LOCAL CONCEPTUAL MODELS

SIS CAROL AGRAVANTE

Earned Bachelors Degree in Nursing in St. Paul College Manila in
1964 (Magna cum Laude, first placer in the Board exam for Nurses
on the year 1964)
Finished her Masters Degree in Nursing Education in Catholic
University of America in 1970
Obtained her Doctoral degree in nursing in University of the
Philippines Manila on April 2002
Currently, Sr. Carol is the president of the St. Paul University of Iloilo since her installation last
2004.
Aside from that she is the current president of the Association of the Deans of the Philippine
Colleges of Nursing.

Complete title of the model is:
The CASAGRA Transformative Leadership Model: Servant Leader Formula & the Nursing
Facultys 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
designed to lead to radical change from apathy or indifference to a spiritual person.
Main Propositions
CASAGRA transformative leadership is a psycho-spiritual model, was an effective means
for faculty to become better teachers and servant-leaders.
Care complex is a structure in the personality of the caregiver that is significantly related
to the leadership behavior.
The CASAGRA servant-leadership formula is an effective modality in enhancing the
nursing facultys servant-leadership behavior.
Vitality of Care Complex of the nursing faculty is directly related to leadership behavior

The model is a Three-Fold Transformation Leadership Concept rolled into one, comprising of
the following elements:
A. Servant-Leader Spirituality;
B. Self-Mastery expressed in a vibrant care complex;
C. Special Expertise level in the 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.

Servant-leader formula is the enrichment package prepared as intervention for the study which
has three parts that parallel the three concepts of the CASAGRA transformative leadership
model, namely:
o the care complex primer
Care complex is the nucleus of care experiences in the personality of a nurse
formed by a combination of maternal care experiences, culture based-care
practices indigenous to a race and people, and the professional training on care
acquired in a formal course of nursing.
o a retreat-workshop on Servant-leadership
Retreat-workshop is the spiritual exercise organized in an ambience
of prayer where the main theme is the contemplation of Jesus Christ as a
Servant-leader.
o a seminar-workshop on Transformative Teaching for nursing faculty.
Transformative teaching may also be termed Reflective teaching, an
umbrella term covering ideas, such as thoughtful instruction,
teacher research, teacher narrative, and teacher empowerment.

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 ASSERTED

The CASAGRA Servant-Leadership Theory is the major breakthrough that the nursing
profession urgently needs. The harmony and synergy in being a servant and a leader as well must be
manifest in the nursing graduate by TRANSFORMING faculty with the servant-leader formula.

The professional nurse must harmonize and manifest the other side of the service coin, which is
the conscious choice to aspire to lead while washing ones another's feet as Jesus did.

Transformative teaching for nursing guarantees the nursing students formation as nursing
leaders in the art of caring which only an artist for whom caring is second nature can teach. This is
the first lesson learned by nursing students at the lap of the nursing faculty of her school.

The transformative teacher is basically the one who looks into her self vis--vis her profession,
sees her assumptions and feelings in the light of the nursing profession in modern days, how her own
philosophy of life affects her professional life and her students.

Worldwide leadership crises have demanded the nursing leaders to REVISIT the formation
of future nursing leaders.
The TIME to revisit the leadership formation as modeled by nursing faculty is NOW.
The focus is on leadership style of Jesus himself who has become the model in the nursing
profession of service as synonymous with leadership.
The nursing profession needs leaders who will model for the profession that which is beautiful,
true, and good in this new millennium.









STRENGTHS
o It provided the task of the formation of the nurse leaders at the baccalaureate level so
that the profession assured the graduates possess the mind and heart of a nursing
leader who is of the nursing profession
o It can also be use in other educational settings not just on nursing profession
WEAKNESSES/ LIMITATIONS
o CASAGRA transformative leadership limits only on Roman Catholic and Christians
nursing educators.
o Did not consider other religion to this study. In the Philippines we have a variety of
religion present. Every religion has its own traditions and practices to be considered.
o According to the study the control and study groups were selected from the same
faculty in the two schools, it is highly possible that experience could have been
discussed casually in faculty room and in some way must contaminated the
intervention.
USEFULNESS (PRACTICABILTY)
It is significant to the nurse educators. It will help them to achieve the
vision-mission as a network of innovative, competent empowered educators
towards excellence in national and global development. The theory could be
the answer in the modern-world challenges in nursing education that is
centered on the teaching of Jesus, a paradigm of peace.

Carmelita Divinagracia
Finished her Masteral degree in Nursing in 1975 and a doctoral degree holder in 2001
She has been lauded for developing the art and competency of teaching nursing.
She has lectured and written about her work as a nurse and how she has used her hands-on
experience to develop better ways to teach nursing.
Her love for nursing and her dedication to carve out learning tools for nursing students has
been a commendable and rare field of discipline.
As a teacher, she could not be anything else but a perfect thesis adviser. She has teamed up
with the Commission on Higher Education for the drafting of a higher standard of competency
in nursing schools in the Philippines.
She was the former president of the Association of Deans of
Philippine Colleges of Nursing (ADPCN) and the dean of UERMMMC
College of Nursing. She is also a member of CHEDs Technical
Committee on Nursing Education. On 2008, Dean Divinagracia
received the Anastacia Giron Tupas Award.


