Human-To-Human Relationship Model

Introduction

• Joyce Travelbee (1926-1973) developed the Human-to-Human Relationship Model presented in her bookInterpersonal Aspects of Nursing (1966, 1971).
  
• She dealt with the interpersonal aspects of nursing.
  
• She explains “human-to-human relationship is the means through which the purpose of nursing if fulfilled” 
  

Abou the Theorist

• A psychiatric nurse, educator and writer born in 1926. 
• 1956, she completed her BSN degree at Louisiana State University
• 1959, she completed her Master of Science Degree in Nursing at Yale University.
• 1952, Psychiatric Nursing Instructor at Depaul Hospital Affilliate School, New Orleans.
• Later in Charity Hospital School of Nursing in Louisiana State University, New York University and University of Mississippi.
• Travelbee died at age 47.
  

Development of the Theory

• Travelbee based the assumptions of her theory on the concepts of existentialism by Soren Kierkegaard and logotherapy by Viktor Frankl.
  
• Existential theory believes that that humans are constantly faced choices and conflicts and is accountable to the choices we make in life
  
• Logotherapy theory was first proposed by Viktor Frankel, a survivor of Auschwitz, in his book Man's Search for Meaning (1963).
  
• Logotherapy
  

Basic Concepts

• Suffering
  
  • "An experience that varies in intensity, duration and depth ... a feeling of unease, ranging from mild, transient mental, physical or mental discomfort to extreme pain and extreme tortured ..."
    
• Meaning
  
  • Meaning is the reason as oneself attributes
    
• Nursing
  
  • is to help man to find meaning in the experience of illness and suffering.
    
  • has a responsibility to help individuals and their families to find meaning.
    
  • The nurses' spiritual and ethical choices, and perceptions of illness and suffering, is crucial to helping to find meaning.
    
• Hope
  
  • Nurse's job is to help the patient to maintain hope and avoid hopelessness.
    
  • Hope is a faith that can and will be change that would bring something better with it.
    
  • Hope's core lies in a fundamental trust the outside world, and a belief that others will help someone when you need it.
    
  • Six important factors charecteristics of hope are:
    
    • It is strongly associated with dependence on other people. 
      
    • It is future oriented.
      
    • It is linked to elections from several alternatives or escape routes out of its situation.
      
    • The desire to possess any object or condition, to complete a task or have an experience.
      
    • Confidence that others will be there for one when you need them.
      
    • The hoping person is in possession of courage to be able to acknowledge its shortcomings and fears and go forward towards its goal
      
• Communications
  
  • "a strict necessity for good nursing care"
    
• Using himself therapeutic
  
  • " one is able to use itself therapeutic."
    
  • Self-awareness and self-understanding, understanding of human behavior, the ability to predict one's own and others' behavior are imporatnt in this process.
    
• Targeted intellectual approach
  
  • Nurse must have a systematic intellectual approach to the patient's situation.
    

Nursing Metaparadigms

• Person
  
  • Person is defined as a human being.
    
  • Both the nurse and the patient are human beings.
    
• Health
  
  • Health is subjective and objective.
    
    
  • Subjective health 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 of defect as measured by physical examination, laboratory tests and assessment by spiritual director or psychological counselor.
    
• Environment
  
  • Environment is not clearly defined. 
    
• Nursing
  
  • "an interpersonal process whereby the professional nurse practitioner assists an individual, family or community to prevent or cope with experience or illness and suffering, and if necessary to find meaning in these experiences.”
    

Description of the theory

• Travelbee believed nursing is accomplished through human-to-human relationships that begin with the original encounter and then progress through stages of emerging identities, developing feelings of empathy, and later feelings of sympathy.
  
• The nurse and patient attain a rapport in the final stage. For meeting the goals of nursing it is a prerequisite to achieving a genuine human-to-human relationships.
  
• This relationship can only be established by an interaction process.
  
• It has five phases.
  
  • The inaugural meeting or original encounter
    
  • Visibility of personal identities/ emerging identities.
    
  • Empathy
    
  • Sympathy
    
  • Establishing mutual understanding and contact/ rapport
    
• Travelbee's ideas have greatly influenced the hospice movement in the west.
  

Conclusion

• Travelbee's theory has significantly influenced nursing and health care.
  
• Travelbee's ideas have greatly influenced the hospice movement in the west.
  

Publications& References

1. Travelbee, J. (1963). Humor survives the test of time. Nursing Outlook, 11(2), 128.
2. Travelbee, J. (1963). What do we mean by rapport? American Journal of Nursing, 63(2), 70-72.
3. Travelbee, J. (1964). What's wrong with sympathy? American Journal of Nursing, 64(1), 68-71.
4. Travelbee, J. (1966). Interpersonal aspects of nursing. Philadelphia: F.A. Davis.
5. Travelbee, J. (1969). Intervention in psychiatric nursing: Process in the one-to-one relationship.Philadelphia: F.A. Davis.
6. Travelbee, J. (1971). Interpersonal aspects of nursing (2nd ed.). Philadelphia: F.A. Davis.
7. Travelbee, J., & Doona, M. E. (1979). Intervention in psychiatric nursing (2nd. ed). Philadelphia: F.A. Davis.