Module 5: Mid-Range Nursing Theories Flashcards
1
Q
are the least abstract theory level for concrete
practice applications.
A
Middle-range theories
2
Q
Middle-range theories include the characteristics of ___________________________________
A
nursing practice or situations.
3
Q
Middle-range theories are theoretical __________ of __________ and __________.
A
evidence ; applicability ; outcome
4
Q
Middle-range theories develop evidence for _______________________.
A
nursing practice outcomes
5
Q
Middle-range theories are recognizable as such because they contain characteristics of nursing practice:
A
The situation or health condition of the client or patient
Client or patient population or age group
Location or area of practice (e.g., community)
Action of the nurse or intervention
The client or patient outcome anticipated
6
Q
Theorist of Maternal Role Attainment – Becoming a Mother
A
Ramona T. Mercer
7
Q
Head nurse in pediatrics and staff nurse in intrapartum, postpartum, and newborn nursery units.
Created the Maternal Role Attainment Theory for nursing a Becoming a Mother (2006).
A
Ramona T. Mercer
8
Q
is an interactional and developmental process occurring over time in which the mother becomes attached to her infant, acquires competence in the caretaking tasks involved in the role, and expresses pleasure and gratification in the role
A
Maternal Role Attainment
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
9
Q
is attained when the mother experiences a sense of harmony, confidence, and competence in how she performs the role
A
Maternal Identity
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
10
Q
A relatively stable _________, acquired through _________________ determines how a mother defines and perceives events; her perceptions of her infant’s and others’ responses to her mothering, with her life situation, are the real world to which she responds (Mercer, 1986a).
A
core self ; lifelong socialization
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
11
Q
__________________________ and _______ personality characteristics influence the mother’s behavioral responses (Mercer, 1986a).
A
Developmental level ; innate
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
12
Q
The mother’s role partner, her ________, will reflect the mother’s competence in the mothering role through growth and development (Mercer, 1986a).
A
infant
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
13
Q
The _______ is considered an active partner in the maternal role -taking process, affecting and being affected by the role enactment (Mercer, 1981).
A
infant
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
14
Q
The ______________________________ contributes to role attainment in a way that cannot be duplicated by any other supportive person (Mercer, 1995).
A
father’s or mother’s intimate partner
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
15
Q
________________ develops concurrently with __________________, and each depends on the other (Mercer, 1995; Rubin, 1977)
A
Maternal identity ; maternal attachment
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
16
Q
immediate environment; family functioning, mother-father relationships, social support, economic status, family values, and stressors.
A
Microsystem
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
17
Q
encompasses, influences, and interacts with persons in the microsystem; day care, school, work setting, places of worship, and other entities within the immediate community.
A
Mesosystem
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
18
Q
culture or transmitted cultural consistencies; social, political, and cultural influences on the other two systems.
A
Macrosystem
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
19
Q
Stages of Role Acquisition (based on Thornton and Nardi’s 1975 research) -
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
A
Anticipatory
Formal
Informal
Personal
20
Q
begins during pregnancy; social and psychological adjustments to pregnancy.
A
Anticipatory
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
21
Q
begins with the birth of the infant; learning and taking on the role of mother; affected by mother’s social system.
A
Formal
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
22
Q
develops unique ways not conveyed by the social system.
A
Informal
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
23
Q
when the woman internalizes her role; attains sense of harmony, confidence, and competence in the way she performs the role, and the maternal role is achieved.
