Review
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Professional Identity Formation in Nursing: The Role of Travelbee's Human-to-Human Relationship Model

Year 2025, Volume: 7 Issue: 1, 28 - 36, 30.04.2025

İnci İnceleme , Satı Demir

https://doi.org/10.59124/guhes.1608845

Abstract

Professional identity, which integrates personal values, ethical principles, and professional knowledge with the core concepts of nursing, is an essential aspect of nursing education, especially during the transition to professional practice. However, this development is often hindered by challenges such as low self-confidence, emotional fatigue, and communication barriers, particularly in clinical environments. Joyce Travelbee’s Human-to-Human Relationship Model offers a comprehensive framework for addressing these challenges by emphasizing the significance of empathy, meaningful communication, and interpersonal connections in nursing care. The model delineates five distinct phases of the nurse-patient relationship—orijinal encounter, emerging identities, empathy, sympathy, and rapport—that promote deeper and more meaningful interactions with patients. This holistic, patient-centered approach enables nurses to address not only the physical health of patients but also their emotional and psychosocial needs, thereby fostering the development of a strong professional identity. This review underscores Travelbee’s model as a transformative framework that bridges the technical and emotional dimensions of nursing practice. By cultivating a compassionate, human-centered approach to care, the model empowers both nursing students and professionals to build a robust professional identity. Future research should focus on developing effective strategies to integrate Travelbee’s model into nursing education, ensuring its full potential in supporting professional identity formation is achieved.

Keywords

nursing education nursing model nurse-patient relations person-centered care professional ıdentity formation

Ethical Statement

Ethics committee approval was deemed unnecessary for this study, given that open access sources were utilized.

Supporting Institution

This study did not receive any financial support.

