HUMANISTIC

NURSING
THEORY
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JOSEPHINE PATERSON AND

LORETTA ZDERAD
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Josephine Paterson
Was born on September 1,
1924, in Freeport, New York.

A graduate of Lenox Hill

Hospital School of Nursing and
St. John’s University.
 4

• Dr Paterson majored in
public health, completed
doctor of nursing science
degree at Boston
University – dissertation
in comfort.
LORETTA ZDERAD
5

Born on June 7, 1925 in

Chicago, Illionis.
She is a graduate of St.
Bernard’s Hospital School of
Nursing and of Loyola
University.
 6

• Dr Zderad majored in
psychiatric nursing,
completed her doctorate
at Georgetown University in
philosophy with dissertation
on empathy.
 7

• They met in the 1950’s whilst

working at Catholic University,
where their task was to create a
new program that would include
Psychiatric and Community Health
components as part of the graduate
program
 8

• Their friendship lasted over

35years.

• They shared experiences, ideas and

insight to form a concept that
evolved into the formal Theory of
Humanistic Nursing.
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HUMANISTIC
THEORY
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The Humanistic Nursing

Theory was first developed
in 1976. their initial
commitment to creativity
conceptualized
“NURSOLOGY”.
 11

• It is grounded on two ideas;

existentialism and
phenomenology.
 Existentialism
12

“a philosophical theory or approach

which emphasizes the existence of
the individual person as and
responsible agent determining their
own development through act of the
will.”(Oxford University Press, 2014)
Phenomenology 13

“an approach that concentrate on

the study of consciousness and
the object of direct
experience” . (Oxford
University Press, 2014)
 14

Paterson and Zderad

developed their own
humanistic nursing theory which
border on the belief that the
most vital aspect in nursing is
the nurse- patient relationship.
 15

This is accomplished through what is

describe as a “nursing dialogue”
(Paterson & Zderad, 1988).
Through the lived dialogue along
with the nurse’s presence, the
patient will be valued, respected,
understood and their autonomy
would be honored. (Paterson &
Zderad, 1988)
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FIVE PHASES OF
PHENOMENOLOGIC
NURSOLOGY
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Phase 1
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Phase 2
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Phase 3
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Phase 4
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Phase 5
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METAPARADIGM
Person
24

• The Humanistic Nursing Theory’s

main components are the patient
and the nurse. The patient may be
defined as a person, a family, a
community, or humanity in general.
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• Patient is perceived as an individual

and each situation as unique.
• Human beings, as a being; holistic in
nature, dynamic, aware and
multidimensional, capable of
abstract thought, creativity, and
capable of taking responsibility.
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• An open energy field which

have a special life experiences.

• Humanistic nursing theory

believed that patient can grow
in a healthy and creative way.
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Nursing
• The nurse is defined as the
person who the patient calls
and receives help from. A
nurse's goal is to help others
with their unique healthcare
needs.
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• The author believed that nursing

education should be formed in
experience and a nurse training
should focus as much on the ability
to relate to and interact with
patient and scientific and medical
backgrounds.
 29

• Nursing is a responsible searching,

transaction relationship whose
meaningfulness demands
conceptualization founded on a
nurse's existential awareness of
self and of the others.
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• Nursing, as a human response,

implies the valuing of some human
potential beyond the narrow
concept of health taken as absence
of disease.
 31
Health
• Peterson and Zderad do not
see health as the absence of
disease or an attainable and goal.
instead, they describe it as a
resource that patient can use to
help realize their own potential.
• "Health" is valued as necessary for 32

survival and is often proposed as

goal for nursing.

• There are instances of nursing that

could be describe as "health
restoring", "health sustaining", or
"health promoting", Nurses engage
in "health teaching" and "health
supervision".
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Environment
• The environment is seen as the
time and space where the
events are happening and
nursing experience take place.
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• Environment represents the place

where the service is delivered, the
community of world.

• Place is another component of

space, but it is more personalized;
it belongs to the patient or nurse
and is highly subjective.
GENERAL ASSUMPTIONS OF THE 35

THEORY
• Humanistic Nursing Theory
revolves around everyone being
their own unique person and how
the nurse should understand that.
No person or experience is the
same.
 36

• This should be respected and

reflected in the care provided to
the patient. Here, nursing care
should be multidimensional and
striving towards wholeness.
 37

