Theoretical Foundations

of Nursing: Evocative
Discussion
Neugene Rowan S. Cu, MAN, RN, RM, CSSYB
 Three Basic Aspects of the
Theory
O Patient Behavior -verbal and nonverbal communication
relating to the nurse what the patient immediately needs
O The Nurse’s Reaction–An active thought process by the
nurse in which he/she observes the behavior, interprets
them, and formulates a plan to meet the patient’s needs.
The nurse also communicates with the patient to validate
whether the patient’s behavior was correctly perceived by
the nurse before deciding on an appropriate intervention.
O The Nurse’s Activity –An interactive process with the
patient whereby the nurse performs actions for and with
the patient to meet the patient’s observed needs
 Ida Jean Orlando’s
Deliberative Nursing Process

Professional Presenting
Nsg Function Behavior Deliberative
Immediate Nsg Process Improvement
•Organizing •Problematic Sit.
Principle
Reaction (reflective : Resolution
inquiry)
 Let’s Brainstorm
Mr. Cardo D. a 65 year old Ilonggo, has been in
Tondo, Manila for 5 years with his family. “Mang
Cardo” as he is familiarly called, has been a
construction worker in Iloilo and presently works as
a part-time carpenter. Recently, he had been
experiencing cough, fever, night sweats, weakness,
and loss of appetite to eat. His lymph node
enlarged, Sputum examination and chest xray had
been done and he was diagnosed to have
pulmonary tuberculosis. He is currently being
treated for PTB. Nurse Charles has been involved
in his care in the Outpatient Department.
 Let’s Brainstorm
Nurse Charles was told that Mang Cardo was
really angry but nobody knew why. During one
of his contact with the patient, when he
handed the appointment card. Mang Cardo
took the card with a deep frown on his face.
Nurse Charles thought that this is where the
“mad” part that the staff had previously talked
about comes from. He then asked the
daughter why is his father frowning, Is he
upset about something?
 Let’s Brainstorm
The daughter replied, “Oh no, He is trying to
read what is written on the appointment card.
He doesn’t want people to think that he can’t
read….
 Joyce Travelbee
Human to Human Relationship

Encounter Identities Empathy Sympathy Rapport

 Joyce Travelbee
O "It's cancer! The cancer cells have metastasized
all over your body and its malignant. A chemo-
therapy can be of great help but you have
nothing to do but to pray... only a miracle can
save you ... You have only one short year to live."
These were the words have said by my doctor six
months ago and now, these are the words that
keep on ringing into my ears every time I entered
the chemotherapy room. A tinnitus that made
me deaf and hopeless.
"Miss, your chemo is finish already, how does it feel? Are you feelin' good?", my
chemotherapy nurse said as I replied with a coerce smile. What a question?
Everyone knows how difficult it is to undergo chemotherapy, it causes pain and
weakness to my body, troubles to my mind and cries to my heart. Those questions
should not been asked, the answer is obvious. As my nurse continues, "Miss, its
been 6 months of chemotherapy and ... ", I distracted her with my words, "and still
I have cancer. 6 months ago, meaning I have 6 more months to wait for my death.
What is the purpose of these chemotherapy anyway if still I have to die, this
therapy is useless and this made me feel weak. And look at me, I'm dying. I do
look like a corpse. My skin is desquamating my hairs begun to fall. Honestly, I
started to count my last hair strands." Together with the fall of my hairs are the
shattered of my dreams, washed-out of my youth and end of my value into this
world. I am like a flamed candle that melts as the hour runs, a cigarette that little
by little die and sand in the hour glass that become exhausted. I am useless! I'm
just waiting for my death to be valuable. You know how? ... My body could be a
great help for worms underground and soil fertilizer for plants and grasses over
my tomb." My nurse replied, "Is that the only value you've considered to yourself?
And that will gonna happen after your death and besides you are waiting for 6
months to be valuable for worms and plants only. Miss, you have 6 long months
more to be valuable while you are living. Why don't you make the most of it? There
are so many ways to be valuable, just only take all the opportunities that will
knock on your door. Please think about it.”
I am very young to die. How cruel of life it could be made me suffered like this way
at my early age. On this moment on, I should attend different night life and parties
as teenagers usually do. I should go to school and finish my chosen course.
Perhaps ... I should be valuable. But this cancer ruined everything, it destroys me!, it
destroys my cared beauty, made me weak and useless, made me old and fearful
because of my appearance. I started to have bald-headed, my hair started to fall ...
how could I go out and roamed around to enjoy my last days here on earth. I don't
want to die, I want to become a successful woman, I want to build a big company, to
be rich and famous. I want to raise a family of my own. I want to be valuable and
fulfilled. Actually, I have so much opportunities to attain all of these, I am an only
child of the richest couple in town. I am young, fresh, popular, intelligent and
beautiful. But all of these have nothing to do with cancer... all have faded. Before I
am a very brave and courageous young lady taking up political science for I want to
be a lawyer someday, a fighter fighting for one's right and now I am a useless ill lady
whose coward and frightened. I want to fight for my right, my right to live... my right
for my life. But fate is so cruel. If s not even, I don't have any armor to fight the
battle. If s not right! It is so unfair for not giving me a chance ... a chance to prove
something, to be successful, to be fulfilled... to be valuable.
Health Promotion Model
An Application of Nola Pender’s Theory
 Figure 1
Conceptual Model for Determining the Relationship between the Level of Adherence to
Treatment Regimen and Holistic Health Status
Patients from Selected Hemodialysis Units
In Quezon City1
1Cu, N.R. (2017). “Level of Adherence to Treatment Regimen and Holistic Health Assessment of
Patients on Selected Hemodialysis Patients in Quezon City.” Philippine Association on Graduate
Education Journal. Manila
 Cultural Assessment
(An Overview)*
An application of Transcultural Care Nursing