A
Personal
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
24
Q
This model places the interactions between mother, infant, and father at the center of the interacting, living environments
A
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
25
Mercer (2004) acknowledges that becoming a mother, which connotes _________________________, is more descriptive of the process, which is much _________ than a role. Although some roles may be terminated, motherhood is a lifelong commitment.
continued growth in mothering ; larger
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
26
Developed in 2006. This model depicts the complex issues that have the potential to either facilitate or inhibit the process of becoming a mother (Mercer & Walker, 2006) including environmental variables and maternal-infant characteristics
Interacting environments that affects the process of becoming a mother
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
27
Maternal Role Attainment is Useful to practicing nurses across many _______________ settings.
maternal-child
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
28
Maternal Role Attainment help simplify the very complex process of becoming a ________.
parent
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
29
Maternal Role Attainment provides a framework for students as they learn to ____ and ___________ for parents in a wide variety of settings.
plan ; provide care
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
30
Maternal Role Attainment development of a highly reliable, valid instrument to measure mothers’ attitudes about the ______ and _______ experience.
labor ; delivery
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
31
Maternal Role Attainment served as a springboard for other researchers.
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
32
Theorist of Uncertainty in Illness Theory
Merle Mishel
33
A psychiatric Nurse (acute and community); born in Boston, Massachusetts in1939
Developed a theory of perceived ambiguity in illness scale, later named uncertainty of illness (Bailey & Stewart, 2017).
This uncertainty of illness focuses on one’s outlook of what is happening to them, whether it is a new diagnosis or a chronic illness, one’s perception is the determining factor of the expected outcome.
Merle Mishel
34
is the inability to determine the meaning of illness-related events, occurring when the decision maker is unable to assign definite value to objects or events, or is unable to predict outcomes accurately
Uncertainty
Uncertainty in Illness Theory (Merle Mishel)
35
is the form, composition, and structure of the stimuli that a person perceives, which are then structured into a cognitive schema.
Stimuli frame
Uncertainty in Illness Theory (Merle Mishel)
36
are the resources available to assist the person in the interpretation of the stimuli frame
Structure providers
Uncertainty in Illness Theory (Merle Mishel)
37
refers to the evaluation of uncertainty using related, recalled experiences.
Inference
Uncertainty in Illness Theory (Merle Mishel)
38
refers to beliefs constructed out of uncertainty
Illusion
Uncertainty in Illness Theory (Merle Mishel)
39
reflects biopsychosocial behavior occurring within persons’ individually defined range of usual behavior
Adaptation
Uncertainty in Illness Theory (Merle Mishel)
40
refers to the formulation of a new sense of order, resulting from the integration of continual uncertainty into one’s self structure, in which uncertainty is accepted as the natural rhythm of life
New view of life
Uncertainty in Illness Theory (Merle Mishel)
41
Theorist of Theory of Caring
Dr. Kristen Swanson
42
University of Rhode Island in 1975 and in 1978 from the University of Pennsylvania.
Her focus primarily has been on pregnancy issues.
Her practices have been incorporated into obstetric education models and physician practices.
Dr. Kristen Swanson
43
provides a platform to deal with miscarriage and the subsequent healing required for the parents and family.
Theory of Caring (Dr. Kristen Swanson)
44
is a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility (Swanson, 1991).
Caring
Theory of Caring (Dr. Kristen Swanson)
45
is striving to understand the meaning of an event in the life of the other, avoiding assumptions, focusing on the person cared for, seeking cues, assessing meticulously, and engaging both the one caring and the one cared for in the process of knowing (Swanson, 1991).
Knowing
Theory of Caring (Dr. Kristen Swanson)
46
Being with means being _____________________ to the other.
emotionally present
Theory of Caring (Dr. Kristen Swanson)
47
Doing for means ____________________________ if at all possible.
to do for others what one would do for self
Theory of Caring (Dr. Kristen Swanson)
48
is facilitating the other’s passage through life transitions and unfamiliar events by focusing on the event, informing, explaining, supporting, validating feelings, generating alternatives, thinking things through, and giving feedback (Swanson, 1991).
Enabling
Theory of Caring (Dr. Kristen Swanson)
49
________________ is sustaining faith in the other’s capacity to get through an event or transition and face a future with meaning
Maintaining belief
Theory of Caring (Dr. Kristen Swanson)
50
___________ as informed caring for the well-being of others; “ethical, personal and aesthetic knowledge derived from the humanities, clinical experience, and personal and societal values and expectations” (Swanson, 1993, p. 352).
