HUMAN-TOHUMAN

RELATIONSHIP
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
1926-1973
A psychiatric nurse, educator and writer
Presented by:
ALYSSA AYA L. GERONIMO
Presented to:
DR. RACHEL LAXAMANA
Course Facilitator

INTRODUCTION
As nurses, we have the responsibility towards our patients. This responsibility
does not only focus on the physical defects, difficulties or illness they
experience but as well as their total being whether it may be emotionally,
psychologically and spiritually. In being able to provide quality health care to
our patients, we must be able to have a good interaction and working
relationship with them. We must be able to gain their trust, respect and
establish rapport as well. As care providers, we must be able to assess the
person as a whole not just by mainly focusing in each problem that they
verbalize, share or complain.
The theory of Joyce Travelbee indeed has a very great contribution not only
to those who are in the Psychiatric Nursing field but in the whole nursing
practice. Not only should we be able to assist them towards wellness but also
to be able to find meaning in the situation or experiences they had been
through whether it may be good or bad. This theory does not only focus on
the patient but as well as with the nurse practitioner, both having a unique
personality.

ABOUT THE THEORIST

1956, she completed her BSN degree at Louisiana State University
1959, she completed her Master of Science Degree in Nursing at Yale
University
She started Doctoral program in Florida in 1973. Unfortunately, she was not
able to finish it because she died later that year. She passed away at the
prime age of 47 after a brief sickness.

WORKING EXPERIENCE
1952, Psychiatric Nursing Instructor at Depaul Hospital Affilliate School, New
Orleans.
Also she taught at Charity Hospital School of Nursing in Louisiana State
University, New York University and University of Mississippi.
1970, the Project Director of Graduate Education at Louisiana State
University School of Nursing until her death.

PUBLICATIONS
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com

1963, started to publish articles and journals in nursing.

1966 and 1971, publication of her first book entitled Interpersonal Aspects of
Nursing.
1969, when she published her second book Intervention in Psychiatric
Nursing: Process in the One-to-One Relationship.

THEORETICAL SOURCES
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.
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.
Viktor Frankl, a survivor of Auschwitz and other Nazi concentration camps
proposed the theory of logotherapy in which a patient is actually confronted
with and reoriented toward the meaning of his life.

Geronimo, Alyssa Aya L.

aiahgeronimo@gmail.com

Nursing Metaparadigm
1. Person
Person is defined as a 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.
2. Health
Travelbee
stated
that
health
is
measured by subjective and objective
health. A persons 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 disease, disability, or defect
as measured by physical examination,
laboratory tests, assessment by a spiritual director or psychological
counselor.
3. Environment
Environment was not clearly defined in Travelbee;s theory. She defined
human conditions and life experiences encountered by all men as sufferings,
hope, pain and illness. These conditions are associated to the environment.
Illness being unhealthy, but rather explored the human experience of
illness
Suffering 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 dispairful not caring and
apathetic indifference.
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
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com

Hopelessness being devoid of hope

4. Nursing
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. She explained that nursing is an interpersonal process
because it is an experience that occurs between the nurse and an individual
or group of individuals.

Human-to-Human Relationship Model

In her human-to-human relationship
model, the nurse and the patient
undergoes the following series of
interactional phases:
1. Original Encounter
This is described as the first
impression by the nurse of the sick
person and vice-versa. The nurse
and patient see each other in
stereotyped or traditional roles.
2. Emerging Identities
This phase is described by the nurse
and patient perceiving each other as
unique individuals. At this time, the
link of relationship begins to form.
3. Empathy
According Travelbee is the ability to penetrate or take part in and understand
the mental state of another person is in at this time.
Ability to recognize and understand other people's feelings. It is often
described as the ability to put themselves in the place of others.
4. Sympathy
Sympathy happens when the nurse wants to lessen the cause of the
patients suffering. It goes beyond empathy. When one sympathizes, one is
involved but not incapacitated by the involvement. The nurse should use a
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com

disciplined intellectual approach together with therapeutic use of self to

make helpful nursing actions.
5. Rapport
Rapport is described as nursing interventions that lessens the patients
suffering. The nurse and the sick person are relating as human being to
human being. The sick person shows 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.

THE GOALS OF THE NURSE

1. The nurse helps the ill person cope with present problems.
The nurse is concerned with here-and-now problems as perceived and
defined by the ill person. She is not concerned with uncovering unconscious
content or with tracking present problems back through the patients earliest
formative years. This is not to deny that such information is useful (or
interesting)-it does imply that the nurses primary aim is to help the patient
conceptualize his present problem. Knowledge of the ill persons past history
as obtained from the chart, resource people and others is helpful insofar as
what is learned guides the nurse in structuring nursing intervention;
however, the nurse does not probe or request this information from the
patient. If the patient reveals it, the nurse uses its knowledge to help her
understand his present problem. It is well to remember that there may be a
discrepancy between problems as perceived and defined by the patient and
the patients problem as perceived and defined by nurses, psychiatrists and
etc.

