Joyce Travelbee, Lydia Hall, Virginia Henderson

JOYCE TRAVELBEE Theory?

(HUMAN TO HUMAN RELATIONSHIP MODEL)

“assist an individual, family, or community to prevent or cope with the experience of illness and sufferings, and if necessary, to find meanings in these experience”

CENTRAL THEME OF JOYCE TRAVELBEE (HUMAN TO HUMAN RELATIONSHIP MODEL)

Concepts JOYCE TRAVELBEE (HUMAN TO HUMAN RELATIONSHIP MODEL) are

suffering, hope, communications, meaning, nursing, and self-therapy

HOPE

- The person hopes that other people will support and help them

Depends on others

HOPE - Hope is focused on what may happen in the future

Future-oriented

HOPE - The person sees different options or possible ways out of the situation

Has choices

HOPE - The person wants something to happen, accomplish a task, or have a desired experience.

Has a goal or desire

HOPE - The person believes that others will be there

Trust others

HOPE - The person recognizes their fears and weaknesses but continues moving toward their goal

Has courage

Accomplished thru human-to-human relationship beginning with original encounter and progressed to stages until nurse and patient attained rapport.

NURSING by Travelbee

The _ assists an individual, family, or community to prevent or cope with the experience of illness and suffering, if necessary, to find meaning in these experience.

NURSING by Travelbee

Focuses on the individuality of human being.

NURSING by Travelbee

She believed that the purpose of nursing is achieved through the establishment of human-to-human relationship via the communication process.

NURSING by Travelbee

According to her, it is the responsibility of the nurse to assist the patient to find meaning in his illness and sufferings.

NURSING by Travelbee

The term is defined as being HUMAN.

PERSON by Travelbee

The nurse, patient, family, including community under the umbrella of illness is HUMAN.

PERSON by Travelbee

“A unique irreplaceable individual – a one-time being in this world, like yet unlike any person who ever lived or ever will live.”

PERSON by Travelbee

Travelbee defines health in two ways:

Subjective and Objective

Travelbee’s definition of Health:

it is the individual’s perception of what is healthy

subjective

Travelbee’s definition of Health:

it is an absence of disease, disability, or defect as measured by physical exams, lab, tests, assessments by a spiritual director or psychological counselor

objective

According to Travelbee, to be human is to experience _.

illness

who wrote:

“a basic assumption is that illness and suffering are spiritual encounters as well as emotional-physical experience”

Travelbee

FIVE INTERACTIONAL PHASES IN HUMAN-TO-HUMAN MODEL BY TRAVELBEE

1. ORIGINAL ENCOUNTER

2. EMERGING IDENTITIES

3. EMPATHY

4. SYMPATHY

5. RAPPORT

FIVE INTERACTIONAL PHASES IN HUMAN-TO-HUMAN MODEL BY TRAVELBEE:

● It is the nurse’s and the ill patient’s first impressions of each other. They view each other in stereotyped roles (expected roles patient and nurse)

● Breaking bond of categorization

1. ORIGINAL ENCOUNTER

FIVE INTERACTIONAL PHASES IN HUMAN-TO-HUMAN MODEL BY TRAVELBEE:

● At this stage, the nurse and patient begin to see each other as unique individuals. Rather than simply as “nurse” and “patient” It involves:

● Recognizing that each person is different

● Understanding that the patient’s experiences are not the same as the nurse’s experiences

● Not judging the patient based on the nurse’s own experiences or beliefs

● Avoiding stereotyping the patient

● Looking beyond the nurse-patient roles and getting the real person.

