the first two
methods.
2. Change Stage, which is also called
"moving to a new level" or "movement,"
involves a process of change in thoughts,
feeling, behavior, or all three, that is in some
way more liberating or more productive.
3. Refreezing Stage is establishing the
change as the new habit, so that it now
becomes the "standard operating procedure."
Without this final stage, it can be easy for the
patient to go back to old habits.
Theory of Change is a specific type of
methodology for planning, participation and
evaluation that is used in companies,
philanthropy, not for profit and government
sectors to promote social change. Theory of
change defines long term goals and then maps
backward to identify
necessary precondition.
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice
General Systems
Theory
This theory was proposed by Ludwig Von
Bertalanffy
General Systems Theory is based on the
assumption that there are universal
principles of organization, which hold for
all systems, be they physical, chemical,
biological, mental or social.
General system theory (science of
wholeness) describes “ how to break
whole things into parts and then to learn
how the parts work together in systems”.
Emphasizes the relationships between
parts
Describes how parts function and behave
Basic Concepts of General System Theory
A system is a set consisting of integrated,
interesting parts or components that
function as a whole. Each part is
necessary to make a complete and
meaningful whole.
Principles of General System Theory and
its Application in Nursing
1. The principle of wholeness: It is the core
of General system theory , This principle
provides the guidance or methodology to us
in order that we can study all kinds of objects
effectively.
2. The principle of optimization: The
principle of optimization of a system is to
achieve an optimal state in certain conditions
and to perform its best function by
organization and coordination
Fatima Aira Legaspi
ACADEMICIAN
3. The principle of modeling: modeling is to
design a model similar to a real system first ,
then to describe and understand the
characterization and level of the real system
by studying the model.
a. Concrete model : is to reproduce a
prototype by using a similar model in some
degree and forms eg. CPR model
b. Abstract model : is the reflect the
similar relation of a prototype of a system by
non objective forms of language, symbol and
diagram, such as Nursing diagnosis
Three Aspects of the Principle of Modeling
1. Principle of similarity: A model should
be an imitation and abstract of an actual
system.
2. The Principle of simplicity: A model with
lose its function if there is no reality we
should be good at grasping key
contradiction, neglecting the secondary
factors to achieve simplicity under the
precondition of ensuring necessary
precision.
3. The principle of objectivity: The relations
of similarity and simplicity between a
model and a prototype may result in
completely consistency in data and
production provided by model and the
situation of a real system.
The Revolution of General System Theory to
Nursing
To look at a person with systematic view
point
The human being is the
object of Nursing.
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice

The human being is a system that is

Developmental
composed of many elements, such as
Theories
physiological, psychological, social ,
spiritual and cultural elements.
This theory was developed by Erik
The human being is a natural system
Erickson.
a. A basic condition of life activities
describes the human life cycle as a series
and heath of human being is hormony and
of 8 ego development stage from birth to
equilibrium of internal and external
death
environment in the human body.
each stage present a psychosocial crisis,
b. A human being is an open and
the goal of which is to integrate
dynamic system. A human being exchanges
psychological, maturation and social
the energy, matter, and information with its
demands
environment constantly, as well as within its
the result of 1st stage may not be
body to maintain life and health.
permanent but can be changed by
c. A Human being is an system with a
experience later in life
subjective activity
occurs a life long series of crises
A human being is conscious and able to
affected by social and cultural, social
supervise and control his / her state of
factors
functions
each psychosocial crises must be
resolved for the child or adult to progress
Characteristic of Systems
emotionally, unsuccessful resolution can
1. Systems refer specifically to self regulating
leave the person emotionally disabled.
systems
2. Systems are self correcting through
The Stages that Make Up this Theory are
feedback
as follows:
3. System have structure that is defined by its
Stage 1: Trust vs. Mistrust
process and parts.
Stage 2: Autonomy vs. Shame and Doubt
4. Systems are generalization of reality.
Stage 3: Initiative vs. Guilt
5. The various parts of a system have
Stage 4: Industry vs. Inferiority
functional as well as structural relations
Stage 5: Identity vs. Confusion
between each others.
Stage 6: Intimacy vs. Isolation
6. System tends to function in the same way
Stage 7: Generativity vs. Stagnation
7. Every living organism is essentially an open
Stage 8: Integrity vs. Despair
system

