LOCAL MODELS OF

NURSING
INTERVENTION
The Local Theorists:

Sis. Carolina Sis. Letty Kuan Carmencita Abaquin Cecilia Laurente Carmelita
Agravante Divinagracia
Sister Carolina Agravante SPC, PhD, RN
She is famous for being the first Filipina Theorist due to
her proposed theory, the CASAGRA Transformative
Leadership Model.

The title of the theory was derived from her name

CArolina S. AGRAvante.

The theory focus on the type of leadership in nursing

that can challenge the values of the changing world
Early Life:
She was born on January 15, 1959
*Her specific details about her early life and family background are not widely available.*

She finished her secondary education at St. Paul Univeristy -

Manila (formerly St. Paul College - Manila) as class
salutatorian.

In 1964, she earned her BS Nursing degree in the same school

as magna cum laude. In the same year, she passed the nurse
licensure examinations as the board topnotcher.
From 1967 to 1969, she studied Master’s Degree in
Nursing Education at Catholic University of America as
a full-fledged scholar.

In 2002, she earned her Doctoral Degree in Philosophy

at University of the Philippines Manila - the same year
her theory was published.
She served as the president of St. Paul University - Iloilo,
where she taught research subjects among senior
students.

She was a former president of the Association of Deans

of the Philippines Colleges of Nursing (ADPCN) as she
became the representative in the International Nursing
Congress that was held in Brunei in 1996. A year after, she
was a part of a delegation that participated in the
International Council of Nursing in Vancouver, Canada.
One of the founding members of the Integrated
Registered Nurses of the Philippines (IRNP).

She is the Former President of St. Paul College - Ilocos

Sur while performing the duties of the Vice-President
for Academics. Moreover, she also functions as the
program chair of the school's Department of Nursing.
Received a Service Award from the Philippine
Accreditation Association of Schools, Colleges and
Universities (PAASCU) for being one of the
accreditors.
Nursing Theory:

The CASAGRA Transformative Leadership Model:

Servant - Leader Formula & the Nursing Faculty’s
Transformative Leadership Behavior
Nursing Theory: The CASAGRA Transformative Leadership Model: Servant - Leader Formula &
the Nursing Faculty’s Transformative Leadership Behavior

Sister Agravante have noticed the demands and challenges brought by modern
nursing profession.

She thinks that the formation of new nursing leaders is needed.

Nurses needs a competent leader that with a dream what nursing can be.

This theory explains the psycho-spiritual technique.

This was formulated to lead a radical change from apathy or indifference to

becoming a spiritual person.
Nursing Theory: The CASAGRA Transformative Leadership Model: Servant - Leader Formula &
the Nursing Faculty’s Transformative Leadership Behavior

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: the care complex primer, a retreat-
workshop on Servant-leadership, and a seminar-workshop on Transformative
Teaching for nursing faculty.

Special expertise is the level of competence in the particular nursing area that
the professional nurse is engaged in 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.
Nursing Theory: The CASAGRA Transformative Leadership Model: Servant - Leader Formula &
the Nursing Faculty’s Transformative Leadership Behavior

Servant-leadership behavior is the manner of the nursing faculty

manifested through the ability to model the servant-leadership qualities to
students. It is an ability that assists to bring out the best in students, competence
in nursing skills, commitment to the nursing profession and a sense of
collegiality with the school, other health professionals and the local
community.
Nursing leadership is a factor that sets the vision for its practitioners to help
them grow. It lays down roles and functions to guide them towards
influencing others to improve the quality of care. Lastly, it influences the
direction towards which the profession should go because it involves a clear
vision and goals to achieve.
Nursing Theory: The CASAGRA Transformative Leadership Model: Servant - Leader Formula &
the Nursing Faculty’s Transformative Leadership Behavior

Transformative teaching may also be termed Reflective teaching, an umbrella

term covering ideas, such as thoughtful instruction, teacher research, teacher
narrative, and teacher empowerment.

