LYDIA E.

HALL

LYDIA HALL’S LIFE AND CREDENTIALS

 She was a rehabilitation nurse who used her philosophy of nursing to

established Loeb for Nursing and Rehabilitation at Montefiore Hospital in New
York.

 She served as administrative Director of the Loeb Center from the time of its
opening in 1963 until her death in 1969.

 In the 1960s, she published more than 20 articles about the Loeb Center and
her theories of long term care and chronic disease.

 In 1964 Halls work presented in “Nursing: What is it?” in the Canadian Nurse.

 In the 1969 the Loeb Center for Nursing and Rehabilitation was discussed in
the International at Journal of Nursing Studies.

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 LYDIA HALL’S MODEL

LYDIA HALL’S THEORY OF NURSING

THE CARE CIRCLE

The care circle represents the nurturing component and I exclusive to nursing.
Nurturing involves using the factors that make up the concept of mothering (care and
comfort of the person) and provide for teaching-learning activities. The professional
nurse provides bodily care for the patient and helps the patient to complete such
basic daily biological functions as eating, bathing, elimination, and dressing.

The Body

Natural and biological

sciences

Intimate bodily care

aspect of nursing 2

“The Care”
THE CORE CIRCLE

The core circle of patient care is based in the social science, ,involves the
therapeutic use of self, and is shared with other members of the health team. The
professional nurse, by developing an interpersonal relationship with the patient, is
able to help the of patient verbally express feelings regarding the disease process
and its effect, as well as discuss the patient’s role in recovery.

The Person

Social sciences

Therapeutic use of
self aspect of
nursing.

THE CURE CIRCLE

The cure circle of patient care is based in the pathological and therapeutic sciences
and is shared with other members of the health team. The professional nurse helps
th patient and family through the medical, surgical, and rehabilitative prescriptions
made by the physician. During this aspect of nursing care, the nurse is an active
advocate of the patient.

The Disease

Pathological and
therapeutic sciences

Seeing the patient and

family through the medical
care aspects of nursing.

“The Cure”

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INTERACTION OF THE THREE ASPECTS OF NURSING

Hall emphasizes the importance of a total person approach, it is important that the
three aspects of nursing not be viewed as functioning independently but as
interrelated. The three aspects interact, and the circles representing them change
size, depending on the patient’s total course of progress.

In the philosophy of Loeb Center, the professional nurse functions most

therapeutically when patients have entered the second stage of their hospital stay.
During this recuperation stage, The care and core aspects is less prominent. The
size of the circles represents the degree to which the patient is progressing in each
of the three areas.

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 HALL’S THEORY AND NURSING PROCESS

 ASSESMENT - this phase involves collection of data about the health status
of then individual.
According to Hall, the process of the data collection is directed for the benefit
of the patient rather than for the benefit of the nurse. Data collection should be
directed to toward increasing the patient’s self-awareness. Through use of
observation and reflection, the nurse is able to assist the patient in becoming
aware of both verbal and non-verbal behaviors.

 NURSING DIAGNOSIS - or statement of the patient’s need or problem area.

How a nurse envisions the nursing role influences the interpretation of
assessment data and conclusions reached.
Viewing the patient as the power for self-healing directs conclusions
differently than if the healing power rests in the physician or nurse. The
patient is the one in control, the one who identifies the need.

 OUTCOMES AND PLANNING - involves setting priorities and mutually

establishing patient-centered outcomes and goals.
The patient decides what is of highest priority and also what outcomes and
goals are desirable. The core in outcomes and planning. The role of the nurse
is to use reflection to help the patient become aware of and understand
needs, feelings, and motivations. Once motivations are clarified, Hall indicates
that the patient is the best person to identify outcomes, set goals, and arrange
priorities. The nurse seeks to increase patient awareness and to support
decision making based on the patient’s new level of awareness.

 IMPLEMENTATION - Involves the actual institution of the plan of care. This

phase is the actual giving of nursing care.
In the care and core circles, the nurse works with the patient, helping with
bathing, eating, and other care comfort needs. The professional nurses uses
a “permissive non-directive teaching-learning approach” to implement nursing
care, thus helping the patient reach the established goals.

 EVALUATION - is the process of assessing the patient’s progress toward the

health goals.

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The evaluation phase of the process is directed toward deciding whether or not the
patient is successful in reaching the established goals. The following questions apply
to the use of Hall’s theory in the evaluation phase:

1. Is the patient learning “who he is, where he wants to go, and how he wants to get
there?”

2. Is the patient learning to understand and explore the feelings that underlie
behavior?

3. Is the nurse helping the patient see motivations clearly?

4. Are the patient’s goals congruent with the medical regime? Is the patient
successful in meeting the goals?

5. Is the patient physically more comfortable?

Whether or not a person is growing in self-awareness regarding his or her feelings

and motivations can be recognized through changes in his or her outward behavior.

DEFINITIONS

PERSON/INDIVIDUAL

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 care in Hall’s work. The source of energy
and motivation for healing is the individual care recipient, not the health care
provider. Hall emphasizes the importance of the individual as unique, capable of
growth and learning, and requiring a total person approach.

HEALTH

Health can be inferred to be a state of self-awareness with conscious selection of

behaviors that are optimal for that individual. Hall 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.

SOCIETY AND ENVIRONMENT

The concept of environment I dealt with in relation to the individual. Hall I credited
with developing the concept of Loeb Center because she assumed that the hospital
environment during treatment of acute illness creates a difficult psychological
experience for the ill individual. Loeb center focuses on providing an environment
that is conducive to self-development. In such a setting, the focus of the action of
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nurses is the individual, so that any actions taken in relation to society or
environment are for the purpose of assisting the individual in attaining a personal
goal.

NURSING

Nursing is identified as consisting of participation in the care, core, and cure

aspects of patient care. Care is the sole function of nurses, whereas core and cure
are shared with other members of the health care team. However, the major purpose
of care is to achieve an interpersonal relationship with the individual that will facilitate
the development of core.

MAJOR CONCEPTS

BEHAVIOR

Hall broadly defines behavior as everything that is said or done. She said that
behavior is dictated by feelings, both concious and unconscious.

