Test #2 Flashcards
Week 5-9
What does “Nursing” mean to Sister Callista?
a healthcare profession that focuses on human life processes and patterns and emphasizes promotion of health for individuals, families, groups, and society as a whole.
What does the “Environment” mean to sister Callista?
Serves as the input that any one person has as an adaptive system. Negative or positive stimuli all stem from the environment, whether those stimuli be blatant (focal), subconscious (contextual), or even unknown (residual)
What does “Person” mean to sister Callista?
: holistic, adaptive systems made of many parts with internal processes acting to maintain adaptation in the four adaptive modes
What does “Health” mean to sister Callista?
: supported by adaptive responses; defined as a state and a process of being and becoming integrated and whole
Coping means:
Coping processes act to maintain adaptation and promote person and environment transformations
Adaptation means:
Process and outcome by which thinking and feeling are used in conscious awareness and choice to create human and environmental integration
What is “ Philosophic” according to RAM’s assumptions:
People have mutual relationships with the world and God. People use human creative abilities of awareness, enlightenment, and faith.
What is “ Scientific” according to RAM’s assumptions:
Self and environmental awareness is rooted i thinking and feeling, system relationships include acceptance, protection, and fostering interdependence.
What is “Cultural” according to RAM’s assumptions:
Cultural expression may lead to changes nursing practices like nursing assessment, cultural experiences influence how Roy’s Model is expressed.
What does Roy’s Model consist of?
Environmental stimuli, coping processes and Modes of Adaptation
One of the factors of environmental stimuli is focal, what does it mean?
Factors that immediately affect the person
One of the factors of environmental stimuli is contextual, what does it mean?
all other stimuli affecting the situation
One of the factors of environmental stimuli is Residual, what does it mean?
Factors whose effects are unclear
What is Health Expanding Consciousness(HEC)?
Open-minded people don’t care to be right; they care to understand.
There’s never a right or wrong answer.
Everything is about understanding.
What does “Nursing” mean to Newman?
The study of caring in the human health experience
Role of the nurse is to help clients to recognize their own patterns so that transformation occurs
This happens as the nurse forms relationship with clients at critical points in their lives and connects with them in an authentic way
Nurses are partners with patients in the process of expanding consciousness
What does “Person” mean to Newman?
Consciousness, not just in our heads, but in all aspects of ourselves
Consciousness is the ability of the system to interact with the environment
What does “Health” mean to Newman?
Health is a fusion of disease and non-disease as opposed to the traditional view of “good” or “bad” health (value judgment)
Health is the pattern of the whole and we can’t lose or gain health
Becoming ill doesn’t diminish wholeness, but instead changes it
What does the”Environment” mean to Newman?
The larger whole, beyond the consciousness of the individual
Consciousness resides in all matter in the universe and coextends (builds on each other)
Interactions between the person and the environment are a key process that creates our own unique self/experience
What are Newmans’ Perspectives with HEC
Expanding Consciousness (mindful)
Time
Presence
Resonating with the Whole
Attention to Pattern and Meaning
Insight Occurring as Choice Points of Action Potential
The Mutuality of the Nurse-Client Interaction in the Process of Pattern Recognition
Expanding consciousness is
Defined consciousness as the information of the system: the capacity of the system to interact with the environment.
Occurs when there is a meaningful quality relationship between nurse and patient.
Evident when people transcend their own egos, dedicate their energy to something greater than their individual selves, and learn to build order against the trend of disorder.
Time according to Newman is
“When the nurse moves away from a sense of linear time to a more universal synchronization with here and now, they can be truly present to the patients in a meaningful and whole manner”.
Presence according to Newman is
When the nurse considers the patient a mystery to be engaged in rather than a problem to be solved, the relationship is characterized by presence”.
Resonating with the whole according to Newman is
Mechanism for acquiring essential information to guide nursing action and understand the meaning in patient’s life.
Learning to resonate with patients involves relational engagement and reflection.
“Resonance is a way to sense the whole through attention to one aspect or part of it, always with an eye on comprehending the whole”.
Attention to pattern and meaning according to Newman is
Newman’s theory is the belief that each person exhibits a distinct pattern, which is constantly unfolding and evolving as the person interacts with the environment.
Nurses grounded in the theory of HEC are able to be in relationships with patients, families, and communities in such a way that insights arising in their pattern recognition dialogue shed light on an expanded horizon of potential actions
Insight as choice points according to Newman is
The disruption of disease and other traumatic life events may be critical points in the expansion of consciousness.
Body system move in an orderly manner until some disruption occurs, and the system moves in seemingly random, chaotic, disorderly way until at some point it choose to move into a higher level of organization.
