Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar
Web: http://uep.edu.ph Email: [email protected]

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

BS NURSING

NCM 100:
THEORETICAL FOUNDATION IN NURSING

LESSON 6

Prepared by:

NEMIA G. FLORANO, RN, MAN, PhD

Professor
 LESSON 6.
Local Theories and Models of Nursing Intervention (Philippine Setting)

O VERVIEW
Introduction Welcome to Lesson 6.

This section presents the Local Theories and Models of

Nursing Intervention (Philippine Setting). These local
nursing models demonstrate caring as a core of nursing,
love of country, and love of people as a manifestation of
professionalism, integrity, and excellence.

Are you excited in knowing these competent, dedicated,

commendable Filipino nursing theorists who with their
love for nursing used their hands-on experience as a tool in
making a difference in nursing?
Let’s read and learn!

Figure 1. Welcome to Theoretical Foundation

Interesting? Let’s start digging now!
In Nursing -Module Lesson 6

LEARNING OUTCOMES:
1. Exemplify love for country in service of the Filipino.
2. Discuss the systems of informatics related to the application of nursing theories.
3. Demonstrate caring as a core of nursing, love of country, and love of people.
4. Manifest professionalism, integrity and excellence.
LEARNING OBJECTIVES
1. Define key terms.
2. Identify the different views of local theorists and models relevant to nursing practice.
3. Analyze the metaparadigm of the different local theories and models of nursing
interventions.
4. Value the theoretical works of the local nursing theorists as it relates to nursing knowledge
development.

KEY TERMS:
Care Complex: is the nucleus of care experiences in the personality of a nurse formed by a
combination of maternal care experiences, culture based-care practices indigenous to a race and
people, and the professional training on care acquired in a formal course of nursing.
 Nursing Leadership: is the force within the nursing profession that sets the vision for its
practitioners, lays down the roles and functions, and influences the direction toward which
profession should go.
Retreat-workshop: is the spiritual exercise organized in an ambiance of prayer where the main
theme is the contemplation of Jesus Christ as a Servant-leader.
Servant-leadership behavior: refers to the perceives behavior of nursing faculty manifested
through the ability to model the servant leadership qualities to students, ability to bring out the
best in students, competence in nursing skills, commitment to nursing profession, and sense of
collegiality with the school, other health professionals, and local community.
Special expertise: is the level of competence in the particular nursing area that the professional
nurse is engaged in.
Transformative teaching: termed Reflective teaching, an umbrella term covering ideas, such as
thoughtful instruction, teacher research, teacher narrative, and teacher empowerment.

ACTIVITY

Before reading the abstraction, do this activity:

Previous lessons presented the definition of nursing theory as an organized,

knowledge-based concepts that essentially define the scope of nursing practice and aims
to describe, predict and explain the phenomenon of nursing, provide the foundation of
nursing practice, and help generate further knowledge and indicate in which direction
nursing should develop in the future. Everyone can be a theorist. If you are to develop a
nursing theory, from among the four (4) concepts common in nursing theory; the person,
the environment, health, and nursing - As a new nursing theorist, what concept will you
define and describe? Present your theory. Answer the why and how question.

ANALYSIS

Now that you have written your nursing theory, did you find it easier to become a
nursing theorist? What realization did you find? Did you brainstorm before writing? Did
you review all the compiled life experiences, concepts, and works presented by the
nursing theories that you thought worth relating to the theory that you will be writing?
Challenge yourself by always keeping on doing each activity correctly that will help you
understand and appreciate every lesson.