REFLECTION

Is a Rogerian method of communicatin in which selected verbalizations of patients

are repeated back to them with different phraseology, to invite them to explore
feelings further

SELF AWARENESS

According to Hall, self-awareness refers to the state of being that nurses endeavor
to help their patients achieve.

PHASES OF MEDICAL CARE

• BIOLOGICALLY CRITICAL - medicine last for few days to a week or more and is
the period when physician device treatment plans that help the patient reach the
second phase.
• EVALUATIVE FOLLOW UP

SECOND STAGE ILLNESS

Hall's defines second-stage illness as the nonacute recovery phase of illness. This
stage is conductive to learning and rehabilitation.

WHOLLY PROFESSIONAL NURSING

Implies nursing care given exclusively by professional registered nurses educated in
the behavioral sciences who take the responsibility and opportunity to coordinate
and delivered the total care of their patients.

MAJOR ASSUMPTIONS
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  What is the historical context of the theory?
 What are the basic concepts and relationships presented by the theory?
 What major phenomena of concern to nursing are presented?
 To whom does this theory apply?
 By what method can tbis theory be tested?
 Does this theory direct critical thinking in nursing practice?
 Does this theory direct communication i n ursing practice?
 Does this theory direct nursing actions that lead to favorable outcomes?
 How contagious is this theory?

ACCEPTANCE BY THE NURSING COMMUNITY

PRACTICE

Hall's emphasis on the professional nurses as the primary caregiver parallels primary
care nursing to the extend that continuity and coordination of patient care are
provided.

EDIUCATION

Hall's theory delineates definite ideas regarding nursing care provided by a

professional nursing staff.
Hall's also emphasis the concept of nurses practicing nursing rather than practicing
as practical doctors

RESEARCH

Until the late 1980's, research testing Hall's theory had been conducted only in Loeb
center. Two different facilities Europe used Hall's idea to develop nursing care units.
Pearson, Durand, Punton, compared patients in an acute care hospital with patients
receiving care at a nursing unit.

CRITIQUE

GENERALITY

The flaw in Hall's theory of nursing is its limited generality. This concept limits
application of the theory of the population of patients of specific age and stage of
illness.
Even though the ideas of core, care and cure can be applied of their illness, this
theory is difficult to apply in infants, small children, and comatose patients.

SIMPLICITY

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Hall's theory is simple and easy understood. The major concept and relationships
are limited and clear. It is identified both individually and as they are relate to each
other in the total process of patient care.
Hall's theory is simple if you are be able to understand the major aspects but if you
cant identify how they relate to each other in the total process it will not be easy

EMPIRICAL PRECESION

Hall's concept of professional nursing hastening patient recovery with increase care
as a patient improves has been subjected to a great amount of testing at the Loeb
Center for Nursing. The fact that the theory is identified with empirical reality cannot
be disputed.

DERIVABLE CONSEQUENCES

The theory provides general framework for nursing and the concepts are within the
domain of nursing, although the aspects of Cure and Core are shared with other
health professionals and family members.

REFERENCE

5TH Edition NURSING THORIES: The base for professional Nursing Practice

Ann Marinner Tomey and Martha Raile Alligood,Critique, Nursing Theorists and their
Work, Fifth Edition/

o Activity Please complete the table below.

Theorist Practice Education Research

Theory Conceptual Person Environment Health Nursing
Model/Framework
Lydia
Hall

9
“A nurse does not only seek to alleviate physical pain or render physical care – she
ministers to the whole person. The existence of the suffering whether physical,
mental or spiritual is the proper concern of the nurse.”
- Joyce Travelbee

JOYCE TRAVELBEE
 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 in Louisiana State
University, New York University
and University of Mississippi.
 Travelbee died at age 47.

WORKS OF TRAVELBEE:
 ARTICLES:
 WHAT'S WRONG WITH SYMPATHY?
TRAVELBEE J.
American Journal of Nursing. 64:68-71, 1964 Jan.
 What do we mean by rapport?.
TRAVELBEE J.
American Journal of Nursing. 63:70-2, 1963 Feb
 BOOKS:
 INTERPERSONAL ASPECTS OF NURSING
1966 & 1971

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  INTERVENTION IN PSYCHIATRIC NURSING: PROCESS IN THE ONE-TO-
ONE RELATIONSHIP
1969
HUMAN-TO-HUMAN RELATIONSHIP MODEL

The human-to-human relationship model, shown in the figure, represents the

interaction between the nurse and patient. The half circles at the point of the original
encounter indicate the possibility of and need for developing the encounter into a
therapeutic relationship. As the interaction process progresses toward rapport, the
circles join into one full circle, representing that the potential for a therapeutic
relationship has attained.
According to the model, nursing is accomplished through relationships
between humans beginning with an original encounter and then progressing through
stages of emerging identities, developing feelings of empathy and sympathy.

The nurse and patient establish a rapport in the final stage. Meeting the
nursing goals requires the creation of a genuine human-to-human relationship, which
can only be established by an interaction process. This process has five phases: the
initial meeting or original encounter, the visibility of personal and emerging identities,
empathy, sympathy, and establishing mutual understanding and rapport.

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SUBCONCEPTS IN TRAVELBEE’S MODEL
ORIGINAL ENCOUNTER
The original encounter is characterized by first impressions by the nurse of
the ill person and by the ill person of the nurse. The nurse and patient perceive each
other in stereotyped roles.
EMERGING IDENTITIES
The emerging identities phase is characterized by the nurse and patient
perceiving each other as unique individuals. The bond of a relationship is beginning
to form.
EMPATHY
The empathy phase is characterized by the ability to share in the other
person’s experience. The result of the empathic process is the ability to predict the
behavior of the individual with whom he or she has empathized. Travelbee believed
that two qualities that enhanced the empathy process were similarities of experience
and the desire to understand another person.
SYMPATHY
Sympathy goes beyond empathy and occurs when the nurse desires to
alleviate the cause of the patient’s illness or suffering. “When one sympathizes, one
is involved but not incapacitated by the environment.” The nurse is to create helpful
nursing action as a result of reaching the phase of sympathy. “This helpful nursing
action requires a combination of the disciplined individual approach combined with
the therapeutic use of self.”
RAPPORT
Rapport is characterized by nursing actions that alleviate a person’s distress.
The person and ill person are relating as human being to human being. The ill
person exhibits both trust and confidence in the nurse. “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.”