Mutuality of the Nurse-Client Interaction according to Newman is
Nursing within the HEC perspective involves being fully present to the patient without judgments, goals, or intervention strategies.
It involves being with rather than doing for patients.
It is caring in its deepest, most respectful sense with focus on what is important to the patient
Nurses must be able to practice from center of their own truth, being fully present to patient, while sensing into their own feelings, perception, knowing that they contain potentially valuable insights.
Nurse must have a tolerance for disequilibrium and disorganization, even if they are uncomfortable.
The humanbecoming Theory is
Human science
Martha Rogers ideas about human beings
energy fields, irreducible, ever-changing, and
recognized by patterns
Existential-phenomenological thought
focus on the lived experience of human
beings and their freedom and participation in life
Nursing as a unique knowledge base
Humans are indivisible, unpredictable, ever-changing.
Focus - Quality of life, dignity, and freedom
What are the symbols of the Humanbecoming theory?
Black and White - Opposite Paradox
Green - Hope
Green and Black swirls merging - Human-Universe cocreate as an ongoing process of becoming
Joined Centre - Co-created mutual human universe process at the ontological level and nurse-person process
What are the three major themes of Parse’ theory
Meaning, Rhythmicity and Transcendence
What does “Meaning” mean to Parse?
Humanbecoming is choosing personal meaning in situations, and that a person’s reality is given meaning through experiences he or she lives in the environment.
What does “Rhythmicity” mean to Parse?
Humanbecoming is co-creating rhythmical patterns of relating person and environment.
What does “Transcendence” mean to Parse?
Moving with now moments is living the becoming visible-invisible becoming with the ambiguity of the continuous change of the emerging now.
What does “Nursing” mean to Parse?
A state of biological, psychological, social, and spiritual well-being.
A process of changing value priorities: not static state, but ever-changing as the human chooses ways of living
What does “Health, Person and Environment” mean to Parse
Humanbecoming
Structuring meaning, cocreating rhythmical patterns of relating and cotranscending with the possibilities
A personal commitment, a personal creation, and a personal responsibility
What does intentionality mean according to Parse?
To be human is to be intentional and to be involved with the world
Involved through knowing, being present, and being open
What is human subjectivity mean according to Parse?
It is living what is and also what is not-yet all-at-once
Humans participate with the world through choosing to live their values
Every person creates a unique relationship with the universe that is open to new possibilities
What does Co-consititution mean to Parse?
The way we individually create meaning in a situation
We change and are changed through our interpretation of life situations
The ways we think and act open and close possibilities as we create our reality
What does Coexistence mean to Parse?
Human beings are in the world with others
Other human beings act as a mirror for us
We think of ourselves in relation to how we are with others and how we might be with our plans and dreams
There are no cause-effect relationships for human beings because there is always freedom to choose
What does Situated freedom mean to Parse?
We participate in choosing the situations that we find ourselves in and our attitude toward those situations
In choosing how we will be, we show what we value and create value systems
We decide what is important in our lives
Sometimes being able to act on our beliefs is as important as being successful in achieving the outcome we desire
What is Reed’s Theory of Self Transcendence?
Middle Range Theory
Focus for the purpose of enhancing well being.
“The theory proposes what when people face life-threatening illness or undergo health-related changes that intensify one’s awareness of vulnerability, there may be a readiness or need to expand (or transcend) the self-boundary to integrate those changes in order to achieve a sense of wellbeing.”
What are the two core assumptions of Reed’s Theory?
1) Potential for Well-Being: a Nursing Process
Human beings possess an inner potential for healing, growth & well-being throughout lifespan & described as a nursing process
Self-organization is the term used as the inner potential for well-being
2) Self-Boundary & Pandimensionality
Humans impose a conceptual boundary on their “openness“ to define their reality & provide sense of identity & security
Reflected in perspectives regarding the inner-self, mind-body-spirit connections & connection to others
One of Reed’s major theoretical concepts is Self Transcendence, what does it mean?
A means by which to connect with self, others & environment
Expand self in 4 ways:
Intrapersonally
Interpersonally
Transpersonally
Temporally
One of Reed’s major theoretical concepts is Well-being, what does it mean?
A subjective feeling of health or wholeness defined by individuals & linked with self-transcendence
What does “Person” mean to Reed?
People are viewed as human beings who develop through life events and environments.
What does the”Environment” mean to Reed?
Composed of family, social networks, physical surroundings, and community.
What does “Health” mean to Reed?
Health in the context of well-being.Well-being is a sense of feeling whole and healthy, according to one’s own criteria for wholeness and health.
