human to human relationship model
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advance nursing practiceTRANSCRIPT
Human-To-Human Relationship Model
Free Powerpoint TemplatesPage #Human-To-Human Relationship ModelJoyce Travelbee(1926-1973)
PRESENTED BYBELBI MOL E1ST YEAR MSC NURSING
Free Powerpoint TemplatesPage #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
Free Powerpoint TemplatesPage #Introduction
Joyce Travelbee(1926-1973) developed the Human-to-Human Relationship Model presented in her book Interpersonal Aspects of Nursing(1966, 1971).She dealt with the interpersonal aspects ofnursing.She explains human-to-human relationship is the means through which the purpose of nursing if fulfilled
Free Powerpoint TemplatesPage #About the Theorist
A psychiatric nurse, educator and writer born in 1926.1956, she completed her BSN degree at Louisiana State University1959, she completed her Master of Science Degree in Nursing at Yale University.
Free Powerpoint TemplatesPage #Continued...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.
Free Powerpoint TemplatesPage #Development of the Theory
Travelbees formulation of her theory was greatly influenced by her experiences in nursing education and practice in Catholic charity institutions. She concluded that the nursing care rendered to patients in these institutions lacked compassion. She thought that nursing care needed a humanistic revolution- a return to focus on the caring functions towards the ill person.
Free Powerpoint TemplatesPage #Continued...Travelbees mentor, Ida Jean Orlando, is one of her influences in her theory. Orlandos model has similarities to the model that Travelbee proposes. The similarities between the two models are shown in Travelbees statement: the nurse and patient interrelate with each other and by her description of the purpose of Nursing. She stated that the purpose of nursing is to assist an individual, family or community to prevent or cope with the experience of illness or suffering, and if necessary, to find meaning in these experiences.
Free Powerpoint TemplatesPage #Continued...Travelbee based the assumptions of her theory on the concepts of existentialism by Soren Kierkegaard and logotherapy by Viktor Frankl.Existential theory believes that that humans are constantly faced choices and conflicts and is accountable to the choices we make in lifeLogotherapy theory was first proposed by Viktor Frankel, a survivor of Auschwitzand other Nazi concentration camps , in his bookMan's Search for Meaning(1963) in which a patient is actually confronted with and reoriented toward the meaning of his life.
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Auschwitz Nazi concentration campsFree Powerpoint TemplatesPage #Continued..Frankls concept is based on the premise that the primary motivational force of an individual is to find a meaning in life. The following list of tenets represents basic principles of logotherapy:Life has meaning under all circumstances, even the most miserable ones.Our main motivation for living is our will to find meaning in life.We have freedom to find meaning in what we do, and what we experience, or at least in the stand we take when faced with a situation of unchangeable suffering
Free Powerpoint TemplatesPage #Basic Concepts
Sufferingsuffering is a feeling of displeasure that varies in intensity, duration and depth and a feeling of unease, ranging from mild, transient mental, physical or spiritual discomfort to extreme anguish and those phases beyond anguish, namely the malignant phase of despair full not caring and the terminal phase of apathetic indifference."Free Powerpoint TemplatesPage #Continuum of sufferingSuffering
Transitory extreme malignant terminalFeeling of anguish phase ofphase ofDispleasure despairful apathetic not caring indifference
Conceptualized by Theresa Lansinger based on Joyce Travelbees definitionFree Powerpoint TemplatesPage #Continued.MeaningMeaning is the reason as oneself attributes.Nursingis to help man to find meaning in the experience of illness and suffering.has a responsibility to help individuals and their families to find meaning.The nurses' spiritual andethicalchoices, and perceptions of illness and suffering, is crucial to helping to find meaningFree Powerpoint TemplatesPage #14Continued.HopeHope is a mental state the is characterised 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 Nurse's job is to help the patient to maintainhopeand avoid hopelessness.Hope is afaiththat can and will be change that would bring something better with it.Hope's core lies in a fundamentaltrustthe outside world, and a belief that others will help someone when you need it.Free Powerpoint TemplatesPage #Continued.
Six important factors characteristics of hope are:
It is strongly associated with dependence on other people.
It is future oriented.Free Powerpoint TemplatesPage #Continued.NnNmmm
It is linked to elections from several alternatives or escape routes out of its situation.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 ofcourageto be able to acknowledge its shortcomings andfearsand go forward towards its goal
Free Powerpoint TemplatesPage #17Continued.Communicationscommunication is a process which can enable the nurse to establish a human- to- human relationship and there by fulfill the purpose of nursing, namely to assist the individuals and families to prevent and to cope with the experience of illness and suffering, and, if necessary, to assist them to find meaning in these experiences."a strict necessity for good nursing care"
Free Powerpoint TemplatesPage #ContinuedUsing himself therapeutic"one is able to use itselftherapeutic."Self-awareness and self-understanding, understanding of human behaviour, the ability to predict one's own and others' behaviour are important in this process.Targeted intellectual approachNurse must have a systematic intellectual approach to the patient's situation.