• While the patient and the nurse

may have different concepts of
wholeness (a.k.a. “gestalts”), it is
also important to note the
similarities and use them to provide
proper nursing care.
• The Humanistic Nursing Theory has been applied in 38
research regarding hospice and palliative care. The
World Health Organization has stated the need
for quality end-of-life care as a priority for global
health care. Nurses specializing in such areas have
goals that resonate with the ideals of Paterson and
Zderad’s theory. After all, each patient should be
seen as his own unique person when being provided
with care. A nurse that embraces this idea will
better understand how to help these patients
towards their final goals in life (Wu and Volker,
2011).
• The theory has also been applied in regards to 39
China’s Children Caring Ward School (CCWS), the
pediatric department for Wuhon Union Hospital.
The CCWS is the first humanistic nursing school
among the hospital’s wards. This approach was
taken to see the effects of the theory on a nurse’s
caring ability, nurse-patient relationships, and
patients’ satisfaction. Results have been revealed
to be positive. After implementation, nurses were
found to have significantly developed their caring
ability in regards to cognition, courage, and
patience towards their clients (He et al., 2016).
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HUMAN TO
HUMAN
RELATIONSHIP
JOYCE TRAVELBEE
41
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• Joyce Travelbee was born in 1926,

she was a psychiatric nurse,
educator and writer.
• In 1956, she completed her
Bachelor of Science degree in
Nursing Education at Louisiana
State University and her Master of
Science Degree in Nursing from
Yale University in 1959.
 43

• She started a doctoral program in

Florida in 1973. Unfortunately, she
was not able to finish the program
because she died later that year.
She passed away at the prime age
of 47 after a brief sickness.
 44

• In 1952, Travelbee started to be an

instructor focusing in Psychiatric
Nursing at Depaul Hospital Affiliate
School, New Orleans, while working on
her baccalaureate degree. Besides that,
she also taught Psychiatric Nursing at
Charity Hospital School of Nursing in
Louisiana State University, New York
University and University of Mississippi.
 45

• In 1970, she was named Project

Director at Hotel Dieu School of
Nursing in New Orleans. Travelbee
was the director of Graduate
Education at Louisiana State
University School of Nursing until
her death.
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• In 1963, Travelbee started to publish

various articles in nursing journals. Her
first book entitled Interpersonal
Aspects of Nursing was published in
1966 and 1971. In 1969, she had her
second book published entitled:
Intervention in Psychiatrics Nursing:
Process in One-to-One Relationship.
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HUMAN TO HUMAN
RELATIONSHIP
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• Travelbee’s formulation of her theory was

greatly influenced by her experiences in
nursing education and practice in Catholic
charity institutions. She concluded that the
nursing care rendered to patients in these
institutions lacked compassion. She thought
that nursing care needed a “humanistic
revolution”- a return to focus on the caring
functions towards the ill person.
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• Travelbee based also the assumptions of her
theory on the concepts of existentialism by
Soren Kierkegaard and logotherapy by Viktor
Frankl.

• Existential theory believes that humans are

constantly faced choices and conflicts and is
accountable to the choices we make in life
 50

• Viktor Frankl, a survivor of

Auschwitz and other Nazi
concentration camps—proposed the
theory of logotherapy in which a
patient is actually confronted with
and reoriented toward the meaning
of his life. 
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• Travelbee ’s mentor, Ida Jean Orlando,
Orlando’s model has similarities to the model
that Travelbee proposes. The similarities
between the two models are shown in
Travelbee’s statement: “the nurse and patient
interrelate with each other and by her
description of the purpose of Nursing.” She
stated that the purpose of nursing is to “assist
an individual, family or community to prevent or
cope with the experience of illness or
suffering, and if necessary, to find meaning in
these experiences.”
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Description of the theory:

• Travelbee believed nursing is
accomplished through human-to-human
relationships that begin with the original
encounter and then progress through
stages of emerging identities, developing
feelings of empathy, and later feelings
of sympathy.
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Description of the theory:

• The nurse and patient attain a rapport in
the final stage. For meeting the goals of
nursing it is a prerequisite to achieving a
genuine human-to-human relationships.

• This relationship can only be established

by an interaction process.
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 Human-to-Human
Relationship Model
(Interaction Phase)
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Phase 1:  Original Encounter

This is described as the first

impression by the nurse of the
sick person and vice-versa. The
nurse and patient see each
other in stereotyped or
traditional roles.
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Phase 2: Emerging Identities

• This phase is described by the nurse and

patient perceiving each other as unique
individuals. At this time, the link of relationship
begins to form.
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Phase 3: Empathy

• This phase is described as the ability to share in

the person’s experience. The result of the
emphatic process is the ability to expect the
behavior of the individual whom he or she
empathized.
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Phase 4: Sympathy

• Sympathy happens when the nurse wants to lessen the cause of

the patient’s suffering. It goes beyond empathy. “When one
sympathizes, one is involved but not incapacitated by the
involvement.” The nurse should use a disciplined intellectual
approach together with therapeutic use of self to make helpful
nursing actions.
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Phase 5:  Rapport

• Rapport is described as nursing interventions that

lessens the patient’s suffering. The nurse and the sick
person are relating as human being to human being. The
sick person shows trust and confidence in the nurse.
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•  “A nurse is able to establish rapport because
she possesses the necessary knowledge and
skills required to assist ill persons, and because
she is able to perceive, respond to, and
appreciate the uniqueness of the ill human
being.”
Note that the above stated interactional
phases are in consecutive order and
developmentally achieved by the nurse and the
patient as their relationship with one another
goes deeper and more therapeutic.
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Human to Human Relationship

