NURSING

THEORIES 3
GLADYS C. YARES, RN RM

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 HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

Peplau is a psychiatric nurse

– Focus: Therapeutic process

– Attained through: Healthy

Nurse-Patient Relationship
 HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

Four (4) Phases of

Nurse-Patient Interaction

1. Orientation
• Nurse and patient test the
role each one assumes
• Prepares patient for termi
nation
• Patient identifies areas of
difficulty
 HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

2. Identification Phase
• Patient identifies with th
e personnel who can sati
sfy his needs

3. Exploitation Phase
• Nurse maximizes all the
resources to benefit the
patient
 HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

4. Resolution Phase or
Termination Phase
• Occurs when patient’s
needs have been met
 HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

Application
Significant in terms of the different p
hases of the N-Pt. interaction & the diffe
rent ROLES the N can play in giving nurs
ing care to pts. It thus becomes importa
nt for nurses to understand the principl
es behind each of these concepts so tha
t clinical nsg will be more meaningful for
the nurse. Eventually, this will translate t
o pt. outcomes like: Improved health
Prevention of Disease prevention
Enhancement of care faculties
 IDA JEAN ORLANDO:
NURSING PROCESS THEORY

The Nursing Process is an interaction of Three Basic Elements:

1. Patient’s Behavior
2. Nurse’s reaction
3. Nursing Actions – designed for the patient’s benefit

The Role of the Nurse is to find out & meet the patient’s immediate need for
help. Nurses should use his perception, thoughts about the perception or
the feeling engendered from their thoughts to explore with patients the
meaning of their behavior
IDA JEAN ORLANDO:
NURSING PROCESS THEORY

The use of the theory keeps the N’s focus on the patient

Application:
The Theory increases the Therapeutic Effectiveness of
nurses by the expression of Empathy, Warmth & Genuineness
esp in the light of addressing the Stat Need of the Patient for
help. This framework will be important for Ns who are
assigned in special clinical areas that requires quick decision
making & critical thinking skills.
If the patient’s condition improved, then the intervention is
effective and the patient moves on to new problems
 JOYCE TRAVELBEE
INTERPERSONAL ASPECTS OF NURSING THEORY
Human to Human Relationship
 Greatly emphasized on the Therapeutic Human
Relationship between the Nurse & the Patient.

 Her model emphasizes:

Empathy
Sympathy
Rapport & the
Emotional aspects of Nursing

4 Interlocking Phases that precedes RAPPORT

And the establishment of N-Pt. Relationship:
 Original Encounter
 Emerging Identities
 Empathy
 Sympathy
 JOYCE TRAVELBEE
INTERPERSONAL ASPECTS OF NURSING THEORY
Human to Human Relationship

Application:
The theory describes the various stages of
interpersonal elations that occur bet a Patient and
a N. It thus becomes important for Ns to fully
understand the phases and its effects to the
patient’s welfare. Due consideration should be
given to the pt’s inherent personal characteristics
to interact w/ other people, most especially Ns &
other members of the healthcare professions.
The key concept of Empthy, Sympathy,
Rapport & Emotional Understanding are very
important for the Ns of today because it makes
the patient feel human.
 LYDIA HALL
CORE, CARE, CURE MODEL

Individuals could be
conceptua- lized in 3 Separate
Domains:
1.CARE – hands on bodily care
2.CORE – using the self in rela-
tionship to the client
3.CURE – applying medical
knowledge
 LYDIA HALL
CORE, CARE, CURE MODEL
Nurses function in all 3 Domains but
in different Degrees.
1. CURE – limited to helping
patients/families deals w/ the
measures instituted by the
physician
2. CARE – exclusive for nursing
3. CORE – shared w/ Social workers,
Psychologists, Clergy & other
Professionals
LYDIA HALL
CORE, CARE, CURE MODEL
APPLICATION
Foundation for classifying the Professional Nurse’s
functions today. Nurses are able to carry out Nursing
Interven-----tions : INDEPENDENTLY,
DEPENDENTLY
INTERDEPENDENTLY

CORE – maintains that it is the N responsibility to make

sure that the client receives the highest level of care
possible from all concerned Hx Professionals.
Nurse’s ROLES: COLLABORATOR, COORDINATOR and
in COOPERATION with other members of the HX team
that pertains to PATIENT’S WELFARE.
 LYDIA HALL
CORE, CARE, CURE MODEL

CURE – clearly delineates nursing functions

that are DEPENDENT on the members of
the Medical Profession. Interventions
carried out needs a written
order from the doctor/s
CARE – refers to the independent roles & functions of the
Nurse insofar as her knowledge & skills about the patient’s
condition will allow her to carry on with her Nursing
Responsibilities
 FAYE ABDELLA:
PROBLEM SOLVING APPROACH TO
21 NURSING PROBLEMS
• Focus is on PROPER
IDENTIFICATION of
the problem