References

  • Atta, M., Hammad, H., & Elzohairy, N. (2024). The role of empathy in the relationship between emotional support and caring behavior towards patients among intern nursing students. Bmc Nursing, 23(1), Article 443. https://doi.org/10.1186/s12912-024-02074-w
  • Beckstrom, K., & Farrow, S. (2024). The effects of empathic communication skills training on nurse practitioner students. Journal of the American Association of Nurse Practitioners, 36(5), 286-290. https://doi.org/10.1097/JXX.0000000000000972
  • Brewington, J., & Godfrey, N. (2020). The Professional identity in nursing initiative. Nursing Education Perspectives, 41(3), 201-201. https://doi.org/10.1097/01.NEP.0000000000000667
  • Brewington, J., Phillips, B., & Godfrey, N. (2023). Professional identity in nursing: adopting a systems approach regarding diversity, equity, and inclusion. Nursing Education Perspectives, 44(1), 70-71. https://doi.org/10.1097/01.NEP.0000000000001092
  • Burkhartzmeyer, H., Preston, H., Arcand, L., Mullenbach, D., Nelson, D., Lorentz, P., & Stevens, S. (2021). Speaking to the heart of our patients: an empathic communication education initiative. Journal Of Continuing Education in Nursing, 52(7), 319-325. https://doi.org/10.3928/00220124-20210611-06
  • Cowin, L., Johnson, M., Wilson, I., & Borgese, K. (2013). The psychometric properties of five professional identity measures in a sample of nursing students [Article]. Nurse Education Today, 33, 608-613. https://doi.org/10.1016/j.nedt.2012.07.008
  • Cöplü, M., & Kartin, P. T. (2019). Professional self-concept and professional values of senior students of the nursing department [Article]. Nursing Ethics, 26(5), 1387-1397. https://doi.org/10.1177/0969733018761171
  • de Medeiros, J. A., de Almeida, J. J., de Oliveira, L., da Silva, F. R. S., Silva, C. C. D., & Barros, W. (2022). Death and dying of newborns and children: relationships between nursing and family according to Travelbee [Article]. Revista Brasileira De Enfermagem, 75(2), 8, Article e20210007. https://doi.org/10.1590/0034-7167-2021-0007
  • English, W., Gott, M., & Robinson, J. (2022). The meaning of rapport for patients, families, and healthcare professionals: A scoping review. Patient Education and Counseling, 105(1), 2-14. https://doi.org/10.1016/j.pec.2021.06.003
  • Fernndez-Basanta, S., Lois-Sand, L., & Movilla-Fernndez, M. (2023). The link between task-focused care and care beyond technique: a meta-ethnography about the emotional labour in nursing care. Journal of Clinical Nursing, 32(13-14), 3130-3143. https://doi.org/10.1111/jocn.16407
  • Fitzgerald, A. (2020). Professional identity: a concept analysis [Article]. Nursing Forum, 55, 447-472. https://doi.org/10.1111/nuf.12450
  • Fitzgerald, A., & Clukey, L. (2022). Factors influencing nursing professional identity development: a qualitative study. Nursing Forum, 57, 1346-1353. https://doi.org/10.1111/nuf.12816
  • Haghighat, S., Borhani, F., & Ranjbar, H. (2020). Is there a relationship between moral competencies and the formation of professional identity among nursing students? Bmc Nursing, 19, Article 49. https://doi.org/10.1186/s12912-020-00440-y
  • Jamshidi, N., Molazem, Z., Sharif, F., Torabizadeh, C., & Kalyani, M. N. (2016). The challenges of nursing students in the clinical learning environment: a qualitative study. The Scientific World Journal, 2016(1), 7. https://doi.org/10.1155/2016/1846178
  • Jang, M., & Kim, S. (2019). Person-centered relational care experienced by critical care nurses: an interpretative phenomenological analysis study. Journal of Korean Academy of Nursing, 49(4), 423-436. https://doi.org/10.4040/jkan.2019.49.4.423
  • Kago, R., Ota, K., & Niimi, Y. (2024). Factors affecting early career registered nurses' views of building good relationships with patients: a qualitative empirical research study. Nursing Open, 11(4), Article e2155. https://doi.org/10.1002/nop2.2155
  • Koppel, P., De Gagne, J., Docherty, S., Smith, S., Prose, N., & Jabaley, T. (2022). Exploring nurse and patient experiences of developing rapport during oncology ambulatory care video conferencing visits: qualitative descriptive study. Journal of Medical Internet Research, 24(9), Article e39920. https://doi.org/10.2196/39920
  • Kwame, A., & Petrucka, P. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. Bmc Nursing, 20, Article 158. https://doi.org/10.1186/s12912-021-00684-2
  • Lu, H., Zhao, Y., & While, A. (2019). Job satisfaction among hospital nurses: a literature review. International Journal of Nursing Studies, 94, 21-31. https://doi.org/10.1016/j.ijnurstu.2019.01.011
  • Maginnis, C. (2018). A Discussion of professional identity development in nursing students. Journal of Perspectives in Applied Academic Practice, 6(1), 91-97. https://doi.org/10.14297/jpaap.v6i1.302
  • Mohan, M., Passi, V., Mohan, L., Praveen, S., Agarwal, A., Chowdhury, A., & Sharma, R. (2025). Empathy development through game-based learning: an investigative study on nursing professionals. Nurse Education Today, 144, Article 106409. https://doi.org/10.1016/j.nedt.2024.106409
