ROZZANO LOCSIN

Locsin’s Technological Nursing as Caring Model

Locsin’s Technological Nursing as Caring Model

Locsin earned his Bachelor of Science in Nursing from Silliman University in 1976 and his MA in Nursing
in 1978. He received his PhD in Nursing from the University of the Philippines in 1988.

In 1991, Locsin joined the Florida Atlantic University, Christine E. Lynn College of Nursing, where he
became a tenured Professor of Nursing. He is now a Professor Emeritus Locsin currents resides in Japan
and serves as a professor of nursing at Tokushima University.

was born in 1954, a registered nurse and a native of Dumaguete City, a Filipino author who wrote a
book entitled Technological Competency as Caring in Nursing: A Model for Practice, edited and co-
authored three more books, including one entitled A Contemporary Nursing Practice: The (Un)Bearable
Weight of Knowing in Nursing.

Locsin’s theory was Known for the Middle-range Theory, “Technological Competency as Caring in
Nursing”.

His theory answer the following questions;

 What does it mean to be technologically competent?

 What does it mean to be a caring nurse?
 How does technology support nursing work?
 How does it hinder nursing work?
 How can nurses care for their patients as technological advancements are introduced nearly
every day?
ASSUMPTIONS

 Persons are whole or complete in the moment.

 Knowing persons is a process of nursing that allows for continuous appreciation of persons
moment to moment.

 Nursing is a discipline and a professional practice.

 Technology is used to know persons as whole moment to moment.

 TECHNOLOGICAL COMPETENCY AS CARING IN NURSING

 Technological competency as caring in nursing is the harmonious coexistence between

TECHNOLOGIES and CARING in nursing.

 The harmonization of these concepts places the practice of nursing within the context of
modern healthcare and acknowledges that these concepts can co-exist.

 Technology brings the patient closer to the nurse. Conversely, technology can also
increase the gap between the nurse and nursed.

 When technology is used to know persons continuously in the moment, the process of nursing is
lived.

The Process of Nursing

KNOWING: The process of knowing person is guided by technological knowing in which persons
are appreciated as participants in their care rather than as objects of care. The nurse enters the world of
the other. In this process, technology is used to magnify the aspect of the person that requires revealing
- a representation of the real person. The person’s state change moment to moment - person is
dynamic, living, and can not be predicted.

DESIGNING: Both the nurse and the one nursed (patient) plan a mutual care process from which
the nurse can organize a rewarding nursing practice that is responsive to the patient’s desire for care.

PARTICIPATION IN APPRECIATION: The simultaneous practice of conjoined activities which are

crucial to knowing persons. In this stage of the process is the alternating rhythm of implementation and
evaluation. The evidence of continuous knowing, implementation and participation is reflective of the
cyclical process of knowing persons.

VERIFYING KNOWLEDGE: The continuous, circular process demonstrates the ever-changing, dynamic
nature of knowing in nursing. Knowledge about the person that is derived from knowing, designing, and
implementing further informs the nurse and the one nursed.

Technological Competency as Caring in Nursing: A Model for Practice

Locsin's middle range nursing theory is an interesting discussion of the correlation between hands-on
patient care and the use of technology. Technology is defined as anything that makes things efficient –
from basic diagnostic technologies to therapeutic practices familiar to all nurses. Specifically, he
discusses the importance of understanding the need for knowing “high-tech” instruments, e.g. monitors,
implants, and devices, that are a part of patient care, as these will provide opportunities for the nurse to
know the patient fully as person.

Locsin's work is obviously guided by the question asked by thoughtful nurses everywhere: How can I
satisfactorily reconcile the idea of competent use of technology with the idea of caring in nursing? His
theory significantly describes a practical understanding of the solution enriching the practice value of all
of the general theories of nursing which are grounded in caring. Technological competency as caring in
nursing informs nursing as a critical process of knowing persons’ wholeness. Locsin's theory book
explores, clarifies, and advances the conception of technological competency as caring in nursing. His
theory is essential to modeling a practice of nursing from the perspective of caring. It is a practical
illumination of excellent nursing in a technological world.

