THEORETICAL FOUNDATIONS OF NURSING

S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

○ UP-PGH (1962) = Graduate Degree

00 ○ UP-PGH (1969) = Bachelor’s
Local Theorists Degree
○ UP-PGH (1975) = Master’s Degree
1 Carmencita Abaquin- PREPARE ME Theory
○ UP-PGH (2000) = Doctorate’s
Degree
2 Sister Carolina S. Agravante- CASAGRA
● Staff nurse to head nurse
transformative leadership model
● Exchange student in Harper Hospital (US
3 Dr. Carmelita Divinagracia- Composure
hospital)
Behavior Theory
● Worked in Henry Ford Hospital and Cook
Country Hospital
4 Sister Letty Kuan- Graceful Aging Theory ● Went back to the Philippines to teach as
a professor in UPM for 35 years
5 Cecilia Laurente- Theory of Nursing Practice & ● NNCC
Career ● Specialty = Medical surgical nursing
○ Curative Setting
● Sub specialty = Oncologic Nursing
○ Cancer
1.0 CARMENCITA ABAQUIN ● Engaged in socio-civic and religious
activities
● December 12, 1940 - April 8, 2021 (65
yrs. old)
About Dr. Carmencita Matias Abaquin
● Transformational leader
○ Procedural type COMPETENCY BASED NURSING
■ Semantics vs procedural
● S: concepts/ words, low ● Categorized job description
retention rate ● Outcomes Based Nursing
● P: action, high retention, ○ CMO 15 s. 2017
kinesthetic ○ approach to education in which
○ Influence for change decisions about the curriculum are
○ Impact on progress driven by the outcomes the students
○ Realities + ways forward + real should display by the end of the
goals course professional knowledge, skills,
■ Allow person to realize own abilities, values and attitudes rather
realities than on the educational process
■ Recognize ● NNCC
■ Better coping/better habits ○ National Nursing Care Competency
● Focused on care of patients with cancer, ○ Base for development of
geriatric care curriculum and program-based outcomes in new BSN
development curriculum & outcome-based National
● President of Professional Regulatory License exam
Commission Board (PRCB) from 2006 to
2016
● Education 1.1 PREPARE ME Theory

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

● “To nursing… may be able to provide the 1. Cancer patients → holistic approach of
care that our clients need in maintaining nursing in different aspects of man.
their quality of life & being instrumental in 2. Effective
“birthing” them to external life” 3. Utilization of PREPARE ME as a basic part
○ Birthing to external life – of care given to cancer patients.
acceptance to death 4. Development of training programs for care
● Holistic nursing intervention / care provider as well as the health care
● Addresses multidimensional problems of profession.
cancer patients 5. Nurse must be honest about the feedback
● Given in any setting where patient choose on his/her condition.
to be confined a. This would help the patient and his
● Components family address the needs of the
○ PRESENCE patient in any manner possible.
■ Presence of the nurse or (physical, emotional, spiritual)
anyone that can aid the 6. Nurses must help make a supportive
patient environment for the patient and his family
○ REMINISCE THERAPY in his dying days.
■ Good memories a. An environment like this would
○ PRAYER promote dignity in his days.
■ Can be community based
or personal
1.3 TYPES OF THERAPY BASED ON
■ Religion doesn’t matter
○ RELAXATION - BREATHING THE 5 SENSES
■ Breathing Exercises
● Inhale through 1. Olfactory / Smell
nose ● Aroma Therapy
● Exhale through 2. Touch
mouth ● Therapeutic massage
■ To eliminate negative signs 3. Gustatory / Taste
or symptoms or stress ● Stress eating
○ MEDITATION ● Favorite foods
■ Communication with inner ● If px. Cannot taste
self ○ Through presentation of
■ Combination of breathing food
and stretching ○ The smell of food
○ VALUES CLARIFICATION 4. Auditory /Hearing
■ Open mindedness ● Calming music
■ Patient being able to ○ Classical
express or voice out their ○ Jazz
needs 5. Visual / Sight
● Watching videos that they are
interested or that stimulate them
1.2 Findings and Recommendation ● Going out to see places

*kadto man ata ni naas yellow book

1.4 Types of Massages

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

● Petrissage - kneading ● Para

● Tapotement - tapping ○ No. of deliveries after 20 weeks of
● Effleurage - circular gestation
○ Live births
● Called abortion if it cannot survive 20
1.5 Additional Information weeks

● CCMC was established by Ambulatory - client is able to walk

○ City Ordinance 679 Debilitated - bedridden/in nursing home
■ Due to the shortage of nurses
■ June 4, 1970 Gordon’s theory - head-to-toe
■ Pioneer Batch= 1971 -1974
ADL - activities of daily living
● 3 years only = required years
for a Graduate Degree PRC - Professional Regulation Commission
● Additional 1 year = for BON - Board of Nursing
Bachelor’s Degree - all members have PhD
● Total of 4 years for both - famous for creating dissertations
Graduate and Bachelor’s - nursing theorists that make board exam
questions
Degree
■ Changes such as principal to How to get nursing license:
dean, and school of nursing to - PRC BON gives the license
college of nursing - After grad
○ Curriculum is based on - Complete reg..?
■ COM 15 series of 2017
Process of making theories:
■ Outcomes based curriculum
1. BSN
● Factors for high risk pregnancies 2. RN
○ High risk = doremi 3. MN (MSN/MAN)
○ Too young 4. PhD
○ Too old = 35 years cutoff
● 5 grieving process or 5 stages of grief How to slay board exams:
○ Remember DABDA ● Do not overanalyze what is not written
● Calling other people is not an initial action
1. Denial
2. Anger
3. Bargaining METAPARADIGM OF PREPARE ME THEORY
4. Depression
● Person
5. Acceptance
-
Cancer patients
● Battery = touching of patient with no
● Environment
permission and can be filed a case against
- Settings where the patients choose to
● Contracture
be confined
○ Unable to move
● Health
○ Locked together
- Quality of life
○ Ex. paralyzed patient
- Improvement of quality of life
● 16 weeks of gestation
despite their terminal conditions
○ Baby can hear
● Nursing
● Gravida
- PREPARE ME Nursing interventions
○ No. of pregnancies

