HUMAN-TO-HUMAN

RELATIONSHIP
MODEL
“A nurse does not only seek to
alleviate physical pain or render
physical care – she ministers to the
whole person. The existence of the
suffering whether physical, mental or
spiritual is the proper concern of the
nurse.” 

JOYCE TRAVELBEE
1926-1973
A psychiatric nurse, educator and writer

Presented by:
ALYSSA AYA L. GERONIMO

Presented to:
DR. RACHEL LAXAMANA
Course Facilitator
INTRODUCTION

As nurses, we have the responsibility towards our patients. This responsibility does not only
focus on the physical defects, difficulties or illness they experience but as well as their total
being whether it may be emotionally, psychologically and spiritually. In being able to provide
quality health care to our patients, we must be able to have a good interaction and working
relationship with them. We must be able to gain their trust, respect and establish rapport as
well. As care providers, we must be able to assess the person as a whole not just by mainly
focusing in each problem that they verbalize, share or complain.

The theory of Joyce Travelbee indeed has a very great contribution not only to those who are in
the Psychiatric Nursing field but in the whole nursing practice. Not only should we be able to
assist them towards wellness but also to be able to find meaning in the situation or experiences
they had been through whether it may be good or bad. This theory does not only focus on the
patient but as well as with the nurse practitioner, both having a unique personality. 

ABOUT THE THEORIST

1956, she completed her BSN degree at Louisiana State University

1959, she completed her Master of Science Degree in Nursing at Yale University
She started Doctoral program in Florida in 1973. Unfortunately, she was not able to finish it
because she died later that year. She passed away at the prime age of 47 after a brief sickness.

WORKING EXPERIENCE

1952, Psychiatric Nursing Instructor at Depaul Hospital Affilliate School, New Orleans.
Also she taught at Charity Hospital School of Nursing in Louisiana State University, New York
University and University of Mississippi.
1970, the Project Director of Graduate Education at Louisiana State University School of Nursing
until her death.

PUBLICATIONS 

1963, started to publish articles and journals in nursing.

1966 and 1971, publication of her first book entitled Interpersonal Aspects of Nursing.
1969, when she published her second book Intervention in Psychiatric Nursing: Process in the
One-to-One Relationship.

Geronimo, Alyssa Aya L.

aiahgeronimo@gmail.com
THEORETICAL SOURCES

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.

Travelbee’s mentor, Ida Jean Orlando, is one of her influences in her theory. 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.”

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.

Geronimo, Alyssa Aya L.

aiahgeronimo@gmail.com
Nursing Metaparadigm 
1. Person
Person is defined as a human being. Both the
nurse and patient are human beings. A human
being is a unique, irreplaceable individual who is
in the continuous process of becoming, evolving
and changing. 

2. Health
Travelbee stated that health is measured by
subjective and objective health. “A person’s
subjective health status is an individually defined
state of well-being in accord with self-appraisal
of physical-emotional-spiritual status.” Objective
health is “an absence of discernible disease,
disability, or defect as measured by physical
examination, laboratory tests, assessment by a
spiritual director or psychological counselor.”
3. Environment
Environment was not clearly defined in Travelbee;s theory. She defined human conditions and
life experiences encountered by all men as sufferings, hope, pain and illness. These conditions
are associated to the environment.
Illness – being unhealthy, but rather explored the human experience of illness 
Suffering – is a feeling of displeasure which ranges from simple transitory mental, physical or
spiritual discomfort to extreme anguish and to those phases beyond anguish—the malignant
phase of dispairful “not caring” and apathetic indifference.
Pain – is not observable. A unique experience. Pain is a lonely experience that is difficult to
communicate fully to another individual. 
Hope – the desire to gain an end or accomplish a goal combined with some degree of
expectation that what is desired or sought is attainable 
Hopelessness – being devoid of hope

4. Nursing
“An interpersonal process whereby the professional nurse practitioner assists an individual,
family or community to prevent or cope with the experience of illness and suffering and, if
necessary, to find meaning in these experiences.” She explained that nursing is an interpersonal
process because it is an experience that occurs between the nurse and an individual or group of
individuals.
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com
Human-to-Human Relationship Model

In her human-to-human relationship model,

the nurse and the patient undergoes the
following series of interactional phases:

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. 

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.

3. Empathy
According Travelbee is the ability to penetrate or take part in and understand the mental state
of another person is in at this time. 
Ability to recognize and understand other people's feelings. It is often described as the ability to
put themselves in the place of others.

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.

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. “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.”

Geronimo, Alyssa Aya L.

aiahgeronimo@gmail.com
THE GOALS OF THE NURSE

1. The nurse helps the ill person cope with present problems.

The nurse is concerned with “here-and-now” problems as perceived and defined by the ill
person. She is not concerned with uncovering unconscious content or with tracking present
problems back through the patient’s earliest formative years. This is not to deny that such
information is useful (or interesting)-it does imply that the nurse’s primary aim is to help the
patient conceptualize his present problem. Knowledge of the ill person’s past history as
obtained from the chart, resource people and others is helpful insofar as what is learned guides
the nurse in structuring nursing intervention; however, the nurse does not probe or request
this information from the patient. If the patient reveals it, the nurse uses its knowledge to help
her understand his present problem. It is well to remember that there may be a discrepancy
between problems as perceived and defined by the patient and the patient’s problem as
perceived and defined by nurses, psychiatrists and etc.