Fatima Aira Legaspi

ACADEMICIAN
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice
Stage 1: Trust vs. Mistrust ( Infant)
The first stage of Erikson's theory of
psychosocial development occurs
between birth and 1 year of age and is
the most fundamental stage in life.
Because an infant is utterly dependent,
developing trust is based on the
dependability and quality of the child's
caregivers.
Children develop a sense of trust when
caregivers provide reliability, care, and
affection. A lack of this will lead to
mistrust.
Stage 2: Autonomy vs. Shame and Doubt
(Toddler)
The second stage of Erikson's theory of
psychosocial development takes place
during early childhood and is focused on
children developing a greater sense of
personal control.
Children are just starting to gain a little
independence.
Potty training plays an important role in
helping children develop this sense of
autonomy.
Children who successfully complete this
stage feel secure and confident, while
those who do not are left with a sense of
inadequacy and self-doubt
Stage 3: Initiative vs. Guilt ( Pre-schooler)
The third stage of psychosocial
development takes place during the
preschool years. At this point in
psychosocial development, children begin
to assert their power and control over the
world through directing play and other
social interactions.
Fatima Aira Legaspi
ACADEMICIAN
Stage 4: Industry vs. Inferiority( Grade
schooler)
The fourth psychosocial stage takes
place during the early school years from
approximately ages 5 to 11. Through
social interactions, children begin to
develop a sense of pride in their
accomplishments and abilities.
Stage 5: Identity vs. Confusion (Teenager)
The fifth psychosocial stage takes place
during the often turbulent teenage years.
This stage plays an essential role in
developing a sense of personal identity
which will continue to influence behavior
and development for the rest of a
person's life.
Stage 6: Intimacy vs. Isolation (Young
adults)
Need to form intimate, loving
relationships with other people. Success
leads to strong relationships, while failure
results in loneliness and isolation. This
stage covers the period of early
adulthood when people are exploring
personal relationships.
Stage 7: Generativity vs. Stagnation
(Middle Adults)
Adults need to create or nurture things
that will outlast them, often by having
children or creating a positive change
that benefits other people. Success leads
to feelings of usefulness and
accomplishment, while
failure results in shallow
involvement in the
world.
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice
Stage 8: Integrity vs. Despair (Late Adults)
The final psychosocial stage occurs
during old age and is focused on
reflecting back on life. At this point in
development, people look back on the
events of their lives and determine if they
are happy with the life that they lived or if
they regret the things they did or didn't
do.
Those who are unsuccessful during this
stage will feel that their life has been wasted
and may experience many regrets. The
person will be left with feelings of bitterness
and despair. Those who feel proud of their
accomplishments will feel a sense of
integrity. Successfully completing this phase
means looking back with few regrets and a
general feeling of satisfaction. These
individuals will attain wisdom, even when
confronting death.
Moral
Development
Psychologist Lawrence Kohlberg (1927–
1987) extended upon the foundation that
Piaget built regarding cognitive
development. Kohlberg believed that
moral development, like cognitive
development, follows a series of stages.
Involve acceptance of values & rules of
society in a way that shapes behavior
classified in a series of levels & behaviors
sequential but people do not
automatically go from 1 stage or level to
the next as they mature.
Fatima Aira Legaspi
ACADEMICIAN
Psychologist Lawrence Kohlberg (1927–
1987) extended upon the foundation that
Piaget built regarding cognitive
development. Kohlberg believed that
moral development, like cognitive
development, follows a series of stages.
Involve acceptance of values & rules of
society in a way that shapes behavior
classified in a series of levels & behaviors
sequential but people do not
automatically go from 1 stage or level to
the next as they mature.
Identified three levels of moral reasoning:
Level 1: Preconventional
Level 2: Conventional
Level 3: Postconventional
Level 1: Preconventional
A child’s sense of morality is externally
controlled.
Children accept and believe the rules of
authority figures, such as parents and
teachers.
A child with pre-conventional morality
has not yet adopted or internalized
society’s conventions regarding what is
right or wrong, but instead focuses
largely on external consequences that
certain actions may bring.
Level 2: Conventional
Throughout the conventional level, a
child’s sense of morality is tied to
personal and societal relationships.
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice

Children continue to accept the rules of Kohlberg’s Stages of Moral Development:

authority figures, but this is now due to
their belief that this is necessary to
ensure positive relationships and societal
order.
Adherence to rules and conventions is
somewhat rigid during these stages, and
a rule’s appropriateness or fairness is
seldom questioned.