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

● Creative
○ Different modalities
2.0 SISTER CAROLINA S. ○ Allows students to create a
AGRAVANTE particular environment where they
can discover or explore
“Focus on the type of leadership that can challenge ● Caring
the values of the changing world.” ○ Sensible to the needs of others
○ Catholic; servant leader qualities ○ dole-out approach
○ Anchored her theory in the teachings ■ Giving to the poor
of Jesus Christ ■ Concept taken from the
○ For nursing educators, faculty church
members ● Critical
○ As a nurse, decide if a person
About Sr. Carol Agravante
needs your care or lying
- Proponent of “CASAGRA transformative
○ Patient-nurse interaction only last
leadership model”; coined the word,
for minutes or hours – time is
“CASAGRA” theory from her name itself.
limited
- CArolina S. AGRAvante
● Contemplative
● BSN - St. Paul College Manila- 1964
○ Resembles reflection
● MAN - Catholic University of America-
○ Do proper assessment of patient
1970
○ Determine consensus among team
● PhD- UP Manila - April 2002
members
● Dean’s lister + top 10
● Collegial
● collaborative=collegial
- Ex. CCMC-CN offers variety
2.1 CASAGRA transformative of learning sessions for
leadership model their students
● Leadership controls the minds of the
● Transformative, reflective leadership model faculty to produce good students
● A psycho-spiritual model
○ Changes the mindset of a person
2.2 3 concepts
○ EFFECTIVE for faculty to become
better teachers and servant leaders
● Designed to bring forth change from 1. Care complex- stimulus primer
indifference → spiritual person 2. Retreat workshop on servant leadership
○ Spiritual person = better learner = 3. Seminar-workshop on transformative
servant leader teaching

2.3 Care Complex in CASAGRA

● It acts as a stimulus to facilitate potential

leadership activities
● It is a structure in the personality of the
nurse that is directly related to leadership
behavior.
TRANSFORMATIVE TEACHING
● Not innate

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

○Hands-on experience with

rationale
2.4 CASAGRA servant-leadership ➢ Sense of collegiality with the
formula school, other health
professionals, and local
● An enrichment package prepared as community.
intervention. ○ Exchange of nursing skills
● An EFFECTIVE modality in enhancing the ○ Collaborative – set aside
nursing faculty behavior. personal judgment
3. Transformative Teaching
● It is an umbrella term
2.5 Special Expertise ● Also known as reflective teaching
● It comprises ideas of the following:
● The level of competences in the particular ➢ Thoughtful instruction
nursing area that the professional nurse is ○ Simplify information so it is
engaged in. easier for students
○ The opposite of self-directed
2.6 teaching
Operational Definitions
➢ Teacher research
➢ Teacher narrative
1. Retreat-Workshop
○ Ex. teacher gives feedback
- It is the spiritual exercise organized in
after clinical duty
an ambience of PRAYER
○ Importance of feedback
- The main theme is the contemplation
■ Improvement
of Jesus Christ as a servant-leader
■ Humble self
2. Servant-leadership behavior
➢ Teacher empowerment
- The perceived behavior of nursing
4. Nursing Leadership
faculty
● It is the force within the nursing
- Manifested through:
profession
➢ The ability to model the servant
● It sets the vision for its practitioners
leadership qualities to students
○ “Someday, I will be somebody”
○ Students can feel if teacher
● It lays down the roles and functions, and
has servant leadership
influences toward which the profession
➢ Ability to bring out the best in
should go.
students
○ Teachers stimulate
students physically & 2.7 Strengths & Weaknesses
emotionally
➢ Competence in nursing skills Strengths
➢ Commitment to the nursing ● More on transformative
profession
○ CCMC – competent, Weakness
compassionate, medical ● Complex
care ● Time-consuming
○ Share own skills to the
patients

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

2.8 Conceptual Model Nurses Association to perpetuate

her legacy as the founder of the
Filipino Nurses Association (FNA)
● 1962: Bachelor’s degree in Nursing at
UERMMMC
● 1975: Master’s degree in Nursing at UP
● 2001: Doctorate’s degree in Nursing at
UP

3.1 Research

● Her research title:

- Advanced Nurse Practitioners’
ComPOSURE Behavior And
Patient’s Wellness Outcome
3.0 DR. CARMELITA DIVINAGRACIA ● Main goal of her research study:
- Determine the effects of
composure behavior of the
About Dr. Carmelita Divinagracia advanced nurse practitioner on the
● Dean of University of the East Ramon wellness outcome of the selected
● Magsaysay Memorial Medical Center, cardiac patients.
Inc. ● Significance of the study:
● (UERMMMC) College of Nursing - Nursing as a healthcare profession
● A Former President of Association of the would prove its worth of being at
● Deans Philippine Colleges of Nursing par in quality performance with
(ADPCN) other healthcare professionals.
● She is a member of CHED ‘s Technical ● Study population:
● committee on Nursing Education - Adult Cardiac Patients admitted
● She has an expertise in teaching nursing. and confined at the Philippines
● She has nursing service (clinic nurse, Heart center, Coronary Care Unit
staff nurse, head nurse) and nursing
education (Clinical Instructor, Assistant 3.2 Operational Definition
dean and Dean ) background.
● She is an expert in Research and
1. Advanced Nurse Practitioner
Education.
- A Bachelor of Science in Nursing
● She utilizes her hands-on experience to
graduate
develop better ways to teach nursing.
- A Licensed nurse and has a clinical
● She is a Recipient of the Anastacia Giron
experience of at least 2 years in the
Tupas Award given by the Philippine
clinical area
Nursing Association (PNA) in 2008
- ANP has undergone special
○ Anastacia Giron Tupas is the First
training in critical area
Chief Nurse
- Set of behaviors or nursing
○ It is considered as the highest
measures that the nurse
award given by the Philippine