MAJOR ASSUMPTIONS
NURSING
Travelbee defines nursing as an “interpersonal process whereby the
professional nurse practitioner assists an individual, family, or community to prevent
or cope with the experience of illness and suffering and, if necessary, to find
meaning in these experiences.” Nursing is an interpersonal process because it is an
experience that occurs between the nurse and individual or group of individuals.

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PERSON
The term person is defined as human being. Both the nurse and patient are
human beings. A human being is a unique, irreplaceable individual who is in the
continuous process of becoming, evolving, and changing.
HEALTH
Travelbee defines health by the criteria of subjective and objective health. A
person’s subjective health status is an individually defined state of well-being in
accord with self-appraisal of physical-emotional-spiritual status. Objective health is
“an absence of discernible diseases, disability or defect as measured by physical
examination, laboratory tests, assessment by a spiritual director, or psychological
counselor.
ENVIRONMENT
Travelbee does not explicitly define environment in the theory. She does
define the human condition and life experiences encountered by all human beings as
suffering, hope, pain, and illness. These conditions can be equated to the
environment.

MAJOR CONCEPTS AND DEFINITIONS

HUMAN BEING
“A human being is defined as a unique irreplaceable individual – a one-time
being in this world – like yet unlike any person who has ever lived or ever will live.”
PATIENT
The term patient is a stereotype useful for communicative economy. “Actually
there are no patients. There are only individual human beings in need of the care,
services, and assistance of other human beings, whom, it is believed, can render the
assistance that is needed.”
NURSE
The nurse is also a human being. “The nurse possesses a body of specialized
knowledge and the ability to use it for the purpose of assisting other human beings to
prevent illness, or to maintain the highest maximal degree of health.”
ILLNESS
Illness is “a category and a classification.” Travelbee did not use the term
illness as a definition of being unhealthy, but rather explored the human experience
of illness. Travelbee defined illness by the objective and subjective criteria. The
objective criteria are determined by the outward effects of illness on the individual.
The subjective criteria refer to the way in which a human being perceives himself or
herself as ill.

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SUFFERING
“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, namely the malignant phase of despairful ‘not caring,’ and the
terminal phase of apathetic indifference.
PAIN
“Pain itself is not observable – only its effects are noted.” Pain is a lonely
experience that is difficult to communicate fully to another individual. The experience
of pain is unique to each individual.
HOPE
“Hope is a mental state characterized by the desire to gain an end or
accomplish a goal combined with some degree of expectation that what is desired or
sought is attainable. Hope is related to dependence on others, choice, wishing trust
and perseverance, and courage and is future oriented.
HOPELESSNESS
Hopelessness is being devoid of hope.
COMMUNICATION
“Communication is a process which can enable the nurse to establish a
human-to-human relationship and thereby fulfill the purpose of nursing, namely, to
assist individuals and families to cope with the experience of illness and suffering
and, if necessary, to assist them to find meaning in these experiences.”
INTERACTION
“The term interaction refers to any contact during which two have reciprocal
influence on each other and communicate verbally and/or nonverbally.”
NURSE-PATIENT INTERACTION
“The term nurse-patient interaction refers to any contact between a nurse and
an ill person and is characterized by the fact that both individuals perceive the other
in a stereotyped manner.”
NURSING NEED
“A nursing need is any requirement of the ill person (or family) which can be
met by the professional nurse practitioner and which lies within the scope of legal
definition of nursing practice.”
THERAPEUTIC USE OF SELF
“The therapeutic use of self is the ability to use one’s personality consciously
and in full awareness in an attempt to establish relatedness and to structure nursing
intervention.” It “requires self-insight, self-understanding, an understanding of the
dynamics of human behavior, ability to interpret one’s own behavior as well as the
behavior of others, and the ability to intervene effectively in nursing situations.”
EMPATHY

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 “Empathy is a process wherein an individual is able to comprehend the
psychological state of another.”

SYMPATHY
Sympathy implies a desire to help an individual undergoing stress.
RAPPORT
“Rapport is a process, a happening, an experience, or series of experiences,
undergone simultaneously by the nurse and recipient of her care. It is composed of a
cluster of interrelated thoughts and feelings, these thoughts, feelings and attitudes
being transmitted, or communicated, by one human being to another,”
HUMAN-TO-HUMAN RELATIONSHIP
“A human-to-human relationship is primarily an experience or series of
experiences between a nurse and the recipient of her care. The major characteristic
of these experiences is that the nursing needs of the individual (or family) are met.”
“The human-to-human relationship, in nursing situations, is the means through which
the purpose of nursing is accomplished.” The human-to-human relationship is
established when the nurse and the recipient of his or her care attain a rapport after
having progressed through the stages of the original encounter, emerging identities,
sympathy and empathy.

PROPOSITIONS
The usefulness of a theory is related to its ability to describe, explain, predict,
and control phenomena. Travelbee’s theory does not describe some of variables that
may affect the establishment of a therapeutic relationship between the nurse and
patient. However, the lack of empirical precision also creates a lack of derivable
consequences. Travelbee’s theory focuses on the development of the attribute in
caring. In this respect, the theory can be useful because caring is a major
characteristic of the nursing profession.

CLARITY
All concepts of Travelbee’s theory are defined in the Travelbee theory, but the
definitions are not consistent with regard to origin and explicitness. Some of the
definitions are Travelbee’s own and she adopted others from Webster’s dictionary.
She explicitly presents some of the definitions, but derives others from contextual
usage. None of the concepts are operationally defined. Travelbee also uses different
terms for the same definition. The terms rapport, human-to-human relationship, and
human-to-human relatedness all have the same definition.
The goal or purpose of nursing, as stated in Travelbee’s definition of nursing,
is consistent with the emphasis of her presentation. Travelbee focuses on adult
individuals who are ill and the nurse’s role in helping them find meaning in their
illness and suffering. She addresses families and their needs minimally and does not
include communities.

