TFN Lecture

8/13/2019 TFN Lecture

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Verna S. Oribiana RN


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Dorothy Marie Johnson was bornin McGregor, Clinton Co., Iowa, the onlydaughter of Lester Eugene Johnson and Mary

Louisa Barlow. It was while she was a student at Whitefish

High School that she began to writeprofessionally working as a newspaper

stringer for The Daily Inter Lakein Kalispell,Montana.


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Her writing career began to take off by the1930s when she sold her first magazine articleto The Saturday Evening Post for the sum of$400. In 1935, her story "Beulah Bunny" was

published and began a series of four stories. Herwriting was temporarily sidetracked by WorldWar II as she went to work for the Air WardenService. After the war, she produced some of her

best-known Western stories. Three of thesewould later be made into notable films,namely The Man Who Shot LibertyValance(1949),A Man Called Horse(1950) andThe Hanging Tree(1957).


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Between 1956-60, Johnson taught creativewriting at the University ofMontana, Missoula, Montana, which she alsograduated from. Prior to and during her

tenure she wrote numerous articles andfictional stories for many differentmagazines. These were often based oninterviews with Western old-timers, Native

Americans and characters she met during hertenure as secretary and researcher for TheMontana Historical Society. She was alsosecretary/manager of the Montana PressAssociation in the 1950s.


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Between 1956-60, Johnson taught creativewriting at the University ofMontana, Missoula, Montana, which she alsograduated from. Prior to and during her

tenure she wrote numerous articles andfictional stories for many differentmagazines. These were often based oninterviews with Western old-timers, Native

Americans and characters she met during hertenure as secretary and researcher for TheMontana Historical Society. She was alsosecretary/manager of the Montana PressAssociation in the 1950s.


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Johnson always prided herself on her self-sufficiency after a failed marriage early inlife. She stated that her epitaph should read

"Paid In Full." Her grave in the cemetery inWhitefish, Montana reads simply "PAID". Shedied on November 11, 1984, aged 78.


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Dorothy first proposed her model of nursingcare in 1968 as fostering of the efficientand effective behavioral functioning in the

patient to prevent illness". She also stated that nursing was concerned

with man as an integrated whole and this isthe specific knowledge of order we require.

In 1980 Johnson published herconceptualization of behavioral system of

model for nursing where she explains her

definitions of the behavioral system model.


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She defined nursing as an externalregulatory force which acts to preserve the

organization and integration of the patients

behaviors at an optimum level under thoseconditions in which the behaviors constitutes

a threat to the physical or social health, or

in which illness is found


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Whose behavior commensurate with socialdemands.

Who is able to modify his behavior in ways

that it supports biological imperativesWho is able to benefit to the fullest extent

during illness from the physicians knowledgeand skill.

Whose behavior does not give evidence ofunnecessary trauma as a consequence ofillness


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There are several layers of assumptions thatJohnson makes in the development ofconceptualization of the behavioral system

model.Assumptions about system

Assumptions about structure

Assumptions about functions


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There are 4 assumptions of system: First, there is organization, interaction, interdependency

and integration of the parts and elements of behaviors thatgo to make up the system

A system tends to achieve a balance among the various

forces operating within and upon it', and that man strivecontinually to maintain a behavioral system balance andsteady state by more or less automatic adjustments andadaptations to the natural forces impinging upon him.

A behavioral system, which both requires and results insome degree of regularity and constancy in behavior, isessential to man that is to say, it is functionally significantin that it serves a useful purpose, both in social life and forthe individual.

Last, system balance reflects adjustments andadaptations that are successful in some way and to somedegree.


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from the form the behavior takes and theconsequences it achieves can be inferred whatdrive has been stimulated or what goal isbeing sought

Each individual has a predisposition to act withreference to the goal, in certain ways ratherthan the other ways. This predisposition iscalled as set.

Each subsystem has a repertoire of choices orscope of action

The fourth assumption is that it produceobservable outcome that is the individualsbehavior.


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System must be protected" from noxious

influences with which system cannot cope.

