Week 3: Core Dimensions of Help and Narrative

Question 1

Use of story in helping nurse-client relationship (13 things)

Answer 1

1. Stories entertain and evoke emotions
2. Promote greater understanding and validation
3. Can build traditions and enhance the development of culture/group identity
4. May cause change in narrator and listener
5. Ability to cope with challenges can be modeled through stories
6. Associated with perception, thinking, memory and reflection
7. Story transmits knowledge and promotes problem solving
8. Way of learning/developing insight about human suffering, death, illness - uncover meaning
9. “Life-as-told” different from “Life-as-lived” and “Life-as-experienced”
10. Cultural rules for telling story must be adhered in order to understand the story
11. Nurses analyze the structure or and infer the meaning from clients’ stories
12. Story telling can be healing
13. Narratives are an expression of human consciousness as well as a means to expand it and move it toward the wholeness that defines health

Question 2

Storytelling in Nursing Practice: Telling one’s story…

Answer 2

-Identifies strengths, capabilities and presenting concerns
-Creates an image of daily activities, family relations, sociocultural influences, overall health and heal seeking behaviours, and health promoting or illness maintaining behaviours
-Stresses points of emphasis, select features to include or exclude
-Enables faith, hope, trust, getting well, visualizing a future

Question 3

Still Alice Video

Answer 3

Witnessing other’s stories helps deepen our understanding of the lived experience which enables us to gain deeper insights into ourselves and our clients/patients

Question 4

Carl Rogers (1902-1987): Person-Centered Therapy

Answer 4

Was about…
-Congruence
-Unconditional Positive Regard
-Empathy

Question 5

Carl Rogers: Congruence

Answer 5

Incongruent
-The self-image is different to the ideal self
-There is only a little overlap
-Here self-actualisation will be difficult

Congruent
-The self-image is similar to the ideal self
-There is more overlap
-This person can self-actualise

Question 6

Core Dimensions of Helping: RESPONSIVE DIMENSIONS

Answer 6

-Respect
-Genuineness
-Concreteness
-Empathic understanding (empathy)

Question 7

Core Dimensions of Helping: ACTION DIMENSIONS

Answer 7

-Confrontation
-Self-Disclosure
-Immediacy
-Catharsis

Question 8

RESPONSIVE DIMENSIONS: Respect

Answer 8

-Unconditional positive regard
-DOES NOT depend on behaviour
-Same as caring and valuing
-Attitude -> nonjudgmental
-Accept patients AS THEY ARE
-The communication of acceptance of the client’s feelings, ideas, and experiences
-Have faith in the patient’s ability to solve problems with appropriate help
-Sends the message: “I value you. You are important to me.”
-Respect starts an attitude and translates into a behaviour that is acknowledgment
-Warmth + Respect = Unconditional positive regard

Question 9

Concrete actions to show respect

Answer 9

-Look at your client
-Offer you undivided attention
-Maintain eye contact
-Move toward the other
-Determine how the other likes to be addressed
-Call the client by name and introduce yourself
-Make contact with a handshake or by gently touching the other

Question 10

RESPONSIVE DIMENSIONS: Genuineness

Answer 10

-The presentation of one’s thoughts and feelings both verbally and nonverbally
-What you see is what you get
-Authentic, the real you, not phony
-openness, honesty, sincerity

Question 11

RESPONSIVE DIMENSIONS: Concreteness

Answer 11

-Is specific, avoids being vague, avoids ambiguity
-Opposite of: generalizing, labeling, making assumptions

Three Functions:
1. Keeps the nurse’s response close to client’s feelings and experiences
2. Fosters accuracy of understanding by the nurse
3. Encourages client to attend to specific problem areas

Example:
Abstract: “You seem to have lost some mobility in your right arm”
Concrete: “It seems to be harder for you to pick up you cup today”