What does “Nursing” mean to Reed?
The assistance through interpersonal processes and therapeutic management of environments to promote health
What are the approaches to boundary expansion?
Intrapersonal approach
Interpersonal approach
Transpersonal approach
Temporal approach
what is Story Theory about?(Smith&Liehr)
The context for nurse-person health promoting process
Structure to guide nursing in practice & research by collecting stores about health situations that are important to the person
A growing phenomenon for qualitative research
Extra:
Story- a part of a human experience, bind people and time and are expressions of who we are, where we have been & where we are going
What are the Theoretical & Conceptual roots of Story Theory?
A concept with long historical roots
Many grand theories highlight significance of listening to the patients’ stories
{Recall: Nightingale implored nurses to stop chattering & begin listening}
“Story” is differentiated from “narrative” for Smith & Liehr
What are the three major theoretical concepts for Story Theory associated with dimensions?
Intentional dialogue
Complicating health challenge
Connecting with self-in-relation
Through developing story plot
Creating ease
While moving toward resolving
What are the 7 phases of inquiry?
Phase One
Gathers a story of what matters most about a health challenge
Phase Two
Compose a reconstructed story
Phase Three
Connect existing literature to the health challenge
Phase Four
Refine the name of the health challenge
Phase Five
Describe the developing story plot with high points, low points, and turning points
Phase six
Identify movement toward resolving
Phase seven
Collect additional stories about the health challenge
What does “Person” mean to Smith & Liehrs?
Patient enters into dialogue with nurse.
What does “Environment” mean to Smith & Liehrs?
The patient has to deal with challenges in internal and external environment.
What does “Health” mean to Smith & Liehrs?
What matters most about a complicating health challenge.
What does “Nursing” mean to Smith & Liehrs?
The nurse engages the patient to a resolution.
What is comfort according to Kolcaba?
1.To soothe in distress or sorrow.
2. Relief from distress (absence of previous discomfort) (negative sense)
3. A person or thing that comforts
4. A state of ease and quiet enjoyment, free from worry (neutral sense)
5. Anything that makes life easy
6. Suggests the lessening of misery or grief by cheering, calming, or inspiring with hope (positive sense)
What are the 3 stages of comfot?
Relief - unmet comfort needs
Ease - contentment; attention to risk factors
Transcendence - motivation, confidence, hope
What are the 4 contexts that the 3 types of comfort are experienced?
Physical
Psychospiritual
Environmental
Sociocultural
What are the 3 propositions of Comfort Theory?
Part 1: Effective Comforting Interventions result in increased comfort of our patients and families. Often non-technical/non-pharmacological. Ex. Repositioning, hand-massage, warm blanket etc.
Part 2: Increased comfort strengthens patients allowing them to better engage in Health Seeking Behaviours (HSBs).
Part 3: Increased engagement in HSBs results in better Institutional Integrity leading to improvement in Best Practice & Best Policies; this equates to better patient outcomes, quality of care and cost effectiveness.
What are the 3 types of Comforting Interventions
Technical:Treatment & medication
Coaching: Active listening & advocacy
Comfort food for the soul: Back massage, walks outside etc..
The three levels of adaptation are
Integrated adaptation, compensatory adaptation and compromised adaptation
Integrated adaptation is
Structures and functions of the adaptive modes are working together and meets human needs
Compensatory adaptation is
When the cognator and regular or stabilizer and innovator are activated by a challenge
What are the subsystems of coping
Regulator-cognator (A person)
Stabilizer-Innovator (A group)
What’s a regulator subsystem?
Uses physiologic process such a chemical, neurologic, and endocrine response to cope with the changing environment
what’s a cognator subsystem?
It involves the cognitive and emotional process that interacts with the environment
What’s the stabilizer subsystem?
Structures, values and daily activities work together to accomplish the primary purpose of the group
What’s the innovator subsystem?
Response to environmental change
What’s physiologic-physical mode of adaptation?People as individuals interact as physical beings with environment
sense: fluid, electrolyte, acid-base balance: neurologic function: endocrine function
People as individuals interact as physical beings with environment
sense: fluid, electrolyte, acid-base balance: neurologic function: endocrine function
What’s Self-concept mode of adaptation?
A composite of beliefs and feelings that a person holds about him or herself at a given time: sense of purpose
Involves developing self, perceiving self, and focusing self
What’s role function mode of adaptation?
Role on people in society filing their needs for social integrity, relating self to others
Individual needs to know who one is in relation to others to act
What’s Interdependence mode of adaptation?
Close relationships of people and their purposes, structure and development
