Made by Jao, Jucom, Neyra, & Vicada
BSN1C
Theorist PERSON
LEININGER - Referred to as a human being
- Caring and capable of being
concerned about desires,
welfare, and continued
existence of others
- Although care of human
beings is universal, ways
of caring vary across
cultures
KOLCABA - Patient, not person
- Recipients of care may be
individuals, families,
institutions or communities in
need of health care
- Ex. if the patient has
tuberculosis. The nurse is
also concerned with the
ppl the patient came in
contact with
NCM 200 - FINALS SUMMARY
METAPARADIGMS
ENVIRONMENT
- Environmental Framework
- The totality of an event,
situation, or experience
that gives meaning to
human expressions,
interpretations, & social
interactions
- Physical, Ecological,
Sociopolitical, and/or
Cultural Settings
- Culture
- Centers on groups and
the patterning of actions,
thoughts, and decisions
- Occurs as the result of
“learned, shared, and
transmitted values,
beliefs, norms, and
lifeways”
- The environment is any
aspect of the patient, family, or
institutional setting that can be
manipulated by the nurse,
loved ones, or the institution to
enhance comfort
- Also given by Florence
Nightingale
HEALTH
- State of well-being that is
culturally defined, valued, &
practiced
- The ability of
individuals/groups to perform
their daily roles
- Includes Health–
- Systems
- Care practices
- Patterns
- Promotion &
Maintenance
- Universal across cultures but
distinct within each culture
- Representation of beliefs,
values, & practices of a
particular culture
- Universal & Diverse
- Optimal functioning of a
patient, family, health care
provider, or community as
defined by the patient or group
NURSING
- Learned humanistic art &
science
- Focuses on personalized
behaviors, functions, &
processes to promote and
maintain health or recovery
from illness
- 3 Modes of Action
- Culturally-based
- Consistent with the needs
& values of the client to
deliver care in the
manner best suited to a
client’s culture
1. Culture Care
Preservation /
Maintenance
2. Cultural Care
Accommodation /
Negotiation
3. Cultural Care
Repatterning /
Reconstructing
- The intentional assessment
of comfort needs, the design
of comfort, interventions to
address those needs, and
reassessment of comfort
levels after implementation
compared with a baseline
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LOCSIN - A “whole” person
- Complete in the moment
and continually growing
- Changing in response to
unique personal
conditions and
experiences
- Appreciated through his or her
component parts
- Including sensory data
about a person obtained
through technology
- It is easy for nurses to fall into
the practice of objectification
of persons and considering
nursing as merely the
completion of tasks
- Centers mainly on the
technological world
- Technology use allows greater
insights into the whole state of
health
- Competence in
technological knowledge
allows for continual
movement between tasks
and improved presence
with patients through
mastery
- Technology and machine skill
competence is only a tool for
optimal patient care
- The focus of care is the
person as a whole
Made by Jao, Jucom, Neyra, & Vicada
- “Enhancing of personhood”
- Allows each person to
develop and progress
moment to moment
- It is important to avoid
considering persons as
existing with a “box of
predicted conditions” needing
to be fixed
- Each person is unique
and individual
- The definition of health
varies from person to
person depending on
their hopes and desires
BSN1C
- Compassion, confidence,
commitment, and conscience
are all essential components
of caring in nursing
- The level of knowledge a
nurse has is not what makes
the person the focus of
nursing
- The intentional and
authentic presence
brought into the situation
enables the nurse to
know the other as a
person living unique
hopes, dreams, and
aspirations
- The function of the nurse
- Be with patients in the
pursuit of their health
goals and desires
through caring and
intentional relationships
- The nurse is challenged to be
technologically proficient while
responding authentically and
intentionally to calls for
nursing
- Technological competence as
an expression of caring is only
fulfilled with expertise in the
technologies of nursing
- Nurses act as the
“interface” between
technology and patients
- Both use technology
to know patients
more wholly and to
help patients more
fully understand the
role of technology in
their care
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ABAQUIN - Her theory is specific to
patients in advanced stages of
cancer
- They are holistic beings 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
KUAN
HALL - The individual human who is
16 years of age or older and
past the acute stage of
long-term illness is the focus
of nursing in Hall’s work
- The source of energy and
motivation for healing is the
individual/person care
recipient, not the healthcare
provider
- Emphasizes the importance of
a person as unique, capable
of growth and learning, and
requiring a total person
approach
PENDER NONE
- Just like all the other
paradigms, the environment
was not defined accurately
- Nevertheless, we can assume
that environment is an aspect
or dimension integrated into
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
NONE
- Dealt in relation with the
person/individual
- Conductive to
self-development
- The focus of action of the
nurses is the individual so that
actions taken in relation to
society or the environment are
for the purpose of assisting
the individual in attaining a
personal goal
Made by Jao, Jucom, Neyra, & Vicada
- 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.
- State of self-awareness with
the conscious selection of
behavior that is optimal for the
individual
- Stresses the need to help the
person explore the meaning of
his or her behavior to identify
and overcome problems
through developing
self-identity and maturity
- Defines “health” as a positive
dynamic state rather than
simply the absence of disease
BSN1C
- The goal of nursing care is the
improvement of quality of life
for advance stage cancer
patients despite their current
situation.
- The “participation in care,
core, and cure aspects of
patient care
- CARE is the sole function
of nurses
- CORE and CURE are
shared with other
members of the health
team”
- The major purpose of care is
to achieve an interpersonal
relationship with the individual
that will facilitate the
development of the core
NONE
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PEPLAU - A man who is an organism
that lives in an unstable
balance of a given system
- Defined as forces outside the
organism and in the context of
the socially approved way of
living, from which vital human
social processes are derived
such as norms, customs, and
beliefs
- However, these given
conditions the led to health
always include the
interpersonal process
Made by Jao, Jucom, Neyra, & Vicada
- A word that symbolizes the
movement of the personality
and other ongoing human
processes that direct the
person towards creative and,
constructive, productive, and
community living
- Peplau also gave importance
to the belief that for one’s
health to be achieved and
maintained, his needs must be
met
- These needs are physiological
demands and interpersonal
conditions
BSN1C
- Described as a significant,
therapeutic interpersonal
process
- Is a human relationship
between an individual who is
sick or has felt need and a
nurse who is educated to
recognize and respond to the
need for help
- Achieve its goal by promoting
the patient’s development of
skills to deal with problems
and achieve health
- This is a mutual and
collaborative process that
attempts to resolve this
problem
- Views nursing process as
having sequential steps that
focus on therapeutic
interactions
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THEORY / MODELS / WHATEVER THEY DID

