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situational transitions overview Flashcards

1
Q

5 types of transitions:

A
  1. developmental
  2. health-illness
  3. situational
  4. organizational
  5. multiple
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2
Q

what concepts impact our ability to transition?

A
  1. vulnerability
  2. powerlessness
  3. empowerment
  4. resiliance
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3
Q

Vulnerability

A

Being physically or emotionally wounded.

  • also situational
  • a person who was not vulnerable bfr, then placed in a different situation may become very vulnerable.
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4
Q

what risk factors increase vulnerability?

A
  1. can be underlying predisposing factors- more likely to develop a health problem
  2. may be time limited (situational) or may continue over time
  3. can derive from the individual, family, community, institutions or general environment
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5
Q

predisposing factors to vulnerability:

A
  1. poverty
  2. physically poor/sick
  3. psychologically or poor social health
  4. chronically ill
  5. elderly
  6. young
  7. young mother/baby
  8. mentally ill
  9. immigrant/refugee
  10. mentally ill
  11. unemployment
  12. victims of crime
  13. racial minorities
  14. ppl experiencing crisis
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6
Q

dimensions of vulnerability:

A
  1. limited control - over situations
  2. victimization - feeling blamed for situations
  3. disenfranchisement- separated from mainstreamed society. ex. women who are not allowed to vote
  4. disadvantaged status- health or financial
  5. powerlessness- lacking control and feel that you do not have a choice
  6. health risk- chronic illness
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7
Q

assessment of risks in vulnerable populations:6

A
  1. violence
  2. family situations
  3. childhood risk factors
  4. delinquent behavior
  5. suicidal behaviors
  6. youth at risk
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8
Q

cycle of vulnerability :

A

predisposing factors
no effective interventions
poor health outcomes
worsening situations

nurse needs to be able to identify to make changes. assess and identify to help. include the individual and the community for decision making.

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9
Q

considerations when assessing vulnerability:

A
  1. process of identifying vulnerability can be biased. Be objective
  2. if vulnerability is inappropriately identified, interventions may worsen the situation
  3. identifying vulnerability needs to focus on both strengths and limitations. what can they cope with/manage?
  4. clts and family must be involved in the assessment to ensure a holistic focus
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10
Q

effects of vulnerability: 8

A

anxiety
depression
social isolation
marginalization
physiological - health probs
social forces - marginalization and stigmatism
psychological - effects of the oppression
societal trends - increased numbers of vulnerabe populations

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11
Q

Power

A

the inherited 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.

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12
Q

powerlessness

A
  • the perception that one lacks the capacity or authority to affect an outcome
  • results in imbalance of power btwn nurse and pt.
  • may result in value decisions being forced on the recipient of care.

Nursing Diagnosis: self-care deficit

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13
Q

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

    • process by which power is shared with colleagues and pts
    • nurses facilitate for the pt, not do it for them
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14
Q

philosophies of empowerment:

A
  1. health belongs to the individual and they have the prime responsibility for their health
  2. the individual has the ability to make decisions and act on their own behalf
  3. health care providers cant empower ppl, we provide the tools for self empowerment
  4. health care providers surrender control and develop a collaborative, cooperative relationship
  5. health care providers must be prepared to accept that ppl will make decisions that are different from what is decided for them
  6. mutual respect and trust are necessary components for empowerment to occur.
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15
Q

Resilience and resiliency:

A

–> tendency to rebound or recoil, to return to a prior state. To spring back. the power to recover.

–> the process and being able to successfully adapt despite challenging or threatening circumstances.

–> adaptive stress resistant personality that permits one to thrive in spite of adversity

–> this is the process of how the person interprets how they are going to succeed

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16
Q

an alternative understanding of resiliency:

A
  • -> more than just springing back to a previous state.
  • -> a dynamic process of adjustment, adaptation, and transformation in response to adversity.
  • -> in adapting, the organism often changes the environment.
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17
Q

There can be genetic factors of resiliency:

A

genetic
environmental
perception of the event
past experiences

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18
Q

Inherent qualities of resilience:

A
  1. flexibility
  2. adaptability
  3. perseverance
  4. optimism
  5. balanced perspective on life
  6. self-reliance, self-respect and autonomy
  7. meaningfulness of experiences or life
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19
Q

uniqueness of resilience :

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
  • -> resiliency is +
20
Q

Protective factors within the individual that increase resiliency:

A
  1. sense of responsibility
  2. hx of competence or success
  3. cognitive prob-solving or reading skills
    • self-esteem
  5. feeling in control of ones life
  6. planning for future events such as jobs, education.
21
Q

familial and support factors in individual resiliency:

A
    • parent-child attachment and interactions
  2. effective parenting
  3. structure and rules within the household
  4. responsibilities for all family members in the home
  5. good family coping and family hardiness
  6. strong extended family network / friend network
  7. make sure you can take care of yourself
  8. maintain hope
  9. try to put self in situations for self growth
22
Q

what is hope?