Free Powerpoint TemplatesPage #Definition of domain concepts
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Continued.Free Powerpoint TemplatesPage #AssumptionsThe nurse-patient relationship is the essence of the purpose of nursing.Human beings are rational, social and unique beings and are more different than alike.Human beings undergo certain experiences and will search for meaning in them during the process of living. These experiences are considered a coherent wholes and could be understood(eg: illness anxiety , joy, harm). Therefore, likeness and similarities between human beings are the nature of their experiences.Free Powerpoint TemplatesPage #Continued.Labels tend to evoke stereotypical categories. Nurses should remember that patients are human beings who differ from other human being only in requesting the assistance of other human beings believed capable of helping them solve health problems.Relationships are established when both partners perceive each others uniqueness. Then, such human relationships transcend roles are true, meaningful and effective relationships based on perceptions of uniqueness.Free Powerpoint TemplatesPage #Continued.Nurse- patient relationships are based on perceiving the patient as an illness and nursing as a task. Illness is only understood in the context of perception of the patient and the nurse.Illness, suffering and pain experiences could be self actualising if individuals find meaning in them.Human beings are motivated to search for and understand the meaning of all life experiences.Illness and suffering are not only physical encounters for human beings, they are emotional and spiritual encounters as well.
Free Powerpoint TemplatesPage #Continued.Nurse- patient interaction, when purposeful, fulfils the goals of nursing.Communication is a process that can enable the nurse to establish a nurse-patient relationship and there by fulfil the purpose of nursing namely to assist the individuals and families, to prevent and cope with the experience of illness and suffering and, if necessary, to assist them to find meaning in these experiences.Nurse are expected to ascertain the meaning of exchanged messages.Free Powerpoint TemplatesPage #Nursing Metaparadigms
PersonPerson is defined as a human being.Both the nurse and the patient are human beings.A human being is a unique, irreplaceable individual who is in continuous process of becoming, evolving and changing.
Free Powerpoint TemplatesPage #Continued.HealthHealth is subjective and objective.Subjective health 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 disease, disability of defect as measured by physical examination, laboratory tests and assessment by spiritual director or psychological counsellorFree Powerpoint TemplatesPage #Continued.EnvironmentEnvironment is not clearly defined.She defined human conditions and life experiences encountered by all men as sufferings, hope, pain and illness.Illness being unhealthy, but rather explored the human experience of illnessSuffering is a feeling of displeasure which ranges from simple transitory mental, physical or spiritual discomfort to extreme anguish and to those phases beyond anguishthe malignant phase of despairful not caring and apathetic indifference
Free Powerpoint TemplatesPage #Continued.Pain is not observable. A unique experience. Pain is a lonely experience that is difficult to communicate fully to another individual.
Hope the desire to gain an end or accomplish a goal combined with some degree of expectation that what is desired or sought is attainable
Hopelessness being devoid of hope
Free Powerpoint TemplatesPage #29Continued.Nursing"an interpersonal process whereby the professional nurse practitioner assists an individual, family or community to prevent or cope with experience or illness and suffering, and if necessary to find meaning in these experiences.Free Powerpoint TemplatesPage #Description of the theory
Travelbee believed nursing is accomplished through human-to-human relationships that begin with the original encounter and then progress through stages of emerging identities, 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 nursing it is a prerequisite to achieving a genuine human-to-human relationships.
Free Powerpoint TemplatesPage #Continued.This relationship can only be established by an interaction process.It has five phases.
12345Free Powerpoint TemplatesPage #Continued.1. Original EncounterCharacterized by first impressions by the nurse of the ill person and the ill person of the nurse.Emotional knowledge colours impressions and perceptions of both nurse and patient during initial encounters.The task is to break the bond of categorization in order to perceive the human being in the patient and vice versa.(Travelbee, 1966, p.133)
Free Powerpoint TemplatesPage #Continued.2. Emerging IdentitiesBoth the nurse and the patient begin to transcend their roles and perceives uniqueness of each other.Task include separating oneself and ones experiences from others and avoiding "using oneself as yardstick to evaluate othersBarriers include envy, lack of interest in others, inability transcend self, or refusal to initiate emotional investment.
Free Powerpoint TemplatesPage #Continued.Empathy
Involves sharing of ones psychological state but standing apart and not sharing feelings.It is characterised by ability to predict the behaviour of others.Two qualities that enhance empathy are similarities of experience and desire to understand another person
Free Powerpoint TemplatesPage #Continued.4. SympathyOccurs when the nurse wants to lessen the cause of patients sufferingsharing feeling and experiencing what others are feeling and experiencing accomplishedThis phase demonstrates emotional involvement and discredits objectivity as dishumanizing
Free Powerpoint TemplatesPage #36Continued.it goes beyond empathyWhen one sympathizes, one is involved but not incapacitated by the involvement.The task of the nurse is to translate empathy in to helpful nursing actions.(therapeutic use of self)
Free Powerpoint TemplatesPage #Continued.5. RapportAll previous phases culminate in to rapport, defined as all those experiences, thoughts feelings and attitudes that both nurse and patient undergo and are able to perceive, share and communicate.All those experiences, thoughts, feelings and attitudes that both the patient and the nurse undergoes and are able to perceive, share and communicate Rapport is described as nursing interventions that lessens the patients suffering.