LEININGER DEFINITION OF THEORY

Cultural Care Diversity & - A systematic and creative way to discover knowledge about something or to account for some vaguely known phenomenon
Universality Theory - Nursing Theory
- Must take into account the cultural belief, caring, behaviors, and values of individuals, families, and groups to provide effective,
satisfying, and culturally congruent nursing care

CULTURAL CARE DIVERSITY & UNIVERSALITY THEORY

- Different cultures perceive, know, & practice care in different ways, yet there are some commonalities about care among all cultures of
the world
- Based on Transcultural Nursing Model
- A learned branch of nursing that focuses on the comparative study & analysis of culture as they apply to nurse and health-illness
practices, beliefs, and values
- Goal
- Provide care that is congruent with cultural values, beliefs, and practices
- Care
- Assisting, supporting, or enabling behaviors that ease or improve a person’s condition
- Essential for a person’s survival, development, and ability to deal with life’s events
- Different meanings in different cultures, determined by:
- Examining the group’s view of the world, social structure, and language
- Caring
- Actions and activities directed toward assisting, supporting, or enabling another individual or group with evident or anticipated needs
to improve the human condition either to recover or face death
- Culture
- Learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular
- Guides thinking, decisions, and actions in specific ways
- The basis for cultural values
- Identifies ways of thinking or acting
- Usually held for a long time and help guide decision-making in the culture
- Exhibits both Diversity & Universality
- Diversity: perceiving, knowing, and practicing care in different ways
- Universality: commonalities of care
- Cultural Care
- Subjectively and objectively obtained values, beliefs, and outlines of the lifeways that assist, support, facilitate, or empower another
individual/group to maintain well-being, health, and deal with illness, handicaps, or death
- Cultural Care Diversity
- Different meanings, patterns, values, beliefs, or symbols of care within concepts that are related in supporting and assisting
human care
- such as the role of a sick person
- Ex. masakit ulo ni patient - others get OTC medicine, others have hilot muna before resorting to meds