15
 Although complicated and layered in definitions, Travelbee’s theory clearly
outlines the steps to understanding her concepts. Various sources report a vague
interpretation for defining her theory, but she clearly defines the concept of suffering,
hope, illness, and the steps or phases necessary to establish a rapport. The
challenge for nurses is to identify themselves as being individually human, as are
their patients, and therefore accept and understand each other’s perceptions of self
and illness, striving to know each other and meet each other’s needs.

SIMPLICITY
Travelbee’s theory does not possess simplicity because there are many
variables. The theory is designed to help nurses appreciate not only the patient’s
humanness, but also the nurse’s humanness. To be human is to be unique, so the
variables present in each phase of the human-to-human relationship are numerous.
Multiple variables exist to define our being human, thus separating us via the level of
distress and suffering. How humans define or accept their distress and suffering is
multifaceted. The AP is ever aware of an individual human’s culture, religion,
ethnicity, family, and community connections, or lack thereof, and should identify
ways to connect human to human. Although her theory’s simple goal is to establish a
rapport with ill human beings, there are several phases or stages to accomplish:
encounter, identity, empathy, sympathy, and rapport.

GENERALITY
Travelbee’s theory has a wide scope of application. She generated it primarily
as a result of her experience with psychiatric patients, but it is not limited to use in
this setting. It is applicable whenever the nurse encounters patients in distress. It
seems to be most useful when working with those who are chronically ill, those who
are undergoing long-term rehabilitation, or those who are terminally ill. The Human-to-
Human Relationship Theory has the potential for global use within nursing, as we are all
human, we all have distress, and we all suffer. However, the individual human, family, or
community must see his or her distress or illness as being in need of an intervention if a
relationship is to develop.

EMPIRICAL PRECISION
Travelbee’s theory appears to have a low degree of empirical validity, most
of which can be traced to the lack of simplicity in the theory. She defines the
concepts theoretically and operationally.

IMPORTANCE
Travelbee provides nursing with the criteria for connecting to ill persons. She
has created a conceptual framework upon which to base therapeutic relationships
with patients, families, and communities in distress or having the potential for
suffering. Her definitions of the components of the metaparadigm of nursing’s
phenomena of interest add to the social significance and social utility of her theory.
Travelbee’s model teaches nurses to understand—or at least explore—the meaning
16
of illness and suffering in themselves. It is through this existential identification that
one human being can relate to another human being. The AP should promote self-
reflection as human to help other humans connect.
IMPORTANCE IN PRACTICE
Travelbee believed that the condition of an individual who is exhibiting
apathetic indifference is just as critical as that of an individual who is hemorrhaging.
She believed that both people need emergency resuscitative measures. However,
an examination of patient care given by nurses today indicates that the patient’s
physical needs still hold top priority. The current acceptance and use of nursing
diagnosis appears to focus nursing care more on the total needs of the patient as
compared with when Travelbee published her theory. However, nursing has not yet
reached the humanistic revolution that Travelbee proposed.
Hospice is one of the area of nursing practice in which the philosophy closes
adheres to the tenets of Travelbee’s theory. The hospice nurse attempts to develop
a rapport with the patient and significant others. Most hospice nurses agree with
Kübler Ross in “death does not have to be catastrophic, destructive thing, indeed it
can be viewed as one of the most constructive, positive, and creative elements of
culture and life.” Travelbee asserted that finding meaning in illness and suffering
enables the patient not only to accept the illness, but also to use it as self-actualizing
life experience. An ill individual’s perception of meaningless in his or her illness and
suffering leads to non-acceptance of his or her illness and a feeling of hopelessness.
One hospice nurse believes that the dying person must find meaning in his or her
death before he or she can ever begin to accept the actuality of death, just as his or
her loved ones must find meaning in death before they can complete the grieving
process.

IMPORTANCE IN EDUCATION
Nursing education appears to have identified the need to prepare nurses to
address the emotional and spiritual needs of patients. The focus of nursing
education has from the disease entity (signs, symptoms, and nursing interventions)
to a more holistic approach. However, basic nursing programs do not seem to
prepare nurses adequately to help individuals find meaning in illness and suffering
as Travelbee proposed. Travelbee’s second book, Intervention in Psychiatric
Nursing: Process in the One-to-One Relationship, has been used in various nursing
programs. However, this book does not adequately prepare nurses to help
individuals find meaning in illness and suffering. Nursing programs need to offer a
much broader background in communication techniques, values clarification, and
thanatology. Courses in philosophy and religion would also be helpful in preparing
nurses to fulfill the purpose of nursing adequately as stated in Travelbee’s model.

IMPORTANCE IN RESEARCH
Several sources in research studies have cited some aspects of the one-to-
one relationship proposed by Travelbee. One study by O’Connor, Wicker, and
Germino, which is closely related to some of Travelbee’s ideas, explores how

17
individuals who were recently diagnosed with cancer prescribed their personal
meaning. The researchers identified six major themes:
(1) seeking an understanding of the personal significance of the cancer
diagnosis;
(2) looking at the consequences of the cancer diagnosis;
(3) review of life;
(4) change in outlook toward self, life, and others;
(5) living with cancer; and
(6) hope and two major sources of support: (1) faith and (2) social support.
The findings of this study reveal that the search for meaning seems to be both
a spiritual and psychosocial process. The researchers identified nursing
interventions that would support this process. No other major research studies
generated by Travelbee’s specific theory, which could stimulate further development,
are available. Gregory used Travelbee’s model to study suffering inherent in the
cancer experience. Bennett used the model in relation to immune deficiency and
Baker used it to study schizophrenia.

CONCLUSIONS
Travelbee’s grand theory of Human-to-Human Relationships provides nurses with
a foundation necessary to connect therapeutically with other human beings. The
assumptions involve humans, who are nurses, relating to humans who are suffering, are in
distress, or have the potential to sufferBecause of the nurse’s knowledge and experience,
he or she develops a rapport with ill humans. Nurses perceive and understand the
uniqueness of every ill human being and therefore facilitate their finding meaning in
suffering. The theory is applicable to and has been used in the hospice movement,
helping terminally ill individuals and their families find meaning in suffering and fostering
hope, even at end of life. 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.”

REFERENCES
 Books:
 Alligood, M.R. (2002). Nursing theorists and their work. 5th ed. St. Louis, Mo.:
Mosby/Elsevier.

