Lecture 10 Flashcards by MARY CLAIRE THERESE CASTRO

Who are the theorists?
- Theory of human caring
- Transcultural care theory
- Novice to expert model
- Theory of caring

Watson
Leininger and McFarland
Benner
Swanson

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honored as “living legend”

jean watson

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WATSON’S THEORY OF HUMAN CARING

what are the major concepts?

Caring is central to nursing practice.
Emphasis is on the dignity and worth of individuals.
Each person’s response to illness is unique.
Caring is demonstrated interpersonally.
Caring involves a commitment to care and is based on knowledge.

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___ is the essence of nursing and the most central
and unifying focus of nursing practice.

Caring

from Jean Watson (1985) as cited in
DeLaune and Ladner (2011)

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– comprise the primal, universal psychic energy
and are the basis for our humanity.

care and love

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—composed of 10 carative factors, which are
classified as nursing actions or caring processes

watson’s theory

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serve as the philosophical foundation for
the science of caring.

first 3 carative factors

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provide more specific direction for nursing actions.

The remaining 7 carative factors

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Use loving kindness to extend yourself. Use self-
disclosure appropriately to promote a therapeutic
alliance with your patient

watsons carative factors

Forming a human-
altruistic value system

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Provide a connection with the patient that offers
purpose and direction when trying to find the
meaning of an illness.

Instilling faith-hope

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Learn to accept yourself and others for their full
potential. A caring nurse matures into becoming a self-actualized nurse

Cultivating a sensitivity to
one’s self and to others

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Learn to develop and sustain helping, trusting,
authentic, caring relationships through effective
communication with your patients

Developing a helping,
trusting, human caring
relationship

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Support and accept your patients’ feelings. In
connecting with your patients you show a willingness
to take risks in sharing in the relationship

Promoting and
expressing positive and
negative feelings

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Apply the nursing process in systematic, scientific
problem-solving decision making in providing
patient-centered care.

Using creative problem
solving, caring
processes

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Learn together while educating the patient
to acquire self-care skills. The patient
assumes responsibility for learning

Promoting transpersonal
teaching-learning

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Create a healing environment at all levels,
physical and nonphysical. This promotes
wholeness, beauty, comfort, dignity, and
peace.

Providing for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment

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Assist patients with basic needs with an
intentional care and caring
consciousness.

Meeting human needs

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Allow spiritual forces to provide a better
understanding of yourself and your
patient

Allowing for existential
phenomenological spiritual
forces

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foundress of the worldwide transcultural nursing movement

Madeleine Leininger

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professor of nursing in the university of michigan flint

marilyn mcfarland

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what are the major concepts of transcultural care

Caring is the essence of nursing.
* Caring is universal, occurring in all cultures.
* Caring behaviors are determined by and occur within a cultural context.

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in the nurse-client relationship is ‘‘the direct (or indirect) nurturant and skillful activities, processes, and decisions related to assisting people to achieve or maintain health.’’

caring

Leininger & McFarland (2002) as
cited in DeLaune & Ladner (2011)

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focuses on the study and analysis of different cultures and subcultures
with respect to cultural care, health beliefs, and health practices, with
the goal of providing health care within the context of the client’s
culture

transcultural nursing

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A basic assumption of transcultural nursing is that when health care
providers see problems from the client’s cultural viewpoint, they are
more open to understanding, appreciating, and working effectively with those clients.

transcultural nursing

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Every culture has some kind of system for health care that is based on values and behaviors. * Cultures have certain methods for providing health care. These methods of care are often unknown by nurses from other cultures

other assumptions in transcultural nursing

Attention Comfort Compassion Empathy Instruction Love Nurturance Personalized help Presence Protection Restoration Support Surveillance Tenderness Touch Trust

CARING BEHAVIORS THAT OCCUR IN DIFFERENT CULTURES

novice to expert model

dr. patricia benner

Caring is central to all helping professions. * Caring is the foundation of being. * People and interpersonal concerns are important. * Caring is communicated through actions. * Problem solving is a major component of caring. * Advocacy is caring. | major concepts; novice to expert model

one who has ‘‘courage to be with the patient, offering whatever comfort the situation allows.’

THE CARING NURSE DeLaune and Ladner (2011) | Benner (2001) as cited in DeLaune and Ladner

---occurs within the context of a relationship that consists of the following steps: 1) -- is mobilized for both the client and nurse. 2) The relationship focuses on discovering the meaning of the illness, pain, or emotion. 3) The client is aided in using social and spiritual support.

caring , hope

levels of nursing experience

novice advanced beginner competent proficient expert

univ of colorado

kirsten M. Swanson

a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility.”

caring | Kristen Swanson (1991) as cited in Potter et al. (2013)

Describes caring as consisting of five categories or processes * Supports the claim that caring is a central nursing phenomenon but not necessarily unique to nursing practice. * Identifies 3 types of conditions that affect caring: * Patient related * Nurse related * Organization related

swanson's theory of caring

Being emotionally present to the other

being with | caring process

Being there Conveying ability Sharing feelings Not burdening | subdimensions

being with

Doing for the other as he or she would do for the self if it were at all possible

doing for

Comforting Anticipating Performing skillfully Protecting Preserving dignity

doing for

Facilitating the other’s passage through life transitions (e.g. Birth, death) and unfamiliar events

enabling

Informing/explaining Supporting/ allowing Focusing Generating alternatives Validating/ giving feedback

enabling

Sustaining faith in the other’s capacity to get through an event or transition and face future with meaning

maintaining belief

believing in/holding in esteem Maintaining a hope-filled attitude Offering realistic optimism “Going the distance”

maintaining belief

- Provide care consistent with nursing’s emerging science and knowledge with caring as central focus - With this transcultural care theory, caring is the central and unifying domain for nursing knowledge and practice.