AGRAVANTE CASAGRA Transformative Leadership Model

Sr. Carolina Agravante, SPC, RN, PhD

The author of the theory is Sr. Carolina Agravante, SPC, RN, PhD and the theory was published in 2002.
Sr. Carol Agravante finished her baccalaureate degree in Nursing at St. Paul College of Manila in 1964.
She then took up her Masteral Degree in Nursing Education at the Catholic University of America in
1970, and finally earned her Doctoral Degree in Philosophy in University of Manila on April 2002, the
same time her Theory was published. She earned her Bachelor’s degree as a Magna Cum Laude and a
first place in the Board exam for Nurses on the year 1964 She was also a founding member of the
Integrated Registered Nurses of the Philippines and a Secretary of the Friendly Care Foundation from
2000 to present.

THE THREE-FOLD TRANSFORMATION LEADER CONCEPT

THE THEORY AS DEFINED

The complete title of the model is: The CASAGRA Transformative Leadership Model: Servant – Leader
Formula & the Nursing Faculty’s Transformative Leadership Behavior. The theory “CASAGRA
Transformative Leadership” is a Psycho-Spiritual Model. It is coined after the name of the investigator:
Sr. CArolina S. AGRAvante model
Agravante’s theory of Transformational Leadership Theory is focused primarily on the Educational and
Psycho-Spiritual aspect of Nursing. Sr. Agravante emphasized the need for nursing faculty specially
trained to develop holistic nurses who will become leaders in health service.

Three- Fold Transformation Leadership Concept rolled into one comprising of the following elements:

1. Servant-Leader Spirituality
2. Self- Mastery expressed in a vibrant care complex
3. Special expertise level in nursing field one is engaged in

These elements rolled into one make-up the personality of the modern professional nurse who will
challenge the demands of these crucial times in society today. THE THREE-FOLD TRANSFORMATION
LEADER CONCEPT IN DETAIL I. The Servant-Leadership Spirituality here is prescribed to run parallel to
the generic elements of the transformative leadership model.

This formula consists of a spiritual exercise, the determination of the vitality of the care complex in the
personality of an individual and finally a seminar workshop on transformative teaching. The servant-
leader formula prescription includes a spiritual retreat that goes through the process of awareness,
contemplation, story telling, reflection, and finally commitment to become servant-leaders in the
footsteps of Jesus.

II. The Self-Mastery consists of a vibrant care complex possessed to a certain degree by all who have
been through formal studies in a care giving profession such as nursing. III. The Special-Expertise level is
shown in a creative, caring, critical, contemplative and collegial teaching of the nurse faculty who is
directly involved with the formation of the nursing.

THE THEORY AS A MODEL

THEORY AS CLASSIFIED The CASAGRA Transformative Leadership Theory is classified as a Practice Theory
basing on the characteristics of a Practice Theory stated by McEwen (2007), which are the following:

a. Complexity / Abstractness, Scope - Focuses on a narrow view of reality, simple and straightforward
b. Generalizability /Specificity - Linked to a special populations or an identified field of practice

c. Characteristic of Scope – Single, concrete concept that is operationalized

d. Characteristic of Proposition – Propositions defined

e. Testability – Goals or outcomes defined and testable

f. Source of Development – Derived from practice or deduced from middle range theory or grand

theory.

DIVINA GRACIA’S COMPOSURE MODEL

CARMELITA DIVINAGRACIA

About the Nursing Theorist

 Filipino Nurse Theorist

 Association of the Deans Philippine Colleges of Nursing (ADPCN) Former
 President
 Dean of University of the East Ramon Magsaysay Memorial Medical Center, Inc.
 (UERMMMC) College of Nursing
 Member of CHED ‘s Technical committee on Nursing Education
 Has been lauded for developing the art and competency of teaching nursing.
 Has been a clinic nurse, staff nurse, head nurse, instructor, assistant dean and dean
 Expert in Research and Education

Composure Behaviors

A condition of being in a state of well-being, a coordinated and integrated living pattern that involves
the dimension of wellness.
COMPOSURE behaviors - -are set of behaviors or nursing measures that the nurse demonstrates to
selected cardiac patients.
WELLNESS STATUS - Refers to a condition of being in state of well-being, a coordinated and integrated
living pattern that involves the dimension of wellness.

