Module 5: Mid-Range Nursing Theories Flashcards
are the least abstract theory level for concrete
practice applications.
Middle-range theories
Middle-range theories include the characteristics of ___________________________________
nursing practice or situations.
Middle-range theories are theoretical __________ of __________ and __________.
evidence ; applicability ; outcome
Middle-range theories develop evidence for _______________________.
nursing practice outcomes
Middle-range theories are recognizable as such because they contain characteristics of nursing practice:
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
Theorist of Maternal Role Attainment – Becoming a Mother
Ramona T. Mercer
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).
Ramona T. Mercer
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
Maternal Role Attainment
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
is attained when the mother experiences a sense of harmony, confidence, and competence in how she performs the role
Maternal Identity
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
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).
core self ; lifelong socialization
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
__________________________ and _______ personality characteristics influence the mother’s behavioral responses (Mercer, 1986a).
Developmental level ; innate
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
The mother’s role partner, her ________, will reflect the mother’s competence in the mothering role through growth and development (Mercer, 1986a).
infant
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
The _______ is considered an active partner in the maternal role -taking process, affecting and being affected by the role enactment (Mercer, 1981).
infant
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
The ______________________________ contributes to role attainment in a way that cannot be duplicated by any other supportive person (Mercer, 1995).
father’s or mother’s intimate partner
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
________________ develops concurrently with __________________, and each depends on the other (Mercer, 1995; Rubin, 1977)
Maternal identity ; maternal attachment
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
immediate environment; family functioning, mother-father relationships, social support, economic status, family values, and stressors.
Microsystem
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
encompasses, influences, and interacts with persons in the microsystem; day care, school, work setting, places of worship, and other entities within the immediate community.
Mesosystem
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
culture or transmitted cultural consistencies; social, political, and cultural influences on the other two systems.
Macrosystem
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
Stages of Role Acquisition (based on Thornton and Nardi’s 1975 research) -
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
Anticipatory
Formal
Informal
Personal
begins during pregnancy; social and psychological adjustments to pregnancy.
Anticipatory
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
begins with the birth of the infant; learning and taking on the role of mother; affected by mother’s social system.
Formal
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
develops unique ways not conveyed by the social system.
Informal
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
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.
Personal
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
This model places the interactions between mother, infant, and father at the center of the interacting, living environments
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
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)
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)
Maternal Role Attainment is Useful to practicing nurses across many _______________ settings.
maternal-child
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
Maternal Role Attainment help simplify the very complex process of becoming a ________.
parent
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
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)
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)
Maternal Role Attainment served as a springboard for other researchers.
Maternal Role Attainment – Becoming a Mother (Ramona T. Mercer)
Theorist of Uncertainty in Illness Theory
Merle Mishel
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
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)
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)
are the resources available to assist the person in the interpretation of the stimuli frame
Structure providers
Uncertainty in Illness Theory (Merle Mishel)
refers to the evaluation of uncertainty using related, recalled experiences.
Inference
Uncertainty in Illness Theory (Merle Mishel)
refers to beliefs constructed out of uncertainty
Illusion
Uncertainty in Illness Theory (Merle Mishel)
reflects biopsychosocial behavior occurring within persons’ individually defined range of usual behavior
Adaptation
Uncertainty in Illness Theory (Merle Mishel)
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)
Theorist of Theory of Caring
Dr. Kristen Swanson
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
provides a platform to deal with miscarriage and the subsequent healing required for the parents and family.
Theory of Caring (Dr. Kristen Swanson)
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)
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)
Being with means being _____________________ to the other.
emotionally present
Theory of Caring (Dr. Kristen Swanson)
Doing for means ____________________________ if at all possible.
to do for others what one would do for self
Theory of Caring (Dr. Kristen Swanson)
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)
________________ 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)
___________ 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
____________ 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
______________ 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
is “any context that influences or is influenced by the designated client”; environment and person-client in nursing may be viewed interchangeably.
Environment
Theorist of Theory of Comfort
Katharine Kolcaba
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
first developed in the 1990s.
Theory of Comfort (Katharine Kolcaba)
___________ is an immediate desirable outcome of nursing care
Comfort
Theory of Comfort (Katharine Kolcaba)
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)
Type of Comfort - Theory of Comfort (Katharine Kolcaba)
Relief
Ease
Transcendence
The state of a patient who has had a specific need met
Relief
Theory of Comfort (Katharine Kolcaba)
The state of calm or contentment
Ease
Theory of Comfort (Katharine Kolcaba)
The state in which one rises above one’s problems or pain
Transcendence
Theory of Comfort (Katharine Kolcaba)
Context in Which Comfort Occurs - Theory of Comfort (Katharine Kolcaba)
Physical
Psychospiritual
Environmental
Pertaining to bodily sensations
Physical
Theory of Comfort (Katharine Kolcaba)
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)
Pertaining to the external surroundings, conditions, and influences Social: Pertaining to interpersonal, family, and societal relationships
Environmental
Theory of Comfort (Katharine Kolcaba)
____________________ are comfort needs from stressful health care situations not met by traditional support systems.
Health care needs
Theory of Comfort (Katharine Kolcaba)
____________________ are nursing actions and referrals done to address specific comfort needs.
Comfort interventions
Theory of Comfort (Katharine Kolcaba)
____________________ are interacting forces that influence recipients’ perceptions of total comfort.
Intervening variables
Theory of Comfort (Katharine Kolcaba)
__________ is the immediate state experienced by recipients of comfort interventions.
Comfort
Theory of Comfort (Katharine Kolcaba)
_____________________ compose a broad category of outcomes
Health-seeking behaviors
Theory of Comfort (Katharine Kolcaba)