Nursing
51
____________ as “unique beings who are in the midst of becoming and whose wholeness is made manifest in thoughts, feelings, and behaviors”; life experiences were influenced by complex interplay of “genetic heritage, spiritual endowment and the capacity to exercise free will”
Persons
52
______________ is a complex process of curing and healing that includes “releasing inner pain, establishing new meanings, restoring integration, and emerging into a sense of renewed wholeness”
Health
53
is “any context that influences or is influenced by the designated client”; environment and person-client in nursing may be viewed interchangeably.
Environment
54
Theorist of Theory of Comfort
Katharine Kolcaba
55
Born and educated in Cleveland, Ohio.
1965 - Received a diploma in nursing; medical-surgical nursing, long-term care, and home care
1987 - Case Western Reserve University (cwru) Frances Payne Bolton school of nursing
With a specialty in gerontology.
Job-shared a head nurse position on a dementia unit
Interests include interventions for and documentation of changes in comfort for evidence-based practice.
Katharine Kolcaba
56
first developed in the 1990s.
Theory of Comfort (Katharine Kolcaba)
57
___________ is an immediate desirable outcome of nursing care
Comfort
Theory of Comfort (Katharine Kolcaba)
58
Good nurses made patients comfortable, and the provision of comfort was a primary determining factor of nurses’ ___________________ (Aikens, 1908).
ability and character
Theory of Comfort (Katharine Kolcaba)
59
Type of Comfort - Theory of Comfort (Katharine Kolcaba)
Relief
Ease
Transcendence
60
The state of a patient who has had a specific need met
Relief
Theory of Comfort (Katharine Kolcaba)
61
The state of calm or contentment
Ease
Theory of Comfort (Katharine Kolcaba)
62
The state in which one rises above one's problems or pain
Transcendence
Theory of Comfort (Katharine Kolcaba)
63
Context in Which Comfort Occurs - Theory of Comfort (Katharine Kolcaba)
Physical
Psychospiritual
Environmental
64
Pertaining to bodily sensations
Physical
Theory of Comfort (Katharine Kolcaba)
65
Pertaining to internal awareness of self, including esteem, concept, sexuality, and meaning in one's life; one's relationship to a higher order or being
Psychospiritual
Theory of Comfort (Katharine Kolcaba)
66
Pertaining to the external surroundings, conditions, and influences Social: Pertaining to interpersonal, family, and societal relationships
Environmental
Theory of Comfort (Katharine Kolcaba)
67
____________________ are comfort needs from stressful health care situations not met by traditional support systems.
Health care needs
Theory of Comfort (Katharine Kolcaba)
68
____________________ are nursing actions and referrals done to address specific comfort needs.
Comfort interventions
Theory of Comfort (Katharine Kolcaba)
69
____________________ are interacting forces that influence recipients’ perceptions of total comfort.
Intervening variables
Theory of Comfort (Katharine Kolcaba)
70
__________ is the immediate state experienced by recipients of comfort interventions.
Comfort
Theory of Comfort (Katharine Kolcaba)
71
_____________________ compose a broad category of outcomes
Health-seeking behaviors
Theory of Comfort (Katharine Kolcaba)
72
___________________ are institutions known to be complete, whole, sound, upright, appealing, ethical, and sincere.
Institutional integrity
Theory of Comfort (Katharine Kolcaba)
73
_____________ are health care interventions based on evidence to produce the best possible patient and family outcomes.
Best practices
Theory of Comfort (Katharine Kolcaba)
74
______________ are protocols for procedures and medical conditions to access and
Best policies
Theory of Comfort (Katharine Kolcaba)
75
___________ is the intentional assessment of comfort needs, the design of comfort interventions to address those needs, and reassessment of comfort levels after implementation compared with a baseline
Nursing
Theory of Comfort (Katharine Kolcaba)
76
Recipients of care may be individuals, families, institutions, or communities in need of ___________. Nurses may be recipients of ___________________ when initiatives to improve working conditions are undertaken
health care ; enhanced workplace comfort
Theory of Comfort (Katharine Kolcaba)
77
The _______________ is any aspect of patient, family, or institutional settings that can be manipulated by the nurse(s), loved one(s), or the institution to enhance comfort.
environment
Theory of Comfort (Katharine Kolcaba)
78
________ is optimal functioning of a patient, family, health care provider, or community as defined by the patient or group.