 Online Sources:

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  http://slsu-coam.blogspot.com/2008/09/joyce-travelbee-human-to-human.html
 http://currentnursing.com/nursing_theory/Joyce_Travelbee.html
 https://libraryguides.mayo.edu/c.php?g=280182&p=1867025
 http://nursing-theory.org/theories-and-models/travelbee-human-to-human-
model-of-nursing.php
 https://nursing-theory.org/nursing-theorists/Joyce-Travelbee.php
 https://www.researchomatic.com/Nursing-Theorist-Joyce-Travelbee-
50894.html
https://www.researchgate.net/publication/324071805_Appraising_Travelbee's_Huma
n-to-Human_Relationship_Model

o Activity Please complete the table below.

Theorist Practice Education Research

Theory Conceptual Person Environment Health Nursing
Model/Framework
. Joyce
Travelbee

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 HILDEGARD ELIZABETH PEPLAU

• Was born on September 1, 1909 in Reading, Pennysylvania.

• The second daughter of Gustav and Ottylie Peplau.
• Peplau Began her nursing career in 1931 after graduating from Pottstown,
Pennsylvania School of Nursing.
• Hildegard Peplau is considered to be the mother of psychiatric nursing.
• She died peacefully in her sleep on March 17, 1999 in her home in Sherman
Oaks, California.
• BA in interpersonal psychology from bennington College in 1943
• M.A. in psychiatric nursing from Colombia University, New York City.
• Certified in psychoanalysis by William Alanson White Institute of New York
City.
• Work as executive director and president of ANA
• Worked with WHO, NIMH and nurse corps

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Four sequential phases in the interpersonal relationship:

1.) Orientation

- The individual has felt and seeks professional assistance. The nurse helps
the patient recognize and understand his or her problem and determine his or
her need for help. This is where the nurse meets the patient and gain
essential information about them as people with unique needs and priorities.

2.) Identification

- The patient identifies with those who can help him or her. In this phase the
nurse makes assessment about patient, the selection of appropriate professional
assistance, patients begin to have a feeling of belongings and a capability of dealing
with the problem which decreases the feeling of helplessness and hopelessness.

3.) Exploitation

- Use of professional assistance or problem solving alternatives. The patient

attempts to derive full value from what he/she is offered through the
relationship. The nurse can project new goals to be achieve through personal
efforts and power shifts from the nurse to the patient.

4.) Resolution

- The patient gradually puts aside old goals and adopts new goals. This phase
is the discharge of the patient depending on how well the patients. Patients
drifts away and breaks bond with nurse and healthier emotional balance is
demonstrated and both becomes mature invidual.

Nursing Roles

1.) Stranger – offering the client the same acceptance and courtesy that
the nurse would to any stranger. Nurses are expected to greet patients
with the respect and positive interest accorder a stranger.
2.) Resource Person – providing specific answer within the large context.
One who provide a specific information that aids in the understanding
of a problem or new situation.

21
 3.) Teaching – helping the client to learn formally or informally. It means
that the role is about imparting knowledge in reference to a needs.
4.) Leadership – offering direction to the client or group. It helps client
assume maximum responsibility for meeting treatment goals in a
mutually satisfying way.
5.) Surrogate – recognize similarities between the nurse and the person
recalled by patient. It helps to clarify domains of dependence,
interpendence and independence and act on clients as an advocate.
6.) Counselling – promoting experiences leading to health for the client
such as expression of feelings.
Major Assumptions

- The kind of person that the nurse becomes makes a substantial difference
in what each patient will learn as he or she receive a nursing care.
- Fostering personality development toward maturity is a function of nursing
and nursing education. Nursing uses principle and methods that guide the
process toward resolution of interpersonal problems
Clarity

• Clear and logical fashion

• Readily understandable
• Can be learned with practice
Simplicity

• Her theory is easily understood, she clearly defines the theory’s basic
assumption and key concept, describe her four phases of the interpersonal
process, clearly indicates the roles of the nurse and she takes ideas from
observations of the specific and applies them to the general.
• She is consistent with established theories and principle, she then develops
each of these relationship within the theory in understandable way.
• Peplau’s theory can be described as meeting the evaluative quality of
simplicity.
Generality

• The quality of generality is not met because Peplau’s theory cannot be

applied to all patients. It use is limited in working with the comatose, senile, or
newborn patient.
• In such situations, the nurse-patient relationship is often one sided. The nurse
and the patient cannot work together to become knowledgeable, develop
goals and mature.

22
Empirical Precision

The Interpersonal Relation Theory is considered as empirically precise

because Peplau provides a theory based on reality. The relationship between the
theory and empirical data allows other scientists to validate and verify the theory.
The more a theory is based on reality, the degree of precision will increase.

Derivable Consequences

She provided nursing with a meaningful method of self-directed practice at

a time when medicine dominated the health care field. Peplau’s works, ideas,
thoughts have touched many nurses, from students to practitioners. It continues to
provide direction for nursing practice, education, and research. Peplau’s work has
provided a significant contribution to nursing’s knowledge base. The evaluative of
derivable consequences are unquestionably met.

Education

This theory serves as an aid to graduate nurses and nursing students to

have an adequate knowledge in terms of handling or communicating with a patient.
Through learning this theory, it will increase the nursing knowledge base.

Research

• Use research as a tool to develop a body of nursing knowledge were uneven

in quality and quantity and often did not explicity recognize underlying
assumptions.
• This theory will benefit to the future researchers, this serves as a source of
information, a guidance to gather information and it may serve as a building
block to have a bigger study.
Practice

- Practicing the interpersonal relation between nurse and patient is

important in order to implement the expected therapeutic outcome.
Strengths

Helped later nursing theorists and clinicians develop more therapeutic

interventions regarding the roles that show the dynamic character typical in clinical
nursing.

Weaknesses

Health promotion and maintenance were less emphasized, the theory

cannot be used in a patient who doesn’t have a felt in need such as with withdrawn
patients.

23
Conclusion

Studying Peplau’s Interpersonal Relations Theory of Nursing can be very

substantial especially to those who are aspiring to be part of the profession. Having
this knowledge of interpersonal relation will guarantee their patients to acquire the
best care and will ultimately speed along treatment and recovery.