Level 3: Postconventional
Throughout the postconventional level, a
person’s sense of morality is defined in
terms of more abstract principles and
values. People now believe that some
laws are unjust and should be changed or
Three Levels of Moral Development:
eliminated.
This level is marked by a growing
realization that individuals are separate
entities from society and that individuals
may disobey rules inconsistent with their
own principles.

According to Kohlberg, an individual

progresses from the capacity for pre-
conventional morality (before age 9) to the
capacity for conventional morality (early
adolescence), and toward attaining post-
conventional morality (once formal
operational thought is attained), which only a
few fully achieve.

Fatima Aira Legaspi

ACADEMICIAN
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice

2. Observational Learning - Bandura

Social Learning emphasizes the power and pervasiveness of
Theory social modeling and the process of learning
through observation. SO he suggests the
This theory was developed by Albert
observational learning which can be done
Bandura
through imitation and modeling.
Emphasizes the importance of observing,
modelling, and imitating the behaviors,
a. Imitation -individuals observe and
attitudes, and emotional reactions of
just copy the action.
others.
e.g. drawing or painting by copying a
Considers how both environmental and
subject.
cognitive factors interact to influence
human learning and behavior.
b. Modeling - individuals observe
Bandura viewed people as AGENTS, or
specific models.
originators of experience.
e.g. drawing/painting objects but the
He also conceived HUMAN AGENCY as
individual could just copy or change some of
the ability to act and make things
the patterns to the art piece.
happen.
Factors that influence Modeling
Two Important Ideas
Characteristics of the Model
1. Mediating processes occur between
Attributes of the Observer
stimuli & responses.
Reward consequences associated with
2. Behavior is learned from the environment
the behavior.
through the process of observational
learning.
Process of Observational Learning
Attentional Process
Learning through Observation
Retention Process
Children observe the people around them
Motor Production Process
behaving in various ways:
Motivational Process
1.Bobo Doll - In a famous and influential
experiment known as the Bobo doll
experiment, Albert and his colleagues were
able to demonstrate one of the ways in which
children learn aggression.
the experiment involved 2 diff. models:
an aggressive one and not.
Bandura then believed that television can
be a source of behavior modeling.

Fatima Aira Legaspi

ACADEMICIAN
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice

Reinforcement in Observational Learning Moral Disengagement and Self-Efficacy

Extrinsic Reinforcement - being Self-Efficacy - is defined as the people's
rewarded with objects and stuff. belief that they can successfully perform
e.g. winning a competition and behaviors that will desired effects.
being rewarded with a medal. Central mechanism of self-regulation
Intrinsic Reinforcement - being Govern our thoughts, motivations, and
rewarded by the feedback or the actions.
outcome of the behavior done.
e.g. playing a difficult piece of Essence of Social Cognitive Theory
music well leads to feeling of The social influences shaped our behavior
accomplishment (self-satisfaction) Humans are product of learning
Vicarious Reinforcement - is learning by Emotional arousal stemming from aversive
observing others. experiences motivates aggression
- watching, constructing images, Observational modes may strengthen or
remembering, analyzing, and making weaken every existing response
decisions that affect learning.
e.g. a child who sees a sibling being
spanked for a misdemeanor quickly learns not
to do the same thing. Theory of Cognitive
Self-Reinforcement - controlling your
Development
own reinforces
- this is important for both students
and teachers
e.g. one runner might be satisfied
by completing a mile in five minutes; another
would want to finish it in less time.

Albert Bandura believed that there are

multiple effects of viewing/watching
violence.

Multiple Effects of Violence

Overwhelming of the nervous system
Aggressive style behavior
Desensitization or habitation of viewers
to violence (emotional numb)
Shaping the image of reality (distorted)