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.
 Three-Fold Transformation Leadership Concept

The model is a three-fold transformation leadership concept rolled into one, comprising the following
element:
I. SERVANT-LEADER SPIRITUALITY
II. SELF MASTERY
III. SELF EXPERTISE

SERVANT-LEADER SPIRITUALITY CONT..

here is prescribed to run parallel to the generic elements The servant-leader formula prescription
of the transformative leadership model. includes a spiritual retreat that goes through
the process of awareness, contemplation,
This formula consists of a spiritual exercise, the story telling, reflection, and finally
determination of the vitality of the care complex in the commitment to become servant-leaders in
personality of an individual and finally a seminar the footsteps of Jesus.
workshop on transformative teaching.
 Three-Fold Transformation Leadership Concept

The model is a three-fold transformation leadership concept rolled into one, comprising the following
element:
I. SERVANT-LEADER SPIRITUALITY
II. SELF MASTERY
III. SPECIAL EXPERTISE

SELF MASTERY SPECIAL EXPERTISE

is expressed in care complex variable possessed to this level is the enactment of caring and being
a certain degree by an individual that have been proactive in face of challenges for the profession.

through formal studies in a caregiving profession It is shown in 5C’s of transformational leadership

namely: creative, caring, critical, contemplative and
such as nursing. Thus, it involves a person’s self-
collegial teaching of the nurse faculty who is directly
awareness of the nursing faculty.
involved with the formation of the nursing. It is the
guide designed to form the new professional nurses.
 Metaparadigm
Person Environment
The caring behavior learned by the new The world wherein there is always development It is
emphasized that the theory was focused on the type
nurses from their nursing educators will
of leadership in nursing needed to cope with this
clearly affect the state of being of their
changing world Made for the nursing faculty to
clients of patients in the future strengthen its foundation and take responsibilities in
line with the situation we are experiencing

Health Nursing
Degree of wellness, or well-being A nursing leader should be competent with a
dream of what nursing can be
Aim: improve practice by positively Aim: provide care and service to those who are
influencing the health and quality of life of competent in nursing

patients Goal: improve patient care

Nursing Theory:

CONCEPTUAL FRAMEWORK
Letty G. Kuan, EdD, MAN, MSN
Dr. Kuan is a consummate educator, nurse,
researcher, nun, counselor, author, mentor
and “mother” to many UPCN alumni and
nurses from other schools and hospitals whom
she considers her big family of “adopted
children.”

She known as professor Emeritus

Early Life:
Born on November 19, 1936 in Katipunan-Dipolog, Zamboanga
del Norte.

Born to parents whose father is a native Chinese businessman

and her mother who was a home economics teacher.

She is the sixth child in a family of 4 boys and 4 girls, all

professionals in the field of medicine, pharmacy, nursing,
education and engineer.

Her religious community is the Notre Dame de Vie founded in

France in 1932
1985-Sister Letty G. Kuan is a nurse with Master's Degree in Nursing
and Guidance Counseling.

1975-She completed her graduate studies at the University of the

Philippines, College of Nursing (UPCN).

She also holds a Doctoral Degree in Education.

She has clinical fellowship and specialization in: *Neuropsychology in

University of Paris, France (Salpetriere Hospital). *Neurogerontology
in Waterson, New York (Good Samaritan Hospital) and Syracuse
Master of Arts in Nursing -She is now Professor Emeritus -She
also had Bioethics formal training at Institute of Religion,
Ethics and Law at Baylor College of Medicine in Houston,
Texas.

She authored several books giving her insight in the areas of

Gerontology, Care of Older Persons and Bioethics.

She introduced neuro-psych concepts of care in nursing.

As a former member of the Board of Nursing her latest legacy

the Nursing Community is without a doubt, indisputable.
High Honors with Academic Excellences.

