Ch. 3 Theoretical Basis of Care Flashcards
4 major dimensions of recovery include:
health, home, purpose, community
therapeutic relationship assumes:
the client and nurse enter into a mutual, interactive, interpersonal relationship specifically to focus on the identified needs of the client
True or False: therapeutic relationships are focused on the client’s needs, goal-directed, theory-based, and open to supervision
True
transference:
displacement of feelings for significant people in the client’s past onto the PMHNP in the present relationship
countertransference:
the nurse’s emotional reaction to the client based on their past experiences
Therapeutic Relationship: Introduction (Orientation)
-create trusting environment
-establish professional boundaries
-establish length of anticipated interaction
-provide diagnostic eval
-set mutually agreed-upon tx objectives
Therapeutic Relationship: Working (Identification and Exploitation)
-clarify expectations and mutual goals
-implement tx plan
-monitor health
-preventative care
-measure outcomes
-eval outcomes
-reprioritize plan and objectives as needed
Therapeutic Relationship: Termination (Resolution)
-review progress toward objectives
-establish long-term plan
-focus on self-management strategies
-disengage from relationship
-refer to other services as needed
Common client behavior during Introduction phase
-initially hesitant to participate fully in assessment and tx
(approach avoidance)
Common client behavior during Working phase
-transference/countertransference
-resistance to care practices
-resistance to change
Common client behavior during Termination phase
-resistance to termination
-regression
-reemergence of symptoms or problems
Erik Erikson’s Developmental Stage: Infancy (age range and task)
Birth - 1 yr
trust vs. mistrust
Erik Erikson’s Developmental Stage: Early Childhood (age range and task)
1 - 3 yrs
autonomy vs. shame and doubt
Erik Erikson’s Developmental Stage: Late Childhood (age range and task)
3 - 6 yrs
initiative vs. guilt
Erik Erikson’s Developmental Stage: School-age (age range and task)
6 - 12 yrs
industry vs. inferiority
Erik Erikson’s Developmental Stage: Adolescence (age range and task)
12 - 20 yrs
identity vs. role confusion
Erik Erikson’s Developmental Stage: Early Adulthood (age range and task)
20 - 35 yrs
intimacy vs. isolation
Erik Erikson’s Developmental Stage: Middle Adulthood (age range and task)
35 - 65 yrs
generativity vs. self-absorption or stagnation
Erik Erikson’s Developmental Stage: Late Adulthood (age range and task)
> 65 yrs
integrity vs. despair
mastery of trust vs. mistrust includes (3)
-ability to form meaningful relationships
-hope about the future
-trust in others
failure of trust vs. mistrust includes (3)
-poor relationships
-lack of future hope
-suspicious of others
mastery of autonomy vs. shame and doubt include (3)
-self-control
-self-esteem
-willpower
failure of autonomy vs. shame and doubt include (4)
-poor self-control
-low self-esteem
-self-doubt
-lack of independence
mastery of initiative vs. guilt includes (3)
-self-directed behavior
-goal formation
-sense of purpose
failure of initiative vs. guilt includes (2)
-lack of self-initiated behavior
-lack of goal ortientation
mastery of industry vs, inferiority includes (2)
-ability to work
sense of competency and achievement
failure of industry vs. inferiority includes (2)
-sense of inferiority
-difficulty w/ working and learning
mastery of identity vs. role confusion includes
personal sense of identity
failure of identity vs. role confusion includes (2)
-identity confusion
-poor self-identification in group settings
mastery of intimacy vs. isolation includes (2)
-committed relationships
-compacity to love
failure of intimacy vs. isolation includes (2)
-emotional isolation
-egocentrism
mastery of generativity vs. self-absorption or stagnation includes (2)
-ability to give time and talents to others
-ability to care for others
failure of generativity vs. self-absorption or stagnation includes (3)
-self-absorption
-inability to grow and change as a person
-inability to care for others
mastery of integrity vs. despair includes (3)
-fulfillment and comfort w/ life
-willingness to face death
-insight and balanced perspectives on life’s events
failure of integrity vs. despair includes (3)
-bittnerness
-sense of dissatisfaction w/ life
-despair over impending death
Psychodynamic (Psychanalytic) Theory was developed by _______
Sigmund Freud
True or False: psychodynamic theory focuses on concepts of intrapsychic conflict among the structures of the mind
True