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- Cultural Care Universality
- Commonalities or similarities in meanings, patterns, values, beliefs, or symbols of care
- Observed among many cultures and reflect assistive ways to help people
- Ex. post-operation - give pain reliever right away, no one resorts to hilot
- World View
- Outlook of a person/group on the world or their universe to form a picture or a value perception about their life or world around them
- Social Structure
- Organizational factors of a particular culture and how these factors give meaning and order to the culture
- ex; religion, economics, education
- Environmental Context
- The totality of an event, situation, or experience that gives meaning to human expressions, interpretations, & social interactions
- Physical, Ecological, Sociopolitical, and/or Cultural Settings
- Ethnohistory
- Past facts, events, and experiences of individuals, groups, and various cultures and institutions that are mainly people-centered
- Explains and interprets human lifeways within particular cultural trends
- Generic (Folk or Lay) Care System
- Culturally learned & transmitted
- Indigenous (or traditional) folk (community & home-based) knowledge and skills used to provide assistive, supportive, and enabling
acts towards another individual/group/institution
- Evident needs to improve a human lifeway or health condition (well-being) or to deal with handicaps and death situations
- Ex. hilot - they don’t have principles on why hilot would relieve the ‘pain’
- Professional Care System
- Formally taught, learned, and transmitted professional care, health, illness, wellness, and related knowledge & practice skills
- Prevail in professional institutions usually with multidisciplinary personnel to give service to others
- 3 Modes of Nursing Action
- Cultural Care Preservation or Maintenance
- Assistive, supporting, facilitative, or enabling professional actions and decisions that help people of a particular culture to retain
and/or preserve relevant care values so that they can maintain their well-being, recover from illness, or face handicaps and/or
death
- Cultural Care Accommodation or Negotiation
- Assistive, supporting, facilitative, or enabling professional actions and decisions that help people of a designated culture to
adapt to or negotiate with others for a beneficial or satisfying health outcome with professional care providers
- Cultural Care Restructuring or Repatterning
- Assistive, supporting, facilitative, or enabling professional actions and decisions that help clients change or greatly modify their
lifeways for new, different, and beneficial health care patterns while respecting the client’s cultural values and beliefs & still
providing a beneficial or healthier lifestyle before the changes were laid out with the clients

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KOLCABA COMFORT
The Theory of Comfort - An antidote to the stressors inherent in health care situations today, and when comfort is enhanced, patients and families are
strengthened for the task ahead. In addition, nurses feel more satisfied with the care they are giving
- The immediate experience of having the need to have relief, ease, and coincidence in which the context is being experienced

TAXONOMIC STRUCTURE OF COMFORT

- Used to organize information
- Used as the hierarchy of objects on which
objects you are going to give priority to
- Relief
- The state of the patient who has had a specific need met
- Ex. if pain medication is given to a post-op patient, there is a relief of comfort
- Ease
- Will address the comfort of the patient itself
- State of calm and contentment
- Ex. to make the patient at ease, stress and anxiety(stressor because of the pain), the stressor is being calmed down
- Transcendence
- What the patient thinks
- The state in which one rises above one’s problems of pains
- Will the pain be relieved for hours
- Physical
- Pertaining to bodily sensations
- Psychospiritual
- Pertaining to the internal awareness of self
- Environmental
- Pertaining to the external surroundings, conditions, and influences
- Social
- Pertaining to interpersonal, family, and societal relationship

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MAJOR CONCEPTS & DEFINITIONS
- Health Care Needs
- Needs for comfort arising from stressful health care situations that cannot be met by recipients’ traditional support systems
- Comfort Interventions
- Nursing actions designed to address specific comfort needs of the recipient
- Intervening Variables
- Interacting forces that influence recipients’ perceptions of total comfort
- Consider age, attitude, etc
- Comfort
- The state experienced by recipients of comfort interventions
- Health Seeking Behaviors
- A broad category of outcomes related to the pursuit of health as defined by the recipient in consultation with the nurse
Health-Seeking Behaviours (HSBs) was synthesized by Schlofeldt (1975) and proposed to be internal, external, or a peaceful death
- Best Practices
- Use healthcare interventions based on evidence to produce the best possible patient and family outcome
- Institutional Integrity
- Cooperations, communities, schools, hospitals, regions, states, and countries that possess qualities of being complete, whole,
sound, upright, appealing, ethical, and sincere
- Best Policies
- Institutional or regional policies ranging from protocols for procedures and medical conditions to access and delivery of health care