2. The nurse helps the ill person to conceptualize his problem.

As stated previously, one of the goals in the interactive process is to assist
the ill person to identify or conceptualize problems as he perceives them.
This is the primary focus of inquiry throughout the series of interactions.
Problems identified by patients will and do change as relationship
progresses.
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com

3. The nurse assists the ill person to perceive his participation in an

experience.
The nurse strives to assist the patient to see himself as an active participant
in life and its events. The practitioner strives to assist the patient to gain (or
regain) a sense of immediacy- of aliveness- and an appreciation of the
uniqueness of his individuality. As the relationship progresses, it becomes
easier for the patient to acknowledge that he is an active participant in life
experiences and that what he thinks, feels, and does elicits a response from
others. The patient begins to realize that he affects the behavior of those
about him. The patient also learns that the individuals he encounters will
react toward him on the basis of his behavior toward them. This knowledge is
gained slowly and over a period of time as the patient begins to develop an
appreciation of the cause-and-effect in behavior.
4. The nurse assists the ill person to face emerging problems
realistically.
Problems, as initially conceptualized by the patient, frequently undergo a
change. The initial presentation by the patient of a somewhat superficial
problem gradually changes, and deeper problems begin to emerge as the
relationship progresses and the patient is able to perceive his participation in
life experiences.
5. The nurse assists the ill person to envisage alternatives.
Many ill individuals resort to stereotyped means of solving problems. The
nurse assists the ill person to consider alternative means of solving problems
in living. It may not occur to an ill person that choices are possible in relation
to his particular problem or, if choices do exist, he cannot picture himself
acting any differently than he has is the past. The ill persons ability to
envisage alternatives is a legitimate subject of inquiry.
6. The nurse assists the ill person to test new patterns of behavior.
Another general goal in interacting with ill persons is to assist them to test
new patterns of behavior. A patient who has difficulty conversing with others
is helped by talking with the nurse. The nurse then assists the patient to
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interact with another patient in the unit. A patient who has difficulty in
approaching authority figures is helped by the nurse to approach the
psychiatrist. Nurse and patient together develop the plan and the patient
tests the new pattern of behavior. The extent to which the plan is successful
is discussed during the nurse-patient interaction. The aim of testing new
behavioral skills to help the patient to gain confidence in himself as a person
who can plan, test, envisage alternatives and face the outcome of the
testing. As the result of gaining this ability the patient gains a deeper
appreciation of himself as an active participant in life experiences.
7. The nurse assists the ill person to communicate
Mentally ill individuals generally have difficulty in sharing their thoughts and
feelings with others. A general goal in the nurse-patient relationship is to
assist the patient to communicate logically and clearly with others and to
become aware of what he communicates.

8. The nurse assists the ill person to socialize.

Mentally ill individuals generally have difficulty in socializing with others. The
term socialize means more than the ability to talk with others. An individual
who has the ability to socialize derives pleasure and enjoyment from
interacting with others and is attentive to the needs of others. Socialization is
a reciprocal process.
9. The nurse assists the ill person to find meaning in illness.
The nurse assists mentally ill individuals to find meaning in their suffering
and distress. Meaning is the reason given to particular life experiences by
the individual undergoing the experience. The term meaning is used in a
restricted sense and refers only to those meanings which enable the ill
individual not only to submit to illness, but to use it as an enabling life
experience.

THEORY ANALYSIS
Geronimo, Alyssa Aya L.
aiahgeronimo@gmail.com

Clarity

-Clearly
states
the
main
conceptand only focuses on the
relationship and only focuses on
the relationship between the nurse
and patient then vice versa.
Simplicity
-Not simple. Contains different
variables.
-Definition of terms came from
dictionaries and books etc.
-Used different terms for the same
definition.
Generality
-Has wide scope of application but
applicable only to those patients in
distress and life changing events.
-Focus more on adult individuals
who are sick and the nurses role in
helping them to find meaning in
their sickness and suffering.
Empirical Precision

Geronimo, Alyssa Aya L.

aiahgeronimo@gmail.com

-Defines concepts theoretically but

does
not
define
them
operationally.
-Numerous researches in research
studies have cited some aspects of
the
one-to-one
relationship
projected by Travelbee. One study
by OConnor, Wicker and Germino,
which is nearly related to some of
Travelbees ideas, discovers how
individuals who were recently
diagnosed with cancer described
their personal search for meaning.
Derivable Consequences
-Development of quality of caring.
-It is useful because of its ability to
describe, explain, predict and
control a phenomena.
REFERENCE the variables that affect
-Explains
Octaviano, E.F. & Balita, C.E. (2008). Theoretical
the
establishment
of a therapeutic
foundations
of
nursing:
The
Philippine
relationship
perspective. Perspective.
betweenPhilippines:
nurses Ultimate
and
Learning
Series.
patients
Tomey, A.M. & Alligood, M.R. (2002). Nursing
theorists and their work (5th ed.) .Missouri: Mosby