Fatima Aira Legaspi

ACADEMICIAN
 Week 13:
Non-Nursing Theories Relevant to Nursing Practice

Psychoanalytic
Theory

Fatima Aira Legaspi

ACADEMICIAN
 Week 14:
Local Theories: Agravante and Locsin

The CASAGRA Transformative Leadership

Transformative
Theory is classified as a Practice Theory
Leadership Theory
basing on the characteristics of a Practice
Theory stated by McEwen (2007), which are
CArolina S. AGRAvante, famous for being
the following:
the first Filipina theorist for writing the
a. Complexity / Abstractness, Scope -
CASAGRA Transformative Leadership
Focuses on a narrow view of reality, simple
Model.
and straightforward;
The title of the theory was derived from
b. Generalizibility /Specificity - Linked to a
her name.
special populations or an identified field of
The complete title of the model: The
practice;
CASAGRA Transformative Leadership
c. Characteristic of Scope – Single,
Model: Servant – Leader
concrete concept that is operationalized;
The theory “CASAGRA Transformative
d. Characteristic of Proposition –
Leadership:” is a psycho spiritual model.
Propositions defined;
e. Testability – Goals or outcomes defined
The model is a Three-Fold
and testable;
Transformation Leadership Concept
f. Source of Development – Derived from
rolled into one, comprising of the
practice or deduced from middle range
following elements:
theory or grand theory.
Ø Servant-Leader Spirituality - is
prescribed to run parallel to the generic
PURPOSE
elements of the transformative leadership
The present day demands in the nursing
model.
profession challenge nursing educators to
This formula consists of a spiritual exercise,
revisit their basic responsibility of educating
the determination of the vitality of the care
professional nurses who are responsive
complex in the personality of an individual
to technological, educational and social
and finally a seminar workshop on
changes happening in the Philippines society
transformative teaching.
today. The reopening of the doors of foreign
Ø Self-Mastery - consists of a vibrant care
market to Filipino nurses, migration made
complex possessed to a certain degree by all
easy, attractive salaries and benefits way
who have been through formal studies in a
beyond what hospitals can afford to give.
care giving profession such as nursing
Ø Special Expertise - is shown in a creative,
MAIN PROPOSITIONS
caring, critical, contemplative and collegial
- CASAGRA Transformative Leadership is a
teaching of the nurse faculty who is directly
psycho-spiritual model, was an
involved with the formation of the nursing.
effective means for faculty to
become better teachers and
servant-leaders.

Fatima Aira Legaspi

ACADEMICIAN
 Week 14:
Local Theories: Agravante and Locsin

- Care complex is a structure in the ASSUMPTIONS

personality of the caregiver that is
significantly related to the
leadership behavior.
- The CASAGRA servant-leadership formula is
an effective modality in enhancing the
nursing faculty’s servant-leadership behavior.
- Vitality of Care Complex of the nursing
faculty is directly related to leadership
behavior.
The assumptions of the theory are:
Persons are caring by virtue of their
humanness (Boykin & Schoenhofer, 2001)
Persons are whole or complete in the
moment (Boykin & Schoenhofer, 2001)
Knowing persons is a process of nursing
that allows for continuous appreciation of
persons moment to moment (Locsin,
2005)
Technology is used to know the wholeness
of persons moment to moment (Locsin,
2004)
Nursing is a discipline and a professional
practice (Boykin & Schoenhofer, 2001)

DIMENSIONS OF TECHNOLOGICAL VALUE

IN THE THEORY
Technology as completing human
beings to re-formulate the ideal
human being such as in replacement
parts, both mechanical
Technological (prostheses) or organic (transplantation of
Competency as Caring in organs.)
Nursing
This theory was developed by Rozzano
Locsin.
This is the only middle range theory that
focuses in technology as caring in
nursing.
Technological competency as caring in
nursing informs nursing as a critical
process of knowing persons’ wholeness.
Locsin's theory book explores, clarifies,
and advances the conception of
technological competency as caring in
nursing.
His theory is essential to modeling a
practice of nursing from the perspective
of caring.

Fatima Aira Legaspi

ACADEMICIAN
 Week 14:
Local Theories: Agravante and Locsin
DIMENSIONS OF TECHNOLOGICAL VALUE
IN THE THEORY
Technology as machine technologies,
e.g. computers and gadgets enhancing
nursing activities to provide quality
patient care such as Penelope or Da
Vinci in the Operating Theatres;
Technologies that mimic human
beings and human activities to meet
the demands of nursing care practices,
e.g. cyborgs (cybernetic organisms) or
anthropomorphic machines and robots
such as ‘nursebots’ (Locsin & Barnard,
2007).
Fatima Aira Legaspi
ACADEMICIAN
TECHNOLOGICAL COMPETENCY AS
CARING IN NURSING
Technological competency as caring in
nursing is the harmonious coexistence
between technologies and caring in
nursing.
The harmonization of these concepts
places the practice of nursing within the
context of modern healthcare and
acknowledges that these concepts can
co-exist.
Technology brings the patient closer to
the nurse. Conversely, technology can
also increase the gap between the nurse
and nursed.
When technology is used to know persons
continuously in the moment, the process
of nursing is lived.
THE PROCESS OF NURSING
A. Knowing: The process of knowing person
is guided by technological knowing in which
persons are appreciated as participants in
their care rather than as objects of care. The
nurse enters the world of the other.
 B. Designing: Both the nurse and the one
nursed (patient) plan a mutual care process
from which the nurse can organize a
rewarding nursing practice that is responsive
to the patient’s desire for care.
 C. Participation in appreciation: The
simultaneous practice of conjoined activities
which are crucial to knowing persons. In this
stage of the process is the
alternating rhythm of
implementation and
evaluation.