Sis Lety Kuan
Born on November 19, 1936 in Katipunan-Dipolog, Zamboanga del Norte
Sister Letty G. Kuan is a nurse with two (2) Masters Degrees, MA in Nursing and MS in
Education major in Guidance Counselling.
Holds a Doctoral Degree in Education major in Guidance Counselling. All these
postgraduate studies were obtained from the University of the Philippines - Diliman, Quezon
City
For her vast contributions to the University of the Philippines - College of Nursing faculty and
academic achievements, she was awarded the distinctive post of Professor Emeritus, a title
awarded only to a few who met the strict criteria set by the University of the Philippines in
September 2004.
She has clinical fellowship and specialization in Neuropsychology obtained from University of
Paris, France in (Salpetriere Hospital). Neurogerontology in Watertown, New York (Good
Samaritan Hospital) and Syracuse University, New York
About her Theory: Retirement and Role Discontinuities
Basic Assumptions and Concepts:
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.
Role
-> refers to the set of shared expectations focused upon a particular position. These may
include beliefs about what goals or values the position incumbent is to pursue and the norms
that will govern his behavior. It is also the set of shared expectations from the retirees
socialization experiences and the values internalized while preparing for the position as well as
the adaptations to the expectations socially defined for the position itself. For every social role,
there is complementary set of roles in the social structure among which interaction constantly
occurs.
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

CONCEPTUAL MODEL


Strengths
The theory can be applied not only for the population undergoing retirement process, but also
for the population that is undergoing life transitions.
The theory is easy to understand, wherein most people can relate to the effects of role change.
Weakness/ Limitations
The theory focuses too much on the positive determinants. Retirement
adjustment is clearly a multidimensional process but the theory only
used a single indicator which is the positive determinants to retirement.
Usefulness
The theory is useful in geriatric nursing where nurses can derive a plan
of care to help the patient to have ease of movement through a
transitional process
If individuals have a better understanding of the retirement process and
their new role, they will prepare and adjust better. (Kelly & Swisher, 1998)

Carmencita Abaquin
Obtained her Masters Degree in Nursing from the University of the Philippines College of
Nursing.
An expert in Medical Surgical Nursing with subspecialty in Oncologic Nursing, which made her
known both here and abroad
She had served the University of the Philippines College of Nursing, as faculty and held the
position as Secretary of the College of Nursing.
Being appointed as Chairman of the Board of Nursing speaks of her competence and integrity
in the field she has chosen
Her theory: PREPARE ME Interventions & the Quality of Life of Advance Progressive Cancer
Patients


BASIC ASSUMPTIONS AND CONCEPTS
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. PREPARE ME has the
following components:
1. Presence being with another person during the times of need. This includes therapeutic
communication, active listening, and touch.
2. Reminisce Therapy recall of past experiences, feelings and thoughts to facilitate adaptation
to present circumstances.
3. Prayer
4. Relaxation-Breathing techniques to encourage and elicit relaxation for the purpose of
decreasing undesirable signs and symptoms such as pain, muscle tension, and anxiety.
5. Meditation encourages an elicit form of relaxation for the purpose of altering patients 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.
6. 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.

Origins of the theory
The incidence of cancer has significantly increased not only in the Philippines but also worldwide

Meaning of theory
1. 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.

2. PREPARE ME nursing interventions are effective in improving quality of life in terminally-ill patients.

3. 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.

4. Development of training programs for care provider as well as health care profession where
intervention is a part of treatment modalities.

5. 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)

6. 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.

CONCEPTUAL MODEL












Strengths:
It provides us standardized and holistic approach in addressing the needs of terminally ill cancer
patients.
It can also be used for other terminal cases.
Weakness/ Limitations:
More time is needed to make the patient interested in PREPARE ME interventions because
they are already experiencing loss of interest in things
"Understaffing in Philippine hospitals is prevalent. (Inamarga, 2009)
Holistic Nursing Interventions
Prepare Me
Presence
Reminisce Therapy
Prayer
Relaxation-Breathing
Meditation
Terminally ill Patients (Cancer)
Physical
Psychological
Social
Religious
Level of Independence
SYMPTOM RELIEF
QUALITY
OF
LIFE
In the Philippine setting, due to understaffing and financial constrain, time for bed side care is
limited
Usefulness
1. This theory is useful in addressing the needs of terminally-ill cancer patients. This
encompassed different aspects including family relationship and self-actualization.
2. Appreciating the impact of a relative's cancer and offering guidance and support via patient-
centered counseling can enhance quality of care

Cecilia Laurente

Local nursing theorist in the Philippines, who focused her works on helping a patient through
support systems specifically the family.

She has a publication entitled "Categorization of Nursing activities as Observed in Medical
Surgical Ward Units in Selected Government and Private Hospitals in Metro Manila
She became a dean of the College of Nursing in UP Manila from 1996-2002

Theory of nursing practice and career

In the recent study of Laurente she states that another entry point of helping the
patient is though the family, when nurses can be of great assistance to prevent at the very beginning
serious complications. The nurse can help strengthen the familys term of knowledge, skills, and
attitude through effective communication, employed informative, psychotherapeutic, modeling,
behavioral, cognitive-behavioral, and/or hypnotic techniques are summarized and evaluated.






References:

Octaviano, Eufemia F., RN, RM, MN, EdD, Balita, Carl E.,RN, RM, MAN, DrHum.
Theoretical Foundations of Nursing:The Philippine Perspective , 2008

Retrieved from:

http://nurseslabs.com/new-prc-board-nursing-members/
http://www.scribd.com/doc/79461231/Casagra-Theory
http://nursingcrib.com/nursing-notes-reviewer/sister-letty-g-kuan/