Each subsystem must be nurtured through

the input of appropriate supplies from theenvironment.

Each subsystem must be stimulated for use

to enhance growth and prevent stagnation.

These behaviors are orderly, purposeful andpredictable and sufficiently stable andrecurrent to be amenable to description andexplanation


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Attachment or affiliative subsystem:socialinclusion intimacy and the formation andattachment of a strong social bond.

Dependency subsystem: approval, attention orrecognition and physical assistance

Ingestive subsystem: the emphasis is on themeaning and structures of the socialevents surrounding the occasion when the food iseaten

Eliminative subsystem: human cultures havedefined different socially acceptable behaviorsfor excretion of waste ,but the existence of sucha pattern remains different from culture toCulture.


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Sexual subsystem:"both biological and socialfactor affect the behavior in the sexualsubsystem

Aggressive subsystem: " it relates to thebehaviors concerned with protection and selfpreservation Johnson views aggressive subsystemas one that generates defensive response fromthe individual when life or territory is beingthreatened

Achievement subsystem: " provokes behavior

that attempt to control the environmentintellectual, physical, creative, mechanical andsocial skills achievement are some of the areasthat Johnson recognizes".


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Goal ----- Set --- Choice of Behavior --- Behavior

Johnsons Behavioral system model is a model

of nursing care that advocates the fostering ofefficient and effective behavioral functioningin the patient to prevent illness. The patient isdefined as behavioral system composed of 7

behavioral subsystems. Each subsystemcomposed of four structural characteristics i.e.drives, set, choices and observable behavior.


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(1) Protection from noxious influences,

(2) Provision for the nurturing environment,and

(3) stimulation for growth.

Any imbalance in each system results indisequilibrium .it is nursing role to assist the

client to return to the state of equilibrium.


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Dr. Barnards expertise includes infantmental health and improving support systemsfor families with newborns and youngchildren. She has an international reputation

as a researcher, including development ofthe widely-used NCAST (Nursing ChildAssessment Satellite Training) Scales, asuccessful training model that includes

important tools for observing andunderstanding parent-infant interactions. Shehas been an advocate for prevention innursing, pediatrics, parenting and mentalhealth.


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Preparing health and human serviceproviders to effectively screen, assess andrefer women for perinatal depression.


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Her pioneering work to improve the physical andmental health outcomes of infants and youngchildren has earned her numerous honors,including the Gustav O. Leinhard Award from theInstitute of Medicine, and, from the American

Academy of Nursing, both the Episteme Award,the highest honor in nursing, and the LivingLegend Award, in 2006. Between 1969 and 1993she also received 15 other major awards,including the Lucille Petry Leone Award for

Teaching; the M. Scott Award for Contributions toNursing Science, Education and Service; theMartha May Eliot Award for Leadership inMaternal-Child Health; and the Nurse Scientist ofthe Year Award.


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Kathryn E. Barnard, RN, Ph.D., is ProfessorEmeritus of Nursing and the founder anddirector of the Center on Infant MentalHealth and Development at the University of

Washington. Her pioneering work to improvethe physical and mental health outcomes ofinfants and young children has earned hernumerous honors, including the Gustav O.Leinhard Award from the Institute ofMedicine, and, from the American Academyof Nursing, both the Episteme Award, thehighest honor in nursing, and the LivingLegend Award, in 2006.


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Between 1969 and 1993 she also received 15other major awards, including the LucillePetry Leone Award for Teaching; the M. ScottAward for Contributions to Nursing Science,Education and Service; the Martha May EliotAward for Leadership in Maternal-ChildHealth; and the Nurse Scientist of the YearAward.


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Katharine Kolcabais an American nursingtheorist and nursing professor. Kolcaba isresponsible for comfort theory, a mid-rangenursing theory that has been implemented atthe institutional level.

Kolcaba earned a nursing diploma from St.Luke's Hospital School of Nursing. She earned

a Master of Science in Nursing from CaseWestern Reserve University in 1987 and a PhDfrom the same school in 1997.