  • Müller, A., Ngiam, N., Dunn, M., Samarasekera, D., Goh, B., Goh, C., & Gallagher, P. (2024). Developing empathy in healthcare professions students: protocol of a mixed-methods non-controlled longitudinal intervention study. Frontiers in Medicine, 11, Article 1452516. https://doi.org/10.3389/fmed.2024.1452516
  • Neff, D. F., Imes, S., & Cook, C. (2024). First impressions of the bedside nurse: a grounded theory study. Nursing & Healthcare International Journal (NHIJ), 8(4), 1-9. https://doi.org/10.23880/nhij-16000318
  • Oh, J. (2019). Effects of nursing students' empathy and interpersonal competence on ideal nurse attributes [Article]. Journal of Nursing Education, 58, 130-135. https://doi.org/10.3928/01484834-20190221-02
  • Parola, V., Coelho, A., Fernandes, O., & Apóstolo, J. (2020). Travelbee's theory: human-to-human relationship model - its suitability for palliative nursing care. Revista de Enfermagem Referência, 5(2), 1-7. https://doi.org/10.12707/RV20010
  • Pearson, G. (2021). Empathy in today's health care environment. Journal of the American Psychiatric Nurses Association, 27(1), 5-6, Article 1078390320979704. https://doi.org/10.1177/1078390320979704
  • Peisachovich, E., Sombilon, E., Grant, N., Ladha, N., & Da Silva, C. (2024). Evaluating the effectiveness of empathy-based education in undergraduate nursing: a scoping review. Journal of Nursing Education, 63(6). https://doi.org/10.3928/01484834-20240404-01
  • Philippa, R., Ann, H., Jacqueline, M., & Nicola, A. (2021). Professional identity in nursing: A mixed method research study. Nurse Education in Practice, 52, 7, Article 103039. https://doi.org/10.1016/j.nepr.2021.103039
  • Schwind, J., Lindsay, G., Coffey, S., Morrison, D., & Mildon, B. (2014). Opening the black-box of person-centred care: an arts-informed narrative inquiry into mental health education and practice. Nurse Education Today, 34(8), 1167-1171. https://doi.org/10.1016/j.nedt.2014.04.010
  • Shelton, G. (2016). Appraising travelbee’s human-to-human relationship model. Journal of the advanced practitioner in oncology, 7(6), 657-661. https://doi.org/10.6004/jadpro.2016.7.6.7
  • Sun, L., Gao, Y., Yang, J., Zang, X. Y., & Wang, Y. G. (2016). The impact of professional identity on role stress in nursing students: A cross-sectional study [Article]. International Journal of Nursing Studies, 63, 1-8. https://doi.org/10.1016/j.ijnurstu.2016.08.010
  • Sung, J., & Kweon, Y. (2022). Effects of a nonviolent communication-based empathy education program for nursing students: a quasi-experimental pilot study. Nursing Reports, 12(4), 824-835. https://doi.org/10.3390/nursrep12040080
  • Taleghani, F., Ashouri, E., Memarzadeh, M., & Saburi, M. (2018). Barriers to empathy-based care: oncology nurses' perceptions. International Journal of Health Care Quality Assurance, 31, 249-259. https://doi.org/10.1108/IJHCQA-12-2016-0185
  • Travelbee, J. (1969). İnterpersonal Aspect of Nursing. F.A. Davis Company.
  • Vabo, G., Slettebø, Å., & Fossum, M. (2022). Nursing students’ professional identity development: An integrative review. Nordic Journal of Nursing Research, 24(2), 62-75. https://doi.org/10.1177/20571585211029857
  • Waird, A. (2023). Preventing care factor zero: improving patient outcomes and nursing satisfaction and retention through facilitation of compassionate person-centred care. Australian Journal of Advanced Nursing, 40(4), 33-42. https://doi.org/10.37464/2023.404.1073
  • Wang, Y., Han, T., Han, G., & Zheng, Y. (2023). The relationship among nurse leaders' humanistic care behavior, nurses' professional identity, and psychological security. American Journal of Health Behavior, 47(2), 321-336. https://doi.org/10.5993/AJHB.47.2.12
  • Willetts, G., & Clarke, D. (2014). Constructing nurses' professional identity through social identity theory. International Journal of Nursing Practice, 20, 164-169. https://doi.org/10.1111/ijn.12108
  • Yi, L., Cai, J., Shuai, T., Jiménez-Herrera, M., Gu, L., & Tian, X. (2024). Mediating effect of moral sensitivity and professional identity between moral courage and compassion fatigue among nursing interns: a cross-sectional study [Article]. Bmc Nursing, 23, Article 551. https://doi.org/10.1186/s12912-024-02173-8
  • Younas, A. (2020). Relational inquiry approach for developing deeper awareness of patient suffering. Nursing Ethics, 27(4), 935-945, Article 0969733020912523. https://doi.org/10.1177/0969733020912523
  • Younas, A., Rasheed, S., Sundus, A., & Inayat, S. (2020). Nurses' perspectives of self-awareness in nursing practice: A descriptive qualitative study. Nursing & Health Sciences, 22(2), 398-405. https://doi.org/10.1111/nhs.12671
  • Yu, X., Huang, Y., & Liu, Y. (2022). Nurses' perceptions of continuing professional development: a qualitative study. Bmc Nursing, 21(1), Article 162. https://doi.org/10.1186/s12912-022-00940-z
  • Zeng, L. H., Chen, Q. R., Fan, S. S., Yi, Q. F., An, W. H., Liu, H., & Huang, H. (2022). Factors influencing the professional identity of nursing interns: a cross-sectional study. Bmc Nursing, 21(1), 8, Article 200. https://doi.org/10.1186/s12912-022-00983-2