• Particularly about the

proper NURSING
DIAGNOSIS

• Nurse-centered
FAYE ABDELLA:
PROBLEM SOLVING APPROACH
TO 21 NURSING PROBLEMS
21 Nursing Problems
1.To maintain good hygiene.
2.To promote optimal activity: ex
ercise, rest, and sleep.
3.To promote safety.
4.To maintain good body mecha
nics.
5.To facilitate the maintenance o
f supply of oxygen.
6.To facilitate maintenance of nu
trition.
7.To facilitate maintenance of eli
mination.
FAYE ABDELLA:
PROBLEM SOLVING APPROACH
TO 21 NURSING PROBLEMS
8.To facilitate the maintenance of fluid
and electrolytes balance.
9.To recognize the physiologic respons
e of the body to disease conditions.
10.To facilitate the maintenance of regu
latory mechanisms and functions.
11.To facilitate the maintenance of sens
ory function.
12.To identify and accept positive and n
egative expressions, feelings and reacti
ons.
.
FAYE ABDELLA:
PROBLEM SOLVING APPROACH
13.To identify and accept the interre-
TO 21 NURSING PROBLEMS
latedness of emotions and illness
14. To facilitate the maintenance of
effective verbal and non-verbal com-
munication.
15. To promote the development of

productive interpersonal relationship.

16. To facilitate progress toward
achievement of personal spiritual
goals.
17. To create and maintain a
therapeutic environment.
FAYE ABDELLA:
PROBLEM SOLVING APPROACH
TO 21 NURSING PROBLEMS

18. To facilitate awareness of self

as an individual with varying
needs.
19. To accept the optimum possible
goals.
20.To use community resources as
an aid in resolving problems
arising from illness.
21.To understand the role of social
problems as influencing factors.
FAYE ABDELLA:
PROBLEM SOLVING APPROACH
TO 21 NURSING PROBLEMS

Application:
Bedside Nursing
The N’s ability to address & e
ffectively manage the 21 Nursing pr
oblems will spell the patient’s state
of health – whether he fully recover
s well & fast, or deteriorate further
with devastating consequences
Ns therefore, have very impo
rtant role to play. By adhering to th
ese nursing problems, the work of
a N becomes More Definite
 VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL NEEDS

Assisting sick or healthy

individuals to gain inde
pendence in meeting 14
fundamental needs

• Patient-centered
 VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL NEEDS
• Virginia Henderson’s
14 Fundamental Needs of a Person

1) Breathing normally
2) Eating and drinking adequately
3) Eliminating body waste
4) Moving and maintaining a desirable
position
5) Sleeping and resting
6) Selecting suitable clothes
7) Maintaining body temperature within
normal range by adjusting clothing and
modifying the environment
 VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL NEEDS
8) Keeping the body clean and well groomed to protect the
integument
9) Avoiding dangers in the environment and avoiding injuring
others
10) Communicating with others in expressing emotions,
needs, fears, or opinions
11) Worshipping according to one’s faith
12) Working in a such way that one feels a sense of
accomplishment
13) Playing or participating in various forms of recreation
14) Learning, discovering, or satisfying the curiosity that leads
to normal development and health, and using available
health facilities
 VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL NEEDS

Application:
Bedside Nursing
- pt.’s ability to perform the 14 basic needs should
be assessed before considering the kind of nursing
care function you will administer. Essential to
determine if the N will be performing as a HELPER,
DOER or a PARTNER
Nsg interventions are implemented according to
the 14 basic human needs of the patient. The degree of
performance, involvement of the pt. and the level of
nursing activity will be dependent on the specific role
the nurse will be playing
 NOLA PENDER:
HEALTH PROMOTION MODEL

• Focuses on 10 Categories of
determinants of health-
Promoting Behaviors.

• Views a person’s health-

promoting behavior in the
light of his individual charac-
teristics & experiences
 NOLA PENDER:
HEALTH PROMOTION MODEL
• The 10 Determinants are:
– Prior related behavior
– Perceived benefits of action
– Perceived barriers of action
– Perceived self-efficacy
– Activity related effect
– Interpersonal Influences
(family, friends, providers)
norms, support & models
 NOLA PENDER:
HEALTH PROMOTION MODEL
• The 10 Determinants are:
– Situational Influences
( options, demand characteris-
tics, aesthetics)
– Immediate competing de-
mands (low control) and pre--
ferences (high demand)
– Commitment to a plan of ac--
tion
– Personal Factors ( Biological,
Psychological, Sociocultural)
 NOLA PENDER:
HEALTH PROMOTION MODEL
Application:
Health Promotion Activities are the
major Focus of Hx Care Organizations.
In order for Patients to take on the
Behaviour we, Hx care professionals,
advise them to take, we should carefully
looked into a host of factors that can
influence his decision to really adopt the
behaviour.
It is important for Ns to be ROLE MODELS
for the pts.
 MADELEINE LEININGER:
TRANSCULTURAL NURSING THEORY
• Nursing is a HUMANISTIC and
SCIENTIFIC mode of helping
through CULTURE-SPECIFIC
PROCESS
• Emphasizes human caring
varies among cultures
• Culture Care Preservation and
Maintenance
• Culture Care Accommodation
and Negotiation
• Culture Care Restructuring and
Repatterning
MADELEINE LEININGER:
TRANSCULTURAL NURSING THEORY

Application:
Important esp because of the rapid expansion
of knowledge & increasing globalization with the
advent of advances in ICT.

Working Overseas
Impt to learn the cultures of other people
because each culture has its own sets of patterns,
expressions & values of caring.
Getting acquainted with the culture of a
country you are seeking employment as a
professional nurse will be a good stepping stone
towards a more fulfilling career in nursing.