The document provides biographical information about Dr. Josephine Paterson and Dr. Loretta Zderad, the founders of Humanistic Nursing Theory. It then outlines key aspects of the theory, including its implicit assumptions, theoretical assertions, and conceptualization of nursing, health, man, and environment. The theory presents nursing as an intersubjective relationship and uses existentialism and phenomenology as its philosophical framework. It proposes 5 phases of humanistic nursing inquiry and applies the theory to a case study of a teenage client.

1. HUMANISTIC
NURSING
THEORY
Dr. Josephine Paterson
Dr. Loretta Zderad
Presented By: Palwasha khan
(BSN NMU MULTAN)

2. BIOGRAPHY

3. DR. JOSEPHINE PATERSON

4. BIOGRAPHY
• Josephine Paterson was born on the 1st of
September 1924 in Freeport, New York.
• She had graduated in August 1945 with a
diploma from Lenox Hill School of Nursing
• Nine years later (1954, August) she received her
master’s degree from John Hopkin’s School of
Hygiene and Public Health, Baltimore, Maryland
• Her Doctor for Nursing is from Boston University
School of Nursing, Boston, Massachusetts, where
she specialized in psychiatric nursing

5. • Dr. Paterson conceptualized and taught
humanistic nursing to graduate students, faculty,
and staff in a variety of settings
• She also served on the faculty of the State
University of New York at Stonybrook
• She retired in 1985 as a clinical nurse specialist at
Northport Veterans Administration Medical
Center at Northport, New York

6. DR. LORETTA ZDERAD

7. • Zderad is a graduate of St. Bernard’s Hospital School of
Nursing and Loyola University
• She received her Master of Science degree from Catholic
University, Washington, DC, and a doctor of Philosophy
(1968) from Georgetown University, Washington, DC
• She has taught in several universities and has led groups
on humanistic nursing
• Dr. Zderad also served on the faculty of the State
University of New York at Stonybrook
• She retired in 1985 as the Associate Chief for Nursing
Education at the Northport Veterans Administration
Medical Center, Northport, New York

8. • Paterson and Zderad met in the 1950’s while
working at Catholic University, where their task was
to create a new program that would include
psychiatric and community health.
• Friendship that has lasted over 35 years.

9. HUMANISTIC NURSING
• “Embraces more than a benevolent
technically competent subject-object one-
way relationship guided by a nurse
in behalf of another. Rather it dictates that
nursing is a responsible searching,
transactional relationship whose
meaningfulness demands conceptualization
founded on a nurse's existential awareness
of self and of other“ (Paterson & Zderad)

10. Introduction
• Humanistic Nursing Theory is based on the idea that nursing
is an inter-subjective transactional relationship between a
nurse and a patient who are human beings existing in the
world.
• The conceptual framework of the theory is existentialism and
it presents a phenomenological method of inquiry that can be
used by nurses to examine and understand their everyday
practice.
• The theory serves as a vehicle to describe the essences of
everyday nursing experiences.
• Paterson and Zderad (1988) addressed three central questions:
What is the meaning of nursing? How do nurses and patients
interact? How can nurses develop the knowledge base for the
act of nursing?

11. • They use a phenomenological perspective as the basis for a
dialogue about lived experiences to uncover answers to the
questions. The sum total of all these experiences will enhance
the development of the science of nursing.
• Paterson and Zderad believed that a simple, scientific
approach to nursing education would not be sufficient to
create truly effective and content nurses.

12. IMPLICIT ASSUMPTIONS
• Nursing involves two human beings who are willing
to enter into an existential relationship with each
other.
• Nurses and patients as human beings are unique
and total biopsychosocial beings with the potential
for becoming through choice and intersubjectivity.
• Every encounter with another human being is an
open and profound one, with a great deal of
intimacy that deeply and humanistically influences
members in the encounter.

13. • Human beings are free and are expected to be involved in their
own care and in decisions involving them.
• All nursing acts influence the quality of a person’s living and
dying.
• Nurses and patients coexist; they are independent and
interdependent.
• A nurse has to “accept and believe in the chaos of existence as
lived and experienced by each man despite the shadows he casts,
interpreted as poise, control, order, and joy” (Paterson and
Zderad, 1988,p. 56).
• Human beings have an innate force that moves them to know
their angular views and other’s angular views of the world
(Paterson and Zderad, 1976; Zderad, 1969).

14. THEORETICAL ASSERTIONS
• Through the Humanistic Theory, the nurse is able to connect
with the patient and their struggle, enabling them to gain a
deeper understanding of their situation and face the battle
together.
• Humanistic nursing practice is developed from the lived
experiences of the nurse and the person receiving care.
• The practice of nursing is rooted from “EXISTENTIALISM”.
It is a philosophical approach to understanding life. Individuals
are faced with possibilities when making choices. These choices
determine the direction and meaning in one’s life.

15. • The purpose of the nurse-patient relationship, or
inter-subjective relating, is, “nurturing the well-
being and more-being of persons in need”.
Humanistic nursing focuses on the inter-subjectivity
experience, the most important activity for the nurse
to engage in may be the use of self, or presence with
the patient.

