Theories of Psychological Care in Nursing

Theories of Psychological Care in Nursing The best definition of psychosocial care is found in the National Council for Hospice and Specialist (2000) which describe it as concerned with the psychological and emotional wellbeing of the patients and their families/carers, including issues of self-esteem, insight into an adaption to their illness and its consequences, communication, social functioning and relationships. Psychosocial care theory differs from theory of biomedical care in that the former uses the holistic approach (Sheldon, 1997 and Oliviere et al, 1998) or the diseases, psychology, social and spiritual health of patients whereas the latter care only for patients physical ill-health. Furthermore, the biomedical model predicts poorer health outcome, psychological distress and poorer daily function, more days spent in bed, and more health professionals visit and surgeries (Sheridan Radmacher, 1992). Keywords used will be defined to facilitate understanding. The theory of psychosocial care has the following components; firstly, psychology deals with the way the patients use their conscious and subconscious (Freud) is dealt with their emotions, which is their feeling fine tuned throughout their lifespan development, to be aware of their different moods. Then their self-esteem, the patients perceived their self-worth, value themselves, self-respect and self confidence (Barry, 1992 Niven, 2006), should be respected, hence, make them more confident and themselves. Scherer (2005) referred to emotion and self-esteem as behaviour forming strategies and Emotions are intensified feelings or complex patterns of feelings that one experience when the patients found themselves in a strange environment, giving their intimate information to people they just met moments ago. Nursing professional should respect patients as a person by so doing will make them feel more confident in themselves or raising their self-esteem. Therefore, self-esteem is ones feelings regarding the patients self-worth, values oneself, shows self respect or self confidence Scherer (Barry, 1992 Niven, 2006). (2005) referred to emotion and self-esteem as part of cognition or psyche. The cognitive approach is to let the patient talk about his feelings as most that we do is controlled by our unconscious mind, we have to listen carefully to what the patient is saying (Freud). Moreover, we should ensure that information being given by the nurses is understood by the person (Smith et al, 2003). We should praise the patient if he has done something good. The patients social environment is important for their care as the nursing professionals must understand the supporting mechanism they have and those that needs to be put into place. In doing so one has to understand their need for equality and sensitivity that are required to care for patients from different ethnic and cultural background. The family being a component of the social jigsaw and it is important to involve them as long as the patients have given their consent. One has to be aware of confidentiality when talking about the patients information even to family. Research has shown that the involvement of families/carers greatly improve the psychological aspect of the patients rehabilitation (to put references). Social class again research has shown that patients coming from social class 3 access medical help faster than those living in social class 1. Therefore, this will affect their healing process if they are staying in an overcrowded and damp or living alone and have no family support. If they are staying in a rough area of the Borough therefore they are afraid to go out. Their culture is important as it is their core values and beliefs they have within their society. Environment is important to know if they are staying near a busy and noisy road. Their religion is important especially when it comes to food. The psychological and social aspects of the patients are one of the two elements in psychosocial care. Spiritual health refers to the possession of a belief in some unifying force that gives purpose or meaning to life or to a sense of belonging to a scheme of existence greater than merely personal, is another dimension of psychosocial care. The nursing practice is based on warmth, acceptance, genuineness and empathy and by moving our focus away from the illness to that of the patients (Baughan Smith, 2008), not forgetting to maintain privacy and dignity whilst talking to the patients (Faulkner, 2000) by getting the patients consent and their confidential preserved. Talking, caring, listening and supporting patients are qualities that nursing needs in forming good relationships with patients. Nurses should provide care that is focused on patients and tailored to their individual needs. Words like trusts, empathy, listening and compassion spring to mind. Nursing uses therapeutic comforting touching with confidence, not denying patients information, discussing the problem in a clear and understanding manner, being honest and have empathy not sympathy are useful tools to enhance the nursing practice. Subsequently, through therapeutic communication (Peplau, 1952) it built trust and confidence between the nursing professiona ls and the patients. Moreover, without the proper use of therapeutic communication, which is achieved through touch, silence and humour (where appropriate), listening to their narratives, not being judgemental, being considerate, respect their confidentiality and dignity as a person are important skills. The patients are able to reveal intimate details of their psychological and social health which inform the nursing professionals of better ways to support the patients towards the road to long lasting recovery. Therefore, Allen voiced the opinion of Wright (2004) too posh to wash that bad communication limits the extent that psychosocial care can be effectively given to patients. This will be achieved by using therapeutic communication (Peplau, 1952) through explaining clearly what is being done, touching, silence and humour and listening carefully to what the patients are saying without interaction and being judgmental. Furthermore, they expect to be given the right information when needed, not in jargons but in an understandable language. This is the platform from which one can use to get the correct information from the patients. Caring can be defined as involving concern, empathy and expertise making things better for others and is based on compassion (Smith, 1992; Eriksson, 1994 cited by Barry, 1994; Niven, 2006);). In view of the caring nature of the nursing professionals the patients are willing to (offered) information that they will not do so to other people (including their families/carers)à ¢Ã¢â€š ¬Ã‚ ¦into their confidence therefore could have intimate knowledge than other medical professionals may not be able to tease out. This is possible by listening attentively to what the patients are saying without interruptions, to emphatise () with the In return the patients expect that they are given the right information at the right time in a way that they understood. Their self esteem is ones feeling regarding their self worth, values oneself, show self respect or self confidence (Barry, 1992 Niven, 2006). It can be improved through group support, forming realistic expectations, maintaining physical health, examining problem and seeking help e.g. limit smoking and alcohol. Empowerment ranged from giving patients information and helping them to understand, cope