Free Powerpoint TemplatesPage #Continued.Relation as human being to human being- A nurse is able to establish rapport because she possesses the necessary knowledge and skills required to assist ill persons and because she is able to perceive, respond to and appreciate the uniqueness of the ill human being.
*phases are in consecutive and developmental process.
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Free Powerpoint TemplatesPage #41PropositionsTo know and understand perceptions of time and life experiences increases the nurses abilities to meet the needs of the patient.The nurses perception of patients is a major factor in determining the quality and quantity of nursing care she will render each patient.If nurses perceive patients as illness, tasks or set of stereotype characteristics, their focus in care in (institutional) rather than person centred.
Free Powerpoint TemplatesPage #Continued.As person become chore and a task, the nurse withdraws and directs her energy toward meeting institutional needs" and the patients experience anger, irritability, tension, restlessness, sadness, depression, hopelessness, apathy and transient somatic symptomsThe individuals socio-economic status affects the level of dehumanization a person is subjected to.The quality of nursing care given any patient is determined by nurses beliefs about illness, suffering and death.
Free Powerpoint TemplatesPage #ContinuedThe spiritual values of the nurse or her philosophical beliefs about illness and suffering will determine the extend to which she will be able to help patients to find meaning [or no meaning] in these situations.Nurses are able to empathize with patients who are similar to themselves.Experience of illness affects, to varying degree, all those associated with the patient, and subsequently affects the patients perception of the experience.
Free Powerpoint TemplatesPage #Continued.There is a direct relationship between caring and suffering, the more the person cares and is attached to an object or a person, the more the person suffers when that object or person is lost.Response to pain are influenced by cultural background of the person, philosophical premises, spirituality, level of anxiety and responses of others to the person in pain.Identify the properties of hope, determinants of hope and hopelessness.Free Powerpoint TemplatesPage #Continued.There is direct relationship between the extent to which the individuals need for cognitive clarity and security are met and the individuals anxiety level.
Free Powerpoint TemplatesPage #Application
Practice:Hospice self-actualizing life experience. Assumption of the sick role. Meaning of life and sickness and death.
Education:Teaches nurses to understand the meaning of illness and suffering.
Research:Applied in the theory of caring cancer patients.
Free Powerpoint TemplatesPage #AnalysisClarity is not consistent in clarity and origin.1. Definition of terms came from dictionaries and books etc.2. Used different terms for the same definition.3. Focus more on adult individuals who are sick and the nurses role in helping them to find meaning in their sickness and suffering.4. Deals in families and their needs but not in the community
Free Powerpoint TemplatesPage #Continued.Simplicity not simple.1. Contains different variables.
Generality has wide scope of application but applicable only to those patients in distress and life changing events.
Free Powerpoint TemplatesPage #Continued.Empirical Precision low measures of empirical soundness.1. Result of lack of simplicity.
2. Defines concepts theoretically but does not define them operationally.
3. The model has not been tested.
Free Powerpoint TemplatesPage #Continued.Derivable Consequences development of quality of caring.
1. It is useful because of its ability to describe, explain, predict and control a phenomena.
2. Explains the variables that affect the establishment of a therapeutic relationship between nurses and patients.
3. Lack of empirical precision also creates lack of usefulness.
Free Powerpoint TemplatesPage #Conclusion
Travelbee's theory has significantly influenced nursing and health care.Travelbee's ideas have greatly influenced the hospice movement in the west.
Free Powerpoint TemplatesPage #ApplicationJoanna, a 25 year old woman who appeared at a psychiatric outpatient clinic requesting therapy. She said I do not want to be close with someone other than family.She had a happy childhood, loving parents and liked her sister. Her entire family is very active in religious Catholic activities and even gained a lot of friends. She thought that her fear of closeness began when she slept over with her friends house. During the night, her friend began to fondle her in a way that she interpreted as sexual. She become very frightened and felt guilty. She told no one before entering therapy. Although she attended college, she never dated and only participated in superficial contacts. She realized that this was not a healthy young adult behavior and because the behavior and because the behavior continued into her twenties, Joanna decided to seek help.
In response to her situation, the psychiatric nurse. Luz, who is at the same age as Joanna, tried to get as much information that would help in Joannas situation. Although Joanna was initially hesitant and dry, Luz build a positive feeling of security by genuinely dealing with her as if they were real friends. In the end, Luz noticed that Joanna felt comfortable talking with her and even shared with her more feelings and thoughts.Free Powerpoint TemplatesPage #
But the question remainsWhy go to all this trouble?54
Why not do it the way you are used to?55Referenceshttp://theoriesinnursing.blogspot.in/2012/05/human-to-human-relationship-model.html
http://currentnursing.com/nursing_theory/Joyce_Travelbee.html
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