She is a recipient of the Metrobank Foundation

Outstanding Teachers Award in 1995

Award for Continuing Integrity and Excellence in

Service (ACIES) in 2004. -She is a recipient of the
Metrobank Foundation "Outstanding Teacher's
Award" in 1995
"Award of Continuing Integrity and Excellence
in Service" in 2004. (ACIES)

As a former member of the Board of Nursing

her latest legacy the Nursing Community is
without a doubt, indisputable.

January 28,2018. Award of Distinction Given by

Board of the Southern Islands Alumni
Association.
She authored several books giving her insights in the areas of
Gerontology, Care of Older Persons and Bioethics.. and Essence of
Caring.

Concepts of illness and health care intervention in an urban

community. by Kuan, Letty Gurdiel; [Quezon City): 1975.

Theory of Human Bocoming Most read * Understanding the

Filipino elderly: a textbook for nurses and related health
professional by Kuan, Letty G.; Dipolog City: Jesus G. Kuan
Foundation, 1993
Essence of Caring by Letty G. Kuan, National Teacher Training
Center for the Health Professions, University of the Philippines
Manila, Learning Resources Unit, 1993

Pag-aaruga Sa Mga Taong May Edad Na. by Kuan, Letty G.; Quezon
City: UP-KAT, 1998

Bioethics in Nursing by Kuan, Letty G.; Manila: Educational Pub.

House, 2006
Nursing Theory:

RETIREMENT AND DISCONTINUITY

THEORY
Nursing Theory: Retirement and Discontinuity Theory

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.
PHYSIOLOGICAL AGE
is the endurance of cells and tissues
to withstand the wear-and-tear
phenomenon of the human body.
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.
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
HEALTH STATUS
INCOME
WORK STATUS
FAMILY CONSTELLATION
SELF-PREPARATION

HEALTH STATUS INCOME

refers to healthy or sick status of the refers to the capacity of an

respondents according to their physical individual, financially, that is classified

and mental wellbeing by poor, moderate, and rich.

 WORK STATUS

refers to the status of an individual in

the aspect of employment

HEALTH STATUS SELF-PREPARATION

means the type of family composition described

refers to the preparedness of oneself to the
either close knit or extended family where three more
possible outcomes in life.
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.
 Metaparadigm
Person Environment
In Kuan's Model, she emphasized that Kuan promoted change of life in between role

preparing early in life through cultivation of discontinuities and fruitful retirement as it is a factor
that changes the rhythm of one's life. In this stage, one
other role options at age of 50 to 60 years old
must have approaches coping to alleviate their role
in order for them to have fruitful retirement
discontinuity. retiree's A environment may change as
and aging amidst role discontinuities. change of life from role discontinuity occur.

Health Nursing
Kuan included Health Status of the retiree
Kuan believed that retirement should be recognized
physiologic and mental state, as one of the as the fulfillment of every individual's birthright and
determinants of fruitful retirement of aging. must be lived meaningfully. She suggested that
She believed that proper care of the mind government agency should contrast holistic
retirement preparation pre- program which will take
and body is needed to maintain health in old
care of the retiree's financial and holistic needs.
age.
Nursing Theory:

CONCEPTUAL FRAMEWORK
 COMPOSURE BEHAVIOUR

DETERMINANTS OF FRUITFUL AGING

PREPARED RETIREMENT HEALTH STATUS
INCOME
FAMILY CONSTELLATION
SELF
PREPARATION

PHYSIOLOGICAL OUTCOME BEHAVIORAL OUTCOME

RETIREMENT OUTCOME
ROLE Change of Life FRUITFUL
DISCONTINUITIES RETIREMENT AND
(AGING PROCESS) AGING
 Carmencita "Meng" Matias Abaquin RN, MAN

•Abaquin is a Nurse with Master's Degree in Nursing

obtained 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 abrand.