*Limited to selected categories. Examples are not of a full cultural

assessment
Language and Ethnohistory
O What is your country of origin?
O What ethnic/cultural group do you identify with?
O How long have you lived in this country? What led to you coming here?
O Sometimes when people are trying to leave their country, they
encounter some unpleasant experiences. Is there any experience that
we should know about that would be important to your care while
here?
O What language is spoken in your home?
O Do you speak, read, and/or understand English or another language?
O Are there resources/equipment that you normally use to assist you with
communicating?
O Tell me about any positive or negative experiences with how people
communicate with you that we need to know about to better care for
you?
 Kinship and Social Factors
O How would you prefer to be addressed while here?
O Do you have other family members who live close to you? Do any of
them live in the home with you? How would you like for them to be
involved in your care?
O Are there others that you would like to be involved in your care? Who
are these persons? How would you like for them to be involved?
O Will anyone other than yourself be participating in decisions affecting
your care (child’s care)?
O Are there any barriers related to your family getting to the hospital to
visit you?
O Tell me what good care means to you. In what way would you like for
nurses and other health care providers to care for you while you are ill?
What can we do while you are here that will lead you to feel that you
have receiving good care?
 Worldview
O When looking at yourself, what does the word ‘healthy’ mean to you?
O Share with me what you believe caused your illness?
O Why do you think that your illness started when it did?
O Since you have had this illness, do you feel any different during any
particular part of the day or night or on different days of the week?
O What do you call the illness that you are here for? Have you had this
illness before? When did it start? How has it made you feel?
O How will this illness/hospitalization affect your life and the life of your
family?
O What made you come to the hospital now (or other health care
facility)?
O It can be frightening to be in a hospital. How are you feeling about
having to be in the hospital? What fears do you have about your
illness?
 Environmental Factors
O Are you exposed to anything in the air, water that you drink, etc. where
you live or work that you believe may be harmful to you and your
family?
O Are you allergic to anything in the environment that you are aware of?
(e.g., chemicals, mold, etc.)
O It is possible that you will need equipment of some type when you go
home. Do you have the following in your home – electricity, running
water/well water, indoor plumbing, stairs, etc.?
O Do you have any special item that you have at home that would be
comforting to have with you in the hospital? If so, what meaning does it
have to you? If you are unable to speak for yourself, who would you like
to entrust with the item?
 Cultural Values, Belief, and
Lifeways
O We are interested in honoring your values and beliefs. Are there any
that you would like for us to know about to help you to
regain/maintain your health?
O How many meals per day do you normally eat? At what times?
O Tell me about the foods that you normally eat at mealtime.
O Are there foods that you do not eat ever or don’t eat at certain
times? Why?
O With whom do you usually eat your meals?
O What is your usual bedtime? Is there anything that helps you to
sleep better or worse?
O Many people have a ‘routine’ at home. Is there any part of your
routine that you would like to keep the same, if possible, while you
are here such as the time you take your shower/bath, etc.?
Generic Folk/Care Practices
O Do you seek help from anyone other than a licensed
medical provider that helps you to stay well or helps you
when you are not feeling well?
O What helps you to stay well?
O Tell me about things you do to help yourself feel better
when you are feeling ill.
O Tell me about any herbal or vitamin supplements that you
are taking. Dosage, frequency, and for what reason? How
do you get the supplements? Tell me about any activities
that you are involved in for your health and well-being.
O Have you taken or done anything before coming to the
hospital to treat your present illness? Did it make you feel
better, worse, or was there no change in how you felt?
 Religious, Philosophical,
Spiritual Factors
O Both males and females work in this and other departments in the
hospital, who are normally involved in caring for patients or entering your
room. Are there any special considerations that we should know about
related to persons of the opposite gender being involved in your care?
O Tell me about any considerations that we should know about related to
your religious beliefs/practices – diet, prayer/meditation times, etc.?
O Do you have any restrictions related to receiving blood/blood products?
O Is there anyone that we can call for you now to offer you spiritual/religious
support?
O How can we best support you spiritually while you are here?
O Valuables (if unfamiliar items are worn such as crosses, cloth
bracelets/strings, charms, medicine bag, etc.)
O What meaning does _______ have for you? Do you feel that your well-
being will be affected if _______ is removed? How?
O What normally helps you to feel better if you are feeling down/stressed?
 Professional Care/Cure
Practices
O Where do you most often receive care when
you are feeling ill or for regular checkups?
O Tell me about any prescription drugs that
you are taking. Dosage, frequency, and for
what reason?
O Have you encountered any positive or
negative experiences while receiving
professional care that we need to know
about to better care for you?