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FOUR (4) MAJOR THEORETICAL
- Comfort is generally state-specific
- The outcome of comfort is sensitive to change over time
- Any consistently applied holistic nursing intervention with an established history for effectiveness enhances comfort over time
- Total comfort is greater than the sum of its parts

MAJOR ASSUMPTIONS
- Human beings have holistic responses to complex stimuli
- Comfort is a desirable holistic outcome that is germane to the discipline of nursing
- Comfort is a basic human need that persons strive to meet or have met. It is an active endeavor
- Enhanced comfort strengthens patients to engage in health-seeking behaviors
- Patients who are empowered to actively engage in health-seeking behaviors are satisfied with their health care
- Institutional integrity is based on a value system oriented to the recipient care of equal importance in as orientation to a health-promoting,
holistic setting for families and

ACCEPTANCE BY THE NURSING COMMUNITY

- Practice
- Students and nurse researchers have frequently selected this theory as a guiding framework for their studies in areas such as
nurse-midwifery, hospice care, perioperative nursing, long-term care, stressed college students, dementia patients, and palliative
care
- When nurses ask patients or family members to rate their comfort from 0 to 10 before and after an intervention or at regular
intervals, they produce documented evidence that significant comfort work is being done
- Perianesthesia nurses have incorporated the Theory of Comfort into their Clinical Practice Guidelines for the management of patient
comfort
- Education
- The theory proved to be easy for faculty to understand and apply and provided an effective method to role-model a supportive
learning partnership with the students
- The theory is appropriate for students to use in any clinical setting, and its application can be facilitated by the use of Comfort Care
Plans available on Kolcaba’s website
- The taxonomic structure and conceptual framework guided ways of being a comforting faculty member
- The theory provided ways for students to obtain relief from their heavy course work by facilitating questions to their clinical
problems, maintaining ease with their curriculum through trusting their faculty members, and achieving transcendence from their
stressors with the use of self-comforting techniques
- Research
- Nurses can provide evidence to influence decision making at institutional, community, and legislative levels through studies that
demonstrate the effectiveness of comforting care
- Using the taxonomic structure of comfort as a guide, Kolcaba developed the General Comfort Questionnaire to measure holistic
comfort in a sample of hospital and community participants
- Researchers are welcome to generate comfort questionnaires specific to their areas of research. The verbal rating scales and other
traditionally formatted questionnaires may be downloaded from Kolkaba’s website, where she also responds to inquiries in an effort
to enhance the use of her theory

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LOCSIN TECHNOLOGICAL COMPETENCY AS CARING IN NURSING
Technological - Is a middle-range theory grounded in nursing as Caring
Competency as Caring in - It is illustrated in the practice of nursing grounded in the harmonious coexistence between technology and caring in nursing
Nursing - The assumptions of the theory are:
- Persons are caring by virtue of their humanness
- Persons are whole or complete at the moment
- Knowing persons is a process of nursing that allows for the continuous appreciation of person moment to moment
- Technology is used to know the wholeness of person moment to moment
- Nursing is a discipline and a professional practice

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
(prostheses) or organic (transplantation of organs)
- Technology as machine technologies, e.g. computers and gadgets enhancing nursing activities to provide quality patient care
- 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’
a. Technological competency as caring is nursing the harmonious coexistence between technologies and caring in nursing
b. The harmonization of these concepts places the practice of nursing within the context of modern healthcare and acknowledges
that these concepts can co-exist
c. Technology brings the patient closer to the nurse. Conversely, technology can also increase the gap between the nurse and
nursed
d. When technology is used to know persons continuously at the moment, the process of nursing is lived

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THE PROCESS OF NURSING
A. Knowing:
- The process of knowing a 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, in this process, technology is used to magnify the aspect of the person that requires
revealing - representation of the real person
- The person’s state change moment to moment - a person is dynamic, living, and can not be predicted
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 know persons
- In this stage of the process is the alternating rhythm of implementation and evaluation
- The evidence of continuous knowing, implementation, and participation is reflective of the cyclical process of knowing persons
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