Year 2025, Volume: 7 Issue: 1, 28 - 36, 30.04.2025

İnci İnceleme , Satı Demir

https://doi.org/10.59124/guhes.1608845

Abstract

References

  • Atta, M., Hammad, H., & Elzohairy, N. (2024). The role of empathy in the relationship between emotional support and caring behavior towards patients among intern nursing students. Bmc Nursing, 23(1), Article 443. https://doi.org/10.1186/s12912-024-02074-w
  • Beckstrom, K., & Farrow, S. (2024). The effects of empathic communication skills training on nurse practitioner students. Journal of the American Association of Nurse Practitioners, 36(5), 286-290. https://doi.org/10.1097/JXX.0000000000000972
  • Brewington, J., & Godfrey, N. (2020). The Professional identity in nursing initiative. Nursing Education Perspectives, 41(3), 201-201. https://doi.org/10.1097/01.NEP.0000000000000667
  • Brewington, J., Phillips, B., & Godfrey, N. (2023). Professional identity in nursing: adopting a systems approach regarding diversity, equity, and inclusion. Nursing Education Perspectives, 44(1), 70-71. https://doi.org/10.1097/01.NEP.0000000000001092
  • Burkhartzmeyer, H., Preston, H., Arcand, L., Mullenbach, D., Nelson, D., Lorentz, P., & Stevens, S. (2021). Speaking to the heart of our patients: an empathic communication education initiative. Journal Of Continuing Education in Nursing, 52(7), 319-325. https://doi.org/10.3928/00220124-20210611-06
  • Cowin, L., Johnson, M., Wilson, I., & Borgese, K. (2013). The psychometric properties of five professional identity measures in a sample of nursing students [Article]. Nurse Education Today, 33, 608-613. https://doi.org/10.1016/j.nedt.2012.07.008
  • Cöplü, M., & Kartin, P. T. (2019). Professional self-concept and professional values of senior students of the nursing department [Article]. Nursing Ethics, 26(5), 1387-1397. https://doi.org/10.1177/0969733018761171
  • de Medeiros, J. A., de Almeida, J. J., de Oliveira, L., da Silva, F. R. S., Silva, C. C. D., & Barros, W. (2022). Death and dying of newborns and children: relationships between nursing and family according to Travelbee [Article]. Revista Brasileira De Enfermagem, 75(2), 8, Article e20210007. https://doi.org/10.1590/0034-7167-2021-0007
  • English, W., Gott, M., & Robinson, J. (2022). The meaning of rapport for patients, families, and healthcare professionals: A scoping review. Patient Education and Counseling, 105(1), 2-14. https://doi.org/10.1016/j.pec.2021.06.003
  • Fernndez-Basanta, S., Lois-Sand, L., & Movilla-Fernndez, M. (2023). The link between task-focused care and care beyond technique: a meta-ethnography about the emotional labour in nursing care. Journal of Clinical Nursing, 32(13-14), 3130-3143. https://doi.org/10.1111/jocn.16407
  • Fitzgerald, A. (2020). Professional identity: a concept analysis [Article]. Nursing Forum, 55, 447-472. https://doi.org/10.1111/nuf.12450
  • Fitzgerald, A., & Clukey, L. (2022). Factors influencing nursing professional identity development: a qualitative study. Nursing Forum, 57, 1346-1353. https://doi.org/10.1111/nuf.12816
  • Haghighat, S., Borhani, F., & Ranjbar, H. (2020). Is there a relationship between moral competencies and the formation of professional identity among nursing students? Bmc Nursing, 19, Article 49. https://doi.org/10.1186/s12912-020-00440-y
  • Jamshidi, N., Molazem, Z., Sharif, F., Torabizadeh, C., & Kalyani, M. N. (2016). The challenges of nursing students in the clinical learning environment: a qualitative study. The Scientific World Journal, 2016(1), 7. https://doi.org/10.1155/2016/1846178
