Module 2: Nursing Philosophies Flashcards
1
Q
The broad conceptual boundaries of the discipline of nursing: Human beings, environment and nursing
A
Metaparadigm
2
Q
sets forth the meaning of nursing phenomena through analysis, reasoning and logical presentation of concepts and ideas
A
Philosophy
3
Q
are sets of concepts that are address phenomena central to nursing in proposition that explain the relationship among them
A
Conceptual Models
4
Q
concepts that derive from a conceptual model and propose a testable proposition that tests the major premise of the model
A
Grand Theory
5
Q
testable propositions from philosophies conceptual models, grand theories, abstract nursing theories, or theories from other disciplines. Theories are less abstract than grand theory and less specific than middle-range theory
A
Nursing Theory
6
Q
concepts most specific to practice that propose precise testable nursing practice questions and include details such as patient age, group, family situation, health condition, location of the patient and action of the nurse
A
Middle-Range Theory
7
Q
nursing theoretical systems give direction and create understanding in practice research, administration and education
A
The future of Nursing Theory
8
Q
Sets forth the meaning of nursing
phenomena
A
Nursing Philosophies
9
Q
Contribute to nursing knowledge with
direction for the discipline, forming a
basis for professional scholarship
A
Nursing Philosophies
10
Q
Works that provide broad understanding that advance the discipline of nursing and its professional applications
A
Nursing Philosophies
11
Q
Founder of modern nursing
A
Florence Nightingale
12
Q
Florence Nightingale was born on _____________ in ____________
A
May 12 , 1820 ; Florence Italy
13
Q
Nightingale completed her nursing training at year ____ at age ___ at ________
A
1851 ; 31 ; Kaiserwerth Germany
14
Q
She addressed the environmental
problems that existed (lack of
sanitation and presence of filth)
A
Florence Nightingale
15
Q
Called the Lady of the Lamp from
the poem “___________________”
A
Santa Filomena
16
Q
Modern Nursing is a Theory focuses on the environment and described the concepts of ______ ,________ , ________ , and ________.
A
warmth , light, diet, cleanliness, noise
17
Q
It was written not as a manual to teach nurses to nurse but to assist millions of women who had charge of their families to think how to nurse
A
Notes of Nursing
18
Q
Major Assumption in (Florence Nightingale - Modern Nursing Theory)
A
Health
Nursing
Person
Environment
19
Q
Nightingale, Defined ____ as well and using every power to the fullest extent in living life
A
Health
20
Q
______ as a reparative process and of the sufferings of disease, disease is not always the cause
A
Disease
21
Q
Nightingale, It has been limited to signify little more than the administration of medicines and application of poultices
A
Nursing
22
Q
Nightingale, ____ ought to assist the reparative process
A
Nursing
23
Q
Nightingale refered to the ______ as a patient
A
Person
24
Q
A passive patient in the nurse-patient relationship
A
Person
25
Nurses was in control of and responsible for the patient's ______________.
environmental surroundings
26
Nightingale struggled to improved war-torn environemtn and workhouses
Environmental Theory
27
Environment Theory includes the five essential components of the environment health:
Pure Air
Light
Cleanliness
Efficient Drainage
Pure Water
28
Focuses ventilation and warmth
Pure air
29
Keep the air he breathes as pure are the external air, without chilling him
Pure air
30
"Without cleanliness, within and without your house, ventilation is comparatively useless"
Cleanliness
31
"People are so unaccustomed from education and habits to consider how to make a home healthy, that they either never think of it at all, and take every disease as a matter of course, to be "resigned to " when it comes" as from the hand of Providence ;"
Cleanliness
32
"No house with any unstrapped drain pipe communicating immediately with a sewer, whether it be from water closet, sink, or gully-grate, can ever be healthy. An untrapped sink may at any time spread fever or pyæmia among the inmates of a palace"
Efficient Drainage
33
"No one would undervalue vaccination; but it becomes of doubtful benefit to society when it leads people to look abroad for the source o evils which exist at home."
Efficient Drainage
34
Nightingale advocated bathing patients on a frequent, even daily, basis at a time when this practice was not the norm. She required that nurses also bathe daily, that their clothing be clean, and that they wash their hands frequently
Pure Water
35
"Unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient. It is rarely the loudness of the noise, the effect upon the organ of the ear itself, which appears to affect the sick."