16. 3 CONCEPTS PROVIDING THE BASIS OF
NURSING
1) DIALOGUE
– Nursing is a lived dialogue. It is a nurse-nursed relating
creatively.
• Meeting Presence
• Response Relating
– Meeting
– is characterized by the expectation that there will be
a nurse and a nursed

17. – Relating
– is a process of nurse-nursed doing with each other
» Subject – Subject Relating
• "I-Thou" is a coming to know the other and the self in
relation, intuitively.
» Subject – Object Relating
• "I-It" is an authentic analyzing, synthesizing, and
interpreting of the "I-Thou" relation through
reflection.

18. – Presence
– is the quality of being open, receptive, ready, and
available to another person
– Call and Response
– nurses and clients call and respond to each other both
verbally and nonverball
Call and response relationship is where the client call for
assistance and the nurses hear the call and respond with
their knowledge, life experience, and skills to help the
caller with the health – related need. What happens
during this dialogue, the “and” in the “call and
response,” the “between,” is nursing.

19. 2) COMMUNITY
– Meaning comes from the realization that it is through each
other that we more fully participate in and expand our lives
– Two or more persons struggling together toward a center
(Paterson & Zderad, 1976)
• Through openness, sharing, and caring, we each will expand
our angular views, each becoming more than before.
Subsequently, we take back into our nursing community these
expanded selves, which in turn will touch our patients, other
colleagues, and the world of health care.
• According to Humanistic Nursing Theory, there is an inherent
obligation of nurses to one another and to the community of
nurses. That which enhances one of us, enhances all of us.

20. 3) PHENOMENOLOGIC NURSOLOGY
– Methodology for understanding and describing
nursing situations
– Assumes a perceived health need by the individual
who is involved in an interaction with a health care
provider
– Concerned with the nature of the facts and what they
mean to individuals

21. 5 PHASES OF HUMANISTIC NURSING
INQUIRY
• Preparation of the nurse knower for coming
to know
– Preparing to get to know the patient’s point-of-view. This
means the nurse uses her education and life experiences to
prepare to relate with patients. Your experience
communicating with different types of people
with different personalities helps you prepare to
communicate with patients.

22. • Nurse knowing the other intuitively
– Moving the other back and forth between the impressions
the nurse becomes aware of herself and recollected real
experience of the other (Paterson & Zderad, 1976)
– It is conceptualized as dialectic (investigating) between the
impression and the real. This shifting back and forth allows
for sudden insights on the nurse’s part, a new overall grasp,
which manifests itself in a clearer, or perhaps a new,
“understanding.” These understandings generate further
development of the process

23. – The nurse gains knowledge of the patient through intuitive
impressions and learning about the patient’s experiences
– At this time, the nurse’s general impressions are in a dialogue
with her unbracketed view

24. • Nurse knowing the other scientifically
– The nurse gains scientific knowledge of the patient by
(phenomenological process) pondering, analyzing, sorting,
comparing, contrasting, relating, interpreting, naming,
and categorizing data (therapeutic techniques: clarification
and verification)
– Collect information about the patient, for example age,
pulse and blood pressure

25. • Nurse complementarily synthesizing known
others
– The nurse combines the subjective and objective information
to gain perspective on the situation
– Nurse as “noetic loci” or “knowing places”. The nurse
examines the communication with the patient and the
information collected in light of her education (theoretical
foundation) and personal experience. The nurse uses all the
information from the patient and from her experiences to
form a conclusion. For example, maybe the nurse had a
patient before who had the same complaint.

27. • Succession within the nurse from the many to
the paradoxical one
– The nurse arrives at a new truth, a concept that includes all
the information gained, refined into a descriptive construct
(Kleiman, 2006)
– The nurse makes a conclusion about what is the best way to
improve the patient’s well-being.
• Paradoxical one: descriptive theoretical construct of
nursing

28. NURSING
METAPARADIGM

29. • NURSING
– Is a nurturing response of one person to another
in a time of need that aims toward the
development of well-being and more being
– Helping to increase responsible choices
– Nursing is concerned with the individual’s unique
being and striving towards becoming, focusing on
the whole
– Is a lived dialogue that incorporates the
intersubjective in which a nurse and a patient
meet, relate, and are totally present in an
existential way that includes intimacy and
mutuality

30. • HEALTH
– Matter of personal survival. It is a process of
experiencing one’s potential for well-being
and more-being, a quality of living and
dying.
• well-being: steady state (maintenance of
quality) or more than absence of disease
• more well-being: process of becoming all
that is humanly possible
– Finding meaning in life

31. • MAN
– Human beings are characterized as being capable, open to
options, person with values, and the unique manifestation
of their past, present, and future
• ENVIRONMENT
– Community: The phenomenon of society or environment
– Two or more persons struggling together toward a center
– It is only through our community that we are able to reach
our full potential