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Dr. Kolcaba is Associate Professor Emeritusat University of Akron. She holds an adjunctposition at Ursuline College.


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Kolcaba, K. (2010). Impaired Comfort. In B.Ackley & G. Ladwig (Eds.). Nursing DiagnosisHandbook: An evidence-based guide to planningcare.(9th Edition)

Kolcaba, K. (2003). Comfort Theory andPractice: A vision for Holistic Health andResearch.Springer Publishing Company.

Kolcaba, K. (2001). Evolution of the mid rangetheory of comfort for outcomes

research. Nursing Outlook, 49(2), 86-92. Kolcaba, K. (1994). A Theory of Comfort for

Nursing.Journal of Advanced Nursing, 19,1178-1184.


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The comfort theory is a nursing theory thatwas first developed in the 1990s by KatharineKolcaba.

Comfort Theory is middle range theory forhealth practice, education, and research.

Kolcaba's theory has the potential to placecomfort once again in the forefront of

healthcare.(March A & McCormack D, 2009).


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Born as Katharine Arnold on December 8th 1944, inCleveland, Ohio

Diploma in nursing from St. Luke's Hospital School ofNursing in 1965

Graduated from the Frances Payne Bolton School of

Nursing, Case Western Reserve University in 1987 Graduated with PhD in nursing and received

certificate of authority clinical nursing specialist in1997

Specialized in Gerontology, End of Life and Long Term

Care Interventions, Comfort Studies, InstrumentDevelopment, Nursing Theory, Nursing Research Currently an associate professor of nursing at the

University of Akron College of Nursing PublishedComfort Theory and Practice: a Vision for

Holistic Health Care and Research


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Kolcaba described comfort as existing in 3forms: relief, ease, and transcendence. Also,Kolcaba described 4 contexts in which

patient comfort can occur:physical,psychospiritual, environmental, and

sociocultural.


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Kolcaba described comfort as existing in 3forms: relief, ease, and transcendence.

If specific comfort needs of a patient are met,for example, the reliefof postoperative pain byadministering prescribed analgesia, the

individual experiences comfort in the reliefsense.

If the patient is in a comfortable state ofcontentment, the person experiences comfort inthe easesense, for example, how one might feel

after having issues that are causing anxietyaddressed. Lastly, transcendenceis described as the state of

comfort in which patients are able to rise abovetheir challenges.


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Health Care Needs are those identified by thepatient/family in a particular practice setting.

Intervening Variablesare those factors that are notlikely to change and over which providers have littlecontrol (such as prognosis, financial situation, extent

of social support, etc). Comfortis an immediate desirable outcome of

nursing care, according to Comfort Theory Health Seeking Behavior (HSBs): Institutional Integrity - the values, financial stability,

and wholeness of health care organizations at local,regional, state, and national levels. Best Policiesare protocols and procedures developed

by an institution for overall use after collectingevidence.


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Kolcaba conducted a concept analysis ofcomfort that examined literature fromseveral disciplines including nursing,medicine, psychology, psychiatry,ergonomics, and English

First, three types of comfort (relief, ease,transcendence) and four contexts of holistic

human experience in differing aspects oftherapeutic contexts were introduced.(Kolcaba KY & Kolcaba RJ, 1991)


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A taxonomic structure was developed toguide for assessment, measurement, andevaluation of patient comfort. ( Kolcaba,1991)

Comfort as a product of holistic nursing art. (Kolcaba K, 1995)

A broader theory for comfort was introduced

( Kolcaba KY,(1994). The theory has undergone refinement and

tested for its applicability.


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Ramona Thieme Merceris the author of amid-range nursing theory known as maternalrole attainment. Mercer has conributed manyworks to the refinement of this theory and iscredited as a nurse-theorist. She was theNahm Lecturer 1984 at the University ofCalifornia.


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Mercer earned a diploma from St. Margarets

School of Nursing in Montgomery, Alabama.She earned an undergraduate degree innursing with distinction from the Universityof New Mexico in 1962, followed by amasters degree in maternal child nursing

from Emory University in 1964.