Patient Wellness Outcome - This refers to the perceived wellness of selected patients after receiving
nursing care in terms of physiologic and biobehavioral.

Two categories:

1. Biobehavioral
2. Physiologic

Physiologic Wellness Outcome - This refers to the perceived wellness of selected patients after receiving
nursing care in terms of vital signs, bone pain sensation, and complete blood count.

Biobehavioral Wellness Outcome - This refers to the perceived wellness of selected orthopedic patients
after receiving nursing care in terms physical, intellectual, emotional, and spiritual.

SISTER LETTY G. KUAN

“Retirement and Role Discontinuities”

 a nurse with Master’s Degree in Nursing and Guidance Counseling.

 also holds a Doctoral Degree in Education.
 had two Master’s Degrees, MA in Nursing and MS Education, Major in Guidance Counseling,
culminating in Doctor of Education (Guidance and Counseling).
 authored several books giving her insight in the areas of Gerontology, Care of Older Persons and
Bioethics.
  In Kuan's theory of retirement and role discontinuities, she values the effect of retirement as a
phase of one's life and its accompanying adjustments. She identified the determinants of
positive perceptions in retirement and positive reactions toward role discontinuities.

RETIREMENT & ROLE DISCONTINUITIES

 Physiological Age
 Role
 Change of Life
 Retiree
 Role Discontinuity
 Coping Approaches

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.

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:

1. Health Status - refer to physiological and mental state of the respondents, classified as either
sickly or healthy.
2. Income - (economic level) refers to the financial affluence of the respondent which can be
classified as poor, moderate or rich.
3. Work Status
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
5. Self-Preparation
 CARMENCITA ABAQUIN

THEORY: “PREPARE ME”

Interventions and the Quality of Life Advance Progressive Cancer Patients.

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.

Cancer is one of the leading causes of death in the world to the fact that up to this point there is no
definite assurance of cure, though the advancement of medicine offers a broader chance of discovering
a cure for each terminal diseases including cancer. The mere fact of the complexity of this disease makes
someone think of death just by thinking of it. How much more on the person encountering this and who
is really experiencing the tortures, the pain, knowing that maybe his days are numbered.

Nursing is not just a profession but is also a passion where nurses are flexible in all aspects of caring and
utilizes all the resources available. We give our whole services to our patients we encounter. And we do
not only focus on the medications that are ordered by the physicians to be given to the patients. In
cancer cases, we can surely make a difference in the improvement of their quality of life by using
alternative ways and a perfect example is this PREPARE ME approach-presence, reminiscence, prayer,
relaxation activities, meditation, values clarification.

METAPARADIGMS AND INTERVENTIONS

1. Person/client : Her theory is specific to patients in advanced stages of cancer. They are holistic
being with physical, psychological, social, religious, level of independence, and environmental
aspects. Patients who are terminally-ill or those with incurable diseases as with cancer must be
approached in multifaceted care to improve their quality of care.

2. Environment: Just like all the other paradigms, environment was not defined accurately.
Nevertheless we can assume that environment is an aspect or dimension integrated to the
cancer patient. Her quality of life can also be assessed in this aspect thus it must be given
consideration in the provision of care.
 3. Health : The concept of her theory revolves around illness, particularly cancer and the provision
of holistic care to improve quality of life despite their terminal cases.

4. Nursing: The goal of nursing care is the improvement of quality of life for advance stage cancer
patients despite their current situation. Her concept of providing holistic nursing care in
addressing the multidimensional problems that cancer patients face is summarized in the
acronym PREPARE ME