with and take control of their disease to psychological support them, rapport-building, reassurance, empathy and promoting self-esteem. The points raised so far is giving the reader a theoretical view of the way psychosocial aspect of care is relevant to nursing practice Stress and coping are concepts that will be used as reference to bring theory into practice observed whilst on the ward. Stress is defined as an interaction between an event in a persons life which is perceived as placing considerable demands on him and their response to coping with it. Therefore, the transactional model (Lazarus Folkman, 1984) of stress and coping is appropriate to further expand the stress being felt by the patient. A transactional model of stress is when a patient is confronted with, does that event present any threat to him at the time, and if not then he does not perceive the event as stressful. However, if it does whether he experiences stress will depend on his secondary appraisal and if he has the necessary resources, such as personal, social, financial support and/or hardiness; is sufficient to allow him to cope effectively with the stressor. Moreover, he may not perceive himself to have sufficient resources available to deal with the problem and as result he will experience a response that one would refer to as a stress response. It will also relate the concept to nursing practice Self-efficacy according to Bandura () is when the patients believe that they can successfully connect with and execute a specific behaviour X, a 65years old Caucasian male, married with two children, was admitted to hospital suffering with excruating abdominal pain. He has been diagnosed a week ago with lung cancer due to his heavy smoking, 15 cigarettes a day, increased to more than 20 after the death of his wife. His children said that he X constantly said that he wants to go and meet his wife wherever she might be. He is not eating properly and recently has been drinking heavily. He has low self-esteem and sometimes cries. Whilst helping him to shower daily the nurse was able get more information, he does not want to go a hospice or a care home like his children are saying. He wants to stay and die in his family home. Moreover, apart from his children he does not have any relatives staying close by. He is afraid of dying Therefore, he is not caring for himself and not eating properly. was admitted to the ward after he was diagnosed with advanced lung cancer. Psychosocial care states that the patients psychological and social factors are taken into consideration when assessing them. The ward is busy though Wright (2004) stated that nurses are too busy to talk to their patient, it is not the case here each patient is treated as an individual and they are listened to without being judgemental. Moreover, the opinions of the patients families/carers are listened to and information is shared with them after getting the consent of the patients due to confidentiality legislation. Mr. X Lists of References Allen D. (2009) Nurses are only effective as their communication skills. Nursing Standard. 23 (28) 28-29. Baer P.E., Garmezy L.B.; McLaughlin R.J., Pokorny A.D. and Wernick M.J. (1987). Stress, Coping, Family Conflict, and Adolescent Alcohol Use. Journal of Behavioural Medicine 10, 5, Pages 449 -466. Bandura A. (1978). Reflections on Self-Efficacy. Advances in Behavioural Research and Therapy 1, Pages 237-269. Bandura A. Locke E.A. (2003). Negative Self-efficacy and Goal Effects Revisited. Journal of Applied Psychology. 88, 1, Pages 87-99. Barry P.D. (1996). Psychosocial Nursing: Care of Physically Ill Patients their families. (3rd Edition) Philadelphia: Lippincott-Raven publishers. Colder C.R. (2001). Life Stress, Physiological and Subjective Indexes of Negative Emotionality, and Coping Reasons for Drinking: Is there Evidence for a Self-Medication Model of Alchol Use? Psychology of Addictive Behaviours. 15, 3, Pages 237-245. Faulkner A. (2000), Effective Interaction with Patients. London: Churchill Livingstone. National Council for Hospice and Specialist (2000). What do we mean by psychosocial? London; March 2000 Briefing No. 4. Niven N. (2006). The Psychology of Nursing Care (2nd Edition) London: Palgrave MacMillan. Oliviere D., Hargreaves R., Monroe B. (1998) Good Practices in Palliative Care: A psychosocial perspective. Aldershot: Ashgate Publishing Ltd. Scherer K.R. (2005). What are emotions? And how can they be measured. Social Science Information. 44 (4) 695-729. Sheldon F. (1997) Psychosocial Palliative Care: Good Practice in the care of the dying and bereaved. Cheltenham: Stanley Thornes (Publishing) Ltd. Sheridan C.L. Radmacher S.A. (1992) Health Psychology: Challenging the Biomedical Model. Chichester: Wiley Smith A. (2009) Exploring the legitimacy of intuition as a form of nursing knowledge. Nursing Standard. 23 (40) 35-40. Smith P. (1992). The Emotional Labour of Nursing. Basingstoke: The MacMillan Press Ltd. Summers L.C. (2002) Mutual Timing: An essential Component of Provider/Patient Communication. Journal of American Academy of Nurse Practitioner. 14(1) 19-25. Wilson V. (2004). Supporting Family carers in the community setting. Nursing Standard. 18, 29, Pages 47-53. Smith said that intuition is a valuable source of knowledge though it could be difficult to put into words as there is little empirical evidenceà ¢Ã¢â€š ¬Ã‚ ¦ Self-esteem refers to ones sense of self-respect or self-confidence. It is how much one likes oneself and values ones own personal worth as an individual. Self-esteem can be improved in several ways: Support groups; Completing required tasks; Forming realistic expectations, Taking/Making time for you ; Maintaining physical health; Examining problems and seeking help External influences are those factors that we do not control, such as who raised us. The family influences include family upbringing. Healthy, nurturing families produce more well-adjusted adults. Dysfunctional families may produce confused adults who have a harder time adapting to life. Influences of the greater environment include safety, access to health services and programs, and socioeconomic status. Internal factors include hereditary traits, hormonal functioning, physical health status, physical fitness, and other selected elements of mental and emotional health (Definition) It can be improved through support group, forming realistic expectations, maintaining physical health, examining problem and seeking help limit smoking and alcohol. He was assessed by the nurse after he gave his consent whereby information about his past and present illness, demographic and his activity of daily living was recorded on the assessment form. The nurse recorded the reading of his vital signs such as pulse, respiratory, temperature, O2 and heart, taking the vital signs at all time Mr. X dignity was not abused. Patients records are confidential information and can only be access by the nursing and medical professionals working with the specific patients. Respondents found it very hard to cope with watching their partners suffering, and not knowing how to deal with it. In this situation the nurses role should include giving information and educating patients and partners, as well as offering support. Information should be accessible throughout the course of the illness, and needs to cover physical and emotional issues (Northouse and Peters-Golden, 1993). Self-efficacy :Learned helplessness is a response to continued failure where people give up and fail to take action to help themselves.