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For ten years, she worked as a staff nurse,head nurse and instructor. She was a facultymember at Emory University for five yearsuntil she left to pursue doctoral studies inmaternity nursing at the University ofPittsburgh.


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1988: Distinguished Research LectureshipAward, Western Society for Research inNursing (inaugural award)2003: Living Legend, American Academy ofNursing2004: Distinguished Alumni Award, Universityof New Mexico College of Nursing


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Mercer believes that nurses can play a vital rolein promoting health of families and

children. Mercer stated in her book Becoming aMother: Research on Maternal Identity from

Rubin to the Present that nurses are the health

professionals having the most sustained and

intense interaction with women in the maternitycycle (1995, p. xii). Mercers theory is practice

oriented and has consistently evolved over timebecause of her commitment to connect researchto practice (Meighan, 2010).


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In addition to the renaming of maternal roleattainment stages, the model has undergone

ongoing revision since its original publication.The work of Walker, Crain, and Thompson

indicated that a change was needed because theterm role attainment indicated an end to the

process as a final goal. Mercer began toreexamine her theory and felt the need to revisethe

models title to Becoming a Mother in order toconnote a continued growth in mothering

throughout the lifespan (Mercer, 2004).


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The concepts of Mercers theory center onthe bond between mother and child whichfosters competency, confidence and joy inthe motherhood role (Role Attainment,2005). Mercers original maternal role

attainment theory follows a process that hasfour stages. In 2004 Mercer revised theterms of these stages although the stagesthemselves remain basically the same. First

is the commitment, attachment, andpreparation stage during pregnancy whenthe mother makes psychological adjusts andprepares for the expectations of her newrole.


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Second is the acquaintance, learning, andphysical restoration stage which begins with

the infants birth when the role of mother is

assumed and learned in the contexts of hersocial system. Third is the moving toward a

new normal stage in the first few months of

the infants life where the mother makes her

new role fit her lifestyle in a personal wayinstead of in context with a social system.


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Lastly is the achievement of maternalidentity stage when the mother internalizesher role and experiences a sense of harmony,competence and confidence which usually

occurs about 4 months after birth. Thesestages can overlap and the timing is highlyvariable however the stages usually progressin a sequential, predictable manner (Mercer,2004). Ramona Mercers early work in the1970s was focused on the needs ofbreastfeeding mothers, teenage mothers,postpartum illness, and mothers bearingchildren with defects.


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She had a deep interest in the development ofthe maternal role as well as self-esteem and selfconcept of mothers (Meighan, 2010). During thespan of Mercers career, her work expandedfurther in the area of maternal-child nursing andshe authored books such as Perspectives onAdolescent Health Care, Transitions in a WomansLife, and Parents at Risk (Ramona Mercer, 2011).She has written a total of six books, published

six book chapters and numerous journal articles.Throughout her career Dr. Mercer has received agreat deal of awards and is a member of severalprofessional organizations and nationalcommittees (Meighan, 2010).


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Educated at Duquesne University, PittsburghMSN and Ph.D. from University of Pittsburgh

Published her theory of nursing, Man-Living-Healthin 1981

Name changed to Theory of HumanBecoming in 1992

Editor and Founder, Nursing ScienceQuarterly

Has published eight books and hundreds ofarticles about Human Becoming Theory

Professor and Niehoff Chair at LoyolaUniversity, Chicago

Dr. Parse is a graduate of Duquesne University in


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g q yPittsburgh and received her master's anddoctorate from the University of Pittsburgh. Shewas a member of the faculty of the University ofPittsburgh, Dean of the Nursing School atDuquesne University, Professor and Coordinator ofthe Center for Nursing Research at Hunter Collegeof the City University of New York (1983-1993),

and Professor and Niehoff Chair at LoyolaUniversity Chicago (1993-2006). Since January2007 she has been a Consultant and VisitingScholar at the New York University College of

Nursing. Dr. Parse is founder and current Editor ofNursing Science Quarterly, and President ofDiscovery International, Inc. She is also founderof the Institute of Huma nbecoming.


