Lecture 10 Flashcards
Who are the theorists?
- Theory of human caring
- Transcultural care theory
- Novice to expert model
- Theory of caring
Watson
Leininger and McFarland
Benner
Swanson
honored as “living legend”
jean watson
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.
___ 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)
– comprise the primal, universal psychic energy
and are the basis for our humanity.
care and love
—composed of 10 carative factors, which are
classified as nursing actions or caring processes
watson’s theory
serve as the philosophical foundation for
the science of caring.
first 3 carative factors
provide more specific direction for nursing actions.
The remaining 7 carative factors
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
Provide a connection with the patient that offers
purpose and direction when trying to find the
meaning of an illness.
Instilling faith-hope
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
Learn to develop and sustain helping, trusting,
authentic, caring relationships through effective
communication with your patients
Developing a helping,
trusting, human caring
relationship
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
Apply the nursing process in systematic, scientific
problem-solving decision making in providing
patient-centered care.
Using creative problem
solving, caring
processes
Learn together while educating the patient
to acquire self-care skills. The patient
assumes responsibility for learning
Promoting transpersonal
teaching-learning
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
Assist patients with basic needs with an
intentional care and caring
consciousness.
Meeting human needs
Allow spiritual forces to provide a better
understanding of yourself and your
patient
Allowing for existential
phenomenological spiritual
forces
foundress of the worldwide transcultural nursing movement
Madeleine Leininger
professor of nursing in the university of michigan flint
marilyn mcfarland
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.
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)
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
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
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.
t
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