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

demonstrates to selected cardiac

patients

3.3 Composure Behavior

● It is a condition of being in a state of

well-being, a coordinated and integrated
living pattern that involves the dimension of
wellness.
● It is a study to determine the effects of
COMPOSURE behaviors of the advanced
practitioner on the recovery of selected
patients at the Philippine Heart Center.
PHYSIOLOGIC OUTCOME
● The nursing behaviors include the following
● Vital Signs
pattern:
○ Should be within normal limits
1. COMPETENCE,
○ Heart rate: 60-100
2. PRESENCE AND PRAYER,
○ Breathing pattern: 12-20
3. OPEN-MINDEDNESS,
■ Should not be labored
4. STIMULATION,
■ Should not be deep and
5. UNDERSTANDING,
rapid
6. RESPECT AND RELAXATION, AND
○ Temperature:
7. EMPATHY
■ Core temperature –check
patency of rectum
Through the COMPOSURE behaviors of the nurse ■ Armpit temp – superficial
↓ ● Chest Pain
HOLISTIC approach is guaranteed to the patient ○ Pressure
■ Myocardial infarction -
● Divinagracia explicitly expressed that for death of cardiac muscles
her, Nursing is a profession that surpasses ○ Stabbing pain
time and aspects of the individual as one of ■ Mild cardiac problem
its clients. ● Hemoglobin
● From the time the nurse admits a patient to ○ Can be affected if patient lives
the time of his discharge, the nurse’s upland or lowland
presence becomes a meaningful occasion ■ ↑ altitude ↑ hemoglobin
for the two parties to develop mutual trust,
acceptance, and eventually satisfying 3.5 COMpetence
relationships.

● An in depth knowledge and clinical

3.4 Theoretical Paradigm expertise demonstrated in caring for
patients.
● This is also stands for consistency and
congruency of words and deeds of the
nurse.

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

○ Verbal & nonverbal care must ● a form of nursing measure demonstrated

coincide by means of providing encouragement that
conveys hope and strength, guidance in the
form of giving explanation and supervision
3.6 Presence and Prayer when doing certain procedures to patient,
use of complimentary words or praise and
● A form of nursing measure which means smile whenever appropriate.
being with another person during times of ● Appreciation of what patient can do is
need. reinforced through positive encouraging
● This includes: remarks and this is done with kind and
✓ therapeutic communication approving behavioral approach.
✓ active listening, and ● Be sensitive to the patient
✓ touch ● Also reflects on gestures: (if you have an
● It is also a form of nursing measure which overbite don’t smile with teeth sa patient??)
is demonstrated through reciting a prayer
with the patient and concretized through
the nurse’s personal relationship and faith 3.9 Understanding
in God.
● According to Divinagracia, it conveys
interest and acceptance not only of
3.7 Open-mindedness patient’s condition but also his entire being.
● This is manifested through concerned and
● A form of nursing measure which means affable facial approach;
being receptive to new ideas or to reason. - this is a way of making the patient
● It conveys a manner of considering feel important and unique
patient’s preferences and opinions related
to his current health condition and
practices and demonstrate the flexibility of 3.10 Respect
the nurse to accommodate patient’s views.
● Acknowledging the patient’s presence.
● Use of preferred naming in addressing the
If patient has difficulty breathing:
patient, po and opo, is a sign of positive
● They sit, mao na ayaw ipahigda balik
regard.
● Sitting position:
● It is also shown through respectful nods
○ Is a compensatory
and recognition of the patient as someone
mechanism
important
○ Decreases workload
○ Allows lung recoil
Choking: 3.11 Relaxation
● Universal sign: hands on throat/chest
● Entails a form of exercise that involves
Therapeutic communication:
alternate tension and relaxation of selected
● Don’t ask why ditso
group of muscles.
● State observation, then ask question
● Massage & meditation

3.8 Stimulation 3.12 Empathy

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THEORETICAL FOUNDATIONS OF NURSING
S.Y. ‘23 - 24 | Midterms-Finals Period LESSON: Local Filipino Theorists & Developmental Theory

● Senses accurately other person’s inner

of Older Persons and Bioethics, and
experience.
Essence of Caring
● The empathic nurse perceives the current
➢ Concepts of Illness and
positive thought and feelings and
Healthcare intervention in an
communicates by putting himself in the
urban community
patient’s place.
➢ Understanding the Filipino elderly;
a textbook for nurses and related
4.0 SISTER LETTY GURDIEL KUAN health professional
➢ Essence of Caring

● Proponent of “GRACEFUL AGING THEORY”