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Dr. Parse is a Fellow in the AmericanAcademy of Nursing where she initiated andis the immediate past Chair of the nursing

theory-guided practice expert panel. In herrole as Editor of Nursing Science Quarterly,she has spear-headed a well-known, highlycited venue for nurse scholars to share and

to debate matters important to nursingresearch and theory development. For thisand her other works, Dr. Parse has receivedseveral honors. She has been given twoLifetime Achievement Awards (one from the

Midwest Nursing Research Society and onefrom the Asian American Pacific IslanderNurses Association)


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The Rosemarie Rizzo ParseScholarship was endowed in her name

at the Henderson State UniversitySchool of Nursing, her books weretwice named to the best pickslist oftheory books by Sigma Theta Tau

International Honor Society in Nursing,and the Society of Rogerian Scholarshonored her with the Martha E. Rogers

Golden Slinky Award. In 2008 she wasthe recipient of the New York TimesNurse Educator of the Year Award.


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Throughout her career, Dr. Parse hasmade outstanding contributions to the

profession of nursing through herprogressive leadership in nursing theory,research, education, and practice. Shehas explored the ethics of human

dignity, set forth human becomingtenets of human dignity, and developedleading-following, teaching-learning,mentoring, and family models that areused worldwide. She has published 9books and more than 100 articles andeditorials about matters pertinent to

nursing.

D P i ht ft k h


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Dr. Parse is a sought-after speaker whohas shared her knowledge and passion in over300 local, national, and, international

presentations and workshops in more than 30countries on 5 continents. Her works havebeen translated into many languages, andshe regularly consults throughout the worldwith educational programs in nursing and

with multiple disciplines in healthcaresettings that are utilizing her work as a guideto research, practice, leadership, education,and regulation of quality standards. Dr. Parse

has planned and implemented manyinternational conferences on nursing theory,the humanbecoming school of thought,qualitative research, and quality of life.


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The human becoming theory was developed

as a human science nursing theory in thetradition of Dilthey, Heidegger, Sartre,Merleau-Ponty, and Gadamer and Science ofUnitary Human Beings by Martha Rogers .

The assumptions underpinning the theorywere synthesized from works by theEuropean philosophers, Heidegger, Sartre,and Merleau-Ponty, along with works by thepioneer American nurse theorist, Martha

Rogers. The theory is structured around three abiding

themes: meaning, rhythmicity, andtranscendence.

Th P h f h b i


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The Parse theory of human becomingguides nurses In their practice to focuson quality of life as it is described andlived (Karen & Melnechenko, 1995).

The human becoming theory of nursingpresents an alternative to both the

conventional bio-medical approach andthe bio-psycho-social-spiritual (but stillnormative) approach of most other

theories of nursing.(ICPS)


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The human becoming theory positsquality of life from each person's own

perspective as the goal of nursingpractice.(ICPS)

Rosemarie Rizzo Parse first published

the theory in 1981 as the "Man-living-health" theory (ICPS)

The name was officially changed to"the human becoming theory" in 1992to remove the term "man," after thechange in the dictionary definition ofthe word from its former meaning of

"humankind."


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The human is coexisting while

coconstituting rhythmical patterns withthe universe.

The human is open, freely choosing

meaning in situation, bearingresponsibility for decisions.

The human is unitary, continuouslycoconstituting patterns of relating.

The human is transcendingmultidimensionally with the possibles


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Becoming is unitary human-living-health.

Becoming is a rhythmically

coconstituting human-universe process.Becoming is the humans patterns of

relating value priorities.

Becoming is an intersubjective processof transcending with the possibles.

Becoming is unitary humans emerging


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Meaning

Human Becoming is freely choosingpersonal meaning in situations in theintersubjective process of living valuepriorities.

Mans reality is given meaning throughlived experiences

Man and environment cocreate

Rhythmicity

Human Becoming is cocreating rhythmicalpatterns of relating in mutual processwith the universe.