2. EMERGING IDENTITIES

FIVE INTERACTIONAL PHASES IN HUMAN-TO-HUMAN MODEL BY TRAVELBEE:

● Ability to share in other person’s experience to gain an understanding of the mental and psychological state of the other. It is putting yourself in the other’s shoes. This is the nurse’s valuable method of communicating with patients

3. EMPATHY

FIVE INTERACTIONAL PHASES IN HUMAN-TO-HUMAN MODEL BY TRAVELBEE:

● Goes beyond empathy. It occurs when the nurse desires to alleviate the cause of the patient's illness/suffering. One ‘shares’ in the feelings of another and experiences compassion. Empathy is understand and sympathy is understand and desire to help

4. SYMPATHY

FIVE INTERACTIONAL PHASES IN HUMAN-TO-HUMAN MODEL BY TRAVELBEE:

● The end of the nursing endeavor, a nurse-patient relationship is well established. It is characterized by the nursing actions that alleviate a patient’s distress. The nurse and patient relate to each other as human beings to human beings. The patient already has trust and confidence in the nurse.

5. RAPPORT

LYDIA HALL THEORY

(CARE, CURE, AND CORE NURSING/ THREE Cs OF LYDIA HALL)

● Purpose: to demonstrate high quality nursing care given to people in the post-acute phase of their illness for recovery >>> to leave center with capability to cope by themselves

● Represented by drawing three interlocking circles representing 3 separate domains as particular aspect of nursing

LYDIA HALL (CARE, CURE, AND CORE NURSING/ THREE Cs OF LYDIA HALL)

● The nurse gives hand on bodily care to the patient in relation to activities to daily living. Nurturing component and exclusive to nursing. A nurse's goal is to comfort the patient. What the nurse does directly for the patient’s physical needs

● Intimate bodily care of nursing

CARE

- nurturing component of care and exclusive to nursing

CARE CIRCLE

.WHAT CIRCLE?

● Providing care for patients at basic need level - opportunity for closeness for nurse and patient>>>> patient can share feelings with a nurse>>> opportunity to explore feelings represents teaching learning aspect of learning.

CARE CIRCLE

WHAT CIRCLE?

● A patient sees a nurse as a potential comforter, one who provides care and comfort through the laying of hand

CARE CIRCLE

.WHAT CIRCLE?

● Also the mothering component

CARE CIRCLE

.WHAT CIRCLE?

● Goal is the comfort of the patient thru laying of hands

CARE CIRCLE

● The nurse addresses the social and emotional needs of the patient for effective communication and a comfortable environment. Nurse help to express verbally regarding disease process and recovery or healing process

CORE

- the nurse helps the patient understand, participate, and regain independence

CORE CIRCLE

.WHAT CIRCLE?

● The nurse develops a relationship with the patient and encourages the patient to participate in recovery.

● Listens to the patient's concerns and frustrations. ○ Encourages the patient to express feelings despite difficulty speaking

CORE CIRCLE

.WHAT CIRCLE?

○ Helps the patient recognize strengths and progress.

CORE CIRCLE

.WHAT CIRCLE?

○ Encourages independence rather than doing everything for the patient.

CORE CIRCLE

.WHAT CIRCLE?

○ Establishes trust and confidence

CORE CIRCLE

● The nurse applies medical knowledge to the treatment of the person. Based on pathological and therapeutic sciences and shared with other members of the team. Nurse role is the active advocate of patient in the course of treatment >> nurse seen as negative aspect rather than sources of comfort (injections etc)

CURE

VIRGINIA HENDERSON THEORY

(14 BASIC NEEDS THEORY OR NATURE OF NURSING MODEL)

● FIRST LADY OF NURSING

VIRGINIA HENDERSON

● FIRST TRULY INTERNATIONAL NURSE

VIRGINIA HENDERSON

● THE 20TH CENTURY FLORENCE NIGHTINGALE

VIRGINIA HENDERSON

● Her major contribution is the identification of 14 BASIC NURSING CARE where a nurse can base her plan of care for the human fundamental needs

VIRGINIA HENDERSON

NEEDS 1–4: PHYSIOLOGICAL AND MOBILITY NEEDS:

Monitor respiratory status and encourage deep-breathing exercises.

1. Breathe normally

NEEDS 1–4: PHYSIOLOGICAL AND MOBILITY NEEDS:

Encourage nutritious meals and adequate fluids to support healing.

2. Eat and drink adequately

NEEDS 1–4: PHYSIOLOGICAL AND MOBILITY NEEDS:

Assist with toileting and monitor bowel and bladder function.