About Sister Letty Gurdiel Kuan, RN, RGC, EdD 4.1 Notes in Bioethics
● Born on November 19, 1936 in
Zamboanga del Norte 1. Beneficence
● She is a nun and a registered nurse. - Giving something for the patient
- Religious community: Notre - Example: Free Health Education,
Dame de Vie, France founded in Direct Nursing Care, Collaborating
1932 with Healthcare Team
● MAN, Master of Science in Education 2. Non-maleficence
Major in Guidance Counseling - Do no harm to patient, avoiding
● September 2004- Professor Emeritus at potential harm
UP - Example: not performing surgical
● She has many contributions to the UP- operation to gerontologic patients
College of Nursing faculty and academic so as not to compromise patient’s
achievements health further
● Aside from UP Manila, she is affiliated in 3. Autonomy
several schools - The right of the patient to refuse
● Clinical fellowship and specialization in (patient: one who is capable to
Neuropsychology obtained from think logically)
University of France in Salpetriere - Also assess patient first if he/she
Hospital is psychologically capable.
● Neurogerentology in Watertown, New - Neurosis: intact with reality pa
York (Good Samaritan Hospital) - Psychosis: nawala na; people could
● She also had Bioethic formal training at no longer appreciate if they are
Institute of Religion, Ethics, and Law at with reality or not.
Baylor College of Medicine in Houston, - Delusion of Persecution: thinking
Texas someone is out to kill them.
- Expertise to clinical ethics 4. Justice
● Metrobank Foundation Outstanding - Distribution of workload must be
Teachers Award in 1995 well justified
● Award for Continuing Integrity and - Example: choosing to care for
Excellence in Service 2004 client who came first over friend
● Former Board of Nursing - For medications: first in first out
● She authored several books giving her
insights in the areas of Gerontology, Care
METAPARADIGM OF GRACEFUL AGING THEORY

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THEORETICAL FOUNDATIONS OF NURSING
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● Person dependence
- Elderly: any person reaching the mid 70s - Must be considered
up to the 80s desirable and satisfying that
- Gerone: old but gracefully able to function will help the person to enjoy
as useful citizens his remaining years of life
● Environment - Primary importance to
- Integrated in any settings- may it be home prepare early in his life by
or wider scope cultivating other role of
● Health options at age 50-60.
- Defined as AGING- It is a slow process
towards maturity of mind, body, and spirit.
- Growing old is reaching a “happy plateau” 4.2 Factors of the Aging Process
but one must understand and accept
what is aging. ● The nurse helps the person survive the
- It brings a decreasing amount of energy struggles and crisis in life
over long periods of activities → hence 1. Healthy genetic background
slowing down and moderation in our 2. Happy, fulfilled, childhood education
activity involvement is one reality of aging 3. Successful middle aged life experience
we all must realize and accept is a fact. 4. Healthy surroundings
- Aging is a reality and must be accepted 5. Relaxation
as a process towards fulfillment of total 6. Recreation and Nutrition
self. 7. Being recognized, appreciated, and
- Developing positive attitudes towards honored with love
aging while still young contributes to a 8. Attained a mastery of knowing oneself & a
great deal to feeling comfortable while mastery of a skill
growing old. 9. Grows closer to divine worship regardless
- GRACEFUL AGING leads the person in of religious affiliation
leaving a legacy. 10. Connectedness with others
- LEGACY is influenced by elements of life
early imprints & the factors of the aging
process. 4.3 Elements of Life’s Early Imprint
- Surviving the struggles & crisis in
life enables the person to leave a 1. Importance of Love
legacy. 2. The Hug-factor
● Nursing 3. Good parental and sibling modeling roles
- Prepare the person to have fulfillment in 4. The sense of humor and relaxation
their retirement years 5. The value of work and prayer life, growing
- Assist their elderly years in leaving a closer to God who loves us tremendously
legacy.
- RETIREMENT
4.4 Basic Assumptions and Concepts
- It is an inevitable change in one’s
life.
- Accompanied by related 1. PHYSIOLOGICAL AGE
disabilities & increased - It is the endurance of cells and
tissues to withstand the wear and

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THEORETICAL FOUNDATIONS OF NURSING
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tear phenomenon of the human retirement and ultimately legacy. ”

body. ● “The longer you stay in life, the more you
2. ROLE have acquired, the better you should be, the
- It refers to the set of shared legacy is given.”- Sister Letty G. Kuan
expectations focused upon a
particular position
5.0 CECILIA LAURENTE
- It may include beliefs about what
goals or values the position
3. CHANGE OF LIFE ● Published a paper entitled, “Categorization
- The period between near of Nursing Activities as Observed in
retirement and post-retirement Medical-Surgical Ward Units in Selected
years Government & Private Hospitals In Metro
4. RETIREE Manila”
- An individual who has left the ● Theory of Nursing Practice & Career
position occupied for the past ● She works in helping a patient through
years of productive life because support systems.
he/she has reached the prescribed
retirement age or has completed About Cecilia Laurente
the required years of age. ● 1967- BSN- UP
5. ROLE DISCONTINUITY ● 1973- MN
- The interruption in the line of ● 1968-1969- Staff Nurse
status enjoyed or performed ● 1970- 1972- Head Nurse
6. COPING APPROACHES ● 1979- CI at UP-CN
- Refer to the interventions applied - Later on she became a Dean of
to solve a problematic situation to College of Nursing in UP Manila
restore normal functioning

METAPARADIGM
4.5 Determinants of positive
perceptions in retirement and ● Person
positive reaction towards role -
Patients: who develop a sense of security
discontinuities & a stable support system
● Environment
- Interactions with family, friends, & other
1. Health Status
people are part in the environment.
2. Income
● Health
3. Work Status
- ANXIETY
4. Family Constellation
- One of the contributing factors
5. Self- Preparation
that could worsen the patient’s
condition
4.6 3 life courses - Healthcare workers and families
should work hand-in-hand to
1. Legacy → Acquisition → Struggles control it.
- “If you have a very happy & nice childhood, - If ignored- major issue both
you will have a very fruitful aging, happy mentally and physically

