Theoretical Foundations

on Nursing

Joyce Travelbee (1926-1973)

Human-to-Human Relationship Model

Reporters: Althea U. Edulan BSN- 1 BENNER

Shania Espiritu BSN- 1 BENNER
Life Story:
A psychiatric nurse, educator and writer born in 1926.
• 1956, she completed her BSN degree at Louisiana State University
• 1959, she completed her Master of Science Degree in Nursing at Yale University
• 1952, Psychiatric Nursing Instructor at Depaul Hospital Affiliate School, New Orleans.
She taught at Charity Hospital School of Nursing in Louisiana State University, New
York University and University of Mississippi.

Work Timeline:

• 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.
1970, the Project Director of Graduate Education at Louisiana State University School of
Nursing until her death.

The Human-to-Human Relationship Model of Nursing deals with the interpersonal aspects of
nursing, focusing especially on mental health. Joyce Travelbee, who developed the theory,
explained that “human-to-human relationship is the means through which the purpose of
nursing is fulfilled.”

Travelbee based the assumptions of her model on the concepts of existentialism by

Kierkegaard and logotherapy by Frankl.

Inspired by being a psychiatric nurse, she struggles for a “Humanistic Revolution” in

nursing, with devotion to caring and compassion for patients. She expressed that
achieving the goal of nursing necessitates a genuine human-to-human relationship,
which can only be established by an interaction process, this process is further
divided into five phases.

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 …”
• Meaning: reason as oneself attributes
• Nursing: is to help man to find meaning in the experience of illness and suffering. has
a responsibility to help individuals and their families to find meaning. The nurses’
spiritual and ethical choices and perceptions of illness and suffering are crucial in
helping to find meaning.
• Hope: The nurse’s job is to help the patient to maintain hope and avoid
hopelessness. Hope is a faith that can and will change that would bring something
better with it. Hope’s core lies in a fundamental trust in 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 you when you need them.
6. The hoping person is in possession of courage to be able to acknowledge their
shortcomings and fears and go forward towards their goal.
• Communications: “a strict necessity for good nursing care” and “one is able to use
itself therapeutic.”
• Using “self” therapeutically”: Self-awareness and self-understanding, understanding
of human behavior, the ability to predict one’s own and others’ behavior are important
in this process.
• Targeted intellectual approach: nurses must have a systematic intellectual approach
to the patient’s situation.

Nursing Metaparadigm
Person
– Person is defined as a human being
- Both the nurse and the patient are human beings.
- A human being is a unique, irreplaceable individual who is in continuous process of
becoming, evolving and changing.
Health
- Health is subjective and objective.
- Subjective health—is an individually defined state of wellbeing in accord with self-appraisal
of physical-emotional-spiritual status.
- 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 –
Environment is not clearly defined.
- She defined human conditions and life experiences encountered by all men as sufferings,
hope, pain and illness.
Nursing
- Nursing is an interpersonal process whereby the professional nurse practitioner assists an
individual, family or community to prevent or cope with experience or illness and suffering,
and if necessary to find meaning in these experiences.”
Human-to-Human Relationship Model
- humanistic revolution
5 Interactional Phases of Human-to-Human Relationship Model:
1. Original Encounter
- First impression by the nurse of the sick person and vice-versa.
- Stereotyped or traditional roles
2. Emerging Identities
- the time when relationship begins - the nurse and patient perceive each other’s 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 of the ill human being.”