GCSE Girl Anachronism Essay

In this essay I will be comparing my â€Å"Girl Anachronism† play with my year 9 dialogue â€Å"Dealer’s Choice†. I will be comparing the deference between the character I was, the style of the play, the mood, the place and whether it is Stanislavski or Brecht. Brecht belied in breaking the fourth wall and trying to make the play as unrealistic as possible by using flash backs, monologues, freeze frames, placards ect. But on the other hand Stanislavski belied in making the play as realistic as possible by having every thing in chronological order and making it as naturalistic as possible making the actors think like their character would. The play â€Å"Girl Anachronism† was developed to the stimulus of the song girl anachronism by the Dresden Dolls. It has a very angry and upset mood throughout, it is in the style of a melodrama and it is like a Brecht play because it breaks the fourth wall, using monologues and flash backs which are theatrical devices used in Verfemdungseffect to remind the audience that it is not real. In the play we used a variety of music to show the emotions of each scene for example at the beginning of our play we played the stimulus of the play, and before our flash back we played past music to show that we had gone back in time. In this play I have adopted the main role where I am crazy teenager that has just been released from a mental institute and have just gone back to my 3 bedroom house with my family which all hate me, and I am also suicidal. All I want is to be left alone and not too be told what to do. My Year 9 play â€Å"Dealers Choice† was a scripted piece about two friends who work in a restaurant and meet once a week for an all-night poker game. Its mood is very happy and funny. It corresponds with Stanislavskis ideas about keeping it as real as possible, building up the fourth wall, and having every thing in chronological order. When we preformed this play we used no music no flash backs and no monologues. The style was a friendly comedy. In this play I was one of the main characters, I was a mid thirty’s waiter working in a restaurant I have worked there for years with my mate Sweeny, Sweeny and I and a few other gather once a week to play poker in the restaurant. The play is set in a London restaurant in the kitchen area. These plays are totally different one is a Brecht like play the other is a Stanislavski. One is unrealistic the other is realistic. They are both very good but I like â€Å"Girl Anachronism† better, because it was more interesting to act and I had more freedom, and I liked improvising.