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THEORETICAL FOUNDATIONS OF NURSING
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● Feeling good about work

- Causing chest pains, tachycardia,
● Learning at school
and hypertension, headaches,
● What patients tell me about the nurse
breathing problems
coping mechanism to problems
● Nursing
encountered
- Delivery of optimal health outcomes for
● communication
the patient

00 Developmental Theory
5.1 Key Concepts
1 Sigmund Freud’s psychoanalytical model of
1. Anxiety personality development
- Mental state of fear or
nervousness about what might 2 Erik Erikson's Stages of Psychosocial Development
happen
2. Presence 3 Jean Piaget’s theory of Cognitive Development
- Person-to-person between the
client and the nurses
3. Concern
- Development in the time through 0 Developmental Theory
mutual trust between nurse and
patient ● Stepping stone of individual and matching
4. Stimulation it to your personality as a nurse
- Nurse stimulation through words ● Encompasses biological, cognitive, &
top the powerful resources of socioemotional changes form womb to
energy of person for healing tomb
○ Biological
■ Biological changes
5.2 Predisposing factors ○ Cognitive
■ Relying on parents and instincts to
● Factors that exert their effects prior to a gross motor skills (standing,
behavior occurring. walking) to refining fine motor
➢ By increasing or decreasing a skills ( raking motion to pincer
person’s motivation to undertake grasp)
that particular behavior. ■ Inductive (general to specific)
1. Age thinking to deductive thinking
2. Sex (specific to general)
3. Civil Status ■ Concrete thinking to abstract
4. Educational Status thinking
5. Length of Work ○ Socioemotional
■ Tantrums – ignore child then they
5.3 stop
Enhancing Factors
■ They like to say “no” – child wants
to have own autonomy– solution:
● One’s caring experience, beliefs, and
give them a choice
attitude
■ If parent is too strict, may produce

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THEORETICAL FOUNDATIONS OF NURSING
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traumatic response
● Provides a guide to assess and better
1.2 Anal Stage
understand the human development.
○ Subjective data – from person
○ Objective data – clinical results ● Anus becomes the center of gratification
● Essential framework to understand a ● Pleasure is derived from withholding
person’s response to an illness /expelling feces
● Helps in planning appropriate individualized ● Fixation leads to:
care for patients ○ anal retentive → obsession with
cleanliness , mean, anxious
○ anal expulsive → untidiness,
1.0 Sigmund Freud’s psychoanalytical care-free, generous
model of personality development

1.3 Phallic Stage

● Pleasure centers around the genitals

● Discovering self manipulation is the chief
source of pleasure
● Children develop attraction towards the
parent of opposite sex
● The child must establish identification with
1. Infant
same –sex parent to reduce tension /
2. Toddler
jealousy
3. Preschool
● fixation leads to:
4. School age
○ confused identity
5. Adolescent
○ vanity, envy
6. adult
○ difficulty to find intimate
relationship
1.1 Oral Stage
1.4 Latency Stage
● Derives pleasure from oral activities
● The child like to put everything to his
● Critical stage to enhance social skills &
mouth.
confidence
● Fixation leads to:
● Gender roles
- obsessive eating
● Most sexual impulses are repressed may
- alcoholism
be due to school work, hobbies and other
- smoking
activities
- nail biting

● 0-6 mos – breastfeeding 1.5 Genital Stage

● 6+ mos – solid food
○ Complimentary feeding ● SEXUAL REAWAKENING
■ Carbs ● THE CENTRAL OF PLEASURE IS OUTSIDE
■ Determine hypersensitivity

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THE FAMILY UNIT stage achieves→ self-control and willpower.

● HAS THE CAPACITY TO DEVELOP A
MATURE RELATIONSHIP
2.3 Initiative versus Guilt (3 to 6
● WELL ADJUSTED, FUNCTION AS AN ADULT
INDEPENDENTLY Years) Play Age

● Children like to pretend and try out new

2.0 Erik Erikson's Stages of roles.
Psychosocial Development ● Fantasy & imagination allow them to
further explore their environment.
● Conflicts often occur between the child’s
desire to explore and the limits placed on
2.1 Trust versus Mistrust (Birth to 1 his or her behavior. → lead to feelings of
Year) Infancy frustration and guilt
● Guilt → also occurs if responses are too
● Establishing a basic sense of trust is harsh
essential for the development of a healthy ● Preschoolers are learning to maintain a
personality. sense of initiative without imposing on the
● Requires consistency to meet the child’s freedoms of others.
needs. ● Successful resolution of this stage results
● From this basic trust in parents, the infant in direction and purpose.
is able to trust in himself, in others, and in
the world. 2.4 Industry versus Inferiority (7 to 11
● No consistency – paranoid/mistrust
Years) School Age

2.2 Autonomy versus Sense of Shame ● School-age children are eager to learn
& Doubt (1 to 3 Years) Early socially productive skills and tools.
Childhood ○ They learn to work and play with
their peers.
○ They thrive on their
● The child is more accomplished in some
○ and praise.
basic self-care activities, including walking,
● Without proper support for learning new
feeding, and toileting.
skills or if skills are too difficult, they
● This newfound independence is the result
develop a sense of inadequacy and
of maturation and imitation.
inferiority
● The toddler develops his or her autonomy
by making choices.
○ Choices typical for the toddler 2.5 Identity versus Role Confusion
age-group include activities related
(Puberty) Adolescence
to relationships, desires, and
playthings.
● Acquiring a sense of identity is essential for
● Limiting choices and/or enacting harsh
making adult decisions such as choice of a
punishment → leads to feelings of shame
vocation or marriage partner.
and doubt.
● Each adolescent moves in his or her unique
● The toddler who successfully masters this
way into society as an interdependent