•She is known as the proponent of the "Prepare Me"

theory in Nursing.
Early Life:

•She was born December 12, 1940

•A wife to Gil Ramos Abaquin and mother of 3 children: Geraldine,

Giovanni and Gregory Abaquin.

•The philosophy of MANUS, CAPUT, COR and SERVICE TO GOD,

COUNTRY and PEOPLE is enshrined in the life and works of her.
She started her nursing career from the University of
the Philippines Philippine General Hospital School of
Nursing, as a graduate of Class 1962.

She continued to grow with her education and

completed her BSN in 1969, followed by MSN in 1975
and PhD in 2000, also at UP College of Nursing
• She worked in progressive capacities from staff nurse to head
nurse at PGH before coming to the United States as an exchange
student to work at Harper Hospital, Henry Ford Hospital and
Cook County Hospital.

• From November 2006 to January 2016, she served as the

Chairperson of the Professional Regulatory Board of Nursing

• Carmencita Abaquin is a registered nurse and she graduated

from the University of the Philippines College of Nursing with a
master's degree in nursing.
• She is known locally and abroad because of her expertise in
Medical Surgical Nursing with subspecialty in Oncologic Nursing

• Dr. Abaquin engaged in the international work to establish

linkages with countries like Germany, Canada, Australia, Japan,
EU and ASEAN countries to support the globalization of nursing
curriculum, evaluation competencies.
Nursing Theory:

Prepare Me Theory
Nursing Theory: Prepare Me Theory

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:
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
an ivocation or act that seeks spiritual communication
between man and God; the requesting of good things and
thanking for blessings from God.
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.
Nursing Theory:

METAPARADIGM
 Person
The theory is developed particularly patients for with advanced
stages of cancer. In order to improve the quality of life of these
patients who are terminally-ill, it should be dealt with a multifaceted
or holistic care.

Environment
The patient and his/ her environment are interrelated with each
other. The patient's quality of life can also be evaluated here,
hence, it is crucial in providing care for the patient.
Health
The theory is centered on cancer, and giving holistic care in order to
enrich the patient's quality of life despite having an incurable illness.
Quality of life is a holistic concept regarding the individual's abilities
and capabilities of enhancing life when it can no longer be prolonged.
This involves keeping the integrity of the holistic being in an existing
state regardless of the limitations brought upon by the patient's state
of health. The quality of life is perceived through different aspects,
which are physical, psychological, social, religious, level
independence, of environment and spiritual.
Nursing
The objective of nursing care is to enrich the quality of life of patients
in the advanced stages of cancer despite their existing state. Her idea
of holistic nursing approach addressing multidimensional problems
patients care in the of is summarized in the acronym PREPARE ΜΕ.
Nursing Theory:

CONCEPTUAL FRAMEWORK
 INPUT PROCESS OUTPUT

HOLISTIC NURSING TERMINALLY III CANCER

INTERVENTIONS: PATIENTS

PREPARE ME

QUALITY OF LIFE
•Presence •Physical
•Reminisce Therapy •Social
•Prayer •Psychological
•Relaxation •Religious/Spiritual
•Meditation •Level of Independence
•Values Clarification •Environment
Cecilia Laurente, RN, PhD
Cecilia Laurente is a filipino nursing
theorist, who focused her works primarily
on helping a patient through support
systems, specifically the family.
Published a paper titled "Categorization of
Nursing Activities as Observed in Bedical-
Surgical Ward Units in Selected
Government and Private Hospitals in
Manila".
Early life:
She was born October 4, 1945, in the Philippines .
*Her specific details about her early life and family background are not widely available.*

1967 - She graduated Bachelor of Science in Nursing at University of the

Philippines.

1969 - She worked as a staff nurse at the Philippine General Hospital

1970-1972 - She worked as a head nurse at the Philippine General Hospital

1973 - She finished her master's degree in nursing at the University of the
Philippines.
1973-1976 - She worked as a nursing supervisor at the Philippine General
Hospital.

She returned in 1979 and became an instructor at the University of the

Philippines College of Nursing.

