Divinagracia

College of Nursing
NCM- 100
Theoretical Foundations in
Nursing
Name: TOQUERO, TRISHA FAYE R. Year and Section: BSN 1-W

Date Submitted:10/11/2023
Professor: Florida O. Cariño
Score:
Composure Model and Patient Wellness Outcome Model
CARMELITA C. DIVINAGRACIA, RN, PhD
“Nursing as a healthcare profession would prove its point

in being at par in quality performance with other
healthcare professional.”
ABOUT THE NUSRING THEORIST:
 Dr. Carmelita C. Divinagracia is a Filipino Cardiologist nurse

 Graduated of Bachelor of Science in Nursing at University of East Ramon
Magsaysay Memorial Medical Center, Inc. (UERMMMC) in 1962
 Master in Nursing in 1975 at University of the Philippines
 Obtained Doctoral Degree holder from UP in 2001
 Former President of the Association of the Philippine Colleges of Nursing (ADPCN)
 She was the Dean in the College of Nursing of U.E.R.M Memorial Medical Center,
Inc (UERMMMC)
 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 carving out learing tools for nursing
students has been commendable and rare in the field of discipline.
 She has teamed up with the Commission on Higher Education (CHED) for the
drafting of a higher standard of competency in Nursing schools in the Philippines.
 In 2008, she received the Anastacia Giron Tupas Award given by the Philippine
Nursing Association (PNA).
 She is an Advanced Nurse Practitioner
 Advance Nurse Practitioner
- A BSN or Bachelor of Science in Nursing
- Licensed and has a clinical experience of atleast 2 years in the clinical area
- Has undergone special training in critical area
WHAT IS HER NURSING THEORY?
Advanced Nurse Practitioner’s Composure Behavior Model and Patient Wellness

Outcome Model
ASSUMPTIONS:
 The use of Composure Behavior of an Advanced Nurse Practitioner will produce a

wellness outcome among cardiac patients and the wellness outcome of a patient will
depend on the interventions the nurse has when administering the client. It involves
staying composed, focused and calm while providing a quality care for the patients.
Theoretical Framework
Divinagracia (2001) stated that nursing is a profession that surpasses time and aspects of
the individual as one of its clients. From the time the nurse admits a patient to the time of
his discharge, the nurse’s presence becomes a meaningful occasion for the two parties to
develop mutual trust, acceptance, and eventually satisfying relationships.
THEORY OF COMPOSURE BEHAVIORS
Dr. Carmelita C. Divinagracia did research to see how a calm and collected approach by
advanced healthcare provides can affect the recovery of specific patients at the Philippine
Heart Center.
COMPOSURE BEHAVIORAL MODEL
- are set of behaviors or nursing measures that the nurse demonstrates to select patients. It
is introduced in her dissertation that should be exhibited by nurses. The acronym
COMPOSURE stands for COMpetence, Presence and Prayer, Open-mindedness,
Stimulation, Understanding, Respect and Relaxation, and Empathy. She conducted a
study using the COMPOSURE Behaviors model to determine its effects on the recovery
of the patients, specifically the selected patients at the Philippine Heart Center.
COMpetence
 Nurses should be equipped with knowledge and expertise in consistency for their
patients
 This is also stands for consistency and congruency of words and deeds of the nurse
Presence and Prayer
 Refers to the availability of the nurses in time of need not only physically but also
holistically. This includes the utilization of therapeutic communication, active
listening, and other techniques.
 It is also a form of nursing measure which is demonstrated through reciting a prayer

with the patient can help the patients to deepen his/her faith and the relationship with
God.
Open-Mindedness
 Nurses should be receptive to different ideas such as opinions and preferences

regarding the patient’s medical status. It also conveys the manner of being flexible to
accommodate the views of patient or others.
Stimulation
 It is an act provides encouragement and appreciation through words that may bring
hope and guidance in the form of positive encouraging remarks.
 A form of nursing measure demonstrated by means of providing encouragement that

conveys hope, strength, guidance in the form of giving explanation and supervision
when doing certain procedures to patient, use of complimentary words and smile
whenever appropriate.
Understanding
 The patient’s holistic being should be equipped by nurses through the manner of
conveying interests and acceptance.
 This is manifested through concerned and affable facial approach; this is way of
making the patients feel important and unique. Nurses should understand the patient
not only because of his/her condition but also the patient’s interest.
Respect and Relaxation
 Refers to acknowledging or recognizing the presence of the patients showing positive

