DIVINAGRACIA'S

COMPOSURE
MODEL
CARMELITA DIVINAGRACIA

 MEET THE REPORTS

KRIZIA FRANCIS JWENETH

LEIGH CHARLOTTE
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BACKGROUND OF
THE THEORIST
DR. CARMELITA DIVINAGRACIA

EDUCATION
Bachelor’s degree in Nursing at the University
of the East Ramon Magsaysay Memorial Medical
Center in 1962-
Master’s degree in Nursing at the University of
the Philippines in 1975
Doctorate’s degree in Nursing at the University
of the Philippines in 2001
 BACKGROUND OF
THE THEORIST
DR. CARMELITA DIVINAGRACIA
CAREER
Former President of The Association of the Philippine Colleges
of Nursing (ADPCN)
Dean of University of the East Ramon Magsaysay Memorial
Medical Center, Inc. (UERMMMC) College of Nursing
Member of CHED'S technical Committee on Nursing Education
Has been a clinic nurse, staff nurse, head nurse, instructor,
assistant dean and dean
Has lectured and written about her work as a nurse and has
use her hands-onexperience to develop better ways to teach
nursing
 BACKGROUND OF
THE THEORIST
DR. CARMELITA DIVINAGRACIA
CAREER
Filipino Nurse Theorist
Lauded by developing the art and competency of teaching
nursing.

AWARD
Anastasia Giron
Tupas Award
 IMPORTANT PRINCIPLES:
ASSUMPTION:
The wellness outcome of a patient will depend on the
intervention the nurse has when administering the client.

OBJECTIVE OF THE STUDY

Determine the effects of composure behavior of the advance nurse
practitioner on the wellness outcome of the selected cardiac patients

SIGNIFICANCE OF THE STUDY

Nursing as a healthcare profession would prove its worth of being at par
in quality performancewith other healthcare professionals.

STUDY POPULATION
Adult Cardiac Patients admitted and confined at the Philippines Heart
center, Coronary CareUnit.
 IMPORTANT PRINCIPLES:
DEFINITION OF TERMS:

ADVANCE NURSE PRACTIONERS

BSN graduate
Licensed and has a clinical experience of at least 2 years in the clinical
area
Has undergone special training in critical area
Set of behaviors or nursing measures that the nurse demonstrates to
selected cardiac patientS.

COMPOSURE BEHAVIORS
A condition of being in a state of well-being,
A coordinated and integrated living pattern that involves the dimension
of wellness
 MAJOR CONCEPTS
1. COMPOSURE BEHAVIOUR

COMPOSURE BEHAVIOUR
A set of behaviors determined by Dr.
Divinagracia that would be demonstrated by
advanced nurse practitioners to see how
would it affect the recovery of the patients in
the Coronary Care Unit of the Philippinbe
Heart Center.
COMPOSURE STANDS FOR: Nurses should be equipped
with knowledge and expertise
in consistency in caring for
their patients.
COMPETENCE
Pertains to the availability of
the nurse in time of need not
only physically but also
hostically
Utilization of therapeutic
PRESENCE AND communication techniques are
also included.
PRAYER
Nurses should be receptive to
different ideas such
asopinions and preferences
regarding the patient's
medical status.
OPEN-MINDEDNESS
A form of nursing measure
demonstrated by means of providing
encouragement and appreciation
that delivers hope and guidance in a
form of positive encouraging
STIMULATION remarks.
COMPOSURE STANDS FOR: It is an approach that conveys
interest and acceptance to
the patient's holistic being.
UNDERSTANDING

Acknowledging the presence of

the patients and showing
positive regard
RESPECT
Entails a form of exercise
that involves alternate
tension and relaxation of
selected group of muscles.
RELAXATION
The empathetic nurse perceives the
current positive thought and
feelings and communicates by
putting himawlf in the patient's
place.
EMPATHY
 MAJOR CONCEPTS
2. PATIENTS WELLNESS OUTCOME

A. PHYSIOLOGICAL OUTCOME
This refers to the perceived wellness of
selected orthopaedic patients after
receivingnursing care in terms of vital signs,
bone pain sensation, and complete blood
count.
A.PHYSIOLOGICAL OUTCOME
VITAL SIGNS
Clinical measurements, specifically
pulse rate, temperature, respiration
rate, and blood pressure, that indicate
the state of a patient's essential body
functions.

CHEST PAIN
Pain in the chest of the patient

HEMOGLOBIN
Blood count of the patient
 MAJOR CONCEPTS
2. PATIENTS WELLNESS OUTCOME

A. BEHAVIORAL OUTCOME
This refers to the perceived wellness of
selected orthopaedic patients after
receivingnursing care in terms physical,
intellectual, emotional, and spiritual.
B.BEHAVIORAL OUTCOME PHYSICAL
concerned or preoccupied with the body
and its needs.
Includes: muscle strength, mobility
posture, gait exercise and activity
tolerance and cardio- respiratory
endurance.

EMOTIONAL
relating to a person's emotions.
Includes:awareness,orientation,
understanding of own and other
personal feelings and ability

INTELLECTUAL
relating to your ability to think and
understand things, especially
complicated ideas,

SPIRITUAL
relating to religion or religious belief
and also defined as the development of
inner self or one's soul through a
relationship with God.
 NURSING
The quality of nursing care could be
improved using an intervention.
METAPARADIGM OF
THE THEORY
P Each
E Rindividual
S O Nneeds humane, caring,
spirituality- oriented intervention that
can facilitate wellness regardless of
creed, social class, gender, age and
nationality.

ENVIRONMENT
Not stated

HEALTH
Not stated
CONCEPTUAL
FRAMEWORK
CONCLUSION
(BASED ON RESEARCH)

1.) The Socio-demographic characteristics of the

participants specifically gender and age are related to
the wellness outcome of adult cardiac patients.

2.) A significant difference exist in the pre-test and

post-test scores of the wellness outcome after the
COMPOSURE behavior intervention in the (3) groups.

3.) The nursing profession can actively deliver quality

care through bio-behavioral carina interventions like the
COMPOSURE behaviors regardless of creed, social
class,gender,age and nationality. Each one needs humane
caring spiritually-oriented interventions.
ACCEPTANCE BY NURSING
COMMUNITY IN PRACTICE:
IN PRACTICE:
COMPOSURE behaviors inspired the principle of
holistic care wherein a patient's wellness outcome
can be achieved through series of quality
attributes of nurses, which caters every aspect of
Wellness, may it be biobehavioral or physiological.
Nurses, specifically Advance Nurse Practitioners
are to use the COMPOSURE behavior when
administering the client.
Divinagracia's COMPOSURE behavior is used when
providing care to the patient to achieve wellness.
ACCEPTANCE BY NURSING
COMMUNITY IN PRACTICE:
IN EDUCATION:
To prepare students to use Composure behavior for practice as
members of the professional community.
To develop, hone and guide nursing education through Composure
Theory.
Made as a basis of different universities in the Philippines.

IN RESEARCH:
Inspired nursing from different and quality theoretical and
conceptual framework.
Made as basis of other researchers.
THANK YOU!
Hav
a gr e
ea t
w ee
k!