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09 PARSE, LEININGER, TRAVELBEE, ABDELLAH
Dr. Ma. Luisa Uayan || October 2022
Transcribers: Kathleen Venus
OUTLINE
I. ROSEMARIE RIZZO PARSE: HUMAN
BECOMING THEORY
II. MADELEINE LEININGER: TRANSCULTURAL
NURSING THEORY
III. JOYCE TRAVELBEE: HUMAN-TO-HUMAN
RELATIONSHIP MODEL
IV. FAYE GLENN ABDELLAH: 21 NURSING
PROBLEMS
I. ROSEMARIE RIZZO PARSE: HUMAN BECOMING
THEORY
A. BACKGROUND
• Graduated from Duquesne
University in Pittsburgh, where she
later served as the dean of nursing.
• Master’s and Doctorate from the
University of Pittsburgh.
• Professor and Coordinator of the
Center for Nursing Research at
Hunter College of the City of New
York (1983-1993)
• Professor and Niehoff Chair at
Loyola University Chicago (1993-2006).
B. ORIGIN OF THE HUMAN BECOMING THEORY
• Originally Published in 1981 and was entitled “Man-
living- health”
• Renamed in 1992 to remove the word “man” which
was formerly in the dictionary as human kind.
• Developed as a human science nursing theory in the
tradition of Dilthey, Heidegger, Sartre, Merleau-Ponty
and Gadamer.
• Assumptions were synthesized from works of
European philosophers: Heidegger, Sartre, Merleau-
Ponty
• Along with the works of American nurse theorist
Martha Rogers.
• Called a “School of Thought” because it
encompasses: otology, epistemology and
methodology
C. ASSUMPTIONS
The human is:
• Coexisting while co-constituting rhythmical patterns.
• Open, freely choosing meaning with situation, bearing
responsibility for decisions.
Becoming is:
• Human-living-health
• Rhythmically co-constituting human universe
• Human’s value priority patterns
• Transcending with possibles
• Human’s emerging
D. BASIC CONCEPTS OF THE HUMAN BECOMING
THEORY
• Meaning
o “Structuring meaning is the imaging and
valuing of languaging” (Cody and Bournes,
2010)
o People coparticipate in creating what is real
for them through self-expression in living their
values a chosen way.
• Rhythmicity
o Configuring rhythmical patterns of relating is
the revealing-concealing and enabling-
limiting of connecting-separating.
NCMA110
o Living moment to moment one shows and
does not show self as opportunities and
limitations emerge in moving with and apart
from others.
• Transcendence
o “Co-transcending with possibles is the
powering and originating of transforming”
o Moving beyond the “now” moment is forging
a unique personal path for oneself in the
midst of ambiguity and continuous change.
“Nurses live the art of human becoming in true presence with
the unfolding of illuminating meaning, synchronizing rhythms,
and mobilizing transcendence.” (Cody and Bournes, 2010)
E. PRINCIPLES
• Structuring meaning is the imaging and valuing of
languaging.
• Configuring rhythmical patterns is the revealing-
concealing and enabling-limiting of connecting-
separating.
• Contransceding with possibles is the powering and
originating of transforming.
F. NURSING PARADIGMS AND PARSE’S THEORY
Open being who is more
PERSON than and different from the
sum of the parts
Everything in the person and
his experiences
ENVIRONMENT
Inseparable, complimentary
to and evolving with
Open process of being and
becoming, involves the
synthesis of values.
HEALTH
Health is not static but,
rather, is ever-changing as
humans choose ways of
living.
A human science and art
NURSING that uses an abstract body of
knowledge to serve people
G. THEORY OVERVIEW: PARSE SCHOLARS BELIEFS
• Quality of Life from patient’s perspective
• Diagnostic practice fails to respect humankind
• Standardized nursing interventions disregard human
dignity
• Understanding human experience= individual freedom
• Humans are change with the process of living
• Inherent freedom is to be honored by nurses
H. THEORY OVERVIEW: REAL WORLD EXAMPLE
• Chronic Pain
• Nurses should ask patient to describe pain in detail
Physiological, psychological, situational factors
• Nurses should be aware of patient’s life situation
• By listening to patients, pain can be improved
• Treatment plan can be developed
• Patients feel closer to nurses who listen
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II. MADELEINE LEININGER: TRANSCULTURAL NURSING ENVIRONMENT
THEORY - The environmental context includes any events:
o physical
A. WHAT IS TRANSCULTURAL NURSING o ecological
”A discipline of study and practice focused on o sociopolitical
comparative culture care differences and o cultural
similarities among and between cultures in
order to assist human beings to attain and Nurses need humanistic and
maintain meaningful and therapeutic health scientific transcultural
care practices that are culturally based" HUMAN BEING knowledge in order to
(Leininger, 2008, p.9). adequately care for patients
B. PHILOSOPHICAL ROOTS OF LEININGER’S THEORY in the 21st century.
Leininger states that the philosophical roots of her theory are: Care values are influenced
• extensive and diverse nursing experiences by many things including
ENVIRONMENT
• anthropological insights worldview, spirituality, and
• life experiences and values environment.
• reflection upon spiritual insights and beliefs Care specific to one's culture
HEALTH promotes health, as valued
The theorist created a theory to develop "new practices for and defined by each culture.
nursing to meet diverse cultural needs and to provide Since 1989 nurses have
therapeutic care with comprehensive and holistic care practices been able to receive global
NURSING
in a caring discipline" Leininger, 2008, p.10) certification in transcultural
C. TRANSCULTURAL NURSING THEORY CONCEPTS nursing,
Transcultural nursing theory incorporates research from
numerous scientific disciplines: G. CLARIFICATION OF ORIGIN
1. Nursing - Originally developed in 1950s
2. Medicine - Leininger's 1st book, Cultural Care Diversity and
3. Education Universality - Published 1991
4. Psychology - Transcultural Nursing (2nd ed.) - Published 1995
5. Public Health - Transcultural Nursing (3rd ed.) - Published 2002
6. Epidemiology
D. INTERRELATIONSHIP H. VIEW
Culturally Competent Transcultural Nursing The transcultural nursing model can be used in all aspects of
Nursing Care Research nursing care, but proper use of the model can only be achieved
promote human rights and if the patient's values are known and meaningfully used in an
address cultural conflicts appropriate way by the nurse with the patient.
quality health care through
within healthcare beliefs
cultural awareness
centered on universal aspect nursing care that is III. JOYCE TRAVELBEE: HUMAN-TO-HUMAN
of human caring as defined beneficial and meaningful to RELATIONSHIP MODEL
within each culture all cultures
assess cultural needs and increase knowledge base to A. TRAVELBEE’S ASSUMPTION OF THEORY
integrate nursing care that is improve cultural competence 1. The nurse-patient relationship is the
congruent with cultural impact global healthcare essence of the purpose of nursing.
values policy and practices 2. The relationships are established when
both partners perceive each others
E. CULTURALLY CONGRUENT NURSING CARE uniqueness.
o Culturally congruent nursing care occurs when nurses 3. Nurse-patient relationships are based on
integrate information from individuals, family, perceiving the patient as an illness or
community, or institution based on cultural: nursing as a task.
• beliefs 4. Human beings are motivated to search
• values for and understand the meaning of all life experiences.
5. Illness and sufferings are not only physical encounters for
• norms
human beings, they are emotional and spiritual encounters as
• patterns/lifeways
well.
• practices 6. Communication is a process that can enable the nurse to
o to provide appropriate and meaningful nursing care. establish a nurse-patient relationship and there by fulfill the
F. METAPARADIGM CONCEPTS purpose of nursing.
CARING
- essence of nursing B. CENTRAL THEME
- universal concept within all cultures A sick person finding meaning in illness and suffering and
- assisting, supporting, or enabling behaviors to improve human-to-human relationship
a person's condition C. METAPARADIGM
- essential for survival, development, ability to deal with
Person is defined as a
life's events
human being.
- greater level of wellness is achieved when caring is in
line with patient's cultural values and beliefs
Both the nurse and the
PERSON
patient are human beings.
- Some cultures do not recognize the concept of
PERSON
"person".
A human being is a unique,
- Leininger's definition includes:
irreplaceable individual who
o individuals
is in continuous process of
o families
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becoming, evolving and

o groups
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changing.
o communities
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Health is subjective and
objective.
Subjective health—is an
individually defined state of
well being in accord with
self-appraisal of physical-
emotional-spiritual status.
HEALTH
Objective health—is an
absence of discernible
disease, disability of defect
as measured by physical
examination, laboratory tests
and assessment by spiritual
director or psychological
counselor.
Environment is not clearly
defined.
She defined human
conditions and life
experiences encountered by
all men as sufferings, hope,
pain and illness.