  • Jang, M., & Kim, S. (2019). Person-centered relational care experienced by critical care nurses: an interpretative phenomenological analysis study. Journal of Korean Academy of Nursing, 49(4), 423-436. https://doi.org/10.4040/jkan.2019.49.4.423
  • Kago, R., Ota, K., & Niimi, Y. (2024). Factors affecting early career registered nurses' views of building good relationships with patients: a qualitative empirical research study. Nursing Open, 11(4), Article e2155. https://doi.org/10.1002/nop2.2155
  • Koppel, P., De Gagne, J., Docherty, S., Smith, S., Prose, N., & Jabaley, T. (2022). Exploring nurse and patient experiences of developing rapport during oncology ambulatory care video conferencing visits: qualitative descriptive study. Journal of Medical Internet Research, 24(9), Article e39920. https://doi.org/10.2196/39920
  • Kwame, A., & Petrucka, P. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. Bmc Nursing, 20, Article 158. https://doi.org/10.1186/s12912-021-00684-2
  • Lu, H., Zhao, Y., & While, A. (2019). Job satisfaction among hospital nurses: a literature review. International Journal of Nursing Studies, 94, 21-31. https://doi.org/10.1016/j.ijnurstu.2019.01.011
  • Maginnis, C. (2018). A Discussion of professional identity development in nursing students. Journal of Perspectives in Applied Academic Practice, 6(1), 91-97. https://doi.org/10.14297/jpaap.v6i1.302
  • Mohan, M., Passi, V., Mohan, L., Praveen, S., Agarwal, A., Chowdhury, A., & Sharma, R. (2025). Empathy development through game-based learning: an investigative study on nursing professionals. Nurse Education Today, 144, Article 106409. https://doi.org/10.1016/j.nedt.2024.106409
  • Müller, A., Ngiam, N., Dunn, M., Samarasekera, D., Goh, B., Goh, C., & Gallagher, P. (2024). Developing empathy in healthcare professions students: protocol of a mixed-methods non-controlled longitudinal intervention study. Frontiers in Medicine, 11, Article 1452516. https://doi.org/10.3389/fmed.2024.1452516
  • Neff, D. F., Imes, S., & Cook, C. (2024). First impressions of the bedside nurse: a grounded theory study. Nursing & Healthcare International Journal (NHIJ), 8(4), 1-9. https://doi.org/10.23880/nhij-16000318
  • Oh, J. (2019). Effects of nursing students' empathy and interpersonal competence on ideal nurse attributes [Article]. Journal of Nursing Education, 58, 130-135. https://doi.org/10.3928/01484834-20190221-02
  • Parola, V., Coelho, A., Fernandes, O., & Apóstolo, J. (2020). Travelbee's theory: human-to-human relationship model - its suitability for palliative nursing care. Revista de Enfermagem Referência, 5(2), 1-7. https://doi.org/10.12707/RV20010
  • Pearson, G. (2021). Empathy in today's health care environment. Journal of the American Psychiatric Nurses Association, 27(1), 5-6, Article 1078390320979704. https://doi.org/10.1177/1078390320979704
  • Peisachovich, E., Sombilon, E., Grant, N., Ladha, N., & Da Silva, C. (2024). Evaluating the effectiveness of empathy-based education in undergraduate nursing: a scoping review. Journal of Nursing Education, 63(6). https://doi.org/10.3928/01484834-20240404-01
  • Philippa, R., Ann, H., Jacqueline, M., & Nicola, A. (2021). Professional identity in nursing: A mixed method research study. Nurse Education in Practice, 52, 7, Article 103039. https://doi.org/10.1016/j.nepr.2021.103039
  • Schwind, J., Lindsay, G., Coffey, S., Morrison, D., & Mildon, B. (2014). Opening the black-box of person-centred care: an arts-informed narrative inquiry into mental health education and practice. Nurse Education Today, 34(8), 1167-1171. https://doi.org/10.1016/j.nedt.2014.04.010
  • Shelton, G. (2016). Appraising travelbee’s human-to-human relationship model. Journal of the advanced practitioner in oncology, 7(6), 657-661. https://doi.org/10.6004/jadpro.2016.7.6.7