Model of Nursing :Seven Basic
Concepts
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1. Suffering
which is "an experience that varies in intensity,
duration and depth...a feeling of unease, ranging
from mild, transient mental, physical or mental
discomfort to extreme pain....“

2. Meaning
which is the reason attributed to a person
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3. Nursing
which helps a person find meaning in the
experience of illness and suffering; has a
responsibility to help people and their families find
meaning; and the nurse's spiritual and ethical
choices, and perceptions of illness and suffering,
which are crucial to help patients find meaning.
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4. Hope
which is a faith that can and will be a change that
would bring something better with it. Six important
characteristics of hope are: dependence on other
people, future orientation, escape routes, the
desire to complete a task or have an experience,
confidence that others will be there when needed,
and the acknowledgment of fears and moving
forward towards its goal.
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5. Communication
which is "a strict necessity for good nursing care.“

6. Self-therapy
which is the ability to use one's own personality
consciously and in full awareness in an attempt to
establish relatedness and to structure nursing
interventions. This refers to the nurse's presence
physically and psychologically.

7. Targeted intellectual approach by the nurse toward the

patient's situation.
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METAPARADIGM
Person
68

• is defined as being human. Nurse as well as

patient, family, or community under the
umbrella of illness is human. 
• "A person is a contingent being to whom things
happen which are beyond his control…The
person suffers and chooses. Through this
search for meaning he creates himself" .Human
beings are unique, irreplaceable, ever evolving,
and interacting (Travelbee, 1971).
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Nursing
• the assumption of nursing is to establish a
human-to-human relationship.

• It is within the paradigm of nursing that the

nurse facilitates the individual, family, or
community to prevent or cope with illness and
suffering. The nurse also assists with trying to
find meaning in these experiences.
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• Travelbee in her book, Travelbee

J. (1971)Interpersonal aspects of
nursing. 2nd ed. Page 119, insisted:
"The final measure of nursing
competency is always in terms of the
extent to which individuals and families
have been assisted with the problems of
illness and suffering" .
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Health
• is defined as being both subjective and
objective. Human beings perceive and
relate their own sense of health and
illness. To be human is to experience
illness.
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• Travelbee (1971) wrote: "A basic

assumption is that illness and suffering
are spiritual encounters as well as
emotional-physical experiences“.

• Humans may see illness as having merit

or as unavoidable. The presence of
distress may not cause one to seek help.
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Environment
•  is not well defined, which one might
relate to the timing of Travelbee’s
writing, the 1960s. Instead,
Travelbee relates that the nurse
must be observant of the patient in
the place where the patient is
present in order to ascertain that
the patient is in need.
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Importance:
• Travelbee provides nursing with the criteria for
connecting to ill persons. She has created a
conceptual framework upon which to base
therapeutic relationships with patients, families,
and communities in distress or having the potential
for suffering.
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• Travelbee’s model teaches nurses to

understand—or at least explore—the meaning
of illness and suffering in themselves. It is
through this existential identification that one
human being can relate to another human
being. 
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Theory Application:
• Travelbee’s Human-to-Human Relationship Theory that
patients are seen as unique individuals and as human
beings is in keeping with the current guidelines and
expectations set forth by agencies such as the Institute
of Medicine, the American Nurses Association, and the
Joint Commission for Hospital Accreditation.
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CONCLUSION:
• Travelbee’s grand theory of Human-to-Human
Relationships provides nurses with a foundation
necessary to connect therapeutically with other
human beings. The assumptions involve humans, who
are nurses, relating to humans who are suffering,
are in distress, or have the potential to suffer.
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CONCLUSION:
• Care should be patient-centered. The
theory is applicable to and has been used
in the hospice movement, helping
terminally ill individuals and their
families find meaning in suffering and
fostering hope, even at end of life.
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• “A nurse does not only seek to alleviate
physical pain or render physical care –
she ministers to the whole person. The
existence of suffering, whether
physical, mental or spiritual is the
proper concern of the nurse.”
- Joyce Travelbee 
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SOURCES:

• Alligood, Martha R. (2018). Nursing Theorists and Their

Work. Pgs 18-19.
• https://prezi.com/wluuzrylv3nz/humanistic-nursing-theory-j
osephine-paterson-and-loretta-zd/?webgl=0
• http://lormacollegesnursinginformatics2018.blogspot.com/2
018/07/paterson-and-zderad-humanistic-nursing.html
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SOURCES:
• http://www.nursing-theory.org/theories-and-models/travelbe
e-human-to-human-model-of-nursing.php
• https://grouphn207nursing-theory.fandom.com/wiki/Human-
To-Human_Relationship_Model_Joyce_Travelbee(1926-19
73)
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866131/