ABAQUIN PREPARE ME THEORY

Prepare Me Theory - The concept of providing holistic nursing care in addressing the multidimensional problems that cancer patients face is summarized in
the acronym PREPARE ME
- Provides a framework on non-pharmacologic, non-surgical approach, of care to advanced cases of cancer patients\
- The focus is not on cure but on assisting the patient to explore her humanity and internal serenity as one is faced with the challenge of
life and death
- Nurses must be seen not as mere caregivers but facilitators of peaceful acceptance of the condition
- Presence
- Being with another person during 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 circumstance
- Prayer
- An act or practice of praying to God
- Relaxation-Breathing
- Techniques to encourage the solicit relaxation for the purpose of decreasing undesirable signs and symptoms such as pain, muscle
tension, and anxiety
- Meditation
- Encourages an elicit form of relaxation for the purpose of altering a patient's level of awareness by focusing on an image or thought
to facilitate inner sight which helps establish connection and relationship with God
- It may be done through the use of music and other relaxation techniques

VALUE CLARIFICATION
- Assisting another individual to clarify his own values about health and illness in order to facilitate effective decision-making skills

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- Through this, the patient develops an open mind that will facilitate acceptance of the disease state or may help deepen or enhance
values
- The process of values clarification helps one become internally consistent by achieving a closer between what we do and what we feed

QUALITY OF LIFE
- Defined as a multifaceted construct that encompasses the individual's capabilities and abilities of enriching life when it can no longer be
prolonged
- This includes proper care and maintaining the 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

KUAN RETIREMENT AND ROLE DISCONTINUITIES THEORY

Retirement and Role - Retirement is another phase in a person’s life that would require some adjustments
Discontinuities Theory - There are some roles that the person has already learned to play for many years
- Now that the rule has to be discontinued, there is a period of adjustment so that the person can adjust to yet again, another new role in
his/her life
- There are different things that can make the role discontinuity and retirement become positive in people’s lives

BASIC ASSUMPTIONS AND CONCEPTS

- Physiological Age
- Endurance of cells and tissues to withstand the wear-and-tear phenomenon of the human body
- Some individuals are gifted with a strong genetic affinity to stay young for a long time
- Role
- Refers to the set of shared expectations focused upon a particular position
- May include beliefs about what goals or values the position incumbent is to pursue and the norms that will govern his behavior
- The set of shared expectations from the retiree’s socialization experiences and the values internalized while preparing for the
position as well as the adaptations to the expectations socially defined for the position itself
- Change of Life
- The period between near retirement and post-retirement years
- In medico-physiologic terms, this equates with the climacteric period of adjustment and readjustment to another tempo of life
- Retiree
- 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
- The interruption in the line of status enjoyed or role performed
- This 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 DISCONTINUITIES
- Health Status

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- The physiological and mental state of the respondents, classified as either sickly or healthy
- Income
- (economic level) refers to the financial affluence of the respondent which can be classified as poor, moderate or rich
- Work Status
- Status of the individual according to his/her work
- Family Constellation
- Means family composition described either close-knit or extended family where three or more generations of family members live
under one roof; or distanced family, whose members live in separate dwelling units; or nuclear type or family where only husband,
wife, and children live together
- Self-Preparation
- Preparing of self to the possible outcome in life

FINDINGS AND RECOMMENDATIONS

- Health Status
- Dictates the capacities and the type of role one takes both for the present and for the future
- It fits for everyone to maintain and promote health at all ages because only proper care of the mind and body is needed to maintain
health in old age
- Income
- Has high correlation with both the perception of retirement and reactions towards role discontinuities
- Since income is one of the factors that secure the outlook of an individual, efforts must be exerted to save and spend money
wisely while still actively earning in order to have some reserve when one grows old
- It also implies that retirement pensions should be adjusted to meet the demands of the elderly
- This should be done in order to have a more relevant and realistic pension and benefits adjustment
- Work Status
- Goes hand in hand with economic security that generates decent compensation
- For the retired, it implies that retirement should not be conceptualized as a period of no work because capabilities to function
get sharpened and refined as they practice it on a regular basis
- Work enhances the aspects of self-esteem and contributes to the feeling of wellness even in old age
- Family Constellations
- A positive index regarding retirement positively and also in reacting to role discontinuities
- In the Philippines, the family undoubtedly stands as the security or trusting bank where all members, young and old can always run
and get help
- When one retires, the shock of the role discontinuities is softened because the family not only cushions the impact but also offers
gainful substitutes, as in providing monetary support, absorbing emotional strains that oftentimes with discontinuities and other
forms of surrogating
- Self-preparation
- Said to be both therapeutic and recreational in essence pays its worth in old age
- Does not only account professionalism or expertise but also benevolent work as in charitable actions with the colleagues
- Investing not in monetary benefits but in something that gives them dignity, enhance their feelings of self-worth, and happiness
- To cope with the changes brought by retirement,
- One must cultivate interest in recreational activities to channel feelings of depression or isolation and facing realities through
confrontation with some issues