Noise
36
"Always sit within the patient's view, so that when you speak to him he has not painfully to turn his head round in order to look at you. Everybody involuntarily looks at the person speaking. If you make this act a wearisome one on the part of the patient you are doing him harm."
Noise
37
Nurse must have some rule of thought about her patient's diet.
Diet
38
Nurse must have some rule of time about the patient's diet.
Diet
39
She generated throughout her lifetime on the varied subjects of health care, nursing, and social reform.
Use of Empirical Evidence
40
A commission had been organized in response to Nightingale's charges of poor sanitary conditions. Nightingale emphasized the concurrent use of observation and performance of tasks in the education of nurses
Use of Empirical Evidence
41
She often capitalized the word Nature in her writings, thereby suggesting that it was synonymous with God. Her Unitarian religious beliefs would support this view of God as nature.
Theoretical Assertions
42
She wrote Notes on Nursing (1969) for women caregivers, making a distinction between the role of house- hold servants and those trained specifically as nurses to provide care for the sick person
Theoretical Assertions
43
Critique (Florence Nightingale - Modern Nursing Theory)
1. Clarity-clear and easily understood
Explains major relationships:
1) Environment to patient
2) Nurse to environment
3) Nurse to patient
2. Simplicity provides a descriptive, explanatory theory
3. Generality - although some activities may no longer be relevant, the universality and timelessness of her concepts remain pertinent
4. Empirical Precision - concepts and relationships are stated implicitly and presented as truths Derivable Consequences
44
Founder of Theory of Transpersonal Caring
Margaret Jean Harman Watson
45
Jean Watson Attended ______________ of Nursing and __________________
Lewis Gale School ; University of Colorado
46
Jean Watson Established the _______________________
Center for Human Caring
47
the nation's first interdisciplinary center using human caring knowledge
Center for Human Caring
48
Watson Authored _____ books on Nursing
11
49
The caring moment can be an existential turning point for the nurse, in that it involves pausing, choosing to "see";
Transpersonal Caring
50
it is informed action guided by an intentionality and consciousness of how to be in the moment-fully present, open to the other person, open to compassion and connection, beyond the ego- control focus that is so common.
Transpersonal Caring
51
In a caring moment, the nurse grasps the gestalt of the presenting moment and is able to "read" the field, beyond the outer appearance of the patient and the patient's behavior.
Transpersonal Caring
52
The moment is "_______________" when the nurse is able to see and connect with the spirit of others, open to expanding possibilities of what can occur.
transpersonal
53
Watson defines ______ as "an imaginative grouping of knowledge, ideas, and experience that are represented symbolically and seek to illuminate a given phenomenon"
theory
54
Watson acknowledges a _________________________________________.
phenomenological, existential, and spiritual orientation from the sciences and humanities
55
Watson attributes her emphasis on the ___________ and _____________ qualities to Carl Rogers and more recent writers of transpersonal psychology
interpersonal ; transpersonal
56
Watson defined health as ________________________________"; associated with the "degree of congruence between the self as perceived and the self as experienced
unity and harmony within the mind, body, and soul
57
She defined _______ as not necessarily disease; subjective turmoil or disharmony within a person's inner self or soul at some level of disharmony within the spheres of the person, for example, in the mind, body, and soul, either consciously or unconsciously
Jean Watson ; Illness
58
According to Watson, while illness can lead to disease, illness and health are phenomenon that is not necessarily viewed on a __________.
continuum
59
According to her , disease processes can also result from _____ , __________________ and manifest themselves when ___________ is present.
genetic ; constitutional vulnerabilities ; disharmony
60
According to her, disease in turn creates more disharmony
Watson
61
As per to her, nursing consists of _______________________________.