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member.
3.0 Jean Piaget’s theory of Cognitive
● There are also new social demands,
opportunities, and conflicts that relate to Development
the emergent identity and separation from
family.
● Erikson held that successful mastery of
3.1 Sensorimotor Stage
this stage resulted in devotion and fidelity
to others and to their own ideals
● Babies use their senses to develop a
concept
2.6 Intimacy versus Isolation (Young ○ refinement of basic reflexes → help
Adult) the baby survive and feed
○ The child experiments with
● Young adults, having developed a sense of different movements to get a
identity, deepen their capacity to love reaction or experience sensations
others and care for them. ■ Example: The child will
● If the young adult is not able to establish hold a rattle or throw it
companionship and intimacy, isolation across the room to see the
results because he or she fears rejection consequences of those
and disappointment. actions

2.7 Generativity versus 3.2 Preoperational Stage

Self-Absorption & Stagnation
● This is also known as “Early Childhood
(Middle Age)
Development.”
○ While the child has already
● Middle-age adults achieve success in this
established that things exist
stage by contributing to future generations
outside of what they can see and
through parenthood, teaching, and
hear → they are still limited to
community involvement.
understanding things from their
● Achieving generativity results in caring for
own perspective. (this is called
others as a basic strength.
egocentrism)
● Inability to play a role in the development of
● As the child moves through the
the next generation results in stagnation.
Preoperational Stage, the child begins to
use symbolic play and thought to move out
2.8 Integrity versus Despair (Old Age) of an egocentric way of thinking. They can
begin to see things from other points of
● Older adults review their lives with a sense view
of satisfaction ● Children also start to develop language at
● Others see themselves as failures, with this time.
their lives marked by despair and regret ○ They use symbols to connect
● Older adults often engage in a retrospective letters and words with sounds.
appraisal of their lives. ○ This is why children begin to read
as early as 2.
● Children also learn to combine different

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schemas to solve problems and like his father is his competitor

understand the world around them. ● Electra Complex- daughter is more close to
● at the start of the Preoperational Stage → father; unresolved stages may result in
children have difficulty understanding future unbounded relationships
Conservation. ● Symbolic Play- good to learn skills
● They can’t comprehend ● Parallel Play- play side-by-side but don’t
○ For example: that the same amount interact with themselves
of liquid can be held in two ● Solitary Play- playing alone; using
containers with different shapes. imagination
They may say a tall, skinny glass ● Therapeutic play- introducing a medical
can hold more liquid than a short, intervention to a child that is less
wide glass of the same volume. threatening
● Infants 0-2 mos can’t control their heads,
unable to move head side-to-side
3.3 Concrete Operational Stage ○ 2 mos can turn head side-to-side
○ 6 mos can roll over
● Uses logic to solve problems and come up ○ 10 mos hold crate and stand, the
with conclusions. one step while holding
● They are limited to inductive reasoning ○ Risk for accident
● Can begin to grasp the idea of ○ Then walk, run climb
Conservation, Classification and ● Greenstick Fracture
Reversibility ○ Usually breaks radius

3.4 Formal Operational 00 System Theory

● This stage lasts for the rest of their lives.
1 The 5 ‘S’ Process: Seiri, Seiton, Seiso, Seiketsu,
○ Uses abstract thinking and
Shitsuke
deductive reasoning to solve
problems.
● Doable - ability to replicate practice
○ Think outside the world's rules and
anywhere
use more than just trial and error to
● It is a systematic approach to workplace
approach problems
organization and standardization that
● Children also develop meta-cognition
originated from Japanese manufacturing
during this time.
practices.
○ Uses hypothetical situations to
● A strategy of organizing, with the intent to
solve problems
improve efficiency by:
○ Solves more complex problems,
➢ Eliminating waste
but they can also think about their
○ Going out of the comfort
thought processes.
zone of “hoarding”
○ Identify the problem within
3.5 Additional Information yourself leads the change
– 1st step to embrace
● Oedipus Complex- son is more close to change is acceptance and
mother; if this is not resolved son may feel acknowledgement

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➢ Improving workflow and working

(CEO - rank &
management
file) where the
○ Ergonomics – ensure
lowest ranks ra
accessibility
ang muclean
○ “Time & effort” principle
(e.g. fast food chains ) Seiketsu Standardization Standardize the
➢ Reducing processes which are way of
unreasonable maintaining
○ Ex. procrastination & being cleanliness.
lazy
○ Needs will to initiate Shitsuke Discipline Practice 5 ‘S’
● A well organized workplace results in a daily- make it a
safe, more efficient, and more productive way of life; this
operation. also means
○ Appropriate apparatus for commitment.
hazardous materials.
○ Pregnant woman → lead apron Most
○ Tools that measure time if naa ka challenging
sa high radiation area because it needs
● It boosts the morale of the workers, consistency
promoting a sense of pride in their work
and ownership of their responsibilities.
1.1 The 5 ‘S’ activities
Japanese English Meaning in
Term Equivalent Japanese ● Work improvement through teamwork
context ○ Identify wastes and reduce the wastes
1. Overproduction
Seiri Tidiness Throw away a. Ex. making too much copies
rubbish and — too tired to start
unrelated 2. Inventory
materials in the a. Good only if products are
workplace consumables
3. Waiting
Seiton Orderliness Set everything in 4. Motion- Work Smart
proper place for 5. Transportation
quick retrieval 6. Rework
and storage a. Working smarter not harder
7. Over processing - overthinking
Seiro Cleanliness Clean the
workspace,
everyone should 1.2 Seiri
be a janitor.
● Act of throwing away all unwanted,
Different from unnecessary, and unrelated materials in the
bureaucracy workplace.