Health
Theory of Comfort (Katharine Kolcaba)
79
Human beings have holistic responses to ____________ (Kolcaba, 2003).
complex stimuli
Theory of Comfort (Katharine Kolcaba)
80
Comfort is a _________________________that is germane to the discipline of nursing.
value-added holistic outcome
Theory of Comfort (Katharine Kolcaba)
81
Comfort is a _______________ need that persons strive to meet or have met. It is an _____________.
basic human ; active endeavor
Theory of Comfort (Katharine Kolcaba)
82
Enhanced comfort strengthens patients to engage in ___________________________ of their choice.
health-seeking behaviors
Theory of Comfort (Katharine Kolcaba)
83
Patients who are empowered to actively engage in health- seeking behaviors are satisfied with their _____________.
health care
Theory of Comfort (Katharine Kolcaba)
84
________________ is based on a value system oriented to the recipients of care. Of equal importance is an orientation to a health- promoting, holistic setting for families and providers of care.
Institutional integrity
Theory of Comfort (Katharine Kolcaba)
85
Nurses want to practice comforting care and that it can be easily incorporated with every _____________.
nursing action
Theory of Comfort (Katharine Kolcaba)
86
Comfort practice promotes greater nurse ___________ and ____________, as well as high patient ____________.
creativity ; satisfaction ; satisfaction
Theory of Comfort (Katharine Kolcaba)
87
To enhance comfort, the nurse must deliver the __________________________ and ____________ the results in the patient record.
appropriate interventions ; document
Theory of Comfort (Katharine Kolcaba)
88
Theorists of Theory of chronic sorrow
Georgene Gaskill Eakes
Mary Lermann Burke
Margaret A. Hainsworth
89
Theory explains the ongoing feelings of loss that arise from illness, debilitation, or death.
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
90
This theory provides a framework to describe the reaction of parents to the ongoing losses associated with caring for a child with chronic illness or disability (Scornaienchi JM, 2003).
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
91
Nurses caring for families need to be aware of the high potential for _______________ to occur in persons with chronic conditions, their family caregivers, and bereaved persons. (Eakes GG, 1999)
chronic sorrow
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
92
is the periodic recurrence of permanent, pervasive sadness or other grief related feelings associated with a significant loss. (Eakes GG, 1998).
Chronic sorrow
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
93
refers to the difference between the ideal and the real situation due to some type of loss
Disparity
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
94
a significant loss that may be ongoing or a single event.
Loss
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
95
The model explains two antecedents: - Theory of chronic sorrow (Eakes, Burke and Hainsworth)
single event of a living loss
chronic sorrow is unresolved disparity resulting from the loss.
96
are events which prompt the recognition of a negative disparity in the disabled loved one or loss which brings out sadness again.
Triggers
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
97
consist of individualized coping interventions initiated by the person experiencing chronic sorrow (Gordon J, 2009).
Internal management methods
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
98
of coping consist of interventions provided by medical professionals to aid in
effective coping (Gordon J, 2009).
External management methods
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
99
Examples of external management methods are
* professional counseling,
* pharmaceutical interventions to treat symptoms of insomnia or anxiety if necessary,
* pastoral care or spiritual support to assist with grieving,
* use of therapeutic communication, and
* referral services
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
100
“Facing difficulties and acting to overcome them
Coping
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
101
“A mother or father who nurtures and raises a child”.
Parents
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
102
A son or daughter, an offspring”.
Child
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
103
The theory provides a framework for understanding and working with people following a single or ongoing loss (Eakes GG, 1998).