1987 - She conducted a study entitled "Categorization of Nursing Activities as

Observed in Medical-Surgical Ward Units in Selected Government and Private
Hospitals in Manila."

1996-2002- She served as the Dean of College of Nursing in UP Manila

She is named as 2002 J. V. Sotejo Medallion of Honor Recipient.

Nursing Theory:

"Categorization of Nursing Activities as Observed in

Medical-Surgical Ward Units in Selected Government
and Private Hospitals in Metro Manila."
Nursing Theory: Categorization of Nursing Activities as Observed in Medical-Surgical Ward Units
in Selected Government and Private Hospitals in Metro Manila

was conducted from January to June year 1987.

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,
modeling, behavioral, cognitive-behavioral, and/or hypnotic techniques are
summarized and evaluated.
What is ?
Anxiety is a mental state
of fear or nervousness
about what might
happen.
 Nurse's Caring Behavior That Affect Patient Anxiety

There are three Nurse Caring Behavior that affects patient anxiety
1. Presence refers to the person to person contact between the client and the nurses.
2. Concern refers to the development in time through mutual trust between the nurse and the patient.
3. Stimulation refers to the nurse's stimulation through the utilization of word that helps more than the
powerful resources of energy of a person for healing.

Enhancing Factor Prediposing Factor

One's caring experience, beliefs and attitude. Age

Feeling good about Sex

Learning at school Civil Status
What patients tell about the nurse coping Educational Background
mechanism to problems encountered. Length of work
Communication Experience
 Metaparadigm
Person Environment
This study will help reduce a patient's This study will help the hospital
anxiety from the health care providers due environment on the increase of efficiency
to this theory that implies that a nurse's due to nurses practicing this theory that will
caring behavior is a significant variable on be beneficial in establishing rapport and
patient care. patient care.

Health Nursing
This study revolves around the nurse's The impact of this study to the nursing system is that
caring behavior,and when nurses execute the results may be critically plled to the teaching and
practice of nursing which will result to improvement
this theory it will not hinder or jeopardize
on the hospitals efficiency on taking care of patience
patient care and health.
but also improve the patient's health,welfare and
quality of life.
CARMELITA C. DIVINAGRACIA, RN, PhD

• Filipino Nurse Theorist and educator.

• She is best known for developing the

Composure Model, a framework that
guides nurses in providing culturally
competent care.

• Has been a clinic nurse, staff nurse, head

nurse, instructor, assistant dean and dean

• Expert in Research and Education

Early Life:
*Her specific details about her early life and family background are not widely available.*

• Bachelor's degree in Nursing at the University of the East

Ramon Magsaysay Memorial Medical Center in 1962

• Master's degree in Nursing at the University of the

Phillippines in 1975

• Doctorate's degree in Nursing at the University of the

Philippines in 2001
• Dr. Divinagracia began her nursing career as a clinic nurse,
progressing through various roles including staff nurse, head
nurse, and instructor

•Dr. Divinagracia served as Dean of the University of the East

Ramon Magsaysay Memorial Medical Center, Inc. (UERM
MMC) College of Nursing

•Dr. Divinagracia was the former President of the Association

of Deans of Philippine Colleges of Nursing (ADPCN)
• Dr. Divinagracia is a member of the Commission on Higher
Education (CHED)'s Technical Committee on Nursing
Education

• Research and Publications: Dr. Divinagracia has conducted

extensive research and has published her findings,
contributing to the body of knowledge in nursing. Her work
has focused on the impact of nurse practitioner behavior on
patient wellness, particularly in the context of cardiac care
• Recipient of the Anastacia Giron Tupas Award given by the
Philippine Nursing Association (PNA) in 2008.
Nursing Theory:

COMPOSURE BEHAVIOUR and

PATIENT’S WELLNESS OUTCOME
THEORY
Nursing Theory: Theory of Composure Behavior

A set of behaviors determined by Dr. Divinagracia

that would be demonstrated by advanced nurse
practitioners to see how would it affect the
recovery of the patients in the Coronary Care Unit
of the Philippine Heart Center.
COMPOSURE stands for:
COMpetence
• Nurses should be equipped with knowledge and
expertise in consistency in caring For their patiente.