32. CONCEPTUAL MODEL

33. CONCEPTUAL FRAMEWORK

34. Nursing Application of
Humanistic Theory
34

35. Case study
Alia is 16-years old high school student who participates in a
variety of school activities, appreciated by both parents and
teachers. She is friend with the number of students in the
school. She has to come to the nursing unit after a recent unit
in health class about reproductive care that include topic
related to abstinence, pregnancy prevention and sexually
transmitted diseases.
She tells you that she has a friend who asked her to find out
some additional information . She asked you where her friend
could go if she needed to find out if she was pregnant.
You know that Alia has been steadily dating a male student.
You suspect that she may be talking about her self.
35

36. As we use phenomenological approach in humanistic
nursing so, before proceeding towards nursing process we
consider these two steps of phenomenological study for
subjective data collection of this patient. Given as:
1) Preparation of the nurse knower for coming to know:
2) Nurse knowing the others intuitively.
36

37. 1. Preparation of the nurse knower for coming to know:
 In the case of the adolescent client, the nurse need to
understand the cognitive development as well as the physical
and psychosocial changes experienced by the adolescent.
 Knowing about the need to meet the developmental
challenges of adolescence helps the nurse be aware of the kind
of behaviours that are often encountered.
2. Nursing Knowing the other intuitively:
 Being with the adolescent client nurse determines the
adolescent's level of comfort in making her “Call for help” to
the nurse.
 Does she appear relaxed, inquisitive, defensive, scared,
relieved or happy?
 Alia appears inquisitive and a bit nervous.
37

38. Assessment phase
(Nurse knowing the others scientifically)
In the phenomenological method of nursology the call comes
first, followed by intuition and assessment than analysis.
So in this case:
 The call is the Alias's approach to the nurse with questions,
intuition is the nurse suspecting the friend is Alia.
 That is why assessment include:
Alia or client says that her friend has
one missed period and is going to the
bathroom more often,
She added that frequently her
friend feel nauseated accompanied with
complain of constipation. Alia is looking
anxious and nervous while providing
history regarding her friend.
38

39. Diagnosis phase
(Succession within the nurse from the many to the
paradoxical one)
Possible nursing Diagnosis in Alias's case would be:
1. Knowledge deficit regarding normal progression of pregnancy
related to lack of knowledge of physiological and psychological
challenges during pregnancy as evidenced by request for
information.
2. Constipation related to excessive water absorption from GIT
tract as evidenced by patient verbalizes difficulty in defecation and
normal elimination pattern
39

40. DIAGNOSIS
(Dialogue)
Planning
(Dialogue)
1. Knowledge deficit regarding normal
progression of pregnancy related to lack of
knowledge of physiological and
psychological challenges during pregnancy
as evidenced by request for information.
2. Constipation related to excessive water
absorption from GIT tract as evidenced by
patient verbalizes difficulty in defecation
and normal elimination pattern
After 2-3 hours of nursing session the client
will be able to:
1. Explain normal physiological/psychological
changes associated with the first trimester.
2. Describe behaviours that promote wellness
and Identify danger signs of pregnancy.
After 2-3 hours of counselling session the
client will able to:
1. Identify individual contributing factors/risk
behaviours.
2. Report adoption of individually appropriate
behaviours to promote elimination
40

41. Implementation for
knowledge deficit
Rational
1. Establish an ongoing and supportive
nurse-client relationship.
2. Evaluate current knowledge and cultural
beliefs regarding normal
physical/psychological changes of
pregnancy, as well as beliefs about
activities, self-care, and so forth.
3. Clarify misconceptions.
4. Maintain open attitude towards the belief
of client.
5. Explain office visit routine and rational for
interventions (Urine testing, B.p
monitoring etc)
6. Using pictures discuss fetal development
process.
1. The role of teacher/counselor can provide
anticipatory guidance and promote
individual responsibility for wellness.
2. Provides information to assist in identifying
needs and creating a plan of care.
3. Fears usually arise out of misinformation
and may interfere with further learning
4. Acceptance is important to developing and
client/couple .maintaining relationship,
supporting independence.
5. Reinforces relationship between health
assessment interventions.
6. Visualization increases strengthen of child
reality and enhance learning.
41

42. Implementation for
Constipation
Rational
1. Determine pregravid elimination habits,
noting alteration in pregnancy.
2. Provide dietary information about
vegetables, fresh fruits, grains, fiber,
roughage, and adequate fluid intake.
3. Provide information regarding regular,
non-strenous exercises . Note cultural
beliefs about exercises.
4. Discuss cautious use of stool softner or
bulk producing agents if exercises is not
comfortable.
1. Usual elimination pattern need to be
maintained, when possible. Increasing
progesterone level relaxes smooth muscle
within the GI tract, resulting in reduced
peristalsis and increased reabsorption of
water and electrolytes.
2. Adequate bulk and consistency in diet choices
help vegetables, grains, fiber, roughage, and
adequate promote effective bowel pattern.
3. promotes peristalsis and assist in prevention
of constipation.
4. May be necessary in combating persistent
constipation and establish a regular routine.
42

43. Evaluation
Goal is achieved.....
After 2-3 hours of nursing session:
1. Client has explain normal physiological/psychological
changes associated with the first trimester danger signs of
pregnancy.
2. Report adoption of individually appropriate behaviours to
promote elimination
43