A

Unique to the individual. recognizing the possibilities. Something to look forward to. life worth living. anticipation of continuous good state.
sense of personal competence. coping ability. physiological well-being, purpose and meaning in life.

23
Q

Levels of hope:

A

Level 1. superficial wishes. Wishing for something for xmas

Level 2. hoping for relationships, self-improvement, self-acomplishments. maybe some anxiety if wishes were not realized. didnt get a certain job.

Level 3. arises out of suffering, personal trial, or state of captivity. Be realistic with pts.

24
Q

critical elements of hope:

A
  1. mutuality and affiliation - significant relationships
  2. sense of the possible
  3. avoidance of absolutes - no rigid “all for nothing” view
  4. anticipation
  5. establishing and achieving goals
  6. freedom and the feeling of choice
  7. psychological well-being and coping
  8. purpose and meaning of life - something to live for
  9. reality surveillance (clues that hope is possible)
  10. optimism - a prerequisite
  11. mental and physical activation to combat despair .
25
Q

Despair:

A

giving up.
Occurs when relief is not imminent by the evaluation of the individual. Related to the individuals perspective. They cannot see any improvements in their conditions

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

Despair leads to hopelessness.

26
Q

Miller’s Hope Despair Model

Hope:

  1. establishes and modifies goals
  2. focuses on past successes
  3. plans for alternative actions
  4. motivates self to succeed
A

Despair:

  1. unable to set goals
  2. perceives unachieved outcomes as personal failures
  3. verbalizes self-doubt
  4. gives up. might give up because they feel too old
27
Q

How does despair trigger hopefulness? 4

A
  1. Enduring
  2. Uncertainty phase
  3. Suffering
  4. Acceptance
28
Q

Enduring phase:

A

awareness without full comprehension:

  • ->suspension of emotions
  • -> energy used to keep self together
  • -> attempt to remain in control
29
Q

Uncertainty Phase:

A
  • -> recognition regarding the event has occured
  • -> 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 benefit and draw backs of options
30
Q

Suffering phase:

A
  • -> reality assessment results in overwhelming feelings of blackness and despair
  • -> support groups can be beneficial at this time
31
Q

Acceptance phase:

A

–> acceptance of the situation eventually occurs and beings with it hope for new path and a new goal

32
Q

Consequences of Despair and Hopelessness:

A
  1. increased symptoms and illness
  2. disability
  3. weakness: physically, emotionally…
  4. impaired power of concentration
  5. fluctuating moods, insomnia
  6. being able to receive info about illness
  7. suicide
33
Q

Strategies to maintain hope:

A
  1. cognitive strategies
  2. determinism
  3. philosophy of life and world view
  4. spiritual strategies
  5. relationship with caregivers
  6. family bonds/social supports
  7. being in control/ autonomy / involvement in decisions
  8. goal accomplishments
34
Q

Brain plays a vital role in the biology of hope:

Anterior hypothalamus:

A

calms emotions and increases body’s immune capabilities

35
Q

Brain plays a vital role in the biology of hope:

Posterior hypothalamus:

A

fight/flight - produces fighting cells to facilitate work of the immune system

36
Q

Brain plays a vital role in the biology of hope:

Neuropeptides:

A

translates emotions into bodily events.

ex. gut feelings, flutter sensations

37
Q

Brain plays a vital role in the biology of hope:

Psychoeuroimmunology:

A

study of how psychological and emotional states influence disease resilience via interactions with the nervous, endocrine and immune system.

38
Q

Nursing interventions and Hope inspiring strategies:
How can nurses help empower vulnerable pts?

Sustaining Relationships:

A

“connectedness”, assist individual and family to identify goals and work together.

39
Q

Nursing interventions and Hope inspiring strategies:

Relinquishing Control:

A

how and why would you do this as a nurse?

40
Q

Nursing interventions and Hope inspiring strategies:

Use life promoting framework:

A

pts are powerful, unique entities that have the ability to cope and succeed

41
Q

Nursing interventions and Hope inspiring strategies::

Assist pt to expand coping repertoire

A

Reduce negative effects and anxiety

42
Q

Nursing interventions and Hope inspiring strategies:

Reality Surveillance:

A

search for cues that confirm that maintaining hope is feasible. checking that hope is possible.

43
Q

Nursing interventions and Hope inspiring strategies:

Devise and Revise Goals:

A

recognize accomplishments, set realistic goals

44
Q

Nursing interventions and Hope inspiring strategies:

Foster renewed spiritual self:

A
  • -> maintain a relationship with “higher” power, helps provide a sense of purpose and meaning of life.
  • ->or establish inspirational resources such as literature, poverty art and music, humor and nature
45
Q

Nursing interventions and Hope inspiring strategies:

Guard against despair:

A

guard against no longer having hope or belief

46
Q

Nursing Actions:

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- within professional boundaries

Nurs301 (2 decks)

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