ABSTRACTION

Lesson 6.
Local Theories and Models of Nursing Intervention
(Philippine Setting)

I. Locsin’s Technological Nursing as Caring Model (Please see Nursing Theories:

Lesson 5)

II. Agravante’s CASAGRA Transformational Leadership Model

 Sr. Agravante's theory of Transformational Leadership Theory is focused
primarily on the educational and psycho-spiritual aspect of nursing. We believe
that Sr. Agravante emphasized the need for nursing faculty specially trained to
develop holistic nurses who will become leaders in health service.
 The Casagra Transformational Leadership Model is suitable for nursing
educators, particularly those who are administrators in the educational setting
(Magallanes, 2009). It has a psycho-spiritual model which can be utilized as a
formula for faculty and administrators to become better teachers and servant
leaders.
 The model is a powerful tool in achieving the organization’s vision and mission
as it is designed and aimed in developing a network of innovative, competent and
empowered educators towards excellence and nation building. Since it is spiritual
and religious, a paradigm of peace is embedded to engage and prepare nursing
administrators and educators to modern world-challenges today.
 The theory is based on Biblical teachings of Jesus Christ, which would impact on
the ethical practice that must be followed in the nursing field. In contrast, the
theory might not be accepted in Muslim countries as it is Bible-Based and does
not conform to diversities in culture, which might face hesitation among other
theorists, and scholars in the field of Nursing particularly among those that are
based in the GCC countries. The theory is designed to transform a servant leader;
an example would be, Agravante possesses Jesus.
 On the other hand, the effect of the CASAGRA leadership model using the
servant leader model on the leadership behavior in the nursing facility is an
effective formula in organizing one direction in achieving organizational goals.
The servant leader formula is an enrichment package prepared as intervention. It
has three parts that parallel the three concepts of the Casagra transformative
leadership model, namely: 1) the care complex primer, 2) a retreat-workshop on
servant leadership and 3) a seminar workshop on Transformative Teaching for
nursing faculty.
  The CASAGRA Transformation Leadership Theory is classified as a Practice
Theory basing on the characteristics of a Practice Theory stated by McEwan
(2007), which are the following:

- Complexity / Abstractness, Scope

– Focuses on a narrow view of reality, simple and straightforward
- Generalizability / Specificity
– Linked to a special population or an identified field practice.
- Characteristic of Scope
– Single, concrete concept that is operationalized.
- Characteristic of Proposition
– Propositions defined;
- Testability
– Goals or outcomes defined and testable; and
- Source of Development
– Derived from practice or deduced from middle range theory or grand
theory.
 These functions, once utilized accordingly will be an effective leadership tool in
the nursing academe and administration fields. And also, would be applicable to
those who are interested to be a nursing educator in the future.
 This theory can serve as a guide for nursing administrators and teachers
to learn something new, and it would be beneficial to those who would
like to learn more about transformational leadership.

III. Carmelita Divinagracia’s COMPOSURE Model

 Advance Nurse Practitioners’ Composure Behaviors and Patients’ Wellness
Outcome Model
 METAPARADIGM
-Individual: Each individual need humane, caring, spirituality-oriented
intervention that can facilitate wellness regardless of creed, social class, gender,
age and nationality.
-Nursing: the quality of nursing could be improved using an intervention
-Individual: each individual need humane, caring, spirituality-oriented
intervention that can facilitate wellness regardless of creed, social class, gender
and nationality.
 Definition of Terms
o Advance Nurse Practitioners
 BSN graduate Licensed and has a clinical experience of at
least 2 years in the clinical area Has undergone special training
in critical area Set of behaviors or nursing measures that the
nurse demonstrates to selected cardiac patients
 Composure Behaviors

A condition of being in a state of well-being, a coordinated and

integrated living pattern that involves the dimension of wellness.

o Theory of COMPOSURE Behaviours Dr. Carmelita C. Divinagracia

conducted a study to determine the effects of COMPOSURE behaviours of
the advanced practitioner on the recovery of selected patients at the
Philippine Heart Center.

o Behaviours include: competence, presence and prayer, open-mindedness,

stimulation, understanding, respect and relaxation, and empathy.

o Composure Behaviours Competence

 `An in-depth knowledge and clinical expertise demonstrated in

caring for patients.
 This also stands for consistency and congruency of words and
deeds of the nurse.
 Presence and Prayer
 A form of nursing measure which means being with
another person during times of need.
 This includes therapeutic communication, active
listening, and touch.