 Week 14:
Local Theories: Agravante and Locsin

D. Verifying knowledge: The continuous,

circular process demonstrates the ever-
changing, dynamic nature of knowing in
nursing. Knowledge about the person that is
derived from knowing, designing, and
implementing further informs the nurse and
the one nursed.

METAPARADIGM CONCEPT
Nursing
Nurses value technological competency as an
expression or caring in nursing.
Person
Patient seen as “participants in their care
rather than object of nurse care”
Health
Humanity is preserved by technology
Environment
Environment as the technological world in
which we live.

Fatima Aira Legaspi

ACADEMICIAN
 Week 15:
Local Theories: Divinagracia & Kuan
Composure Theory
condition of being in a state of well-
being, a coordinated and integrated
living pattern that involves the dimension
of wellness.
Dr. Carmelita C. Divinagracia conducted
a study to determine the effects of
COMPOSURE behaviours of the
advanced practitioner on the recovery of
selected patients at the Philippine Heart
Center.
Behaviours include: competence,
presence and prayer, open-mindedness,
stimulation, understanding, respect and
relaxation, and empathy.
COMPOSURE BEHAVIORS
COMpetence
• An in depth knowledge and clinical
expertise demonstrated in caring for patients.
• This is also stands for consistency and
congruency of words and deeds of the
nurse.
Presence and Prayer
• A form of nursing measure which means
being with another person during times
of need.
• This includes therapeutic communication,
active listening, and touch.
• It is also a form of nursing measure which is
demonstrated through reciting a
prayer with the patient and concretized
through the nurse’s personal relationship
and faith in God.
Fatima Aira Legaspi
ACADEMICIAN
Open-mindedness
A form of nursing measure which means
being receptive to new ideas or to
reason.
It conveys a manner of considering
patient’s preferences and opinions
related to his current health condition
and practices and demonstrate the
flexibility of the nurse to accommodate
patient’s views.
Stimulation
a form of nursing measure demonstrated
by means of providing encouragement
that conveys hope and strength,
guidance in the form of giving
explanation and supervision when doing
certain procedures to patient, use of
complimentary words or praise and smile
whenever appropriate.
Appreciation of what patient can do is
reinforced through positive encouraging
remarks and this is done with kind and
approving behavioural approach.
Understanding
• According to her, it conveys interest and
acceptance not only of patient’s condition
but also his entire being.
• This is manifested through concerned and
affable facial approach; this is a way of
making the patient feel important and
unique.
Respect
• Acknowledging the 31 patient’s presence.
• Use of preferred naming in addressing the
patient, po and opo, is a sign of
positive regard.
• It is also shown through
respectful nods and recognition of the
patient as someone important.
 Week 15:
Local Theories: Divinagracia & Kuan
Relaxation
Entails a form of exercise that involves
alternate tension and
relaxation of selected group of muscles.
Empathy
Senses accurately other person’s inner
experience.
The empathic nurse perceives the current
positive thought and feelings and
communicates by putting himself in the
patient’s place.
Through the COMPOSURE behaviours of
the nurse, holism is guaranteed to the
patient.
Divinagracia (2001) stated that
nursing is a profession that surpasses
time and aspects of the individual as one
of its clients. From the time the nurse
admits a patient to the time of his
discharge, the nurse’s presence becomes
a meaningful occasion for the two parties
to develop mutual trust, acceptance, and
eventually satisfying relationships.
Patient Wellness Outcome
This refers to the perceived wellness of
selected orthopedic patients after
receiving nursing care in terms of
physiologic and biobehavioral.
Two patient wellness outcomes which have
been categorized as:
Biobehavioral
Physiologic
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Physiologic Wellness Outcome
This refers to the perceived wellness of
selected orthopedic patients after
receiving nursing care in terms of vital
signs, bone pain sensation, and complete
blood count.
Biobehavioral Wellness Outcome
This refers to the perceived wellness of
selected orthopedic patients after
receiving nursing care in terms physical,
intellectual, emotional, and spiritual.
Intellectual wellness is a person’s ability to
learn and to use information to enhance the
quality of daily living and optimal functioning.
A person with intellectual wellness is
generally characterized as informed, as
opposed to ignorant.
Physical wellness is a person’s ability to
function effectively in meeting the demands
of the day’s work and to use free time
effectively. Physical wellness includes good
physical fitness and the possession of useful
motor skills. A person with physical wellness is
generally characterized as fit versus unfit.
Spiritual wellness is a person’s ability to
establish a values system and act on the
system of beliefs, as well as to establish and
carry out meaningful and constructive
lifetime goals. It is often based on a belief in
a force greater than the individual that helps
one contribute to an improved quality of life
for all people.
Optimal health includes many areas, thus
the term holistic (total) is
appropriate. In fact, the word
health originates from a root
word meaning “wholeness”
 Week 15:
Local Theories: Divinagracia & Kuan
Retirement and Role
Discontinuity Model
The Theory of Sister Letty G. Kuan is
about “Graceful Aging”. Her interest in
old people initiated her to formulate a
theory for the purpose of knowing the
reasons and variables on how to make
people happy at retirement by
conceptualizing a framework:
Retirement
- is an inevitable change in one's life.
- this developmental stage, even at later
part of life, must be considered desirable and
satisfying through the determination of
factors that will help the person enjoy his
remaining years of life.
- It is of primary importance to prepare
early in life by cultivating other role of
options at age 50-60 to have a rewarding
retirement period.
BASIC ASSUMPTIONS AND CONCEPTS
Physiological Age
- is the endurance of cells and tissues to
withstand the wear-and-tear phenomenon of
the human body.
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Role
- refers to set of shared expectations
focused upon a particular position. These ay
include beliefs about what goals or values
the position in incumbent is to pursue and the
norms that will govern his behavior.
Retiree
- is an individual who has left the
position occupied for the past years of
productive life because he/she has reached
the prescribed retirement age or has
completed the required years of service.
Role Discontinuity
- is the interruption in the line of status
enjoyed or performed. The interruption may
be brought about by an accident, emergency,
and change of position or retirement.
Coping Approaches
- refer to the interventions or measures
applied to solve a problematic situation or
state in order to restore or maintain
equilibrium and normal functioning.
Determinants of Positive Perceptions in
Retirement and Positive reactions toward
Role Discontinuity
1.Health Status - refer to physiological and
mental state of the respondents, classified as
either sickly or healthy.
2.Income - (economic level) refers to the
financial affluence of the respondent which
can be classified as poor,
moderate, or rich.
3.Work Status - status of an
individual according to
his/her work.
 Week 15:
Local Theories: Divinagracia & Kuan

