Swanson & Ruland & Moore

Kristen Swanson

Theory of Caring

Theory of Caring

While a doctoral student, as part of a hands-on experience with a self-selected health promotion activity, She participated in a cesarean birth support group focused on miscarriage. She decided to learn more about the human experience and responses to miscarrying. Caring and miscarriage became the focus of her doctoral dissertation.

Theory of Caring

was generated from phenomenological investigations with women who experienced unexpected pregnancy loss, caregivers of premature and ill babies in the newborn intensive care unit (NICU), and socially at-risk mothers who received long-term care from master’s-prepared nurseS

Caring

Is a nurturing way of relating to a valued other toward whom one feels a personal sense

of commitment and responsibility

Knowing

is striving to understand the meaning of an event in

the life of the other, avoiding assumptions, focusing on the person

cared for, seeking cues, assessing meticulously, and engaging both

the one caring and the one cared for in the process of knowing

Being with

means being emotionally present to the other.

It includes being there in person, conveying availability, and

sharing feelings without burdening the one cared for

Doing for

means to do for others what one would do for self if at all possible,

including anticipating needs, comforting, performing skillfully and competently,

and protecting the one cared for while preserving his or her dignity.

Enabling

facilitating the other’s passage through life transitions and

unfamiliar events by focusing on the event, informing, explaining, supporting,

validating feelings, generating alternatives, thinking things through, and giving

feedback.

Maintaining Belief

Is sustaining faith in the other’s capacity to get

through an event or transition and face a future with meaning, maintaining a

hope-filled attitude, offering realistic optimism, helping to find meaning, and

standing by the one cared for no matter what the situation

Cornelia Ruland & Shirley Moore

Peaceful End-of-Life Theory

Peaceful End-of-Life Theory

the structure-setting is the family system (terminally ill patient and all significant others) that is receiving care from professionals on an acute care hospital unit, and process is defined as those actions (nursing interventions) designed to promote the positive outcomes of the following:

(1) being free from pain,

(2) experiencing comfort,

(3) experiencing dignity and respect,

(4) being at peace, and

(5) experiencing a closeness to significant others

and those who care

Not being in Pain

Being free of the suffering or symptom distress is the central part of

many patients’ end-of-life experience. Pain is an unpleasant sensory or

emotional experience that may be associated with actual or potential tissue

damage.

Experience of Dignity and Respect

Each terminally ill patient is “respected and valued as a human being”. This

concept incorporates the idea of personal worth, as expressed by the ethical

principle of autonomy or respect for persons

Being at Peace

Peace is a “feeling of calmness, harmony, and contentment, [free

of] anxiety, restlessness, worries, and fear”. A peaceful state

includes physical, psychological, and spiritual dimensions.

Closeness to Significant Others

Closeness is “the feeling of connectedness to other human beings

who care”. It involves a physical or emotional nearness that is

expressed through warm, intimate relationships