IV. Letty Kuan’s Retirement and Role Discontinuity Model

Basic Assumptions and Concepts:
 Physiological Age is the endurance of cells and tissues to withstand the wear-
and-tear phenomenon of the human body. Some individuals are gifted with
strong genetic affinity to stay young for a long time.

 Role refers to the set of shared expectations focused upon a particular position.
These may include beliefs about what goals or values the position incumbent is
to pursue and the norms that will govern his behavior. It is also the set of shared
expectations from the retiree’s socialization experiences and the values
internalized while preparing for the position as well as the adaptations to the
expectations socially defined for the position itself. For every social role, there is
complementary set of roles in the social structure among which interaction
constantly occurs.

 Change of Life is the period between near retirement and post retirement years.
In medico-physiologic terms, this equates with the climacteric period of
adjustment and readjustment to another tempo of life.

 Retiree is an individual who has left the position occupied for the past years of
productive life because he/she has reached the prescribed retirement age of has
completed the required years of service.
  Role Discontinuity is the interruption in the line of status enjoyed or role
performed. The interruption may be brought about by an accident, emergency,
and change of position or retirement.

 Coping Approaches refer to the interventions or measures applied to solve a

problematic situation or state in order to restore or maintain equilibrium and
normal functioning.

 Determinants of positive perceptions in retirement and positive reactions toward

role discontinuities:
o 1. Health Status – refer to physiological and mental state of the
respondents, classified as either sickly or healthy
o 2. Income – (economic level) refers to the financial affluence of the
respondent which can be classified as poor, moderate or rich.
o 3. Work Status
o 4. Family Constellation – means the type of family composition
described either close knit or extended family where three more
generations of family members live under one roof; or distanced family,
whose member live in separate dwelling units; or nuclear type of family
where only husband, wife and children live together.
o 5. Self-Preparation
.

V. Abaquin’s PREPARE ME Holistic Nursing Interventions

Basic Assumptions and Concepts:
 PREPARE ME (Holistic Nursing Interventions) are the nursing interventions provided
to address the multi-dimensional problems of cancer patients that can be given in any
setting where patients choose to be confined. This program emphasizes a holistic
approach to nursing care. PREPARE ME has the following components:
o Presence – being with another person during the times of need. This includes
therapeutic communication, active listening, and touch.
o Reminisce Therapy – recall of past experiences, feelings and thoughts to
facilitate adaptation to present circumstances.
o Prayer
o Relaxation-Breathing – techniques to encourage and elicit relaxation for the
purpose of decreasing undesirable signs and symptoms such as pain, muscle
tension, and anxiety.
o Meditation – encourages an elicit form of relaxation for the purpose of altering
patient’s level of awareness by focusing on an image or thought to facilitate inner
sight which helps establish connection and relationship with God. It may be done
through the use of music and other relaxation techniques.
o Values Clarification – assisting another individual to clarify his own values
about health and illness in order to facilitate effective decision- making skills.
Through this, the patient develops an open mind that will facilitate acceptance of
disease state or may help deepen or enhance values. The process of values
clarification helps one become internally consistent by achieving closer between
what we do and what we feel.

VI. Cecilia Laurente’s Theory of Nursing Practice and Career

  This theory aims to promote self- discovery by knowing strengths and weaknesses as
well as to practice controlling internal thought processes that will eventually influence
emotions, ideas and behaviors.

 The theory was from her study, the Categorization of Nursing Activities as Observed in Medical-Surgical
Ward Units in selected Government and Private Hospitals in Metro Manila, which was conducted from
January to June year 1987

 In the recent study of Laurente she states that the other entry point of helping the patient is through the
family, when nurses can be of great assistance to prevent at the very beginning serious complications.

 The nurse can help strengthen the family’s term of knowledge, skills, and attitude through effective
communication, employed informative, psychotherapeutic, modeling, behavioral, cognitive-behavioral,
and/or hypnotic techniques are summarized and evaluated

VII. Synchronicity in Human – Space – Time: A Theory of Nursing

Engagement in a Global Community

 Freslyn Lim-Saco’s SHSTTNEGC undergirds the innovative process of nursing

engagement expressed as interpersonal relating, technological knowing,
rhythmical connecting, and transformational engaging.