However, the idea of nurse-client cooperation is found narrow with those

individuals who are unfit and powerless in conversing, specifically those who are
unconscious and paralyzed.

Reference:

Julia, B.G.,(2002)NURSING THEORIES THE BASE FOR PROFESSIONAL

NURSING PRACTIE., 5TH EDITION., Jurong, Singapore

o Activity Please complete the table below.

Theorist Practice Education Research
Theory Conceptual Person Environment Health Nursing
Model/Framework
.
HILDEGARD
ELIZABETH
PEPLAU

24
 Orlando’s Theory of Deliberate Nursing Process

Ida Jean Orlando

Life and Works:

She was recognized as a “ Nursing Living Legend “
She was born on August 12, 1926 in New Jersy
Her parents, Nicholas and Antoinette Orlando
She died on November 28, 2007, at the age of 81
Worked as a Stuff Nurse
Supervisory positions and the title of Second Assistant Director of Nurses
Research Associate and Principal Investigator
Her first book “ THE DYNAMIC NURSE- PATIENT RELATIONSHIP:
FUNCTION, PROCESS, and PRINCIPLES in 1961 ( REPRINTED 1990 )
Her second book “ THE DISCIPLINE and TEACHING of NURSING
PROCESS in

Major Concepts and Definitions:

Five Major Interrelated Concepts:

 The function of professional nursing

 The presenting behavior of the patient
 The immediate or internal response of the nurse
 The nursing process discipline
 Improvement

Nurse’s Responsibility

25
  It is the nurse’s responsibility to see that “ the patient’s needs for help
are met, either directly by her own activity or indirectly by calling in the
help of others (Alligood, M.R. and Tomey, A.M. p. 401).
Need

 defined as a requirement of the patient which, if supplied, relieves or

diminishes his immediate distressor and improves his immediate sense
of adequacy or well-being (Alligood, M.R. and Tomey, A.M. (2002), p.
401).

Presenting behavior of patient

 Any observable verbal or nonverbal behavior (Alligood, M.R. and

Tomey, A.M. p. 402).

 Presenting behavior is the patient’s problematic situation.

Through the presenting behavior, the nurse finds the patient’s
immediate need for help. To do this, the nurse must first
recognize the situation as problematic. Regardless of how the
presenting behavior appears, it may represent a cry for help
from the patient. The presenting behavior of the patient, which is
considered the stimulus, causes an automatic internal response
in the nurse, which in turn causes a response in the patient
(nurseslabs.com).

Immediate Reactions

 Include both the nurse and patient’s individual perceptions, thoughts,

and feelings (Alligood, M.R. and Tomey, A.M. p. 402).

 The nurses immediate reaction is the internal response. The

patient perceives objects with his or her five senses. These
perceptions stimulate automatic thought, and each thought
stimulates an automatic feeling, causing the patient to act.
These 3 items are patient’s immediate response. The immediate
response reflects how the nurse experience his or her
participation in the nurse-patient relationship (nurseslabs.com)

Nursing Process Discipline

 Includes the nurse communicating to the patient his or her own

immediate reaction, clearly identifying that the item expressed belongs
to the nurse, and then asking for validation or correction. Nursing
process discipline was called deliberative nursing process in Orlando’s
first book, The Dynamic Nurse-Patient Relationship: Function,
26
 Process, and Principles of Professional Nursing Practice, and also
called nursing process and process discipline. (Alligood, M.R. and
Tomey, A.M. p. 402).

Improvement

 Means to grow better, to turn to profit, to use to advantage (Alligood,

M.R. and Tomey, A.M. p. 402).

 Improvement is the resolution to the patient’s situation. In the

resolution, the nurse’s actions are not evaluated. Instead, the
result of his or her actions are evaluated to determine whether
his or her need for help and how it was met. In each contact, the
nurse repeats a process of learning how he or she can help the
patient. The nurse’s own individuality, as we as that of the
patient, requires going through this each time the nurse is called
upon to
Render service to those who need him or her (nurseslabs.com).

Purpose of Nursing

 Supply the help a patient requires in order for his needs to be met
(Alligood, M.R. and Tomey, A.M. p. 402).

 We all know that the nurse is responsible for gathering all the
information directly from the patient and making decisions based
on their information and because of that, nurses can supply the
needs of every patients and they can met what the patients
wants and needs.

Automatic Nursing Action

 Those (nursing actions) decided upon for reasons other than the
patient’s immediate need (Alligood, M.R. and Tomey, A.M. p. 402).

 The nurse can act in two ways: Automatic or Deliberative. Only

the second manner fulfils her professional function. Automatic
actions are “those decided upon for reasons other than the
patient’s immediate need”. Automatic actions fail to meet one or
more of these criteria. Automatic actions are most likely to be
done by nurses primarily concerned with carrying out physician’s
orders.(George, J.B. (2002), p. 197)
Deliberative Nursing Action

 Those actions decided upon after ascertaining a need and then

meeting this need (Alligood, M.R. and Tomey, A.M. p. 402).
27
  Deliberative actions ascertain and meet this need. It is a result
from the correct identification of patient needs by validation of
the nurse’s reaction to patient behavior. The nurse explores the
meaning if the action with the patient and its relevance to
meeting his need. The nurse validates the action’s effectiveness
immediately after completing it. The nurse is free of stimuli
unrelated to the patient’s need when she acts (George, J.B.
(2002), p. 19

ASSUMPTIONS:
Assumptions about nursing:

- “ Nursing is a distinct profession separate from other

disciplines “
- “ Professional nursing has a distinct function and product
“

Assumptions about patients:

- “ Patients have an initial ability to communicate their

needs for help “

Assumptions about nurses:

- “ Nurses should not add to the patient’s distress “

- “ The nurse’s mind is the major tool for helping patients “

Assumptions about the nurse- patient situation:

- “ The phenomenon of the nurse-patient encounter

represents a major source of nursing knowledge “

CRITIQUE

CLARITY:
For me, her theory is being expressed in a very exact way that nursing
process should be developed to understand the behavior of the patient.
Orlando consistently use the same word for her major components and
processes. Although her writing is clear and concise, some redundancy might
facilitate easier comprehension ( Alligood, M.R. and Tomey, A.M. p. 409 ).