“PREPARE ME”
Interventions and the Quality of Life Advance Progressive Cancer Patients.
PRESENCE
REMINISCE THERAPY
PRAYER AND ACCEPTANCE
RELAXATION – BREATHING
MEDITATION
PRESENCE - -Being with another person during the times of need. This includes therapeutic
communication, active listening, and touch.
REMINISCE THERAPY - Recall of past experiences, feelings and thoughts to facilitate adaptation to
present circumstances.
PRAYER AND ACCEPTANCE - The impact of prayer and acceptance
RELAXATION-BREATHING - -Techniques to encourage and elicit relaxation for the purpose of decreasing
undesirable signs and symptoms such as pain, muscle tension, and anxiety
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
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.
PREPARE ME theory provides a framework on non-pharmacologic, non-surgical approach of care to
advanced cases of cancer patients. The focus is not on cure but on assisting the patient to explore her
humanity and internal serenity as one is faced with the challenge of life and death. Nurses must be seen
not as mere caregivers but facilitators of peaceful acceptance of condition.
EXAMINE THE MEANING OF THEORY
Terminally-ill patients especially cancer patients require holistic approach of nursing in different aspects
of man namely the emotional, psychological, social and spiritual. In this premise, patients with incurable
disease require multidimensional nursing care to improve quality of life.
PREPARE ME nursing interventions are effective in improving quality of life in terminally-ill patients.
Utilization of intervention as a basic part of care given to cancer patients, likewise, incorporation in the
basic nursing curriculum in the care of these patients. PREPARE ME must be introduced and focus during
training of nurse both in academe and practice.
Development of training programs for care provider as well as health care profession where intervention
is a part of treatment modalities.
The nurse must be honest about the feedback on his/her condition. Nurses must do this so that they
would know what the expectations of the patient and the family so that they may render a holistic
caring style for the patient together with his family in his dying days. This would help the patient and
family address the needs of the patient in any manner possible. (physical, emotional and spiritual)
The nurse must help make a supportive environment for the patient and his family in his dying days. An
environment like this would promote dignity in his days left thus helping the patient accept his fate and
help him/her be ready for the afterlife. The family is also guided in this rough time addressing their
grieving process by instilling in them that death is part of life
IN SUMMARY, “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.

Cecilia Laurente
Theory of Nursing Practice and Career

WHO IS CECILIA LAURENTE?

➢Cecilia Laurente is a Filipino nursing theorist, who focused her works primarily on
helping a patient through support systems, specifically the family.

➢She published a paper entitled, “Categorization of Nursing Activities as Observed

in Medical-Surgical Ward Units in selected Government and Private Hospitals in
Metro Manila.”

➢Cecilia Laurente is known for her work in the field of nursing. In her theory of
nursing practice, she emphasized effective communication and championed
using the family as an entry point to help a patient.

THEORY OF NURSING PRACTICE AND CAREER

OVERVIEW

❖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
Anxiety – a mental state of fear or nervousness about what might happen

❖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, modelling, behavioural,
cognitive- behavioural, and/or hypnotic techniques are summarized and evaluated
THEORY OF NURSING PRACTICE AND CAREER
Nurses Caring Behaviour that affect the patient anxiety:
PRESENCE – person to person contact between the client and the nurses
CONCERN – development in the time through mutual trust nurse and the patient
STIMULATION – nurse stimulation through words tops the powerful resources of energy of person for
healing
Enhancing and Predisposing Factors

What is a predisposing Factor?

Predisposing factors are defined in these models as factors that exert their effects prior to a behaviour
occurring, by increasing or decreasing a person or population’s motivation to undertake that particular
behaviour.

❖Predisposing Factors

➢Age

➢Sex

➢Civil Status

➢Educational Status

➢Length of Work
➢Experience
Enhancing Factors
1. One’s caring experience, beliefs and attitude
2. Feeling good about
3. Learning at school
4. What patients tell about the nurse coping mechanism to problems encountered
5. Communication
BACKGROUND

➢Communication is key when getting nurses to engage patients and families in their care.

➢Research to develop the guide found that communication gaps between patients and caregivers can
occur when hospitals do not address the issues that patients' thoughts are most important. Another
factor is the available tools are to give health providers insights into patients' needs and concerns. As a
result, efforts by patients, families and health providers to communicate more effectively with each
other can fall short of their goal.

➢Each strategy includes educational tools and resources for patients and families, training materials for
healthcare professionals and real-world examples that show how strategies are being implemented in
hospital settings. The strategies describe how patients and families, working with hospital staff, can: be
advisors; promote better communication at the bedside to improve quality; participate in bedside shift
reports; and prepare to leave the hospital