 A theory of nursing that embraces caring engagement in a neo-modernist

perspective asserts that there is interconnectedness between human thoughts,
synchronistic life events, and meanings of experiences, critical to living the
meaningfulness of human health and well-being in a community.

 The Synchronicity of Human-Space-Time (HST) Theory of Nursing Engagement

(SynHSTTNE) is advanced as foundational to nursing praxis as a theoretically
based nursing encounter, developing practice-based knowledge and methods
focused on the life principles of emancipation, equitability, interconnectivity, and
human transcendence. By harmonizing nursing engagements within the HST
consciousness, the application of these four life principles is viewed as
expressions of wholeness of persons at the moment (Boykin & Schoenhofer,
2013).

 Nursing engagement involves an active relationship in the nursing caring process

that fulfills the commitment to the persons within the HST.

 Human transcendence, the ability to go beyond the limitations of human factors

and space-time influences, has propelled globalization in nursing within a
universal technological domain (UTD) (Locsin, 2015; Locsin & Prudell, 2017).

 Globalization has ultimately lead to the meaningful connectedness of these life

principles and continues to influence access to quality and cost-effective health
care of diverse populations

 Nurses worldwide are guided by the five (5) elements of caring as authentic
intentions grounded in the theory: dance of caring persons, caring moment,
 expression of caring intentions, responsive sensing, and technological
competency.

 The theory can influence nursing research and practice to address diverse human
health experiences guided by the four (4) principles of emancipation, equitability,
interconnectivity, and transcendence of persons within the unity of wholeness of
persons.

 The application of nursing engagement process is guided by these life principles.

Nursing then unfolds in a unitarily developing pattern that upholds the wholeness
of the persons through nursing engagement processes in the HST consciousness.

 The nursing engagement process continuously develops into a “theory-guided

practice model that creatively unites ideas” (Watson & Smith, 2002, p. 460)

 The belief that the HST consciousness and human experiences being reducibly
evolving within the HST drives the human beings to have faith, to hope, and to
love. These motivate caring persons to interconnect, advocate equitability,
emancipate the self and others, sustains human dignity, preserves humanity, and
upholds human caring through the synchronous symphony of the caring
elements.

 In this theory, the nursing engagement process illuminates the appreciation and
application of meaningful connectedness within the HST as crucial to the
panacea for diverse global health situations.

APPLICATION AND EXERCISE:

Post-test
Directions: Explain each question, before you begin writing, read the statement carefully
and plan what you will say. Your essay should be as well organized and as carefully written as
you can make it. Use your own words. Do not google your answer. Remember, this is a post-
test.

Part I. Mastery`

1. Being a good nurse is based on sound nursing theory, such as patient practices, how
to treat patients, and theories in healing. However, good nursing also encompasses
other ideas and learn how to be a better nurse, and how to do your job better. From
among the seven local nursing theories presented in this module, name one or two
theories that strike you most and consider with utmost relevance that will contribute
much to your personal and professional development. Why and how?

2. How do you understand this quote: “The nursing profession needs leaders who will
model for the profession that which is beautiful, true, and good in this new
millennium” Explain in 2 paragraphs, the how’s and why’s of it.

SUMMARY
 This module presented in detail the local nursing theories and models of nursing intervention
(Philippine Setting) that demonstrate caring as a core of nursing, love of country, and love of people as a
manifestation of professionalism, integrity, and excellence.

REFERENCES

1. Alligood, M. R. (2014). Nursing theorist and their work. 8th edition. Elsevier.

2. George, J. (2012). Nursing Theories: The base for Professional Nursing Practice. 6th edition.

3. Tomey, A. M., & Alligood, M. R. (2006). Nursing theorists and their work. 6th Edition. St.
Louis: Mosby

Recommended Follow-Up/Readings:
To reinforce your understanding of the material, you are encouraged to read the following:
1. Nursing Theories from the references listed above and identify the different models/diagrams
used by the nursing theorist to present their theory and use them as a guide in making the
Metaparadigm of the various theories.

Thank you!