3. Eliminate body wastes

NEEDS 1–4: PHYSIOLOGICAL AND MOBILITY NEEDS:

Assist with repositioning, transfers, and ambulation using a walker as ordered.

4. Move and maintain desirable posture

NEEDS 5–9: COMFORT, HYGIENE, AND SAFETY:

Manage pain and provide a comfortable environment.

5. Sleep and rest

NEEDS 5–9: COMFORT, HYGIENE, AND SAFETY:

Initially assist with dressing: gradually encourage self-dressing.

6. Dress and undress

NEEDS 5–9: COMFORT, HYGIENE, AND SAFETY:

Monitor temperature and observe for postoperative infection.

7. Maintain body temperature

NEEDS 5–9: COMFORT, HYGIENE, AND SAFETY:

Assist with bathing, oral care, and grooming.

8. Keep the body clean and well groomed

NEEDS 5–9: COMFORT, HYGIENE, AND SAFETY:

Use fall precautions, keep the call bell accessible, and teach safe walker use.

9. Avoid dangers

NEEDS 10–14: PSYCHOSOCIAL, SPIRITUAL, AND LEARNING NEEDS:

- Encourage expression of pain, fears, concerns, and needs.

10. Communicate

NEEDS 10–14: PSYCHOSOCIAL, SPIRITUAL, AND LEARNING NEEDS:

Respect beliefs and facilitate religious practices when requested.

11. Worship according to one's faith

NEEDS 10–14: PSYCHOSOCIAL, SPIRITUAL, AND LEARNING NEEDS: Encourage safe activities the patient can accomplish independently.

12. Work and feel a sense of accomplishment

NEEDS 10–14: PSYCHOSOCIAL, SPIRITUAL, AND LEARNING NEEDS:

Encourage appropriate activities such as talkin with family, reading, music, or television.

13. Play/recreation

NEEDS 10–14: PSYCHOSOCIAL, SPIRITUAL, AND LEARNING NEEDS:

Teach medications, wound care, exercises, nutrition, fall prevention, and walker safety.

14. Learn

HOW INDEPENDENCE DEVELOPS: Nurse provides substantial assistance with dressing, hygiene, toileting, transfers, and ambulation.

INITIAL STAGE

HOW INDEPENDENCE DEVELOPS:

Nurse assists only when necessary and encourages the patient to participate.

RECOVERY STAGE

HOW INDEPENDENCE DEVELOPS:

Patient performs as many activities as possible independently and safely.

PRE-DISCHARGE

● Key principle: The nurse should not create dependence; nursing assistance is gradually reduced as the patient's strength, will, and knowledge improve

Developing Independence

● Viewed person as an individual who requires assistance to function to the utmost (INDEPENDENTLY) by maintaining physiologic, psychologic, sociologic and spiritual balance. She introduced the concept that mind and body is inseparable and that needs are to be cared based from the 14 needs

PERSON by Henderson

● Nurses must maintain a supportive environment for the 14 activities

ENVIRONMENT by Henderson

● Viewed based on individuals ability to function independently according to 14 human needs "She is temporarily the consciousness of the unconscious, the love of life for the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the infant, knowledge and confidence for the young mother, the mouthpiece for those too weak or withdrawn to speak, and so on."

HEALTH by Henderson

● She believed that the function of the nurse is to increase the independence of the patiently after hospitalization without delay

Virginia Henderson

3 LEVELS OF NURSE-PATIENT RELATIONSHIP

1. SUBSTITUTE

2. SUPPLEMENTARY

3. COMPLIMENTARY

3 LEVELS OF NURSE-PATIENT RELATIONSHIP:

a substitute for the patient

1. SUBSTITUTE

3 LEVELS OF NURSE-PATIENT RELATIONSHIP:

a helper to the patient

2. SUPPLEMENTARY

3 LEVELS OF NURSE-PATIENT RELATIONSHIP:

partner with the patient - both patient and nurse formulate care plan.

3. COMPLIMENTARY