  • Sun, L., Gao, Y., Yang, J., Zang, X. Y., & Wang, Y. G. (2016). The impact of professional identity on role stress in nursing students: A cross-sectional study [Article]. International Journal of Nursing Studies, 63, 1-8. https://doi.org/10.1016/j.ijnurstu.2016.08.010
  • Sung, J., & Kweon, Y. (2022). Effects of a nonviolent communication-based empathy education program for nursing students: a quasi-experimental pilot study. Nursing Reports, 12(4), 824-835. https://doi.org/10.3390/nursrep12040080
  • Taleghani, F., Ashouri, E., Memarzadeh, M., & Saburi, M. (2018). Barriers to empathy-based care: oncology nurses' perceptions. International Journal of Health Care Quality Assurance, 31, 249-259. https://doi.org/10.1108/IJHCQA-12-2016-0185
  • Travelbee, J. (1969). İnterpersonal Aspect of Nursing. F.A. Davis Company.
  • Vabo, G., Slettebø, Å., & Fossum, M. (2022). Nursing students’ professional identity development: An integrative review. Nordic Journal of Nursing Research, 24(2), 62-75. https://doi.org/10.1177/20571585211029857
  • Waird, A. (2023). Preventing care factor zero: improving patient outcomes and nursing satisfaction and retention through facilitation of compassionate person-centred care. Australian Journal of Advanced Nursing, 40(4), 33-42. https://doi.org/10.37464/2023.404.1073
  • Wang, Y., Han, T., Han, G., & Zheng, Y. (2023). The relationship among nurse leaders' humanistic care behavior, nurses' professional identity, and psychological security. American Journal of Health Behavior, 47(2), 321-336. https://doi.org/10.5993/AJHB.47.2.12
  • Willetts, G., & Clarke, D. (2014). Constructing nurses' professional identity through social identity theory. International Journal of Nursing Practice, 20, 164-169. https://doi.org/10.1111/ijn.12108
  • Yi, L., Cai, J., Shuai, T., Jiménez-Herrera, M., Gu, L., & Tian, X. (2024). Mediating effect of moral sensitivity and professional identity between moral courage and compassion fatigue among nursing interns: a cross-sectional study [Article]. Bmc Nursing, 23, Article 551. https://doi.org/10.1186/s12912-024-02173-8
  • Younas, A. (2020). Relational inquiry approach for developing deeper awareness of patient suffering. Nursing Ethics, 27(4), 935-945, Article 0969733020912523. https://doi.org/10.1177/0969733020912523
  • Younas, A., Rasheed, S., Sundus, A., & Inayat, S. (2020). Nurses' perspectives of self-awareness in nursing practice: A descriptive qualitative study. Nursing & Health Sciences, 22(2), 398-405. https://doi.org/10.1111/nhs.12671
  • Yu, X., Huang, Y., & Liu, Y. (2022). Nurses' perceptions of continuing professional development: a qualitative study. Bmc Nursing, 21(1), Article 162. https://doi.org/10.1186/s12912-022-00940-z
  • Zeng, L. H., Chen, Q. R., Fan, S. S., Yi, Q. F., An, W. H., Liu, H., & Huang, H. (2022). Factors influencing the professional identity of nursing interns: a cross-sectional study. Bmc Nursing, 21(1), 8, Article 200. https://doi.org/10.1186/s12912-022-00983-2
There are 43 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Review
Authors

İnci İnceleme 0000-0002-9366-9365

Satı Demir 0000-0003-4232-8891

Publication Date April 30, 2025
Submission Date December 28, 2024
Acceptance Date January 8, 2025
Published in Issue Year 2025 Volume: 7 Issue: 1

Cite

APA İnceleme, İ., & Demir, S. (2025). Professional Identity Formation in Nursing: The Role of Travelbee’s Human-to-Human Relationship Model. Journal of Gazi University Health Sciences Institute, 7(1), 28-36. https://doi.org/10.59124/guhes.1608845
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