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Nursing 301 > Situational Transitions > Flashcards

Situational Transitions Flashcards

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1
Q

What are five types of transitions?

A 
Developmental
Health-illness
Situational
Organizational
Multiple
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2
Q

What are developmental transitions?

A

Changes in life cycle.

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3
Q

What are health-illness transitions?

A

Changes in health.

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4
Q

What are situational transitions?

A

Lifestyle changes.

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5
Q

What are organizational transitions?

A

Leadership/agency restructuring.

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6
Q

What are multiple transitions?

A

Change in more than one category.

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7
Q

Define “transition”.

A

Transition - A passage or process of change from one state, condition, or place to another involving an alteration in identity. May have a successful or unsuccessful outcome, and is influenced by personal, health, and environmental factors.

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8
Q

What concepts impact our ability to transition?

A 
Vulnerability
Powerlessness
Empowerment
Resilience
Hope
Despair
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9
Q

What is the definition of vulnerability?

A

Origin: Latin vulnerabilis from the verb vulnerare – to wound, capable of being physically or emotionally wounded…

Being more susceptible to physical, mental, emotional, environmental or economic harm/neglect

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10
Q

What are risk factors that increase vulnerability?

A

Underlying predisposing factors that make one more likely to develop a health problem. These may be time-limited (situational) or may continue over time.

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11
Q

Where can risk factors for increased vulnerability derive from?

A 
The individual
The family
The community
Institutions
The general environment
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12
Q

What are some predisposing factors to vulnerability?

A 
Lower socioeconomic status
Age related - very old or very young
Developmental transitions and life experiences
Multiple chronic illnesses
Crisis
Gender
Unstable home environment/abuses
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13
Q

What are the dimensions of vulnerability?

A 
Limited control
Victimization
Disenfranchisement
Disadvantaged status
Powerlessness
Health Risk
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14
Q

What risk factors should be assessed for in vulnerable populations?

A 
Violence
Family situations
Childhood risk factors
Delinquent behaviour
Suicidal behaviour
Youth-at-risk
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15
Q

What are the four stages in the cycle of vulnerability?

A

Predisposing factors
No effective intervention
Poor health outcomes
Worsening situation

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16
Q

What are some considerations when assessing vulnerability?

A

Bias
Interventions may worsen the situation (if vulnerability is inappropriately identified).
Clients and family must be involved.
Needs to focus on both strengths and limitations.

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17
Q

What are the possible physiological effects of vulnerability?

A

The resultant stress and anxiety.

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18
Q

What are the social effects of vulnerability?

A

Marginalization and stigmatization.

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19
Q

What are the effects of vulnerability? (Which areas)

A

Physiological
Psychological
Social Forces
Societal Trends

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20
Q

What is the definition of “power”?

A

Power comes from the Latin word, potere, “to be able”.

The inherent ability to control behaviors surrounding life events, the freedom to make informed choices with authority and act on them, and the conviction to realize those choices (Rinehart, 1991, p. 3).

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21
Q

What is the definition of “powerlessness”?

A

Lacking the capacity or authority to affect an outcome (Miller, 2000).

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22
Q

What is the result of feelings of powerlessness in the nurse/patient relationship?

A

Power imbalances in the nurse-patient relationship (Yodder Wise, 1995, pg. 400)

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23
Q

What is the potential result of power imbalance in the nurse-patient relationship?

A

Power imbalance may result in value decisions being forced on the patient.

24
Q

What is the definition of “empowerment”?

A

The process by which we facilitate the participation of others in decision making and taking action within an environment where there is equitable distribution of power.
It is the process by which power is shared with colleagues and patients.

25
Q

What is the definition of “resilience”?

A

Power or ability to rebound or recoil, to return to a prior state, to spring back, the power of recovery (Oxford dictionary).
The process of, or having the capacity for successful adaptation despite challenging or threatening circumstances.
Adaptive, stress resistant personality that permits one to thrive in spite of adversity (Ahern, Ark, & Byers, 2008).

26
Q

What is an alternative understanding of “resilience”? (Kirmayer et al, 2011)

A

More than simply springing back to a previous state - a dynamic process of adjustment, adaptation, and transformation in response to adversity.

27
Q

What are some inherent qualities of resilient people?

A 
Flexibility
Adaptability
Perseverance
Optimism
Balanced perspective of life
Self reliance, self respect and autonomy
Meaningfulness of experiences or life
28
Q

What are some things that make resilience unique?

A

It is a characteristic or state.
It is a process of coping, becoming evident when it is in use.
Can be compartmentalized into physical resiliency, emotional resiliency or resiliency to change.
It may have a spiritual dimension/religious dimension.

29
Q

What are some protective factors within the individual that increase resilience?

A

Sense of responsibility
History of competence or previous success.
Cognitive problem-solving and reading skills.
Positive self-esteem/self-efficacy/optimism.
Feeling of control over one’s life.
Planning for future events such as jobs or education.

30
Q

What are some factors impacting individual resiliency?