Watsons ; knowledge, thought,
values, philosophy, commitment, and action, with some degree of passion
62
Watson calls for nurses to go beyond procedures, tasks and techniques
Trim
63
Watsons aspects of nurse-patient relationship resulting in a therapeutic outcome
Core
64
Watsons meant; elimination of disease
Curing
65
According to her, the person is a unity of _____________________
Watsons ; mind, body, spirit and nature
66
For Watson, ________ is tied to notions that one's soul possesses a body that is not confined by objective time and space
Personhood
67
Watson speaks to the role of nurses in the ___________ as attending to supportive, protective, and/or corrective mental, physical, societal, and spiritual environments
environment
68
She says that "healing spaces can be used to help others transcend illness, pain, and suffering," emphasizing the environment and person connection: "when the nurse enters the patient's room, a magnetic field of expectation is created
Jean Watson
69
Watson calls for joining of ______ with ______ so that nurses have a strong liberal arts background and under- stand other cultures as a requisite for using caring science and a mind- body-spiritual framework.
science ; humanities
70
She proposed that the study of sciences and humanities was required to seal similar cracks in the scientific basis of nursing knowledge
Jean Watson
71
_________ is the essence of nursing and the foundational disciplinary core of the profession.
Caring Science
72
______ can be most effectively demonstrated and practiced interpersonally
Caring
73
Caring consists of _________________ that facilitate healing, honor wholeness, and contribute to the evolution of humanity.
Carative Factors/Caritas Processes
74
_____________ promotes healing, health, individual/family growth and a sense of wholeness, forgiveness, evolved consciousness, and inner peace that transcends the crisis and fear of disease, diagnosis, illness, traumas, life changes, and so on.
Effective Caring
75
Caring responses ____________ not only as he or she is now but as what he or she may become/is Becoming.
accept a person
76
A Caring relationship is one that invites emergence of ____________, opening to authentic potential, being authentically present, allowing the person to explore options
human spirit
77
Caring is more "_______________" than curing.
healthogenic
78
Caring Science is _____________ to Curing Science.
complementary
79
The practice of Caring is central to _______. Its social, moral, and
scientific contributions lie in its _________________ to the values, ethics, and ideals of Caring Science in theory, practice, and research.
nursing ; professional commitment
80
10 Carative Factors
"The formation of a humanistic-altruistic system of values"
"The instillation of faith-hope"
"The cultivation of sensitivity to one's self and to others"
"Development of a helping-trusting, human caring relation"
The promotion and acceptance of the
expression of positive and negative feelings"
Systematic use of a creative problem
solving caring process
"The provision of supportive, protective, and corrective mental, physical, societal, and spiritual environment"
"The assistance with gratification of human needs"
"Allowance for existential- phenomenological-spiritual forces"
81
10 Caritas Processes
1. Cultivating the Practice of Loving-Kindness and Equanimity Toward Self and Other as Foundational to Caritas Consciousness.
2. Being Authentically Present: Enabling, Sustaining, and Honor the Faith, Hope, and Deep Belief System and the Inner-Subjective World of Self/Other.
3. Cultivation of One's Own
Spiritual Practices and Transpersonal Self, Going Beyond Ego-Self.
4. Development and Sustaining a Helping-
Trust Caring Relationship.
5. Being Present to, and Supportive of, the
Expression of Positive and Negative Feelings.
6. Creative Use of Self and All Ways of knowing as Part of the Caring Process; Engage in the Artistry of Caritas Nursing.
7. Engage in Genuine Teaching-Learning Experience that Attends to Unity of Being and Subjective Meaning- Attempting to Stay Within the Other's Frame of Reference.
8. Creating a Healing Environment at All
Levels.
9. Administering Sacred Nursing Acts of Caring- Healing by Tending to Basic Human Needs.
10. Opening and Attending to Spiritual/Mysterious and Existential Unknowns of Life- Death.
82
Founder of Theory of Bureaucratic Caring
Marilyn Anne (Dee) Ray
83
Marilyn Anne Ray is a Professor Emerita at ____________________
Florida Atlantic University (FAU)
84
Ray noted how important ________ were in the development of people's views about nursing and the world.
cultures
85
She retired as a ______ in 1999 after 30 years of service with the U.S. Air Force Reserve Nurse Corps
colonel
86
Her research interests continue to focus on nurses, nurse administrators, and patients in critical care and inter- mediate care, and in nursing administration
Marilyn Anne Ray
87
stimulated by her work with Leininger in 1968
Marilyn Anne Ray
88
She used __________ methods in combination with phenomenology and grounded theory which focuses on nursing in complex organizations such as hospitals
Marilyn Anne Ray ; ethnographic
89
The thesis of caring (humanistic, spiritual, and ethical) and the antithesis of bureaucracy (technological, economic, political, and legal) are reconciled and synthesized into the unitive force, bureaucratic caring.