Findings and Recommendations Application to Nursing

1. Health Status dictates the capacities The theory of Sister Letty G. Kuan stated
and the type of role one takes both for that without positive acquisitions during
the present and for the future. childhood, the person (patient) will be “in
2. Family Constellation is a positive index a pathological state” to delinquency.
regarding retirement positively and also Now, this is the challenge that nurses will
in reacting to role discontinuities. face. The role of the nurse is to put back
3. Income has a high correlation with both what they have missed during childhood
the perception of retirement and and to fill this gap. Nurses need to let
reactions towards role discontinuities. them acquire good things through setting
4. Work Status goes hand and hand with an example and to make them feel loved
economic security that generates decent and important. The role of the nurse is to
compensation. become a therapeutic self and spiritual
5. Self-preparation which are said to be self by showing empathy and
both therapeutic and recreational in compassion.
essence pays its worth in old age.
6. To cope with the changes brought by
retirement, one must cultivate interest in
recreational activities to channel feelings “The Longer you stay in life, the more
of depression or isolation and facing you have acquired, the better you
realities through confrontation with some should be, the Legacy is given.”
issues. - Divinagracia
7. To perceive retirement positively, it
requires early socialization of the various
roles we take in life.
8. Government Agency to construct
holistic pre-retirement preparation
program which will take care of the
retiree's finances, psychological,
emotional, and social needs.
9. Retirement should be recognized as the
fulfillment of every individual's birthright
and must be lived meaningfully.