28
SIMPLICITY:
For me, the theory has an ability to make the nurses understand the behavior
of the patients and what action should be applied. In able to form a good relationship
between the patient and nurse through nursing process.
Her theory would be considered simple. However, it is elegant in its simplicity.
Her theory may also be viewed as simplistic because she is able to make some
predictive statements as opposed to only description and explanation ( Alligood,
M.R. and Tomey A.M. (2002), p. 409 ).

GENERALITY:
The theory generalized that this nursing process is very useful in all fields
especially in a medical professions.
Orlando discusses and illustrates nurse-patient contacts in which the patient
is conscious, able to communicate and in need of help. Although she did not focus
on unconscious patients and groups, application of her theory to unconscious
patients or groups is feasible ( Alligood, M.R. and Tomey, A.M (2002), p. 409 ).

EMPIRICAL PRICISION:
For me, her theory defines the exact meaning of nursing process and
explained it well and it really helps the nurses to perform the right action to all
patients.
Nurses were trained to use the nursing process discipline in nurse-patient
contacts. Those nurses who became clinical nursing supervisors were trained to use
the nursing process discipline in their supervisory contacts and with other contacts
( Alligood, M.R. and Tomey, A.M (2002), p. 409 ).

IMPORTANCE:
It is very important to understand that nursing process is very applicable and a
guidelines on how the proper approach in a nurse- patient applied.
Education
It gives us more knowledge how a good action and behavior must done in the
presence of using the nursing process.
- Orlando developed the process recording, a tool to facilitate self- evaluation
of whether or not the nursing process discipline was used. The process recording is
an educational tool still used in nursing education ( Alligood, M.R. and Tomey, A.M
(2002). p. 406 ).

29
Research

It is very useful in the research because we can improve ourselves especially in

handling the patients in a proper way and to learn more about this specific theory of
nursing process.

- Orlando’s nursing process discipline has been designated the experimental

approach in several studies to examine its effects on a patient’s distress during
admission and before surgery ( Alligood, M.R. and Tomey, A.M. (2002), p. 407 ).

REFERENCES:

Books:
 Alligood, M.R. and Tomey, A.M. Nursing Theorist and their work, 5TH Edition
 George, J.B. (2002), p. 197

Internet:

 https://Nurseslabs.com

o Activity Please complete the table below.

Theorist Practice Education Research

Theory Conceptual Person Environment Health Nursing
Model/Framework
. Ida Jean
Orlando

30
 I. Life and works of Faye Glenn Abdellah

 Faye Abdellah was born on March 13, 1919 in New York City.

 Graduated magna cum laude from Fitkin Memorial Hospital School of Nursing in
Neptune, New Jersey in 1942.
 Received her B.S. (1945), M.A. (1947), and Ed. D. (1955) from Teachers College,
Columbia University.
 She served as Deputy Surgeon General and as Chief Nurse Officer for the U.S.
Public Health Service.
 In 1993 she became the Dean of the newly formed Graduate School of Nursing.
 She has been active in professional nursing associations and is a prolific author,
with more than 140 publications.
 She has been granted 1 honorary doctorates by various institutions.
 She has also been a research consultant to the WHO.

II. Abdellah’s Theory and Nursing’s Metaparadigm

Faye Glenn Abdellah has three major concepts of health, nursing problems, and
problem solving. Abdellah’s theory would state the nursing is the use of the problem-solving
approach with key nursing problems related to the health needs of people. A theoretical
statement maintains problem solving as the vehicle for the nursing problems as the patient is
moved towards health – the outcome. It is also a relatively simple statement and can be used
as a basis for nursing practice, administration, education, and research.

HEALTH:

31
 Her concept of health may be inferred to be dynamic of functioning whereby there is
continued interaction with internal and external forces that results in the optimal use of
necessary resources that serve to minimize vulnerabilities. Emphasis should be placed on
prevention and rehabilitation with wellness as a lifetime goal. By performing nursing services
through a holistic approach to the patient, the nurse helps the patient achieve a state of health.
However, to effectively perform these services, the nurse must accurately identify the lacks
or deficits regarding health that the patient is experiencing. These lacks or deficits are the
patient’s health needs.

NURSING PROBLEMS:
The patient’s health needs can be viewed as problems, which may be overt as an
apparent condition, or covert as a hidden or concealed one. Because covert problems can be
emotional, sociological, and interpersonal in nature, they are often missed or perceived
incorrectly. Yet, in many instances, solving the covert problems may solve the overt
problems as well.
In an effort to differentiate them from medical problems, she says a nursing problem
presented by a patient is a condition faced by the patient or patient’s family that the nurse,
through the performance of professional functions, can assist them to meet. Abdellah’s use of
the term nursing problems can be interpreted as more consistent with “nursing functions” or
“nursing goals” than with patient-centered problems. In her typology of basic nursing
problems presented by patients, she includes three columns: basic nursing problem presented
by the patient, specific problem of patient, and common conditions.

PROBLEM SOLVING:
Quality professional nursing care requires that nurses be able to identify and solve
overt and covert nursing problem. These requirements can be met by the problem solving
approach. The problem-solving process involves identifying the problems, selecting pertinent
data, formulating hypotheses, testing hypotheses through the collection of data, and revising
hypotheses when necessary on the basis of conclusion obtained from the data.
The problem-solving approach was selected because of the assumptions that the
correct identification of nursing problem influences the nurse’s judgment in selecting the next
step in solving the patient’s nursing problems. The problem-solving is also consistent with
such basic elements of nursing practice espoused by Abdellah as observing, reporting and
interpreting the signs and symptoms that comprise the deviations from health and constitute
nursing problems, and with analyzing the nursing problems and selecting the necessary
course of action.

32
  She seems to swing the pendulum to the opposite pole, from the disease
orientation to nursing orientation, while leaving the client somewhere in the
middle.

THE TWENTY-ONE NURSING PROBLLEMS

Three major categories:
 Physical, sociological, and emotional needs of clients
 Types of interpersonal relationships between the nurse and patient
 Common elements of client care

BASIC TO ALL PATIENTS

1. To maintain good hygiene and physical comfort.
2. To promote optimal activity; exercise, rest and sleep.
3. To promote safety through the prevention of accident, injury, or other trauma and
through the prevention of the spread of infection
4. To maintain good body mechanics and prevent and correct deformities.
SUSTENAL CARE NEEDS
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 electrolytes balance.
9. To recognize the physiological responses of the body to disease condition –
pathological, physiological and compensatory.
10. To facilitate the maintenance of regulatory mechanisms and functions.