regard. Relaxation includes alleviating tension in the body and entails a form of
exercise that involves alternate tension and relaxation of selected group of muscles
Empathy
 Makes nurses distinguish positive thoughts and feelings, and reaches a patient out
through putting themselves on the patient’s situation.
 It refers to understand, share your feelings and putting themselves on the patients
situation.
METAPARADIGM:
PERSON ENVIRONMENT HEALTH NURSING
Each individual The intervention Nurses needs wide The nursing

needs humane, that the nurses have knowledge of the profession can
caring, spiritually when administering patient’s condition, actively deliver
oriented the client will have to understand how quality care
interventions that an effect to the their needs can be through caring
can facilitate wellness outcome met and interventions like
wellness regardless of the patient complications are the COMPOSURE
of creed, social prevented behavior which
class, gender, age, regardless of provides care to the
and nationality. diversity. The patient to achieve
patient’s wellness wellness.
outcome is
measured through
the physiologic and
behavioral
outcomes. Socio-
demographic
characteristics
mainly an
individual’s gender
and age are
connected to the
wellness outcome.
APPLICATION TO NURSING:
The COMPOSURE model represents how a nurse in profession should have in order for
the patient’s wellness outcome to be achieved. It enhances and improve the quality of
care that nurses give to the patients. It may also guide them to become an independent
healthcare provider. Thus, this theory can aid to nursing practice.
The COMPOSURE Behaviors Model results into patient’ wellness outcome, so, it have
2 kinds of outcome: the physiologic and behavioral outcomes.
PATIENTS WELLNESS OUTCOME MODEL
Wellness status refers to a condition of being in a state of well-being, a coordinated and

integral living pattern that involves the dimensions of wellness.
A. PHYSIOLOGICAL OUTCOME
- refers to the perceived wellness of selected orthopedic patients after receiving

nursing care in terms of vital signs, chest pain, and complete blood count.
 Vital Signs - clinical measurements, specifically pulse rate, temperature.

Respiration rate, and blood pressure, that indicate the state of a patient’s
essential body functions.
 Chest Pain - pain in the chest of a patient
- It’s like a sore or sharp feeling in the front part of your upper body, where
your heart and lungs are.
 Hemoglobin - blood count of the patient
- It refers to the number and health of the red blood cells in their blood.
B. BEHAVIORAL OUTCOME
- refers to the perceived wellness selected orthopedic patients after receiving nursing
care in terms of physical, emotional, intellectual, spiritual.
 Physical - concerned o preoccupied with body and its needs.
Includes: muscle strength, mobility posture, gait 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 to control and cope with emotions.
 Intellectual - relating to your ability to think and understand things,

especially complicated ideas. Also refers to the knowledge and perception of
a healthy self and ability to recognize the presence of risk factor and
preventive measures.
 Spiritual - relating to religion or religious belief and defined as the

development of inner self or one’s soul through a relationship with God.

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College of Nursing

Name: TOQUERO, TRISHA FAYE R. Year and Section: BSN 1-W

Composure Model and Patient Wellness Outcome Model

CARMELITA C. DIVINAGRACIA, RN, PhD

“Nursing as a healthcare profession would prove its point

ABOUT THE NUSRING THEORIST:

 Dr. Carmelita C. Divinagracia is a Filipino Cardiologist nurse

Advanced Nurse Practitioner’s Composure Behavior Model and Patient Wellness

 The use of Composure Behavior of an Advanced Nurse Practitioner will produce a

THEORY OF COMPOSURE BEHAVIORS

COMPOSURE BEHAVIORAL MODEL

Presence and Prayer

 It is also a form of nursing measure which is demonstrated through reciting a prayer

 Nurses should be receptive to different ideas such as opinions and preferences

 A form of nursing measure demonstrated by means of providing encouragement that

Respect and Relaxation

 Refers to acknowledging or recognizing the presence of the patients showing positive

PERSON ENVIRONMENT HEALTH NURSING

Each individual The intervention Nurses needs wide The nursing

PATIENTS WELLNESS OUTCOME MODEL

Wellness status refers to a condition of being in a state of well-being, a coordinated and

- refers to the perceived wellness of selected orthopedic patients after receiving

 Vital Signs - clinical measurements, specifically pulse rate, temperature.

 Chest Pain - pain in the chest of a patient

 Physical - concerned o preoccupied with body and its needs.

 Emotional - relating to a person’s emotions.

Includes: awareness, orientation, understanding of own and other personal

 Intellectual - relating to your ability to think and understand things,

 Spiritual - relating to religion or religious belief and defined as the

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