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
104
Diagnosing chronic sorrow and providing interventions are within the scope of nursing practice
Nursing
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
105
The primary roles of nurses include
Empathetic presence
Teacher-expert and
Caring and competent caregiver
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
106
Humans have an idealized perception of life processes and health
Person
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
107
There is a normality of functioning.
Health
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
108
A person’s health depends upon _________ to disparities associated with loss
adaptation
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
109
Interactions occur within a social context, which includes family, social, work, and health care environments.
Environment
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
110
_____________ is a normal human response related to ongoing disparity created by a loss situation.
Chronic sorrow
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
111
_____________ is cyclical in nature.
Chronic sorrow
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
112
Predictable internal and external triggers of heightened grief can be _______________ and _____________.
categorized ; anticipated
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
113
Humans have inherent and learned _______________ that may or may not be effective in regaining normal equilibrium when experiencing chronic sorrow.
coping strategies
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
114
Health care professionals’ _______________ may or may not be effective in assisting the individual to regain normal equilibrium.
interventions
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
115
A human who experiences a single or an ongoing loss will perceive a __________ between the ideal and reality.
disparity
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
116
The disparity between the real and the ideal leads to feelings of pervasive __________ and _____ (Eakes, Burke, & Hainsworth, 1998
sadness ; grief
Theory of chronic sorrow (Eakes, Burke and Hainsworth)
117
Theorist of Theory of Illness Trajectory
Carolyn L. Wiener
Marylin J. Dodd
118
sociologist
Carolyn L. Wiener
119
Nurse and educator; focused her research in oncology nursing, specifically self-care and symptom management.
Marylin J. Dodd
120
Expanded through a secondary analysis of qualitative data that examined family coping and self-care during 6 months of chemotherapy treatment.
Theory of Illness Trajectory (Weiner & Dodd)
121
Being _____ creates a disruption in normal life.
ill
122
disruption in normal life affects all aspects of life, including:
physiological functioning
social interactions
conceptions of self
123
compendium of strategies used to manage the disruption
Coping
124
attempts to isolate specific responses to one event
Coping
125
Not a simple stimulus-response.
Coping
126
Cannot be isolated from complex context of life.
Coping
127
Disruption leads to interwoven responses (all life contexts)
Coping
128
used sociological perspective
Theory of Illness Trajectory (Weiner & Dodd)
129
experience of disruption related to illness within the changing contexts of interactional and sociological processes that ultimately influence the person’s response to such disruption.
Theory of Illness Trajectory (Weiner & Dodd)
130
__________ is best viewed as change over time that is highly variable in relation to biographical and sociological influences. The trajectory is this course of change, of variability, that cannot be confined to or modeled in linear phases or stages.
Coping
Theory of Illness Trajectory (Weiner & Dodd)
131
: the conception of self at a given time that unifies multiple aspects of self and is situated in the body
Identity
Theory of Illness Trajectory (Weiner & Dodd)
132
: biographical time reflected in the continuous flow of the life course events; perceptions of the past, present, and possible future interwoven into the conception of self
Temporality
Theory of Illness Trajectory (Weiner & Dodd)
133
: activities of life and derived perceptions based in the body
Body
Theory of Illness Trajectory (Weiner & Dodd)
134
Uncertainty are manifested in an unsettling intermingling of perceptions of: - Theory of Illness Trajectory (Weiner & Dodd)
the uncertain body
uncertain temporality
uncertain identity
135
llness-related uncertainty vary in dominance across the ______________
illness trajectory
Theory of Illness Trajectory (Weiner & Dodd)
136
The activities of life and of living with an illness are forms of work performed by __________________ (the person and family and HCPs)
total organization
Theory of Illness Trajectory (Weiner & Dodd)
137
The ill person (or patient) is the ______________ ; however, all work takes place within and is influenced by the _________________.
central worker ; total organization
Theory of Illness Trajectory (Weiner & Dodd)
138
Diagnostics, symptom management, care regimen, and crisis prevention
Illness-related work
Theory of Illness Trajectory (Weiner & Dodd)
139
Activities of daily living, keeping a household, maintaining an occupation, sustaining relationships, and recreation
Everyday-life work
Theory of Illness Trajectory (Weiner & Dodd)
140
The exchange of information, emotional expressions, and the division of tasks through interactions within the total organization
Biographical work
Theory of Illness Trajectory (Weiner & Dodd)
141
Activities enacted to lessen the impact of temporal, body, and identity uncertainty
Uncertainty abatement work
Theory of Illness Trajectory (Weiner & Dodd)
142
is the focus of this middle-range theory.