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 Week 16:
Local Theories: Abaquin & Laurente
Prepare Me Theory
“To Nursing... may be able to provide
the care that our clients need in
maintaining their quality of life and being
instrumental in “birthing” them to
external life.”
- Carmencita Abaquin
Basic Assumptions and Concepts
PREPARE ME (Holistic Nursing
Interventions) are the nursing
interventions provided to address the
multidimensional problems of cancer
patients that can be given in any setting
where patients choose to be confined.
This program emphasizes a holistic
approach to nursing care.
Metaparadigms and Interventions
Person/Patient. Her theory is specific to
patients in advanced stages of cancer.
They are holistic being with physical,
psychological, social, religious, level of
independence, and environmental
aspects. Patients who are terminally-ill
or those with incurable diseases as with
cancer must be approached in
multifaceted care to improve their
quality of life.
Environment. Just like all the other
paradigms, environment was not defined
accurately. Nevertheless we can assume
that environment is an aspect or
dimension integrated to the cancer
patient. Her quality of life can also be
assessed in this aspect thus it must be
given consideration in the provision of
care.
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Health. The concept of her theory
revolves around illness, particularly
cancer and the provision of holistic care
to improve quality of life despite their
terminal cases.
Quality of life is defined as a multifaceted
construct that encompasses the individuals
capabilities and abilities of enriching life
when it can no longer be prolonged. This
includes proper care and maintaining
integrity of the body, mind and spirit despite
the limitations brought about by the present
condition. The quality of life is seen through
the patient's many dimensions.
Nursing. The goal of nursing care is the
improvement of quality of life for
advance stage cancer patients despite
their current situation. Her concept of
providing holistic nursing care in
addressing the multidimensional problems
that cancer patients face is summarized
in the acronym PREPARE ME.
Presence – being with another person during
the times of need. This includes therapeutic
communication, active listening, and touch.
Reminisce Therapy – recall of past
experiences, feelings and thoughts to
facilitate adaptation to present
circumstances.
Prayer
Relaxation-Breathing – techniques to
encourage and elicit relaxation for the
purpose of decreasing
undesirable signs and
symptoms such as pain,
muscle tension, and anxiety.
 Week 16:
Local Theories: Abaquin & Laurente

PREPARE ME theory provides a CONCERN- development in the time

framework on non-pharmacologic, non- through mutual trust nurse and the
surgical approach of care to advanced patient.
cases of cancer patients. The focus is STIMULATION- nurse stimulation through
not on cure but on assisting the patient words tops the powerful resources of
to explore her humanity and internal energy of person for healing.
serenity as one is faced with the
challenge of life and death. Enhancing factors
PREPARE ME Interventions are said to be One’s caring experience, beliefs and
effective in improving the quality of life attitude
of cancer patients. this can be further Feeling good about work
applied not only with terminally-ill Learning caring at school
patients but also promisingly introduced What patients tell about the nurse coping
to those patients with acute and chronic mechanism to problems encountered.
diseases and those with prolonged Communication
hospital stays.
Predisposing Factors
Terminally-ill patients require holistic Age
approach of nursing that encompasses the Sex
different aspects of man namely physical, Civil Status
psychological, social, religious, level of Educational Background
independence, environment, and spiritual. in Length of work
this premise, patients with incurable illness, Experience
specially cancer patients, require a whole
faceted care that will improve the quality of
their life.

Theory of Nursing
Practice and Career

Anxiety - a mental health state of fear or

nervousness about what might happen.

Nurse’s Caring behavior that affect

patient anxiety:
PRESENCE- person to person contact
between the client and the nurses