Man and environment cocreate ( imaging,valuing, languaging) in rhythmicalpatterns


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Transcendence

Human Becoming is cotranscendingmultidimensionally with emerging

possibles.Refers to reaching out and beyondthe limits that a person sets

One constantly transforms


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Black and white = opposite paradoxsignificant to ontology of human becomingand green is hopeCenter joined =co created mutual human

universe process at the ontological level &nurse-person processGreen and black swirls intertwining =human-universe co creation as an ongoing

process of becoming


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Differentiates nursing from otherdisciplines

Practice - Provides guidelines of care and

useful administrationUseful in Education

Provides research methodologies

Provides framework to guide inquiry ofother theories (grief, hope, laughter, etc.)


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Research considered to be in a closed

circle Rarely quantifiable results - Difficult to

compare to other research studies, nocontrol group, standardized questions, etc.

Does not utilized the nursingprocess/diagnoses

Negates the idea that each person engages ina unique lived experience

Not accessible to the novice nurse

Not applicable to acute, emergent care


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A transformative approach to all levels ofnursing

Differs from the traditional nursing process,particularly in that it does not seek to fix

problems

Ability to see patients perspective allowsnurse to be with patient and guide them

toward desired health outcomesNurse-person relationship cocreates changing

health patterns


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Enhances understanding of human livedexperience, health, quality of life andquality of nursing practice

Expands the theory of human becomingBuilds new nursing knowledge about

universal lived experiences which mayultimately contribute to health and

quality of life


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Dr Patricia Benner introduced the concept thatexpert nurses develop skills and understanding


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expert nurses develop skills and understandingof patient care over time through a soundeducational base as well as a multitude of

experiences. She proposed that one could gain knowledge

and skills ("knowing how") without ever learningthe theory ("knowing that").

She further explains that the development ofknowledge in applied disciplines such asmedicine and nursing is composed of theextension of practical knowledge (know how)through research and the characterization and

understanding of the "know how" of clinicalexperience.

She coneptualizes in her writing about nursingskills as experience is a prerequisite for

becoming an expert.


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She described 5 levels of nursingexperience as;

Novice

Advanced beginnerCompetent

Proficient

Expert


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Demonstrates acceptable performance

Has gained prior experience in actualsituations to recognize recurring

meaningful componentsPrinciples, based on experiences, begin

to be formulated to guide actions


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Typically a nurse with 2-3 yearsexperience on the job in the same area orin similar day-to-day situations

More aware of long-term goalsGains perspective from planning own

actions based on conscious, abstract, andanalytical thinking and helps to achieve

greater efficiency and organization


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Perceives and understands situationsas whole parts

More holistic understanding improves

decision-makingLearns from experiences what to

expect in certain situations and how

to modify plans


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No longer relies on principles, rules, orguidelines to connect situations anddetermine actions

Much more background of experienceHas intuitive grasp of clinical situations

Performance is now fluid, flexible, and

highly-proficient


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Movement from relying on abstractprinciples to using past concreteexperiences to guide actions

Change in learners perception of

situations as whole parts rather than inseparate pieces

Passage from a detached observer to an

involved performer, no longer outside thesituation but now actively engaged inparticipation


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These levels reflect movement from relianceon past abstract principles to the use of pastconcrete experience as paradigms andchange in perception of situation as a

complete whole in which certain parts arerelevant

Each step builds on the previous one asabstract principles are refined and expandedby experience and the learner gains clinicalexpertise.


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Nursing practice guided by the humanbecoming theory live the processes of theParse practice methodology illuminatingmeaning, synchronizing rhythms, and

mobilizing transcendence Research guided by the human becoming

theory sheds light on the meaning ofuniversal humanly lived experiences such ashope, taking life day-by-day, grieving,suffering, and time passing


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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 Affilliate School, New Orleans.

Later in Charity Hospital School of Nursing inLouisiana State University, New YorkUniversity and University of Mississippi.

Travelbee died at age 47.


