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Culture care expression generic 600mg zyvox amex, meanings buy 600mg zyvox fast delivery, and experi- ings of interest to practicing nurses who care ences of pregnant Mexican American women within Leininger’s for clients of all ages from diverse and similar culture care theory. Mexican American women’s expressions of the tional and community contexts around the meaning of culturally congruent prenatal care. Nursing and anthropology: Two worlds to found in the Journal of Transcultural Nursing blend. Transcultural nursing presents an exciting (1989 to 2004) and in the numerous books challenge. Caring: The essence and central focus Nurses in clinical practice are advised to con- of nursing. Nursing Research Foundation Report, 12(1), sult a list of research studies and doctoral dis- 2–14. Care: Discovery and uses in clinical and cultural and general nursing knowledge with community nursing. Journal of Transcultural mained the strongest advocates of the culture Nursing, 1(1), 4–16. Part I: The theory of culture care and cessity to advance nursing knowledge and practices. Transcultural nursing: Concepts, theories, and practice (3rd Detroit: Wayne State University Press. Culture care diversity and universality: A study conceptualized within Leininger’s theory. Ethnonursing: A research method with American elderly residents within the environmental context of enablers to study the theory of culture care. Transcultural nursing: Concepts, theories, Nursing Science Quarterly, 10(4), 186–192. Overview and reflection of the theory of German American elders within a nursing home context. Special research report: Dominant culture versity: A worldwide theory of nursing (2nd ed. Basic psychiatric concepts in ceiving professional nursing care: An ethnonursing study. Schoenhofer’s Nursing as Caring Theory 335 Introducing the Theorists as a discipline, the academic role in higher educa- tion, and the world of nursing theories and theo- Anne Boykin is dean and professor of the College of rists; and Anne Boykin, PhD, who introduced her Nursing at Florida Atlantic University. Lynne Center for Caring, Schoenhofer created and manages the Web site and which is housed in the College of Nursing. This discussion forum on the theory of nursing as caring center was created for the purpose of humanizing (www. She has demonstrated a long-standing commitment to the International Association for Introducing the Theory Human Caring, holding the following positions: president-elect (1990 to 1993), president (1993 to This chapter is intended as an overview of the the- 1996), and member of the nominating committee ory of nursing as caring, a general theory, frame- (1997 to 1999). The theory of served as coeditor of the journal International nursing as caring offers a view that permits a broad, Association for Human Caring from 1996 to 1999. This theory serves as an organizing frame- coauthored book, Nursing As Caring: A Model for work for nursing scholars in the various roles of Transforming Practice (1993), and the book Living a practitioner, researcher, administrator, teacher, and Caring-based Program (1994). She serves as theory in relation to practice and other nursing a consultant locally, regionally, nationally, and in- roles. In the second part of this chapter, Danielle ternationally on the topic of caring. Certain fundamental beliefs about what it means to Savina Schoenhofer’s initial nursing study was at be human underlie the theory of nursing as caring. Wichita State University, where she earned under- These assumptions, which will be illustrated later, graduate and graduate degrees in nursing, psychol- reflect a particular set of values and key themes that ogy, and counseling. She completed a PhD in provide a basis for understanding and explicating educational foundations and administration at the meaning of nursing, listed as follows and de- Kansas State University in 1983. In 1990, Schoen- tailed here: hofer cofounded Nightingale Songs, an early venue for communicating the beauty of nursing in poetry • Persons are caring by virtue of their humanness. In addition to her work on caring, in- • Persons are whole and complete in the moment. Model for Transforming Practice, she has written on • Personhood is a way of living grounded in nursing values, primary care, nursing education, caring. Caring is not the unique allowing for reflection and creativity in advancing province of nursing. The full meaning of caring Personhood is understood to mean living grounded cannot be restricted to a definition but is illumi- in caring. From the perspective of the theory of nated in the experience of caring and in the reflec- nursing as caring, personhood is the universal tion on that experience. A profound understanding of person- hood communicates the paradox of person-as- Focus and Intention of Nursing person and person-in-communion all at once. Disciplines as identifiable entities or “branches of Call for Nursing knowledge” grow from the holistic “tree of knowl- edge” as need and purpose develop. A discipline is a “A call for nursing is a call for acknowledgment and community of scholars (King & Brownell, 1976) affirmation of the person living caring in specific with a particular perspective on the world and what ways in the immediate situation” (Boykin & it means to be in the world. Calls for nursing are calls munity represents a value system that is expressed for nurturance through personal expressions of in its unique focus on knowledge and practice.