Evolution Psychology Essay

For many years, personality psychology and behavior studies have always viewed individuals as risk indisposed or risk seekers. However, recent studies in the field of evolution psychology are changing these convectional assessments of individuals risk taking. There is evidence that risk taking in individuals is domain specific. This understanding of human behaviors has brought about a better understanding of the inter individual and intra individual variations in the risk taking tendencies. The basic arguments of evolution psychology are that the human brain has the ability to adapt in order to solve the recurrent problems and cannot be as static as a computer. The domain in the adaptation of the mind in this case is the problems, challenges or pressures faced by the individual. The psychological adaptations of human being to the recurrent problems have been compared to the physiological evolution when an adaptation occurs to solve challenges in a specific domain. Consequently, psychological evolution is domain specific. Recent studies have therefore indicated that risks and challenges that individuals are exposed to results into development of mental algorithms that provide a solution to the risks related to the domain (Kruger, 2007). Human beings have faced various problems and challenges in the history or evolution. These challenges are reflected by the risk taking domain. There are several domains that have been studies in evolution psychology. One of the most important domains is group competition. The human race was able to obtain dominance in the universe ecosystem at some during the history of evolution. For many ages, the human race has been hostile to itself with humans rising against other humans. It is believed that the most significant selection pressure that ever existed was competition between groups. These competitions are evident in the modern world for example in business, sports, politics, gang violence, ethic and racial hostility and uprisings between communities and nations. Moreover, the competition is promoted by cooperation between groups (Kruger, 2007). Competition within a certain group is also an important domain in the study of evolution psychology. Competition within the group is aimed at promoting an individuals position in the group rather than eliminating a possible threat. However, psychical threat and the resultant competition are also evident within a group. It is also important to note that competition within a group is more complex and therefore very significant in psychological evolution. This is because it involves both physical and social infighting and competition. In many societies, the fight for higher status in the society is more relevant to the males that females although the competition is evident in both sexes. The relevance of social status to the males has been as a result of cultural values and mating patterns that are evident in all societies. For example, mating success in males is a function of the individual’s social status since females seek males of high social status and they can use their resources to pressurize other males. For this reason, throughout history, social status has always dictated access to mates, mating success and reproductive success in males. Moreover, the economic and social competitiveness of male in the society has been compared to a survival and reproductive advantage presented by peacock’s tail in the Darwin theory of evolution (Kruger, 2007). Sociosexuality or the perception of a sexual relationship requirement varies from one individual to another. Some individuals have unrestricted sociosexuality and have a perception that mating efforts requires more resources sacrificing parental efforts. Consequently, the success of matting in males increases with increase in number of mates provided that reproduction is not limited. On the other hand, female mating success does not increase with the increase in the number of mating partners. However, extra pair mating relationships has been associated with many risks such as desertion of the mate and transmission of infections. They could also lead to violence and hatred between jealous partners. Other that the social and resource allocation challenges that face an individual, there are environmental risks and challenges that are significant in psychological evolution. Studies carried out over the years have indicated that forage strategies that have been evident throughout the history have been an important aspect of human survival (Kruger, 2007). In a research carried out by Kruger et al (2007), student from two universities, university of South Dakota and University of Michigan, reacted to questioners posted online. They were requested to rate thirty risky behaviors and the tendencies in which they would involve themselves in these risky behaviors. In another survey conducted at the University of Michigan, students from diverse ethnic backgrounds completed the same online questioners for partial fulfillment of an academic course in the university. From the two surveys, the results were consistent with the earlier theoretical predictions. The risk taking domains were a clear reflection of the recurrent social and environmental challenges that faced the individuals. Kruger et al (2007) were able to generate behavior trends that matched the specific domains in the modern society. They were also successful in distinguishing between significant domains in the society such as within group and between group competitions. However, it was confirmed that between groups competition was not limited in scope as for the case of ancient competition, while competition within the group was observed to be even more complex. Moreover, the fertility risks which are induced by behaviors were found to be lower than expected or observed in other similar studies. The linkage between fertility risks and other specific domains was observed to be generally lower except in its linkage with mating behaviors and allocation of social and economic resources. The study concluded that that people who have more risk taking behaviors in specific domain do not show similar trends in other domains. The high tendencies of risk taking in males compared to females with exceptional cases in environmental risks were also confirmed to be consistent with the literature. It was also concluded that men benefit more from risky behaviors when compared to females. Moreover, there are some riskier behaviors that are more likely to be observed in females than in males such as risking ones life to save a child because of the limited opportunities of getting another offspring in the future and the psychological investment placed on the child by the mother. This modern approach of development psychology and the current risk scale is an important step in the validation of evolution based psychological assessments of behaviors. The study of the relationship between risk taking behaviors in different individuals in the society and the survival and reproduction challenges faced by individuals is important. Reference Kruger, D. J. , Wang, X. T. & Wilker, A. (2007). â€Å"Towards the development of an evolutionarily valid domain-specific risk-taking scale. † Evolutionary Psychology, 5(3): pp 555-568

Health And Health Care Act - 1380 Words

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