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● Eliminate guilt feelings about having to ○ Have consensus among

throw away things. co-workers on where and how to
○ The idea is to ensure that organize necessary items.
everything left in the workplace is
related to work. → refrain from
1.4 Seiso
putting sentimental value
○ Don’t be too emotional
■ Ex. picture frames on desk ● “Everyone is a janitor.“
is unnecessary and creates ● It consists of cleaning up the workplace
clutter and giving it a shine.
● Even the number of necessary items in the ● A good idea to have every area of the
workplace must be kept to its absolute workplace assigned to a person or group
minimum. for cleaning.
○ Simplification of tasks, effective ● No area should be left uncleaned.
use of space & careful purchase of ● Everyone should see the workplace through
items follow. the eyes of a visitor- think if it is good
○ Ex. no impulsive buying enough to make a good impression.
● Categorize materials in the working place
→ eliminates “just in case” attitude ● Check integrity of supplies
1. Necessary ○ Absence of microorganisms
2. Unnecessary ○ Intact packaging
3. May not be necessary ○ No smudges/moisture on
● Indicate “red tag” for categorization of packaging
items to identify unnecessary items. ■ Moisture can cause
● Move unnecessary items to the main contamination
stored area.
● Free up valuable floor space.
● Evaluate the integrity of the equipments. 1.5 Seiketsu

1.3 Seiton ● Standardized cleanup

○ Consists of defining the standards
by which personnel maintain
● Orderliness is all about efficiency.
cleanliness.
● This step consists of putting everything in
● Visual management is essential in this
an assigned place so that it can be
process.
accessed quickly, as well as returned in
● Color-coding and standardized color of
that same place.
surrounding are used for easier visual
○ If everyone has quick access to an
identification of the surroundings.
item, workflow becomes efficient, &
● Personnel are trained to identify deviations
worker becomes productive
using their senses.
● Every single item must be allocated its own
place for safekeeping.
● Apply “Can see, can take out, can return” 1.6 Shitsuke
philosophy.
○ It saves time & energy to look for ● Having discipline
something.

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● Denotes commitment to maintain the first 4 ● Describe the characteristics and factors
‘S’ that ensure successful change through the
● Elimination of bad habits and constant application of the 3 stages.
practice of good ones ● Transpose Kurt Lewin’s Change
● Once true shitsuke is achieved, Management theory to their own
○ Personnel voluntarily observe development within the field of nursing
cleanliness and orderliness at all informatics.
times without having to be ○ Ex. pneumatic system in hospitals
reminded by management. ○ “What are the concepts that need to
■ Ex. : nurses’ nature to do be innovated?”
aftercare ● Changes in healthcare are inevitable.
○ Metal syringe → disposable
syringe
00 Change Theory ○ Mercury thermometer → digital
thermometer
1 Kurt Lewin’s Change Management Theory ● Health Care is no exception
● Using change theory will help make
● Very simplified making it highly debatable changes more smoothly
● Used by lots of contemporary theorists ● Fits well with healthcare changes

About Kurt Lewin (1890-1947)

➢ “Father of Social Change Theories” 1.1 Stage 1: Unfreeze
○ Contemporary models mostly based
on Lewin’s work ● The need for change is identified, and
➢ Gestalt social psychology ● Readiness for change is established.
○ Conveying and sending a message ● It requires leaders and managers to help
that is easily understandable. prepare for change.
○ Bigger picture from smaller pieces ○ Help others to prepare for the
○ “Law of Similarity” change through education and
○ “Law of Proximity” motivation.
○ “Classical Conditioning” ○ Ex. persuasion – ability to motivate
■ Reward system others to participate in change
● Time- tested ● Establish a deadline that everyone
● Epitome of change models understands there is a need for change and
○ Suitable for both personal and there is a timeline to follow.
organizational change ● A timeline helps to establish urgency that
● Identify the driving and restraining forces change is necessary & change must be
that influence change. done.
● Recognize the behaviors and actors that ● Provides opportunity → “Force Field
help lead the change process, through the Analysis”
three stages. ○ Listing pros (driving force) and
1. Unfreezing cons (restraining force) with
2. Changing change you need to make.
3. Refreezing

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1.2 Stage 2: Change

● Provide continuous education to staff

regarding the changes taking place.
● Provide support especially if someone is
having difficulty with change.
● Provide feedback to staff regarding how 0 Legal Bases: Article 3, Sec. 9 © of
the change is going and any new steps that R.A. 9137
need to be taken.
○ If change is beneficial for client &
“Philippine Nursing Act of 2002”
coworkers
● If you are in high authority, give recognition
to induce action from employees. ● Board shall monitor & enforce quality
● Feedback works both ways. standards of nursing practice necessary to
● Not everyone is receptive to change ensure the maintenance of efficient, ethical
because of comfort zone displacement → and technical, moral and professional
provide emotional support standards in the practice of nursing taking
● If you are not open-minded to feedback → into account the health needs of the nation.
you think your idea is the best (delusion)
● Key idea of this stage: consider the 0.1 Significance of Core Competency
sentiments of others
Standards

1.3 Stage 3: Refreezing ● Unifying framework of nursing practice,

education & regulation
● Change has been made ● Guide in nursing curriculum development
○ Stability is critical to the change, ● Framework in developing test syllabus
■ to not go back to what was done ● Tools for nurse performance evaluation
before the change. ● Basis for advanced nursing practice.
● Allow the staff to accept the change ● Yardstick for unethical, unprofessional
● This is also the stage where individuals nursing practice
who were not advocates of the change
need to embrace the change.
○ Accepting change takes time.
○ Do not rush the process.
● Reinforce the importance of change.