The results of a prospective study indicated that the best predictors of exercise behaviour were low body fat zyvox 600 mg with amex, low weight and high self-motivation (Dishman and Gettman 1980) discount zyvox 600mg mastercard. However, whether factors such as access to facilities and self-motivation should be regarded as non-modifiable is problematic. They described the profile of an active individual as younger, better educated, more affluent and more likely to be male. However, it is possible that other individuals (less affluent/less educated) may be more active at work. Several studies indicate that blacks are less active than whites, that black women are especially less active and that these differences persist even when income and education are controlled (e. The role of attitudes and beliefs Research has examined the role of attitudes and beliefs in predicting exercise. Cross-sectional research examines the relationships between variables that co-occur, whereas prospective research attempts to predict future behaviour. Cross-sectional research This type of research indicates a role for the following beliefs and attitudes: s Perceived social benefits of exercise. Research examining the predictors of exercise behaviour consistently suggests that the main factors motivating exercise are the beliefs that it is enjoyable and provides social contact. In a cross-sectional study examining the differences in attitude between joggers and non-joggers, the non- joggers reported beliefs that exercise required too much discipline, too much time, they did not believe in the positive effects of jogging and reported a lower belief that significant others valued regular jogging (Riddle 1980). In support of this, the non- joggers in the study by Riddle (1980) also reported a lower value on good health than the joggers. Exercisers have also been shown to differ from non-exercisers in their beliefs about the benefits of exercise. For example, a study of older women (aged 60–89 years) indicated that exercisers reported a higher rating for the health value of exercise, reported greater enjoyment of exercise, rated their discomfort from exer- cise as lower and perceived exercise programmes to be more easily available than non-exercisers (Paxton et al. They developed a questionnaire entitled the ‘Temptation to not exercise scale’ which measured two forms of barriers ‘affect’ and ‘competing demands’. The answers include ‘when I am angry’ and ‘when I am satisfied’ to reflect ‘affect’ and ‘when I feel lazy’ and ‘when I am busy’ to reflect competing interests. The authors argue that such temptations are central to understanding exercise uptake and should be used alongside the stages of change model. Prospective research This has examined which factors predict the uptake of exercise. It has often been carried out in the context of the development of exercise programmes and studies of adherence to these programmes. The results indicated that exercise self-efficacy, attitudes to exercise and health knowledge were the best pre- dictors. They concluded that having realistic aims and an understanding of the possible outcomes of a brief exercise programme were predictive of adherence to the programme. To further understand the predictors of exercise adherence, social cognition models have been used. Riddle (1980) examined predictors of exercise using the theory of reasoned action (Fishbein and Ajzen 1975; see Chapter 2) and reported that attitudes to exercise and the normative components of the model predicted intentions to exercise and that these intentions were related to self-reports of behaviour. Research has also used the health belief model (Sonstroem 1988) and models emphasizing exercise self-efficacy (e. Research has also applied the stages of change model to exercise behaviour (see Chapters 2 and 5). This model describes behaviour change in five stages: precontem- plation, contemplation, preparation, action and maintenance (e. DiClemente and Prochaska 1982) and suggests that transitions between changes is facilitated by a cost benefit analysis and by different cognitions. This suggests that encouraging individuals to focus on the pros of exercise may increase the transition from thinking about exercising to actually doing it. The study included a large sample of adults who completed measures by telephone at baseline and then recorded their exercise stage by mail after one year. The results showed that baseline attitude, intention and subjective norm predicted the transition from precontemplation to contemplation, that progression from contemplation to preparation was predicted by intention, perceived behavioural control, attitudes and social support, that progression from preparation to action was predicted by intention and attitude and that transition from action to maintenance was predicted by intention, attitude and social support. This study was an attempt to test directly the role of two social cognition models in predicting exercise behaviour. Background Social cognition models such as the theory of reasoned action and the health belief model have been used to predict and examine health behaviours such as smoking (see Chapter 5), screening (see Chapter 9) and contraception use (see Chapter 8). Norman and Smith (1995) used the theory of planned behaviour (Ajzen 1988) to predict exercise behaviour over a six-month period. Methodology Subjects Eighteen people were asked to complete open-ended questions in order to identify beliefs about exercise that could then be incorporated into a questionnaire. The questionnaire was distributed to 250 subjects and returned by 182 (a response rate of 72. Because the study used a prospective design, a second questionnaire was sent out after six months; 83 individuals returned it completed. Design The study involved a repeated-measures design with questionnaires completed at baseline (time 1) and after six months (time 2).