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A psychiatric nurse, educator and writer bornin 1926.

1956, she completed her BSN degree atLouisiana State University

1959, she completed her Master of ScienceDegree in Nursing at Yale University


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Joyce Travelbee(1926-1973) developed theHuman-to-Human Relationship Modelpresented in her bookInterpersonal Aspectsof Nursing(1966, 1971).

She dealt with the interpersonal aspectsof nursing.

She explains human-to-human relationshipis the means through which the purpose ofnursing if fulfilled


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1952, Psychiatric Nursing Instructor atDepaul Hospital Affilliate School, NewOrleans.

Also she taught at Charity Hospital School ofNursing in Louisiana State University, NewYork University and University of Mississippi.

1970, the Project Director of GraduateEducation at Louisiana State UniversitySchool of Nursing until her death.


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1963, started to publish articles and journalsin nursing.

1966 and 1971, publication of her first bookentitled Interpersonal Aspects of Nursing.

1969, when she published her second bookIntervention in Psychiatric Nursing: Process inthe One-to-One Relationship.


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She started Doctoral program inFlorida in 1973. Unfortunately, she wasnot able to finish it because she died laterthat year. She passed away at the primeage of 47 after a brief sickness.


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Travelbee based the assumptions of her

theory on the concepts of existentialism bySoren Kierkegaard and logotherapy by ViktorFrankl.

Existential theory believes that that humans

are constantly faced choices and conflictsand is accountable to the choices we make inlife

Logotherapy theory was first proposed by

Viktor Frankel, a survivor of Auschwitz, in hisbook Man's Search for Meaning(1963).


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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

Meaning is the reason as oneselfattributes


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Nursing is to help man to find meaning in theexperience of illness and suffering.

has a responsibility to help individualsand their families to find meaning.

The nurses' spiritual

and ethical choices, and perceptionsof illness and suffering, is crucial tohelping to find meaning.


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Hope Nurse's job is to help the patient to

maintain hope and avoid hopelessness.

Hope is a faith that can and will bechange that would bring somethingbetter with it.

Hope's core lies in a

fundamental trust the outside world,and a belief that others will helpsomeone when you need it.

Six important factors charecteristics of hope are:


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It is strongly associated with dependence onother people.

It is future oriented.

It is linked to elections from severalalternatives or escape routes out of itssituation.

The desire to possess any object or condition,to complete a task or have an experience.

Confidence that others will be there for one

when you need them.The hoping person is in possession

of courage to be able to acknowledge itsshortcomings and fears and go forward towards

its goal


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Communications "a strict necessity for good nursing care"

Using himself therapeutic

" one is able to use itself therapeutic." Self-awareness and self-understanding,

understanding of human behavior, theability to predict one's own and others'

behavior are imporatnt in this process.Targeted intellectual approach

Nurse must have a systematic intellectualapproach to the patient's situation.


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Person

Person is defined as a human being. Both the nurse and the patient are human

beings.

Health

Health is subjective and objective. Subjective health is an individually defined state

of well being in accord with self-appraisal ofphysical-emotional-spiritual status.

Objective health is an absence of discernibledisease, disability of defect as measured byphysical examination, laboratory tests andassessment by spiritual director or psychological

counselor.


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Environment Environment is not clearly defined.

Nursing

"an interpersonal process whereby theprofessional nurse practitioner assists anindividual, family or community toprevent or cope with experience or

illness and suffering, and if necessary tofind meaning in these experiences.


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Travelbee believed nursing is accomplished

through human-to-human relationships thatbegin with the original encounter and thenprogress through stages of emergingidentities, developing feelings of empathy,

and later feelings of sympathy. The nurse and patient attain a rapport in the

final stage. For meeting the goals of nursingit is a prerequisite to achieving a genuine

human-to-human relationships. This relationship can only be established by

an interaction process.


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The inaugural meeting or originalencounter

Visibility of personal identities/

emerging identities. Empathy

Sympathy

Establishing mutual understanding andcontact/ rapport

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