33
 11. To facilitate the maintenance of sensory functions.
REMEDIAL CARE NEEDS
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 non-verbal communication.
15. To promote the development of productive interpersonal relationships.
16. To facilitate progress toward achievement of personal spiritual goals.
17. To create and/or maintain therapeutic environment.
18. To facilitate awareness of self as an individual with varying physical, emotional, and
developmental needs.
RESTORATIVE CARE NEEDS
19. To accept the optimum possible goals in the light of limitations, physical and
emotional.
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.

III. Sub-concepts

Ten Original Areas of Nursing Services:

1. Recognizing the nursing-problems of the patient.
2. Deciding the appropriate courses of action to take in terms of relevant nursing
principles.
3. Providing continuous care of the individual’s total health needs.
4. Providing continuous care to relieve the pain and discomfort and provide immediate
security of the individual.
5. Adjusting the total nursing care plan to meet the patient’s individual needs.
6. Helping the individual to become more self-directing in attaining or maintaining a
healthy state of mind and body.
7. Instructing nursing personal and family to help the individual do for himself that which
he can within his limitations.
8. Helping the individual to adjust to his limitations and emotional problems.
9. Working with allied health professions in planning for optimum health on local, state,
national, and international levels; and
10. Carrying out continuous evaluation and research to improve nursing techniques to
meet the health needs of people.

The Eleven Nursing Skills in the Theory are:

1. Observation of health status
2. Skills of communication

34
 3. Application of knowledge
4. Teaching of patients and families
5. Planning and organization of work
6. Use of resource materials
7. Use of personnel resources
8. Problem-solving
9. Direction of work of others
10. Therapeutic use of the self
11. Nursing procedure

USE OF THE TWENTY-ONE PROBLEMS IN THE NURSING PROCESS

ASSESSMENT PHASE:
 Nursing problems provide guidelines for the collection of data.
 A principle underlying the problem solving approach is that for each identified
problem, pertinent data are collected.
 The overt or covert nature of the problems necessitates a direct or indirect approach,
respectively.

NURSING DIAGNOSIS:
 The results of data collection would determine the client’s specific overt or covert
problems.
 These specific problems would be grouped under one or more of the broader nursing
problems.
 This step is consistent with that involved in nursing diagnosis

PLANNING PHASE:
 The statements of nursing problems most closely resemble goal statements. Once the
problem has been diagnosed, the nursing goals have been established.

IMPLEMENTATION:
 Using the goals as the framework, a plan is developed and appropriate nursing
interventions are determined.

EVALUATION:

35
  The most appropriate evaluation would be the nurse progress or lack of progress
toward the achievement of the stated goals.

Criteria might be used to determine effectiveness of patient-centered care:

1. The patient is able to provide for the satisfaction of his own needs.
2. The nursing care plan makes provision to meet four needs-sustenal care, remedial
care, restorative care, preventive care.
3. The care plan extends beyond the patient’s hospitalization and makes provision
for continuation of the care at home.
4. The levels of nursing skills provided vary with the individual patient care
requirement.
5. The entire care plan is directed at having the patient help himself.
6. The care plan makes provision for involvement of members of the family through
out the hospitalization and after discharge.

IV. Assumptions
The assumptions Abdellah’s “21 Nursing Problems Theory” relate to change and
anticipated changes that affect nursing; the need to appreciate the interconnectedness of
social enterprises and social problems; the impact of problems such as poverty, racism,
pollution, education, and so forth on health and health care delivery; changing nursing
education; continuing education for professional nurses; and development of nursing leaders
from underserved groups.
1. Learn to know the patient.
2. Sort out relevant and significant data.
3. Make generalizations about available data in relation to similar nursing problems
presented by other patients.
4. Identify the therapeutic plan.
5. Test generalizations with the patient and make additional generalizations.
6. Validate the patient’s conclusions about his nursing problems.
7. Continue to observe and evaluate the patient over a period of time to identify any
attitudes and clues affecting this 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 problems.
10. Discuss and develop a comprehensive nursing care plan

VI. Analysis
CLARITY:
 All the terms and consistent and easy to understand and are all nursing related.

36
SIMPLICITY:
 Concepts are simple and relevant to modern day patient centered care.
GENERALITY:
 Provides basis for determining and organizing nursing care.
 The problems also provide a basis for organizing appropriate nursing strategies.
 Has interrelated the concepts of health, nursing problems, and problem solving.
EMPERICAL PRECISION:
 This theory is present and future oriented.
 Theory is both broad and narrow.
 All the concepts mentioned in the 21 nursing problems, 10 steps, and 1 skills are
clinically relevant to nurses and even us nursing students.
IMPORTANCE: (Education, Research, and Practice)
 Education - professors and educators realized the importance of client centered care
rather than focusing on medical interventions. Nursing education then slowly deviated
its concentration from the complex, medical concepts, into exercising better attention
to the client as the primary concern. It’s very strong nurse-centered orientation—is, on
the other hand, it’s major contribution to nursing education.
 Research - her theories continue to guide researchers to focus on the body of nursing
knowledge itself, the identification of patient problems, the organization of nursing
interventions, the improvement of nursing education, and the structure of the
curriculum. The extensive research done regarding the patient’s needs and
problems has served as a foundation for the development of what is now known as
nursing diagnoses.
 Practice - Abdeallah’s main goal is the improvement of the nursing education. The
most important impact of Abdellah’s theory to the nursing practice is that it helped
transform the focus of the profession from being “disease- centered” to “patient-
centered.” The steps of the nursing process are assessment, diagnosis, planning,
implementation and evaluation

VII. References

1. Julie B. George. (NURSING THEORIST: The base for nursing practice, 5 th Edition),
Pearson Education, Inc. (2002)

o Activity Please complete the table below.

37
Theorist Practice Education Research
Theory Conceptual Person Environment Health Nursing
Model/Framework
Faye
Glenn
Abdellah

38