Illness – being unhealthy,
but rather explored the
ENVIRONMENT 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
Nursing is an interpersonal
process whereby the
professional nurse
practitioner assists an
individual, family or
NURSING
community to prevent or
cope with experience or
illness and suffering, and if
necessary to find meaning in
these experiences.”
D. BASIC CONCEPTS
SUFFERING
- “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 and extreme tortured…”
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
E. HOPE
• Nurse’s job is to help the patient to maintain hope and
avoid hopelessness
•
Hope is a faith that can and will be change that would
bring something better with it
• Hope’s core lies in a fundamental trust the outside
world, and a belief that others will help someone when
you need it.
Six important factors characteristics of hope are:
1. It is strongly associated with dependence on other
people
2. It is future oriented
3. It is linked to elections from several alternatives or
escape routes out of its situation
4. The desire to possess any object or condition, to
complete a task or have an experience
5. Confidence that others will be there for one when you
need them
6. The hoping person is in possession of courage to be
able to acknowledge its shortcomings and fears and
go forward towards its goal
F. NURSING
• The critical work of psychiatric nursing is to help
people develop a sense of self through a healing
interpersonal relationship
• The instrument for the delivery of interpersonal nursing
is the therapeutic use of self.
i. THERAPEUTIC USE OF SELF
• The ability to use one’s personality consciously and in
full awareness in an attempt to establish relatedness
and to structure nursing interventions
• Refers to the nurse’s presence, “a physical ‘being
there’, and psychological being with a patient for the
purpose of meeting the patient’s health care needs”
G. INTERACTIONAL PHASES OF HUMAN-TO-HUMAN
RELATIONSHIP MODEL:
Human-to-human relationships begin with the original
encounter and then progress through stages of emerging
identities, developing feelings of empathy, and later feelings of
sympathy.
It has five phases which include: the inaugural meeting or
original encounter; visibility of personal identities/ emerging
identities; empathy; sympathy; and establishing mutual
understanding and contact/ rapport
1. Inaugural meeting or Original encounter
- First impression by the nurse of the sick person and
vice-versa.
- Stereotyped or traditional roles
2. Visibility of personal identities or Emerging
Identities
- the time when relationship begins
- the nurse and patient perceives each others
uniqueness
3. Empathy
- the ability to share in the person’s experience
4. Sympathy
- when the nurse wants to lessen the cause of patient’s
suffering.
- it goes beyond empathy—“When one sympathizes,
one is involved but not incapacitated by the
involvement.”
- therapeutic use of self
5. Rapport
- Rapport is described as nursing interventions that
lessens the patient’s suffering.
- Relation as human being to human being
- “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
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of the ill human being.”
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[NCMA110] 1.09 PARSE, LEININGER, TRAVELBEE, ABDELLAH – Dr. Ma. Luisa Uayan
IV. FAYE GLENN ABDELLAH: 21 NURSING PROBLEMS
A. BACKGROUND
• Introduced “Patient-Centered
Approaches in Nursing Model
• Identified 21 nursing problems
which determines nursing care
• Nursing as service to individuals
and families, therefore to society
• Conceptualized nursing as an art
and science
B. PATIENT-CENTERED APPROACHES TO NURSING
• Patient-centered approach to nursing was developed
by Faye G. Abdellah. Developed inductively from her
practice and is considered a human needs theory
• This theory was created to assist with nursing
education, and is most applicable to the education of
nurses
• The intension was to guide care of patients in the
hospital, it also has relevance for nursing care in
community settings.
• According to Faye, nursing is based on an art and
science that mould the attitudes, intellectual
competencies, and technical skills of the individual
nurse into the desire and ability to help people, sick or
well, cope with their health needs.