Presence and Prayer

• Pertains to the availability of the nurse in time of need
not only physically holistically Utilization but also of
therapeutic communication techniques are also included.
COMPOSURE stands for:
Open-mindness
• Nurses should be receptive to different ideas such as
opinions and preferences regarding the patient's medical
status.

Stimulation
• A Form of nursing measure demonstrated by means of
providing encouragement and dappreciation that delivers
hope and guidance in a Form of positive encouraging
remarks.
 COMPOSURE stands for:
Understanding
• It is an approach that conveys interest and acceptance
to the patient's holistic being.

Respect
• Acknowledging the presence of the patients and
showing positive regard
 COMPOSURE stands for:
Relaxation
• Entails a Form of exercise that involves alternate tension
and relaxation of selected group of muscles.

Emphaty
• The empathetic nurse perceives the current positive
thought and Feelinge communicates by putting himawlf
in the patient's place. and
 PATIENTS WELLNESS OUTCOME
A. PHYSIOLOGICAL OUTCOME
This refers to the perceived wellness of selected orthopedic
patients after receiving nursing care in terms of vital signs.
bone pain sensation, and complete blood count.

B. BEHAVIORAL OUTCOME
This refers to the perceived wellness of selected orthopedic
patients after receiving nursing care in terms physical.
intellectual, emotional, and spiritual.
PHYSIOLOGICAL OUTCOME
VITAL SIGNS
• Clinical measurements, specifically pulse rate, ate,
temperature, to r respiration rate, and blood pressure, that
indicate the state of a patient's essential body functions.

CHEST PAIN
• Pain in the chest of the patient

HEMOGLOBIN
• Blood count of the patient
BEHAVIORAL OUTCOME
PHYSICAL
• concerned or preoccupied with the body and its needs.
Includes: muscle strength, mobility posture, gain exercise
and activity tolerance and cardio- respiratory endurance.

EMOTIONAL
• relating to a person's emotions.
Includes: awareness, orientation, understanding of own and
other personal feelings and ability
BEHAVIORAL OUTCOME
INTELLECTUAL
• relating to your ability to think and understand things.
complicated ideas,

SPIRITUAL
• relating to religion or religious belief and also defined
as the development of inner self or one's soul through a
relationship with God.
 Metaparadigm
Person Environment
Each individual needs humane caring, The intervention that the have nurses when
spiritually oriented interventions can administering the client will have an effect
facilitate wellness regardless of creed, to the wellness outcome of the patient.
social class, gender, age

Health Nursing
Nurses needs wide -knowledge of the patient's condition,
The profession nursing can actively deliver quality
to understand how their needs can be met and
complications are prevented regardless diversity. of The care through caring interventions like COMPUSURE
patient's wellness outcome is measured through the the behavior which provides care to the patient to
physiologic and behavioral outcomes. Socio- demographic achieve wellness.
characteristics mainly an individual's gender and age are
connected to the wellness outcome.
Nursing Theory:

CONCEPTUAL FRAMEWORK
 CONCEPTUAL FRAMEWORK
COMPOSURE BEHAVIOUR

COMPETENCE
PRESENCE AND PRAYER
OPEN-MINDEDNESS WELLNESS OUTCOME
STIMULATION
UNDERSTANDING
RESPECT AND RELAXATION
PHYSIOLOGICAL OUTCOME BEHAVIORAL OUTCOME
EMPATHY

VITAL SIGNS PHYSICAL

CHEST PAIN EMOTIONAL
HEMOGLOBIN INTELLECTUAL
SPIRITUAL
Thank you