2. The nurse helps the ill person to conceptualize his problem.

As stated previously, one of the goals in the interactive process is to assist the ill person to
identify or conceptualize problems as he perceives them. This is the primary focus of inquiry
throughout the series of interactions. Problems identified by patients will and do change as
relationship progresses.

3. The nurse assists the ill person to perceive his participation in an experience.

The nurse strives to assist the patient to see himself as an active participant in life and it’s
events. The practitioner strives to assist the patient to gain (or regain) a sense of immediacy- of
aliveness- and an appreciation of the uniqueness of his individuality. As the relationship
progresses, it becomes easier for the patient to acknowledge that he is an active participant in
life experiences and that what he thinks, feels, and does elicits a response from others. The
patient begins to realize that he affects the behavior of those about him. The patient also learns
that the individuals he encounters will react toward him on the basis of his behavior toward
them. This knowledge is gained slowly and over a period of time as the patient begins to
develop an appreciation of the cause-and-effect in behavior. 

4. The nurse assists the ill person to face emerging problems realistically.
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com
Problems, as initially conceptualized by the patient, frequently undergo a change. The initial
presentation by the patient of a somewhat “superficial” problem gradually changes, and deeper
problems begin to emerge as the relationship progresses and the patient is able to perceive his
participation in life experiences.

5. The nurse assists the ill person to envisage alternatives.

Many ill individuals resort to stereotyped means of solving problems. The nurse assists the ill
person to consider alternative means of solving problems in living. It may not occur to an ill
person that choices are possible in relation to his particular problem or, if choices do exist, he
cannot picture himself acting any differently than he has is the past. The ill person’s ability to
envisage alternatives is a legitimate subject of inquiry.

6. The nurse assists the ill person to test new patterns of behavior.

Another general goal in interacting with ill persons is to assist them to test new patterns of
behavior. A patient who has difficulty conversing with others is helped by talking with the
nurse. The nurse then assists the patient to interact with another patient in the unit. A patient
who has difficulty in approaching authority figures is helped by the nurse to approach the
psychiatrist. Nurse and patient together develop the plan and the patient tests the new pattern
of behavior. The extent to which the plan is successful is discussed during the nurse-patient
interaction. The aim of testing new behavioral skills to help the patient to gain confidence in
himself as a person who can plan, test, envisage alternatives and face the outcome of the
testing. As the result of gaining this ability the patient gains a deeper appreciation of himself as
an active participant in life experiences.

7. The nurse assists the ill person to communicate

Mentally ill individuals generally have difficulty in sharing their thoughts and feelings with
others. A general goal in the nurse-patient relationship is to assist the patient to communicate
logically and clearly with others and to become aware of what he communicates.

8. The nurse assists the ill person to socialize.

Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com
Mentally ill individuals generally have difficulty in socializing with others. The term socialize
means more than the ability to talk with others. An individual who has the ability to socialize
derives pleasure and enjoyment from interacting with others and is attentive to the needs of
others. Socialization is a reciprocal process. 

9. The nurse assists the ill person to find meaning in illness.

The nurse assists mentally ill individuals to find meaning in their suffering and distress.
“Meaning is the reason given to particular life experiences by the individual undergoing the
experience.” The term “meaning” is used in a restricted sense and refers only to those
meanings which enable the ill individual not only to submit to illness, but to use it as an
enabling life experience.

THEORY ANALYSIS
Empirical Precision
Clarity -Defines concepts theoretically but does not
-Clearly states the main conceptand only define them operationally. 
focuses on the relationship and only focuses -Numerous researches in research studies
on the relationship between the nurse and have cited some aspects of the one-to-one
patient then vice versa. relationship projected by Travelbee. One
study by O’Connor, Wicker and Germino,
Simplicity which is nearly related to some of
-Not simple. Contains different variables.  Travelbee’s ideas, discovers how individuals
-Definition of terms came from dictionaries who were recently diagnosed with cancer
and books etc.  described their personal search for
-Used different terms for the same meaning.
definition. 
Derivable Consequences
Generality -Development of quality of caring. 
-Has wide scope of application but -It is useful because of its ability to describe,
applicable only to those patients in distress explain, predict and control a phenomena. 
and life changing events.  -Explains the variables that affect the
-Focus more on adult individuals who are establishment of a therapeutic relationship
sick and the nurse’s role in helping them to between
REFERENCE nurses and patients
Octaviano, E.F. & Balita, C.E. (2008). Theoretical foundations
find meaning in their sickness and suffering. of nursing: The Philippine perspective. Perspective.
Philippines: Ultimate Learning Series. 
Tomey, A.M. & Alligood, M.R. (2002). Nursing theorists and
their work (5th ed.) .Missouri: Mosby
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com