Theoretical basis of care Flashcards
Recovery
Recovery is the most important goal.
It includes 4 dimensions: home, health, purpose, and community.
Unlike previous editions, the DSM-V does not use
the multiaxial system
Phases of a therapeutic nurse-client relationship: introduction
Finding the diagnosis
Phases of a therapeutic nurse-client relationship: Working phase
Also called “identification and exploitation”
Clarifying the expectations you talked about during the introduction
Start the treatment
Evaluate the treatment
This is when transference/countertransference happens
Phases of a therapeutic nurse-client relationship: Termination phase
Also called “resolution”
Reviewing progress toward goals (you also measure outcomes in the working phase)
Establishing a longterm plan of care
Focusing on self-management
This is the phase where the client’s symptoms might er-emerge
Erikson
Infancy, birth to 1 year old
Trust versus mistrust, because the first thing you have to do when you’re born is rely on others for help. You have to trust someone else.
Ability to form meaningful relationships with trust, and have hope for the future.
If it doesn’t go well, you will have the opposite- poor relationships, mistrust, and hopelessness
Erikson
Early childhood, 1 to 3 years old
Autonomy vs shame and doubt. This age has to do with autonomy because it’s when you can first crawl and walk around on your own.
Self control, self esteem, willpower
Erikson
Late childhood, 3 to 6 years old
Initiative vs guilt. Because when you’re around 4 or 5, they might ask you to take the initiative to clean up your toys.
Self-directed behavior, goal formation, sense of purpose
Erikson
School age, 6 to 12
Industry verse inferiority
Ability to work, be competent, and achieve things (which makes since they are in school, where you try to get good grades)
Erikson
Adolescence, 12 to 20
Identity verse role confusion
Forming an identity when you’re a teenager
Erikson
Early adulthood, 20 to 35 years old
Intimacy vs isolation. The age where most people get married.
Getting married.
If unsuccessful, you’ll be emotionally isolated and start to think everything is about you (egocentric)
Erikson
Middle adulthood, 35 to 65
Generativity vs stagnation. You’ve already gotten married and “made it” in life, so what do you do next?
If unsuccessful, you can’t grow as a person and can’t care for others
Erikson
late adulthood, 65 and up
Integrity vs despair
Psychodynamic theory was initially designed for which kind of disorders
Anxiety, neurosis, phobias, hysteria
Principle of Psychic Determinism
All behavior serves a purpose
Onset of intellectual disability
Birth
Onset of Schizophrenia
Men 18 to 25
Women 25 to 35
Onset of MDD
late teens to young adult
The 2 types of normal drives in psychodynamic theory
Sexual and aggressive
Freud’s Oral stage
0 to 18 months
Schizophrenia, paranoia, substance abuse (the beer bottle pertains to the oral stage)
Freud’s Anal stage
18 months to 3 years
Depression
Freud’s Phallic stage
3 to 6 years
At this age they satisfy their drives through exhibitionism, masturbation, oedipal complex, they have castration anxiety, and females fear losing their mother’s love.
Sexual identity disorders.
Freud’s Latency stage
6 years to puberty
Peer relationships, learning, motor skills develop, socialize
If unsuccessful you can have problems forming relationships
Freud’s Genital Stage
Puberty and everything beyond
Combining all the earlier stages.
If unsuccessful, you can have sexual perversion disorders
Ego defenses
Become a part of the personality
Promote self esteem and sense of well being
In neurosis, the defenses are used constantly and are fixed
Cognitive theory
Piaget
Humans develop through cognition and learning (which is obvious from the name)
Native endowment sets the course for the child’s development
The 4 stages of Piaget’s cognitive theory
Sensorimotor
Preoperational
Concrete operations
Formal operations
Piaget’s sensorimotor stage
0 to 2 years old
They achieve object permanence
Piaget’s Preoperational stage
2 to 7 years old
More extensive use of language and symbolism. Magical thinking.
Piaget’s Concrete operations stage
7 to 12 years old
Logical. Understands reversibility and conservation.
Reversibility means something can turn into something else, and back again (like water and ice)
Conservation means even if the shape changes, the amount is still the same
Piaget’s Formal operations stage
12 years old to adult
Thinks abstractly, operates more logically
Interpersonal Theory
Harry Stack Sullivan
The “Self System” is the total components of personality traits
Behavior is driven by (1) drive for satisfaction (basic needs like sleep and food), and (2) drive for security (conforming to norms).
Mental illness occurs when there’s a disagreement between the self system and the drives (satisfaction and security.
People have anxiety, behavior is used to relieve the anxiety, which then gets Interpersonal Security.
Maslow’s Hierarchy
It’s a health model not an illness model
Hunger Shelter Friends/Lovers Self esteem Self actualize
Harry Stack Sullivan’s interpersonal development stages
0 to 18 months - Oral gratification, anxiety occurs for the 1st time
18 months to 6 years - delayed gratification
6 to 9 years - Forming peer relationships
9 to 12 years - Sam-sex relationships
12 to 14 years - Opposite sex relationships
14 to 21 years - Self-identity develops
Health Belief Model
Healthy people do not always take advantage of screening and prevention because:
- They think they’re not susceptible
- Thinking the illness isn’t serious
- Perceived benefits of treatment
- Perceived barriers to change
- Expectations of efficacy
Self-Efficacy and Social Learning Theory
Bandura
Behavior is the result of cognitive and environmental factors
People learn by observing others, relying on role modeling
The theory talks about self-efficacy
Behavioral change and maintenance depend on outcome expectations and efficacy expectations
Nursing Theories: Theory of cultural care
Leininger
Regardless of the culture, care is the essence of nursing
Health and well-being can be predicted through cultural care
Nursing Theories: Theory of Self-Care
“Self-Care” means activities that maintain life, health, and well-being
Nursing Theories: Therapeutic Nurse-Client Relationship Theory or Interpersonal Theory
Peplau
This was the 1st psychiatric nursing theory
It’s partially based on Sullivan’s interpersonal theory
Sees nursing as an interpersonal process in which all interventions happen within the nurse-client relationship
It includes 3 phases (Orientation, Working, Termination)
The goal of nursing is promoting adaptive responses
Behavior represents the person trying to adapt to internal or external forces
Nursing Theories: Caring Theory
Jean Watson
Caring is an essential part of nursing
“Carative factors” guide the core of nursing and should be implemented in health care
Carative factors are the part of care that allows for therapeutic healing and relationships
