From Theory to Competence: A Conceptual Review of Humanized Care in Community Nursing in the Ecuadorian Context

Abstract

Community nursing in Latin America requires a shift from control-oriented biomedical models toward relational and culturally responsive approaches capable of addressing persistent structural inequalities and intercultural complexity. This review develops the Relate–Capacity–Comfort (RCC) framework. This integrated model synthesizes three foundational nursing theories: Jean Watson’s Theory of Human Caring, Dorothea Orem’s Self-Care Deficit Nursing Theory, and Katharine Kolcaba’s Comfort Theory. The framework conceptualizes community nursing as a sequential process comprising relational engagement (Relate), strengthening of self-care capacity (Capacity), and achievement of experienced comfort (Comfort) as an outcome. Grounded in the Ecuadorian primary healthcare context where biomedical and Indigenous systems intersect within conditions of ongoing socioeconomic disparity, this review translates theoretical constructs into operational professional competence. Addressing a gap in the literature, the RCC framework integrates the relational engagement, self-care capacity, and experienced comfort into a coherent, practice-oriented structure aligned with the realities of community-based nursing. Evidence from Ecuadorian contexts indicates that humanized, integrated approaches are associated with increased trust, improved treatment adherence, enhanced patient satisfaction, and progress toward health equity, particularly in resource-limited rural settings. By providing a concise and contextually grounded model, the RCC framework supports the transition from theoretical knowledge to embodied practice. This review positions the RCC framework as a practical, scalable contribution to community nursing, demonstrating that theory-informed, culturally responsive care is essential to advancing equitable, person-centered health systems in Latin America.