• Nursing is the use of problem-solving approach with
key nursing problems related to the health needs of
people
• Abdellah and colleagues developed a list of 21 nursing
problems,
• They identified 10 steps to identify the client’s
problems and 11 nursing skills to be used in
developing a treatment typology
i. 10 WAYS TO IDENTIFY A CLIENT’S PROBLEM
1. Learn to know the patient
2. Sort out relevant and significant data
3. Analyze and make generalizations about available
data
4. Identify the therapeutic plan
5. Test generalizations with the patient and make
additional generalizations
6. Validate the patient’s conclusion about his nursing
problems
7. Continue to observe and evaluate the patient over
time to identify any attitudes and clues affecting his
behavior
8. Explore the patient’s and family’s reaction to the
therapeutic plan and involve them in the plan
9. Identify how the nurse feels about the patient’s nursing
problem
10. Discuss and develop a comprehensive nursing care
plan
ii. 11 NURSING SKILLS
1. Observation of health status
2. Skills of communication
3. Application of knowledge
4. Teaching of patients and families
5. Planning and organization of works
6. Use of resource materials
7. use of personnel services
8. Problem solving
9. Direction of work of others
10. therapeutic use of the self
11. Nursing procedures
C. THREE MAJOR CATEGORIES
1. Physical sociological and emotional needs of the client
2. Types of interpersonal relationships between the
nurse and the patient
3. Common elements of client care
D. CLASSIFICATION OF THE 21 NURSING PROBLEMS
Basic to all patients
• To maintain good hygiene and physical comfort
• To promote optimal activity ; rest, exercise, sleep
• To promote safety
• To maintain good body mechanics
Sustenal Care Needs
• To facilitate the maintenance of a supply of oxygen
• To facilitate the maintenance of nutrition
• To facilitate the maintenance of elimination
• To facilitate maintenance o fluid and electrolyte
balance
• To recognize the physiological responses of the body
to disease
• To facilitate the maintenance of regulatory
mechanisms & functions
• To facilitate maintenance of sensory function
Remedial Care Needs
• To identify and accept positive and negative
expressions, feelings, and reactions
• To identify and accept interrelatedness of emotions
and organic illness
• To facilitate the maintenance of effective verbal &
nonverbal communication
• To promote the development of productive
interpersonal relationships
• To facilitate progress toward achievement of personal
spiritual goals
• To create or maintain a therapeutic environment
• To facilitate awareness of self as an individual with
varying physical, emotional, & developmental needs
Restorative Care Needs
• To accept the optimum possible goals in the light of
limitations, physical, & emotional
• To use community resources as an aid in resolving
problems that arise from illness
• To understand the role of social problems as
influencing factors in the case of illness
E. ABDELLAH’S TYPOLOGY OF NURSING PROBLEMS
1. To promote good hygiene and physical comfort
2. To promote optimal activity, exercise, rest, and sleep
3. To promote safety through prevention of accidents,
injury, or other trauma and through the prevention of
the spread of infection
4. To maintain good body mechanics and prevent and
correct deformities
5. To facilitate the maintenance of a supply of oxygen to
all body cells
6. To facilitate the maintenance of nutrition of all body
cells
7. To facilitate the maintenance of elimination
8. To facilitate the maintenance of fluid and electrolyte
balance
9. To recognize the physiologic responses of the body to
disease conditions
10. To facilitate the maintenance of regulatory
mechanisms and functions
11. To facilitate the maintenance of sensory function
12. To identify and accept positive and negative
expressions, feelings, and reactions
13. To identify and accept the interrelatedness of
emotions and organic illness
14. To facilitate the maintenance of effective verbal and
nonverbal communication
15. To promote the development of productive
interpersonal relationships
16. To facilitate progress toward achievement of personal
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spiritual goals
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17. To create and maintain a therapeutic environment
[NCMA110] 1.09 PARSE, LEININGER, TRAVELBEE, ABDELLAH – Dr. Ma. Luisa Uayan
18. To facilitate awareness of self as an individual with
varying physical, emotional, and developmental needs
19. To accept the optimum possible goals in light of
physical and emotional limitations
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 in the cause of illness

Abdellah’s 21 problems are actually a model describing the

“arenas” or concerns of nursing, rather than a theory describing
relationships among phenomena. In this way, the theory
distinguished the practice of nursing, with a focus on the 21
nursing problems, from the practice of medicine, with a focus
on disease and cure.

F. METAPARADIGM
People having 21 physical,
emotional and sociological
nursing problems. The
patient’s needs may be overt
which is obvious and consist
PERSON
of physical needs or covert,
hidden and concealed
because it is emotional,
sociological and
interpersonal in nature
It is not clearly specified,
although total health needs
HEALTH and a healthy state of mind
is comprehensively included
in her concept of nursing
Nursing is an art of science
aiming to help people cope
with health needs. It involves
service to an individual,
family and society.
Professionalization of
NURSING
nursing requires nurses to
identify nursing problems
that depends on the nurses’
use of her capacity to
conceptualize and make
some decision.
The focus is on individual,
family, and society.
Although, individuals are the
ENVIRONMENT
main focus of nursing
service. Society is served by
serving individuals.

G. FOCUS OF CARE PENDULUM

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