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- To perceive retirement positively,
- It requires early socialization of the various roles we take in life
- The best place to start is at home extending to schools, neighborhoods, the community, and society in general
- Important decisions are rich should be eliminated in order to give recognition and appreciation of the knowledge, wisdom,
experience, and values which are the social assets that make the retirement age and custodians’ folk wisdom
- Government Agency
- To construct a holistic pre-retirement preparation program which will take care of the retiree’s finances, psychological, emotional,
and social needs
- Retirement
- Should be recognized as the fulfillment of every individual’s birthright and must be lived accordingly

HALL ASSUMPTIONS
Care, Cure, Core Theory 1. The motivation and energy necessary for health exist within the patient, rather than in the healthcare team
2. The three aspects of nursing should not be viewed as functioning independently but as interrelated
3. The three aspects interact, and the circles representing them change the size, depending on the patient’s total course of progress

CARE, CURE, CORE THEORY

- Hall’s nursing theory is sometimes called The Cs of Lydia Hall
- The three components are represented by three separate but interconnected circles
- The size of each circle constantly varies and depends on the state of the patient
- The theory emphasizes the total patient rather than looking at just one part and depends on all three components of the theory working
together
- The major purpose of care is to achieve an interpersonal relationship with the individual that will facilitate the development of the core
- As Hall says, “To look at and listen to self is too often too difficult without the help of a significant figure (nurturer) who has learned how to
hold up a mirror and sounding board to invite the behaver to look and listen to himself. If he accepts the invitation, he will explore the
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concerns in his acts and as he listens to his exploration through the reflection of the nurse, he may uncover in sequence his difficulties
the problem area, his problem, and eventually the threat which is dictating his out-of-control behavior.”

SUBCONCEPTS: THE CARE CIRCLE

- Care: The Body (Intimate Bodily Care)
- This circle solely represents the role of nurses and is focused on performing the task of nurturing patients
- Nurturing involves using the factors that make up the concept of mothering (care and comfort of the person) and providing for
teaching-learning activities
- The care circle defines the primary role of a professional nurse such as providing bodily care for the patient and helping the patient
complete such basic daily biological functions as eating, bathing, elimination, and dressing
- When providing this care, the nurse’s goal is the comfort of the patient
- Moreover, the role of the nurse also includes educating patients, and helping a patient meet any needs he or she is unable to meet alone
- This presents the nurse and patient with an opportunity for closeness
- As closeness develops, the patient can share and explore feelings with the nurse

SUBCONCEPTS: THE CORE CIRCLE

- Core: The Person (Therapeutic Use of Self)
- The core, according to Hall’s theory, is the patient receiving nursing care
- The core has goals set by him or herself rather than any other person and behaves according to his or her feelings and values
- This involves the therapeutic use of self and is shared with other members of the health team
- This area emphasizes the social, emotional, spiritual, and intellectual needs of the patient in relation to family, institution, community, and
the world
- This is able to help the patient verbally express feelings regarding the disease process and its effects by the use of the reflective
technique
- Through such expression, the patient is able to gain self-identity and further develop maturity
- Reflective Technique
- Used by the professional nurse in a way that he or she acts as a mirror to the patient to help the latter explore his or her own
feelings regarding his or her current health status and related potential changes in lifestyle
- Motivations
- Are discovered through the process of bringing into awareness the feelings being experienced, with this awareness, the patient is
now able to make conscious decisions based on understood and accepted feelings and motivation

SUBCONCEPTS: THE CURE CIRCLE

- Cure: The Disease (Seeing the patient and family through medical care)
- The cure as explained in this theory is the aspect of nursing which involves the administration of medications and treatments
- Hall explains in the model that the cure circle is shared by the nurse with other health professionals, such as physicians or physical
therapists
- In short, these are the interventions or actions geared toward treating the patient for whatever illness or disease he or she is suffering
from
- During this aspect of nursing care, the nurse is an active advocate of the patient

