Ch 2: Values, Beliefs, and Caring

Zero-order beliefs

basic and fundamental beliefs often at an unconscious level

-taught as a child

ex: murder is wrong

First-order beliefs

conscious foundation or an individual’s belief system

- developed through experience or people

ex: changing religion

Higher-order beliefs

derived from a person’s first-order beliefs, using either inductive or deductive reasoning

-Generalization

-Stereotypes

-Prejudice

Generalizations

general statements or ideas about people or things

-may arise at an unconscious level

Stereotypes

is a conceptualized depiction of a person, a group, or an event that is thought to be typical of all others in that category

Values

• Values system: is a set of somewhat consistent values and measures that are organized hierarchically into a belief system on a continuum of relative importance

-prevails and consists of culturally defined moral and ethical principles and rules that are learned in childhood

-helps the person choose b/t alternatives, resolve values conflicts, and make decisions

Values conflict

• Occurs when there is an actual or perceived difference b/t two or more belief systems

ex: providing care for a convicted murderer

Values clarification

• A therapeutic process that allows individuals to consider, clarify, and prioritize their personal values

-can help patients identify the nature of a conflict and reach a decision based on their values

-better identify their own personal values in challenging care situations

Theory of Cultural Care Diversity and Universality

Madeleine Leininger

-Identified the role that culture plays in health and health care

-Founder of transcultural nursing and developed an ethnonursing method of research used by many nurse scientists

1) care is central unifying focus of nursing

2) a cure cannot occur without caring

3) culture is embedded in all aspects of one’s being

4) culturally congruent care promotes health and well-being

-promote understanding of care needs among diverse populations

Three nursing actions focus on finding ways to provide culturally congruent care by:

1) preserving or maintaining the patient’s cultural health practices

2) accommodating, adapting, or adjusting health care practices for culturally congruent care

3) culture care repatterning or restructuring of professional actions and health care decisions as mutually established by the patient and nurse

Theory of Human Caring

Jean Watson

-identified 10 caritative factors that described the components of the transpersonal nurse - patient relationship

• Improved patient outcomes, nurse satisfaction, and student learning

• Promote positive coping skills, reducing anxiety and distress in women experiencing infertility

• Contribute to the creation of a healing environment

Theory of Caring

Kristen Swanson

-Was developed upon completion of threes studies that explored the experiences of women who suffered a miscarriage

Caring: “nurturing way of relating to a valued ‘other’ toward whom one feels a personal sense of commitment and responsibility”

Characterized by 5 processes:

1. Knowing/ being understood

2. Being with/ feeling valued

3. Doing for/ feeling safe and comforted

4. Enabling/ feeling capable

5. Maintaining belief/ feeling hopeful

Theory of Nursing as Caring

Anne Boykin and Savina Schoenhofer

6 attributes of caring:

1. compassion

2. Competence

3. Conscience

4. Confidence

5. Commitment

6. Comportment (behavior)

Mayeroff defined eight caring ingredients:

• alternating rhythms

• courage

• honesty

• hope

• humility

• knowing

• patience

• trusting

Compassion

The force that impels and empowers one to recognize, acknowledge, and act to alleviate human suffering

Act in one’s sympathetic and empathetic response to another’s situation

One needs to be empathetic in order to be compassionate

-Sympathy and empathy are often used interchangeable with compassion

Factors of compassion:

• attentiveness

• listening

• confronting

• involvement

• helping

• presence

• understanding

Presence

The shared perception of human connectedness b/t a nurse and a patient

-Fully engaged and emotional available

Theory of Nurse Presense

Five components to nurse presence:

• Individual nurse characteristics

• individual patient charctertics

• Shared characteristics w/n the nurse - patient pair

• Environmental characteristics reflective of reflective of relational work

• the nurse’s intentional decision to engage in practice

Touch

Intentional contact b/t two or more people

-can be viewed as an intervention, such as the use of healing touch (HT) or therapeutic touch (TT)

Task-oriented touch

Contact when performing nursing interventions

Such as:

-Giving baths, changing dressing, giving an injection, starting an IV line, or inserting a NG tube

-Should be done gently, skillfully, and in a way that conveys competence

Each procedure should be explained to a patient, followed by feedback indicting patient understanding, before care is initiated

Caring touch

Contact used to communicate caring

-essential aspect of patient-centered care

-Can be used to soothe, comfort, establish rapport, and create a bong b/t the nurse and the patient

Healing touch

The use of intentional light touch to promote relaxation

-aid in pain management, reduce anxiety, lower blood pressure, and positively impact patient satisfaction

-may help decrease overall length of stay for hospitalized patients

Therapeutic touch

A process of energy exchange performed by certified practitioners

-Practitioners lightly touch or pass their hands above the patient’s body, concentrating on energy fields

-associated with decreased anxiety, decreased incidence of cardiac dysrhythmias, improved vital signs, and improved sleep quality

Compassion fatigue

is extreme distress experienced as a result of continued exposure to stress in the therapeutic use of self in caring for others

-seen in nurses who experience a lack of resources and time to provide comprehensive patient care

-May result in feelings of vulnerability, anxiety, depression, and anger

-May decrease their engagement with patients, have a higher risk of medical errors, experience decreased job satisfaction, and have trouble maintaining interprofessional relationship

Self-care

including maintenance of good physical and emotional health, yoga, meditation, and mindfulness-based stress reduction activities- is shown to help protect nurses from developing compassion fatigue