leininger - 1978

- Promote health, restore patient to health, and prevent illness - Involves the philosophy and science of caring. Caring is an interpersonal process comprising interventions to meet human needs

watson - 1979

- Focus on patient’s need for caring as a means of coping with stressors of illness - Caring is central to the essence of nursing. It creates the possibilities for coping and enables possibilities for connecting with and concern for others.

benner and wrubel- 1989

- Nursing is informed caring for the well-being of others - Provides a structure of caring composed of interrelated processes.

swanson- 1991

a process by which information is exchanged between individuals through a common system of symbols, signs, or behavior (Merriam-Webster, 2021). | theories in communicating health messages

communication

how people use messages to generate meanings within and across various contexts, cultures, channels and media

communication

- Individual (intrapersonal) level -Theory of planned behavior

azjen

Interpersonal level - Social cognitive theory

bandura

population level - diffusion of innovation theory

rogers

theory of planned behavior

icek ajzen

states that an individual’s behavior is predicted by his or her behavioral intentions, which, in turn, are predicted by his or her * attitudes toward the behavior, * subjective norms, and * perceived control over the behavior * assumes the best predictor of a behavior is behavioral intention

theory of planned ehavior

percieved behavioral control, subjective norm, attitude toward the behavior ehavioral intention behavior

theory of planned behavior

Perceived likelihood of performing behavior -

behavioral intention

Are you likely or unlikely to (perform the behavior)?

behavioral intention

Personal evaluation of the behavior

attitude

Do you see (the behavior) as good, neutral, or bad?

attitude

Beliefs about whether key people approve or disapprove of the behavior; motivation to behave in a way that gains their approval

sujective norm

Do you agree or disagree that most people approve of/disapprove of (the behavior)?

subjective norm

Belief that one has, and can exercise, control over performing the behavior

perceived behavioral control

Do you believe (performing the behavior) is up to you, or not up to you?

perceived behavioral control

a single, observable action performed by an individual, or a category of actions with a specification of target, action, context, and time (TACT)

behavior

The combination of personal and societal acceptance -- the likelihood of the person enacting the behavior.

increases

social cognitive theory

albert bandura

Evolved from social learning theory, which was created by Albert Bandura in the early 1960s. * Officially launched in 1986 by Bandura with his book Social Foundations of Thought and Action: A Social Cognitive Theory . * The most frequently used paradigm in health promotion. * Based on the reciprocal determinism between behavior, environment, and person; their constant interactions constitute the basis for human action.

social cognitive theory

t or f individuals learn from their interactions and observations.

An individual ’ s behavior is uniquely determined by these three factors:

personal, environmental, behavioral

A person ’ s expectations, beliefs, self - perceptions, goals, and intentions shape and direct behavior

personal factors

Human expectations, beliefs, and cognitive competencies are developed and modified by social influences and physical structures within the environment

environmental factors

A person ’ s behavior will determine the aspects of the person ’ s environment to which the person is exposed, and behavior is, in turn, modified by that environment.

behavioral factors

Social or physical circumstances or conditions that surround a person

Environment

A person ’ s perception of his or her environment

situations

The knowledge and skill needed to perform a given behavior

Behavioral capability

Anticipation of the probable outcomes that would ensue as a result of engaging in the behavior under discussion

outcome expectations

The values that a person places on the probable outcome that results from performing a behavior

outcome expectancies

Personal regulation of goal - directed behavior or performance

self control

Behavioral acquisition that occurs through watching the actions of others and the outcomes of their behaviors

Observational learning

A person ’ s confidence in performing a particular behavior

self efficacy

Personal techniques employed to control the emotional and physiological states associated with acquisition of a new behavior

emotional coping

Initially developed by Everett Rogers (1962) * One of the oldest social science theories * Addresses how new ideas, concepts, or practices can spread within a community or society or from one society to another * Identifies and defines five subgroups on the basis of the audience’s characteristics and propensity to accept and adopt innovation

diffusion of innovation theory

2.5 %

innovators

13.5 %

early adopters

34%

early majority

34%

late majority

16%

laggards

People who want to be the first to try the innovation. * Are venturesome and interested in new ideas. * Are very willing to take risks, and are often the first to develop new ideas

innovators

Very little, if anything, needs to be done to appeal to this population

innovators

People who represent opinion leaders. * Enjoy leadership roles, and embrace change opportunities. * Are already aware of the need to change and so are very comfortable adopting new ideas

early adopters

How-to manuals and information sheets on implementation. * Do not need information to convince them to change

early adopters

Are rarely leaders, but they do adopt new ideas before the average person. * Typically need to see evidence that the innovation works before they are willing to adopt it.

early majority adopters

success stories and evidence of the innovation's effectiveness.

early majority adopters

Are skeptical of change, and will only adopt an innovation after it has been tried by the majority.

late majority adopters

Information on how many other people have tried the innovation and have adopted it successfully.

late majority adopters

Are bound by tradition and very conservative. * Are very skeptical of change and are the hardest group to bring on board

laggards

Statistics, fear appeals, and pressure from people in the other adopter groups.

laggards