psychanalytical theory assumes that all behavior is ____ and ______
purposeful and meaningful
principle of psychic determinism:
even apparently meaningless, random, or accidental behavior is motivated by underlying unconscious mental content
typical age of onset for intellectual disability
infancy -usually evident at birth
typical age of onset for ADHD
early childhood (per DSM-5 by age 12)
typical age of onset schizophrenia (men/women)
men 18-25 yrs
women 25-25 yrs
typical age of onset major depression
late adolescence to young adulthood
typical age of onset dementia
most common after age of 85
The id:
-primary drives/ instincts
-seeks immediate satisfaction/pleasure
-says “i want”
The ego:
-contains concept of external reality
-rational mind
-says “i think, i evaluate”
The superego:
-sense of conscience
-right vs. wrong
-moral values
- says “i should, i ought”
denial:
avoidance of unpleasant realities by unconsciously ignoring their existence
projection:
unconscious rejection of emotionally unacceptable personal attributes, beliefs, or actions by attributing them to other people, situations, or events
regression:
return to more comfortable thoughts, behaviors or feelings used in earlier stages of development in response to current conflict, stress or threat
reaction formation:
overcompensation; unacceptable feelings, thoughts, or behaviors are pushed from conscious awareness by displaying and acting on the opposite feeling, thought or behavior
rationalization:
justification of illogical, unreasonable ideas, feelings or actions by developing an acceptable explanation that satisfies the person
undoing:
behaviors that attempt to make up for or undo an unacceptable action, feeling or impulse
intellectualization:
attempts to master current stressor or conflict by expansion of knowledge, explanation, or understanding
suppression:
conscious analog of repression; conscious denial of a disturbing situation, feeling or event
sublimation:
unconscious process of substitution of socially acceptable, conservative activity for strong unacceptable impulse
altruism:
meeting the needs of others in order to discharge drives, conflicts, or stressors
True or False: defense mechanisms are a function of the id
False, they’re a function of the ego
cognitive theory was developed by:
Jean Piaget
cognitive theory proposes that:
human development evolves through cognition, learning and comprehending
Piaget’s 4 stages of cognitive development:
-sensorimotor
-preoperational
-concrete operations
-formal operations
sensorimotor stage (age and definition):
birth- 2 yrs
-object permanence is critical achievement of this stage
preoperational stage (age and definition):
2-7 yrs
-more extensive use of language and symbolism
-magical thinking
concrete operations stage (age/definition)
7-12 yrs
-begin to use logic
-concepts of reversibility and conservation
formal operations stage (age/definition)
12yrs -adult
-ability to think abstractly
-thinking in a formal, logical manner
Interpersonal Theory developed by______ and says ______
Harry Stack Sullivan
-behavior occurs because of interpersonal dynamics
Maslow’s Hierarchy of Needs:
-survival
-safety and security
-love and belonging
-self-esteem
-self-actualization
Health Belief Model developed by _____ and says_____
Marshall Becker
-healthy people do not always take advantage of screening or preventative programs d/t certain variables
Transtheoretical Model of Change 6 stages:
-precontemplation
-contemplation
-preparation
-action
-maintenance
True or False: Motivational Interviewing is focused, goal-directed, builds on transtheoretical model of change, elicits motivation from client and is nonconfrontational, nonadversarial
True
(Miller & Rollnick, 1991)
Self-efficacy and Social Learning Theory says that
-behavior is result of cognitive and environmental factors
(Albert Bandura)
self-efficacy is:
the perception of one’s ability to perform a certain task at a certain level of accomplishment
Theory of Cultural Care developed by _____ and says ______
Madeline Leininger
-regardless of culture, care is the unifying focus and essence of nursing
Theory of Self-Care developed by ____ and says _____
Dorothy Orem
-discusses activities that maintain life, health, and well-being (self-care)
Therapeutic Nurse-Client Relationship Theory developed by _____ and says ______
Hildegard Peplau
-based in part on interpersonal theory
-all interventions occur w/in context of nurse-client relationship
-includes phases
Caring Theory developed by ______ and says______
Jean Watson
-caring is an essential component of nursing
