situational transitions overview Flashcards
5 types of transitions:
- developmental
- health-illness
- situational
- organizational
- multiple
what concepts impact our ability to transition?
- vulnerability
- powerlessness
- empowerment
- resiliance
Vulnerability
Being physically or emotionally wounded.
- also situational
- a person who was not vulnerable bfr, then placed in a different situation may become very vulnerable.
what risk factors increase vulnerability?
- can be underlying predisposing factors- more likely to develop a health problem
- may be time limited (situational) or may continue over time
- can derive from the individual, family, community, institutions or general environment
predisposing factors to vulnerability:
- poverty
- physically poor/sick
- psychologically or poor social health
- chronically ill
- elderly
- young
- young mother/baby
- mentally ill
- immigrant/refugee
- mentally ill
- unemployment
- victims of crime
- racial minorities
- ppl experiencing crisis
dimensions of vulnerability:
- limited control - over situations
- victimization - feeling blamed for situations
- disenfranchisement- separated from mainstreamed society. ex. women who are not allowed to vote
- disadvantaged status- health or financial
- powerlessness- lacking control and feel that you do not have a choice
- health risk- chronic illness
assessment of risks in vulnerable populations:6
- violence
- family situations
- childhood risk factors
- delinquent behavior
- suicidal behaviors
- youth at risk
cycle of vulnerability :
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.
considerations when assessing vulnerability:
- process of identifying vulnerability can be biased. Be objective
- if vulnerability is inappropriately identified, interventions may worsen the situation
- identifying vulnerability needs to focus on both strengths and limitations. what can they cope with/manage?
- clts and family must be involved in the assessment to ensure a holistic focus
effects of vulnerability: 8
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
Power
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.
powerlessness
- 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
empowerment
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
philosophies of empowerment:
- health belongs to the individual and they have the prime responsibility for their health
- the individual has the ability to make decisions and act on their own behalf
- health care providers cant empower ppl, we provide the tools for self empowerment
- health care providers surrender control and develop a collaborative, cooperative relationship
- health care providers must be prepared to accept that ppl will make decisions that are different from what is decided for them
- mutual respect and trust are necessary components for empowerment to occur.
Resilience and resiliency:
–> 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
an alternative understanding of resiliency:
- -> 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.
There can be genetic factors of resiliency:
genetic
environmental
perception of the event
past experiences
Inherent qualities of resilience:
- flexibility
- adaptability
- perseverance
- optimism
- balanced perspective on life
- self-reliance, self-respect and autonomy
- meaningfulness of experiences or life
uniqueness of resilience :
- -> 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 +
Protective factors within the individual that increase resiliency:
- sense of responsibility
- hx of competence or success
- cognitive prob-solving or reading skills
- self-esteem
- feeling in control of ones life
- planning for future events such as jobs, education.
familial and support factors in individual resiliency:
- parent-child attachment 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 / friend network
- make sure you can take care of yourself
- maintain hope
- try to put self in situations for self growth
what is hope?
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.
Levels of hope:
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.
critical elements of hope:
- mutuality and affiliation - significant relationships
- sense of the possible
- avoidance of absolutes - no rigid “all for nothing” view
- anticipation
- establishing and achieving goals
- freedom and the feeling of choice
- psychological well-being and coping
- 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 .