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PENDER HEALTH PROMOTION THEORY
Health Promotion Theory - Notes that each person has unique personal characteristics and experiences that affect subsequent actions
- Health promoting behavior is the desired behavioral outcome and is the endpoint in the health promotion model
- Health promoting behavior should result in improved health, enhanced functional ability, and better quality of life at all stages of
development
- The final behavioral demand is also influenced by the immediate competing demand and preferences, which can derail intended
health-promoting actions
- It defines “Health” as a positive dynamic state rather than simply the absence of disease
- Health promotion is directed at increasing a patient’s level of well-being
- The help promotion model describes the multidimensional nature of persons as they interact within their environment to pursue health
- Designed to be a “complementary counterpart to models of health protection”
- It develops to incorporate behaviors for improving health and applies across the life span
- Its purpose is to assist nurses in knowing and understanding the major determinants of health behaviors as a foundation for behavioral
counseling to promote well-being and healthy lifestyles

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- The model focuses on the following three areas:
- INDIVIDUAL CHARACTERISTICS AND EXPERIENCES
- Prior related behavior and personal factors
- BEHAVIOR-SPECIFIC COGNITIONS AND AFFECT
- Perceived benefits of action, perceived barriers to action, perceived self-efficacy, activity-related affect, interpersonal
influences, and situational influences
- BEHAVIORAL OUTCOMES
- Commitment to a plan of action, immediate competing demands and preferences, and health-promoting behavior

SUBCONCEPTS OF THE HEALTH PROMOTION MODEL

- Personal factors
- Categorized as biological, psychological, and socio-cultural. These factors are predictive of a given behavior and shaped by the
nature of the target behavior being considered
- Personal Biological factors
- Include variables such as age, gender, body mass index, pubertal status, aerobic capacity, strength, agility, or balance
- Personal Psychological Factors
- Include variables such as self-esteem, self-motivation, personal competence, perceived health status, and definition of
health
- Personal Socio-cultural factors
- Include variables such as race, ethnicity, acculturation, education, and socioeconomic status
- Perceived Benefits of Action
- Anticipated positive outcomes that will occur from health behavior
- Perceived Barriers to Action
- Anticipated, imagined, or real blocks and personal costs of understanding a given behavior
- Perceived Self-Efficacy
- Judgement of personal capacity to organized and execute a health-promoting behavior
- Perceived self-efficacy influences perceived barriers to action so higher efficacy results in lowered perceptions of barriers to the
performance of the behavior
- Activity-Related Affect
- Subjective positive or negative feeling that occurs before, during, and following behavior based on the stimulus properties of the
behavior itself
- Activity-related affect influences perceived self-efficacy, which means the more positive the subjective feeling, the greater the
feeling of efficacy. In turn, increased feelings of efficacy can generate a further positive effect
- Interpersonal Influences
- Cognition concerning behaviors, beliefs, or attitudes of the others. Interpersonal influences include norms (exceptions of significant
others), social support (instrumental and emotional encouragement) and modeling (vicarious learning through observing others
engaged in a particular behavior)
- Primary sources of interpersonal influences are families, peers, and healthcare providers
- Situational Influences
- Personal perceptions and cognitions of any given situation or context that can facilitate or impede behavior
- Include perceptions of options available, demand characteristics and aesthetic features of the environment in which given health
promoting is proposed to take place

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- Situational influences may have direct or indirect influences on health behavior
- Commitment to Plan of Action
- The concept of intention and identification of a planned strategy leads to the implementation of health behavior
- Immediate Competing Demands and Preferences
- Competing demands are those alternative behaviors over which individuals have low control because there are environmental
contingencies such as work or family care responsibilities
- Competing preferences are alternative behaviors over which individuals exert relatively high control, such as choice of ice cream
or apple for a snack
- Health Promoting Behavior
- An endpoint or action outcome that is directed toward attaining positive health outcomes such as optimal wellbeing, personal
fulfillment, and productive living

MAJOR ASSUMPTIONS
- Individuals seek to actively regulate their own behavior
- Individuals, in all their biopsychosocial complexity, interact with the environment, progressively transforming the environment as well as
being transformed over time
- Health professionals, such as nurses, constitute a part of the interpersonal environment, which exerts influence on people through their
life span
- Self-initiated reconfiguration of the person-environment interactive patterns is essential to changing behavior