1.4 Schematic Diagram

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THEORETICAL FOUNDATIONS OF NURSING
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6. Administers medications and other health

00 11 Key Areas of therapeutics.
Responsibility of Nursing 7. Utilizes the nursing process as framework
for nursing.
Core Competencies 8. Formulates a plan of care in collaboration
with patients and other members of the
1 Safe and Quality Nursing Care health team.
9. Implements planned nursing care to
2 Management of Resources and Environment
achieve identified outcomes.
10. Evaluates progress toward expected
3 Health Education
outcomes.
11. Responds to the urgency of the patient's
4 Legal Responsibility
condition.
5 Ethico-Moral Responsibility

0.2 Management of Resources and

6 Personal and Professional Development
Environment
7 Quality Improvement
● Be resourceful
8 Research
1. Organizes work load to facilitate patient
9 Record Management care.
2. Utilizes resources to support patient care.
10 Communication
3. Ensures availability of human resources.
4. Checks proper functioning of
11 Collaboration & Teamwork
equipment/facilities.
5. Maintains a safe and therapeutic
environment.
0.1 6. Practices stewardship in the management
Safe and Quality Nursing Care
of resources.

● Makes up 60-70% of questions in board

exam 0.3 Health Education
● Knowledge based on health/illness
● Always safeguard your nursing actions ● Provide health education to promote
based on standards continuity of care

1. Demonstrates knowledge based on the

health/illness status of individual groups. 1. Assesses the learning needs of the patient
2. Provides sound decision making in the care and family.
of individuals/groups. 2. Develops health education plan based on
3. Promotes wholeness and well-being assessed and anticipated needs.
including safety and comfort of patients. 3. Develops learning materials for health
4. Sets priorities in nursing care based on education.
patients' need. 4. Implements the health education plan.
5. Ensures continuity of care. 5. Evaluates the outcome of health education.

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4. Projects a professional image of the nurse.

0.4 Legal Responsibility 5. Possesses positive attitude towards
change and criticism.
● Nurse’s legal responsibility 6. Performs function according to
● Jurisprudence professional standards.
● Avoid actions that can end in lawsuits ● Improve your educational background
● What is not written is considered not done ○ Join training programs
○ Work is useless without ○ Participate in seminars or in-house
documentation activities in the hospital/workplace
● For documentation:
○ No liquid/tape eraser
0.7 Quality Improvement
○ Statement to be corrected to have a
single crash out line with initial
signature on top 1. Utilizes data for quality improvement.
○ Why? In court, liquid/tape erasures are 2. Participates in nursing audits and rounds.
considered tampering of evidence/ 3. Identifies and reports variances.
documentation. A strikethrough is 4. Recommends solutions to identified
considered correcting the mistake but causes of the problems.
the lawyers and judge can still see 5. Recommends improvement of systems and
what you wrote processes.
● Make sure your standards are at par with
the international & national standards
1. Adheres to practice in accordance with the
nursing law and other relevant legislation 0.8 Research
including contracts, informed consent.
2. Adheres to organizational policies and
procedures, local and national. 1. Utilizes varied methods of inquiry in solving
3. Documents care rendered to patients. problems.
2. Recommends actions for implementation.
3. Disseminates results of research findings.
0.5 Ethico-Moral Responsibility 4. Applies research findings in nursing
practice.
1. Respects the rights of individuals/groups.
2. Accepts responsibility and accountability 0.9 Record Management
for own decisions and actions.
3. Adheres to the national and international
code of ethics for nurses. 1. Maintains accurate and updated
documentation of patient care.
2. Records outcome of patient care.
0.6 Personal and Professional 3. Observes legal imperatives in record
Development keeping.
4. Maintains an effective recording and
1. Identifies own learning needs. reporting system.
2. Pursues continuing education.
3. Gets involved in professional organizations 0.10 Communication
and civic activities.

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1. Utilizes effective communication in relating

○ achieve a common goal and address the
with clients, members with the team and
multifaceted needs of the patient.
the public in general.
○ Examples: Interdisciplinary care
2. Utilizes effective communication in
planning, developing and implementing
therapeutic use of self to meet the needs of
care protocols, and participating in
clients.
healthcare team meetings are
3. Utilizes formal and informal channels.
collaborative interventions.
4. Responds to needs of individuals, families,
○ work together to provide comprehensive
groups and communities.
and holistic care
5. Uses appropriate information technology to
facilitate communication.

0.11 Collaboration & Teamwork

1. Establishes collaborative relationships with

colleagues and other members of the
health team for the health plan.
2. Functions effectively as a team player.

Types of Nursing Interventions:

1. Independent
○ actions that a nurse can initiate and
carry out without the need for a
physician's order or direction.
○ Ex. Health education, counseling,
providing emotional support,
administering prescribed medications

2. Dependent
○ actions that require a physician's order
or direction for implementation.
○ execute these interventions based on the
healthcare provider's prescribed plan of
care
○ Ex: Administering medications,
performing specific treatments or
procedures, and carrying out diagnostic
tests are dependent interventions.

3. Collaborative
○ involve the joint efforts of multiple
healthcare professionals, such as
nurses, physicians, therapists, and other
team members.

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