Marilyn Anne Ray
90
__________ theory describes
simultaneous order and disorder, and order within disorder (Peat, 2002).
Chaos
91
She compares change in complex organizations with this creative process and challenges nurses to step back and renew their perceptions of everyday events, to discover embedded meanings.
Marilyn Anne Ray
92
To her Nursing is holistic, relational, spiritual, and ethical caring that seeks the good of self and others in complex community, organizational, and bureaucratic cultures.
Marilyn Anne Ray
93
As per Ray, Caring is _____ and ______
cultural ; social
94
For her, Through compassion and justice, nursing strives toward __________ in the activities of caring through the dynamics of complex cultural contexts of relationships, organizations, and communities
Marilyn Anne Ray ; excellence
95
To Ray, a person is a ______ and _____ being.
spiritual ; cultural
96
To her, Persons are created by _____, the Mystery of Being, and they engage co-creatively in human organizational and transcultural relationships to find meaning and value
Marilyn Anne Ray ; God
97
She defines health as a concept that provides a pattern of meaning for individuals, families, and communities.
Marilyn Anne Ray
98
She believe, people construct their reality of _______ in terms of biology; mental patterns; characteristics of their image of the body, mind, and soul; ethnicity and family structures; structures of society and community (political, economic, legal, and technological); and experiences of caring that give meaning to lives in complex ways.
Marilyn Anne Ray ; health
99
For her Environment is a ________ spiritual, ethical, ecological, and cultural phenomenon.
Marilyn Anne Ray ; complex
100
To _____, Embodies knowledge and conscience about the beauty of life forms and symbolic (representational) systems or patterns of meaning.
101
_____________ play a role in facilitating understanding of the meaning of caring, cooperation, and conflict in human cultural groups and complex organizational environments
bureaucracy
102
means that everything is a whole in one con- text and a part in another with each part being in the whole and the whole being in the part (Talbot, 1991).
Holography
103
the relationship between charity and right action, between love as compassion in response to suffering and need and justice or fairness in terms of what ought to be done
Caring
104
involves creativity and revealed in attachment, love and community
Spirituality
105
related to moral obligation towards others
Ethical
106
Never treating people as a means to an end but as beings with the capacity to make choices
Ethical
107
Includes formal and information programs, use of AV media to convey information and other teaching/sharing information r/t the meaning of caring
Educational
108
related to the physical state of
being including biological and mental patterns
Physical
109
Includes ethnicity and family structures, intimacy with friends and family communication; social interaction and support; understanding interrelationships, involvement, and intimacy; and structures of cultural groups, community, and society
Socio-Cultural
110
Include nonhuman resources, such as the use of machinery to maintain the physiological well-being of the patient, diagnostic tests, pharmaceutical agents, and the knowledge and skill needed to use these resources
Technological
111
r/t to the meaning of caring including money, budget, insurance systems, limitations and guidelines imposed by managed care organizations
Economic
112
Allocation of scarce human and material resources to maintain economic viability
Economic
113
r/t the power structure within health care administration and how it influences
nursing
Political
114
Includes pattern of communication and decision making, role and gender stratification, union activities, government and insurance company negotiations
Political
115
Competition for scarce human and material resources
Political
116
Founder of Caring, Clinical Wisdom and Ethics in Nursing Practice Theory
Patricia Benner
117
Patricia Benner was Born in _____________
Hampton, Virginia
118
- Benner's PhD in stress, cooping, and health was conferred in ____ at the _____________
1982 ; University of California
119
Benner is currently the _______________ with Dr. Pat Hooper-Kyriakidis on continued development of the textbook replacement learning program, NovEx
Chief Development Officer
120
Benner published her landmark book: From Novice to Expert in _____ which garnered several awards
1984
121
She is Greatly influenced by Virginia Henderson
Patricia Benner
122
She refers to her work as Articulation Research which is defined as describing, illustrating and giving language to taken- for-granted areas of practical wisdom, skilled know-how and notions of good practice
Patricia Benner
123
Distinction between practical
knowledge and theoretical knowledge
Benner
124
She believes that nurses have been delinquent in documenting their clinical learning
Benner
125
To her, by studying practice, nurses uncover ____________.