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ACADEMICIAN
 Week 17:
Synchronicity in Human-Space-Time Theory of Nursing
Management
Synchronicity in
Human-Space-Time
The shift from a fragmented and
inequitable health care to a well-
integrated global approach ensures the
quality of nursing care focused on human
caring in nursing engagement. .The
process of nursing in the Synchronicity in
Human–Space–Time theory of nursing
engagement.
The HST theory is a study of caring, HST,
and the perspective of synchronicity and
nursing engagement.
This theory aims to enlighten nurses in
their practice through an innovative
demonstration of nursing care processes
grounded on authentic intentions of
caring transcending extant reductionistic
approaches.
Furthermore, SynHSTTNE is a useful
theoretical base for future research that
aims to describe the meaningful
connectedness in human experiences of
transcendence, interconnectivity,
emancipation, and equitability with
humanistic approaches in the discipline
of nursing.
Four Life Principles of the Synchronicity in the
Human-Space-Time Theory of Nursing
Engagement (SHSTTNE) are:
interconnectivity
equitability
emancipation
human transcendence
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1. Interconnectivity is a principle of human
interconnectedness of energy. Energy is
continuously moving from “subatomic
particles to the biosphere, including the
planet Earth, all forming a whole” (Patterson,
1998, p. 289). Interconnectivity leads to the
understanding of holism that the bio-psycho-
social-spiritual dimensions of persons are
interrelated (Lai & Hsieh, 2003) and that the
whole being is more than the sum of its
organs or systems.
2. Interconnectivity is a principle of human
interconnectedness of energy. Energy is
continuously moving from “subatomic
particles to the biosphere, including the
planet Earth, all forming a whole” (Patterson,
1998, p. 289). Interconnectivity leads to the
understanding of holism that the bio-psycho-
social-spiritual dimensions of persons are
interrelated (Lai & Hsieh, 2003) and that the
whole being is more than the sum of its
organs or systems.
3. Emancipation is a principle of liberating
the self and others from the limits of human-
space-time realities. The human-space-time
realities of health care could include human
factors or attributes such as fear, shame, lack
of communication skills, lack of knowledge,
powerlessness and human resources. Space
factors could mean internal and external
environmental limitations. Internal
environmental limitations are physiologic,
psychologic, emotional and spiritual
conditions while the external environment
limitations refer to the socio-economic-
political challenges as well as
the organizational dynamics
that influence the nurse and
the nursed.
 Week 17:
Synchronicity in Human-Space-Time Theory of Nursing
Management
4. Through human transcendence, nurses
and the nursed can rise beyond their present
difficulties. Just as self-transcendence is
revealed in the expansion of self-boundaries
that enhances well-being (Reed, 2015),
human transcendence is also evident in the
ability to go beyond the limits of the HST
through nursing engagement that fosters
human health and well-being. Resilience, for
example, is meaningfully connected with
well-being through human transcendence.
ASSUMPTIONS
1.HST is a metaphysical sphere of caring
experiences among persons with patterns of
occurrence viewed as meaningful for both
the nurse and the nursed. The HST conscious
ness of caring experiences is similar to
Watson’s caring moment that transcends
space and time (Watson, 2007) as well as
Parse’s human universe viewpoint that is
indivisible, unpredictable, and ever changing
in co-creating reality of becoming (Parse,
2013).
The theory claims that synchronicity and
nursing engagement occurs through the
appreciation of the integrality of human—
environment and the time being. This is
illustrated, for example, as synchronistic
nursing engagement in various settings (e.g.,
emergency department, community setting,
hospital ward) perceiving the patient not as a
disease or a product of some stereotypical
clients, rather as individuals whose internal
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2. Nursing unfolds in a unitarily pattern of
wholeness integrated within the HST
processes. Humans are assimilating their lives
with technology, instigating the nursing
profession toward transformations. The
conceptualization of caring, nursing, and
technology by Locsin (2015)elucidates the
nursing profession as continually evolving
here, now, and beyond.
3. The nurse–nursed HST consciousness is
irreducibly evolving thus co-creating human
transcendence. The individual experiences
and perspectives of the nurse and the one
being nursed are not deductively viewed
apart from the whole nurse–nursed
relationship. This is summarily illustrated, for
instance, in the practice of nursing in disaster
occasions.
4. SynHSTTNE is a pandimensionally
transforming process of interconnectedness
among humanity and beyond infinity. Based
on the tenets of the Rogerian Science of
Unitary Human Beings, pandimensionality is
viewed as “a nonlinear domain without
spatial or temporal attributes” (Watson &
Smith, 2002), and transformation is the
outcome of the ever-evolving human
transcendence.
 Week 17:
Synchronicity in Human-Space-Time Theory of Nursing
Management

Synchronicity as “meaningful
connectedness” strengthens a more
human-to-human interaction co-creating
patterns, new interpretations or
meanings, new understanding, and
realities.

Application of the Synchronicity in the HST

Theory in Practice
Technological Knowing
- Adapted from Locsin (2015) Theory of
Technological Competency as Caring in
Nursing, TK is focused on providing authentic
and humane caring.
- Technological knowing is the process
that leads the nurse in sensing relevant data
and pattern information about the nursed in
interaction as persons and not as objects of
care (Locsin & Purnell, 2017).
Rhythmical Connecting
- it means dancing to the cadence of
treatments and nursing activities where each
meaningful, caring experience is not merely
an encounter, but a fit into a rhythmical
pattern through which the interconnectivity of
persons within the HST is nurtured.
Transformational Engaging
- means dancing to the cadence of
treatments and nursing activities where each
meaningful, caring experience is not merely
an encounter, but a fit into a rhythmical
pattern through which the interconnectivity of
persons within the HST is nurtured.
- In this process, transformational
learning is flourished by the engagement of
caring attributes, knowledge, and skills.

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