A

Positive parent-child attachments and interactions.
Effective parenting.
Structure and rules within the household.
Responsibilities for all family members in the home.
Good family coping and family hardiness.
Strong extended family network.

31
Q

What is hope? (Miller, 2000, p. 523)

A

A state of being, characterized by anticipation of a continuous good state, an improved state or a release from perceived entrapment which may, or may not, be founded on concrete or real world evidence. It is an anticipation of a future that is good and is based on mutuality, sense of personal competence, coping ability, psychological well being, purpose and meaning in life as well as a sense of “the possible”. (Miller, 2000, p. 523)

32
Q

What is hope? (Sachse, D. 2007)

A

Hope is a multidimensional construct arising from our memories, beliefs, and values that is believed to be a part of all activities and thoughts that strengthen the spirit and facilitates behaviour to elicit an outcome and/ or promote a level of comfort while impacting life quality. Hope is unique to each individual, yet universal to all.
(Sachse, D., 2007).

33
Q

What is hope? (Kylma, 2005)

A

Hope is recognizing constructive possibilities
in one’s life situation and believing in a life
worth living during the present and in the future.
(Kylma, 2005)

34
Q

What is level 1 of hope?

A

Superficial wishes

35
Q

What is level 2 of hope?

A

Includes hoping for relationships, self-improvement and self-accomplishments.

36
Q

What is level 3 of hope?

A

Arises out of suffering, personal trial, or state of captivity.

37
Q

What are some critical elements of hope?

A

Mutuality and affiliation in significant relationships.
Sense of the possible.
Avoidance of absolutes - no rigid “all or nothing” view.
Anticipation.
Freedom and the feeling of choice.
Psychological well being and coping.
Establishing and achieving goals.
Purpose and meaning of life - something to live for.
Reality surveillance (clues that hope is possible).
Optimism - a prerequisite.
Mental and physical activation to combat despair.

38
Q

What is the definition of “despair”?

A

Despair, or giving up, occurs when relief is not imminent by the evaluation of the individual.

39
Q

When does despair occur?

A

Despair occurs when goals and the path of reaching goals are lost.

40
Q

What does despair lead to?

A

Hopelessness.

41
Q

According to Miller’s “Hope-Despair” model, what are the manifestations of hope?

A

Establishes and modifies goals.
Focuses on past successes.
Plans for alternative actions.
Motivates self to succeed.

42
Q

According to Miller’s “Hope-Despair” model, what are the manifestations of despair?

A

Unable to set goals.
Perceives unachieved outcomes as personal failures.
Verbalizes self doubt.
Gives up.

43
Q

How does despair trigger hopefulness? (5 stages)

A 
Enduring
Awareness
Uncertainty
Suffering
Acceptance
44
Q

What occurs during the awareness stage of despair?

A

Awareness without full comprehension.

  • suspension of emotions
  • Energy used to keep self together
  • attempt to remain in control
45
Q

What occurs during the uncertainty stage of despair?

A

Recognition regarding the event has occurred.
The individual is ready to make goals (or has made goals) but is uncertain how to achieve them.
At this point they are unable to determine benefits and draw backs of options.

46
Q

What occurs during the suffering stage of despair?

A

Reality assessment results in overwhelming feelings of blackness and despair.

47
Q

What can be helpful during the suffering stage of despair?

A

Support groups.

48
Q

What occurs during the acceptance stage of despair?

A

Acceptance of the situation eventually occurs and brings with it HOPE for a new path and a new goal.

49
Q

What are some consequences of despair and hopelessness?

A 
Increased symptoms and illness.
Disability.
Weakening.
Impaired concentration.
Fluctuating moods, insomnia.
Unable to receive/absorb information about illness.
Suicide.
50
Q

What are some strategies to maintain hope?

A 
Cognitive strategies.
Determinism.
Philosophy of life and world view.
Spiritual strategies.
Relationship with caregivers.
Family bonds.
Being in control.
Goal accomplishment.
51
Q

What are some nursing interventions and “hope” inspiring strategies?

A 
Sustaining relationships.
Relinquishing control.
Use life promoting framework.
Assist patient to expand coping repertoire.
Reality surveillance.
Devise and revise goals.
Foster renewed spiritual self.
Guard against despair.
52
Q

What is reality surveillance?

A

Searching for cues to confirm that maintaining hope is feasible.

53
Q

How can a nurse foster renewed spiritual self?

A

Maintain a relationship with “higher” power, helps provide a sense of purpose and meaning of life.
Pr establish inspirational resources such as literature, poetry, art and music, humor, nature

54
Q

What are some nursing actions that can be done to stop the cycle of despair?

A

Nurture factors contributing to unfolding possibilities - open up to life.
Minimize factors contributing to folding possibilities.
Consider individual, interpersonal care and surrounding levels.
Share experiences.

55
Q

What are the steps in the cyclic relationship between enduring, uncertainty, suffering and hope?

A

Event (leads to) awareness, (enduring), recognition, (uncertainty), acknowledgement, (suffering), acceptance, (hope), reformulated self.

Nursing 301 (19 decks)

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