Patricia Benner ; new knowledge
126
According to her, Theory is derived from practice and practice is extended by theory
Patricia Benner
127
As per Benner, Nursing is viewed as _______________ whose science is guided by the moral art and ethics of care and responsibility
caring practice
128
To her , Nursing practice as the care and study of lived experiences of health, illness and disease and the relationships among these elements
Patricia Benner
129
Benner defined a person as a ____________ being and gets defined in the course of living a life.
self-interpreting
130
According to Benner, a person must deal with:
1. The role of the situation
2. The role of the body
3. The role of personal concerns
4. The role of temporality
131
Benner believe that Health is defined as what can be _________________
assessed
132
To her, Well-being is the human ___________ of health or wholeness
experience
133
Major Assumptions: Environment
She used the term situation rather than environment
Benner
134
To her, situation is defined by the person's engaged _______, _________ and _____________ of the situation.
Patricia Benner ; interaction ; interpretation ; understanding
135
According to her, the current situation is influenced by each person's ___ , ______ and ________ and includes their own personal meanings, habits and perspectives
Patricia Benner ; past ; present ; future
136
Novice to Expert Skill Acquisition
Novice
Advanced Beginner
Competent
Proficient
Expert
137
The person has no background experience of the situation
Novice
138
Context-free rules and objective attributes must be given to guide performance
Novice
139
Difficulty discerning relevant vs
irrelevant aspects
Novice
140
Applies to students but can be
applied to nurses placed in a situation completely foreign to them
Novice
141
The person can demonstrate marginally acceptable performance
Advance Beginner
142
Has enough experience to grasp aspects of the situation
Advance Beginner
143
Guided by rules and oriented by task completion
Advance Beginner
144
Clinical situations are viewed as a test of their abilities and demands rather than in terms of patient needs and responses
Advance Beginner
145
Defined by conscious and deliberate
planning which aspects of current
and future situations are important and which can be ignored
Competent
146
Display hyper-responsibility for the patient and exhibit an ever-present and critical view of self
Competent
147
Learner begins to recognize patterns and determine which element warrant attention
Competent
148
Perceives the situation as whole rather than in terms of aspects and the performance is guided by maxims
Proficient
149
Recognizes the most salient aspects and has an intuitive grasp of the situation
Proficient
150
Ability to see changing relevance in a situation including recognition and implementation of skilled responses
Proficient
151
Having an intuitive grasp of the situation and being able to identify the region of the problem without losing time considering a range of alternative diagnoses and solutions
Expert
152
Demonstrating a clinical grasp and resource-based practice
Expert
153
Possessing embodied know-how
Expert
154
Seeing the big picture
Expert
155
Seeing the unexpected
Expert
156
Founder of Philosophy of Caring
Kari Marie Martinsen
157
Kari Marie Martinsen was born in _______ in ______ during WWII
Oslo, Norway ; 1943
158
Moral and sociopolitical discussions dominated home life
Kari Martinsen
159
She is a specialized as a psychiatric nurse and became aware of the social inequalities in general
Kari Martinsen
160
To her, performing nursing is essentially directed towards persons not capable of _______ , who are ill and in need of care. To encounter the ill person with caring through nursing involves a set of pre- conditions such as knowledge, skills, and organization.
Kari Martinsen ; self-help
161
Trinity of Caring (Kari Martinsen)
1. Relational
2. Practical
3. Moral
162
caring requires at least 2 people
Relational
163
it is about concrete and practical action
Practical
164
acknowledgement of the other in light of his situation
Moral
165
To her, the person cannot be torn away from the social milieu and the community of persons In one way, there is a parallel between the person and the body. It is as bodies that individuals relate to ourselves, to others, and to the world
Kari Martinsen
166
For her, health does not only reflect the __________ of the organism, it is also an expression of the current level of competence in medicine.
Kari Martinsen ; condition
167
To put it pointedly, the tendencies of the modern concept of health are such that if one has an unnecessary 'defect' or an organ which 'could' be better, one is not completely healthy"
Kari Martinsen
168
For Martinsen, what is important is to ___ sometimes, ___ often, and ____ always.
cure ; help ; comfort
169
Architecture, interactions among individuals, use of objects, words, knowledge, one's being-in-the-room-all set the tone and color the situation and the space.