Person
Theory of Illness Trajectory (Weiner & Dodd)
143
The _______________ involves the total organization (the person with the illness, the family, and health care professionals who render care)
illness trajectory
Theory of Illness Trajectory (Weiner & Dodd)
144
“The varied players in the organization have different types of work; however, the patient is the ‘___________’ in the ______________” (Wiener & Dodd, 1993, p. 20).
central worker ; illness trajectory
Theory of Illness Trajectory (Weiner & Dodd)
145
As the central worker, actions are undertaken by the person to manage the effects of living with illness within a range of contexts, including:
the biographical (conception of self)
the sociological (interactions with others).
Theory of Illness Trajectory (Weiner & Dodd)
146
_________ is a highly variable and dynamic process.
Coping
Theory of Illness Trajectory (Weiner & Dodd)
147
Uncertainty with loss of control, described as “the most problematic facet of living with ______”
cancer
Theory of Illness Trajectory (Weiner & Dodd)
148
Core social-psychological process of living with cancer is “tolerating the _____________ that permeates the disease”
uncertainty
Theory of Illness Trajectory (Weiner & Dodd)
149
Factors that influenced the degree of uncertainty includes:
the nature of family support
financial resources
quality of assistance from health care providers
Theory of Illness Trajectory (Weiner & Dodd)
150
Theorists of Peaceful End of Life Theory
Cornelia M. Ruland
Shirley M. Moore
151
Director of the Center for Shared Decision Making and Nursing Research at Rikshospitalet University Hospital in Oslo, Norway, and adjunct faculty at Columbia University in New York.
Cornelia M. Ruland
152
Cornelia M. Ruland focuses on aspects of and tools for shared decision making in clinically challenging situations:
(1) for patients confronted with difficult treatment or screening decisions for which they need help to understand the potential benefits and harms of alternative options and to elicit their values and preferences
(2) preference-adjusted management of chronic or serious long-term illness over time. As primary investigator on a number of research projects, she has received numerous awards for her work.
153
Associate Dean for Research and Professor, School of Nursing, Case Western Reserve University.
She earned a master’s degree in psychiatric and mental health nursing (1990) as well as a doctorate in nursing science (1993) at Case Western Reserve University.
Influenced by these experiences, she assisted in the development and publication of theories (1998). She recognized theory construction as an essential doctoral student skill.
Shirley M. Moore
Peaceful End of Life Theory (Ruland and Moore)
154
Being free of the suffering or symptom distress is the central part of many patients’ end-of-life experience.
Not Being in Pain
Peaceful End of Life Theory (Ruland and Moore)
155
is an unpleasant sensory or emotional experience that may be associated with actual or potential tissue damage
Pain
Peaceful End of Life Theory (Ruland and Moore)
156
“relief from discomfort, the state of ease and peaceful contentment, and whatever makes life easy or pleasurable” (Ruland & Moore, 1998, p. 172).
Experience of Comfort
Peaceful End of Life Theory (Ruland and Moore)
157
Each terminally ill patient is “respected and valued as a human being” (Ruland & Moore, 1998, p. 172). This concept incorporates the idea of personal worth, as expressed by the ethical principle of autonomy or respect for persons, which states that individuals should be treated as autonomous agents, and persons with diminished autonomy are entitled to protection (United States, 1978).