14 THEORETICAL ASSERTIONS
- Prior behavior and inherited and acquired characteristics influence beliefs, affect, and enactment of health-promoting behavior
- Persons commit to engaging in behaviors from which they anticipate deriving personally valued benefits
- Perceived barriers can constrain commitment to action, a mediator of behavior as well as actual behavior
- Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual
performance of the behavior
- Greater perceived self-efficacy results in fewer perceived barriers to a specific health behavior
- Positive affect toward a behavior results in greater perceived self-efficacy, which in turn, result in increased positive affect
- When positive emotions or affect are associated with a behavior, the probability of commitment and action is increased
- Persons are more likely to commit to and engage in health-promoting behaviors when significant others model the behavior, expect the
behavior to occur, and provide assistance and support to enable the behavior
- Families, peers, and health care providers are important sources of interpersonal influence that can increase or decrease commitment to
and engagement in health-promoting behavior
- Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior
- The greater the commitments to a specific plan of action, the more likely health-promoting behaviors are to be maintained over time
- Commitment to a plan of action is less likely to result in the desired behavior when competing demands over which persons have little
control require immediate attention
- Commitment to a plan of action is less likely to result in the desired behavior when other actions are more attractive and thus preferred
over the target behavior
- Persons can modify cognitions, affect, and the interpersonal and physical environment to create incentives for health actions

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PEPLAU INTERPERSONAL RELATIONS MODEL
Theory of Interpersonal - Peplau based her model on the psychodynamic nursing, which she defines as using the understanding of one’s behavior to help others
Relations identify their difficulties
- In this model, the phases of nurse-patient relationship reflect occurrences in personal interactions and during these phases, the nurse
assumes various roles such as teacher, resource, counselor, leader, technical expert, and surrogate
PHASES OF NURSE-PATIENT RELATIONSHIP
- Orientation Phase
- The individual has a felt need and seeks professional assistance
- The nurse helps the patient recognize and understand his or her problem and determine his or her need for help
- Collaborative clarifying and defining of the problem
- Patient and nurse work together to understand their reactions to each other, mindful of potential influencing factors such as culture,
religion, personal experiences and preconceived ideas
- Identification Phase
- The patient identifies with those who can help him/her (relatedness)
- The nurse permits exploration of feelings to aid the patient in undergoing illness as an experience that reorient feelings and
strengths positive forces in the personality and provides needed satisfaction
- The patient may begin to feel a sense of belonging and may gain confidence in dealing with the targeted problem
- Exploration Phase
- The patient derives the full value of the relationship as he moves on from a dependent role to an independent role
- The nurse can project new goals to be achieved through personal effort and power shifts from the nurse to the patient delays
gratification to achieve newly formed goals
- Gratification Phase
- After the patient’s needs have been met, the therapeutic relations ends
- The patient earns independence over his care as he gradually puts aside old goals and formulates new goals
- This is a process in which the patient free himself/herself from identification (from) the nurse
NURSING ROLES
- Role of the Stranger
- The nurse must treat the patient with utmost courtesy, which includes acceptance of the patient as a person and due respect over
his individuality
- Coincides with identification phase
- Role of the Resource person
- The nurse provides specific answers to questions which include health information, advice and a simple explanation of the
healthcare team’s course of care
- Teaching Role
- Combination of all roles
- Gives instructions and provides training; involves analysis and synthesis of the learner’s experience
- The nurse gives much importance for self-care and in helping him understand the therapeutic plan
- Leadership Role
- The nurse as a leader must act in behalf of the patient’s best interest and at the same time enable him to make decisions over his
care
- This is achieved through cooperation and active participation
- Surrogate Role

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- The patient’s dependency for his care gives the nurse a surrogate role
- This creates an atmosphere wherein feelings previously felt such as feelings towards her mother; some other relationships are
reactivated and nurtured
- The nurse then helps the patient and see the differences between the nurse’s role and that of the recalled person
- Counseling Role
- The role that has the greatest importance and emphasis in nursing
- This role strengthens the nurse-patient relationship as the nurse becomes a listening friend, an understanding family member and
someone who gives sound and emphatic advises
- Helps client understand and integrate the meaning of current life circumstances; provides guidance and encouragement to make
changes

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