Kari Martinsen
170
To her, the ________ is important as a physical, material and constructed place, but it is also a place we share with other people.... The room with its interior and objects makes visible the patient's and the nurse's interpretation of it"
Kari Martinsen ; sick-room
171
What is needed then is deliberate knowledge gathered in slowed down, deliberate spaces, "space in which to perceive smell, listen, see and care"
Kari Martinsen
172
the positive development of the person through the good
Care
173
Care is a trinity:
1) Relational
2) Practical
3) Moral simultaneously
174
Through its exercise in practical living contexts that nurses learn clinical observation
Professional Judgment
175
Training not only to see, listen and touch clinically but to see, listen and touch clinically in a good way
Professional Judgment
176
When empathy and reflection work together in such a way that caring can be expressed in nursing
Moral Practice
177
Present in concrete situations and individual actions need to be accounted for
Moral Practice
178
Demand professional knowledge which affords the view of the patient as a suffering person, and which protects his integrity
Person-oriented professionalism
179
Phenomenon that are beyond human control and influence and therefore sovereign
Sovereign life utterances
180
Includes openness, mercy, trust, hope and love
Sovereign life utterances
181
Boundaries for which individuals must have respect
Untouchable Zone
182
Given as a law of life concerning neighborly love which is foundationally human
Vocation
183
Being touched or moved by the suffering of the other and the situation the other
experiences
Eye of the Heart
184
Eye of the Heart
Participatory event based on the
reciprocation that unifies perception and understanding
185
Concerned with finding connections, and analyzing it into a system
Registering Eye
186
Alliance with modern natural science and technology
Registering Eye
187
Founder of Caritative Caring Theory
Katie Eriksson
188
Pioneers of caring science in the Nordic countries.
Katie Eriksson
189
Katie Eriksson was born in ____________ in Finland
November 18, 1943
190
Developed a leading educational program in caring science and nursing
Katie Eriksson
191
Worked as a leader of many symposia and published numerous journals
Katie Eriksson
192
Honored as a Knight, First Class, of the Order of the White Rose
Katie Eriksson
193
She believe that, love and charity (caritas) is the basic motive of caring
Katie Eriksson
194
visible motive of caritas
Caritative Outlook
195
For her, Caring Nursing represents a kind of caring without ________ that emphasizes the patient and his/her suffering and desire
Katie Eriksson ; prejudice
196
To her, a human being is fundamentally a _____ being, holy and related to the idea of human dignity
Katie Eriksson ; religious
197
For her, a person is seen as a constant becoming, constantly in change and therefore never in a state of full _________
Katie Eriksson ; completion
198
According to her, Health Implies being whole in ___, ____and ____
Katie Eriksson ; body ; soul ; spirit
199
To Eriksson, Health is a pure concept of ___________ and _________
wholeness ; holiness
200
To Eriksson, health is both a _______ and __________ Implies a change, between actual and potential
movement ; integration
201
To Eriksson, _____ is dependent on vital forces
Health
202
3 Dimensions (Katie Eriksson)
Doing
Being
Becoming
203
For her, Environment is a concept of Ethos in accordance with Aristotle which consists of the idea of love, charity, respect, honor of holiness and dignity of the human being
Katie Eriksson
204
______ originally refers to home, representing a person's innermost space
Ethos
205
The ultimate purpose of caring is to alleviate suffering: (Eriksson)
1) suffering r/t illness
2) suffering r/t care
3) suffering r/t life
206
eros and agape are united, constitutes the motive for all caring
Caritas
207
structure that determines caring reality
Caring Communication
208
caring elements (faith, hope, love, tending, playing and learning) and invites to deep communion
Act of Caring
209
deals with the basic relationship between the patient and the nurse
Caritative Caring Ethics
210
ethical principles and rules that guide one's work or decisions
Nursing Ethics
211
is granted the human being through creation
Absolute dignity
212
is influenced and formed through culture and external contexts
Relative dignity
213
the act that occurs when the carer welcomes the patient to the caring communion
Invitation
214
human being's struggle between good and evil in a state of becoming
Suffering
215
experience in connection with illness and treatment
Suffering r/t Illness
216
the patient is expose to suffering caused by care or absence of care (not be be taken seriously, not to be welcomed, being blamed)
Suffering r/t Care
217
situation of being a patient
Suffering r/t Life
218
implies a change through which a new wholeness is formed of the life the human being has lost in suffering
Reconciliation
219
total caring reality and is based on cultural elements such as tradition, rituals and basic values
Caring Culture