Experience of Dignity and Respect
Peaceful End of Life Theory (Ruland and Moore)
158
a “feeling of calmness, harmony, and contentment, [free of] anxiety, restlessness, worries, and fear”
Being at Peace
Peaceful End of Life Theory (Ruland and Moore)
159
A peaceful state includes:
physical
psychological
spiritual dimensions
Peaceful End of Life Theory (Ruland and Moore)
160
is “the feeling of connectedness to other human beings who care” (Ruland & Moore, 1998, p. 172). It involves a physical or emotional nearness that is ex- pressed through warm, intimate relationships.
Closeness to Significant Others
Peaceful End of Life Theory (Ruland and Moore)
161
The occurrences and feelings at the _____________________ are __________ and ______________
end-of-life experience ; personal ; individualized
Peaceful End of Life Theory (Ruland and Moore)
162
_______________ is crucial for creating a peaceful end-of-life experience. Nurses assess and interpret cues that reflect the person’s end-of-life experience and intervene appropriately to attain or maintain a peaceful experience, even when the dying person cannot communicate verbally.
Nursing care
Peaceful End of Life Theory (Ruland and Moore)
163
a term that includes all significant others, is an important part of end-of-life care.
Family
Peaceful End of Life Theory (Ruland and Moore)
164
The goal of end-of-life care is not to _____________, in the sense that it must be the best, most technologically advanced treatment, a type of care that commonly results in overtreatment.
Rather, the goal in end-of-life care is to ___________ —that is, the best possible care will be provided through the judicious use of technology and comfort measures to enhance quality of life and achieve a peaceful death.
optimize care ; maximize treatment
Peaceful End of Life Theory (Ruland and Moore)
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Theorist of Self-Transcendence Theory
Pamela G. Reed
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Born in Detroit, Michigan.
Bachelor of science degree in nursing in 1974
Masters in nursing in psychiatric–mental health of children and adolescents and in nursing education in 1976
Pamela G. Reed
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Clinical nurse specialist in child-adolescent psychiatric– mental health nursing.
Professor & Associate Dean for Academic Affairs at The University of Arizona College of Nursing.
Her research has focused on well-being and mental health across the lifespan, spirituality at end-of-life, and moral distress and ethical concerns of frontline caregivers and terminally ill individuals.
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refers to awareness that personal or physical well-being is at risk. Life events or crises such as life-threatening illness or loss may increase awareness of personal mortality.
Vulnerability
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is the expansion of self-boundaries multidimensionally such as the following: inwardly (toward greater awareness of one’s own beliefs, values, and goals through introspective activities); outwardly (toward others and the environment); temporally (toward integration of past and future in a way that enhances the relative present); and transpersonally (to connect with dimensions beyond the typically discernible world) (Reed, 1991a, 1997b, 2014).
Self-transcendence
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is “the sense of feeling whole and healthy, in accord with one’s own criteria for wholeness and well-being” (Reed, 2014, p. 112).
Well-being
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Middle range theory but may also serve more broadly as a theoretical framework for applications to particular situations and populations of interest in an individual’s research or practice
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______________ is a human capacity to expand personal boundaries in many ways, for example, intrapersonally, interpersonally, and transpersonally to connect within self, with others and nature, and with purposes or dimensions regarded as larger than or beyond the self.
Self-transcendence
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Self-transcendence facilitates __________, and also mediates the _____________ between experiences of increased vulnerability and well-being outcomes. Various personal and contextual factors, including nursing interventions, influence self-transcendence as related to well-being.
well-being ; relationship
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The theory was created from a lifespan developmental perspective of human-environment processes of health and well-being
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Increased ______________ is related to self-transcendence. This may be a positive relationship with adequate support.
vulnerability
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Self-transcendence is positively related to _________________
well-being
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Self-transcendence also may function as a mediator between ___________ and _____________.
vulnerability ; well-being
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Personal and contextual factors may influence the relationship between ____________ and self transcendence and between _______________ and well-being.
vulnerability ; self-transcendence
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is a pathway for helping the healer, or healing the healer, so that nurses learn to maintain a healthy lifestyle as they care for others”
Self-transcendence
Self-Transcendence Theory (Pamela G. Reed)