Kazdin (eds) order zyvox 600mg without a prescription, International Handbook of Behavior Modification and Therapy zyvox 600mg discount, 2nd edn, pp. Nested analysis of never smoking and ex smoking traits and unnested analysis of a committed smoking trait, American Journal of Human Genetics, 37: 153–65. A longitudinal study exploring the role of previous behaviour, Psychology and Health, 13: 237–50. Weinman (eds), Perceptions of Health and Illness: Current Research and Applications. Journal of Gerontology Series B-Psychological Sciences and Social Sciences, 50B: S344–S353. Young people’s knowledge of their partners at first intercourse, Journal of Community and Applied Social Psychology, 1: 117–32. A comparison of the health status of patients before and after treatment: postal questionnaire survey, British Medical Journal, 313: 454–7. Myocardial infarction can induce positive changes in life style and in the quality of life, Scandinavian Journal of Primary Health Care, 6: 67–71. Lancet (1985) Cancer of the cervix – death by incompetence (Editorial), Lancet, ii: 363–4. Wohlwill (eds), Human Behavior and the Environment: Current Theory and Research, Vol. A model for the doctor-patient interaction in family medicine, Family Practice, 3: 24–30. Weiss (eds), Behavioral Health: A Handbook of Health Enhancement and Disease Prevention, pp. A survey in General Practice of willingness to accept treatment for hypertension, British Journal of General Practice, 51, 276–9. Moyer, A (1997) Psychosocial outcomes of breast conserving surgery versus mastectomy: a meta analytic review, Health Psychology, 16: 284–98. Norman (eds), Predicting Health Behaviour: Research and Practice with Social Cognition Models, pp. An experimental study of patients’ views of the impact and function of a diagnosis, Family Practice, 20(3): 248–53. Combined experience of randomised clinical trials, Journal of the American Medical Association, 260(7): 945–50. A Q-methodological analysis of the diverse understandings of acceptance of chronic pain, Social Science and Medicine, 56(2): 375–86. Overmier (eds), Affect Conditioning and Cognition: Essays on the Determinants of Behavior. Cytological surveillance avoids overtreatment, British Medical Journal, 309: 590–2. I: three month follow up of health outcomes, British Medical Journal, 316: 1786–91. Henderson (eds), New Horizons in Breast Cancer: Current Controversies, Future Directions. Quine (eds), Changing health behaviour: intervention and research with social cognition models, pp. Results from a three wave prospective study in England, Journal of Epidemiology and Community Health, 49: 413–18. Van Doornen (eds), Psycho- physiology of cardiovascular control: models, methods and data, pp. World Health Organization (1980) International classification of impairment, disabilities and handicaps. Resources include further readings, "Focus on Research" boxes, web links, sample essay questions, chapter overviews, PowerPoint slides and an instructor resource manual. Health Psychology: A Textbook is essential reading for all students and researchers of health psychology and for students of medicine, nursing and allied health courses. Thomas’s School of Medicine, University of London, where she carries out research into health-related behaviours and teaches health psychology to both medical and psychology students. No part of it may be reproduced, stored in a re- trieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, record- ing, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 Acquisitions Editor: Joanne P. Forgione As new scientific information becomes available through basic and clinical research, recommended treat- ments and drug therapies undergo changes. The authors and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information re- garding dose and contraindications before administering any drug. Library of Congress Cataloging-in-Publication Data Nursing theories and nursing practice / [edited by] Marilyn E.

Nursing has inherited a culture of negative criticism discount zyvox 600 mg amex, which undermines the confidence of nurses who usually only receive feedback when they have done something wrong generic zyvox 600mg mastercard. Pressures should be recognised, and Managing change 453 planned for; actions should be specific and timetabled, with achievable targets for everyone to work towards. It is necessary therefore to plan: who will achieve something by what date how all staff will be made aware of changes how they will be achieved, and where specific events will occur Plans which remain flexible and adaptable are more likely to succeed (Wilkinson 1994); targets may need modification later. Evaluation However good ideas may sound, their effects in practice, together with their strengths and weaknesses, should be evaluated and, if necessary, the ideas should be modified, developed further, or even abandoned. Evaluations may be achieved through questionnaires, interviews, or more informal approaches. Beyond change Having successfully seen through changes, staff should gain satisfaction (boosting morale) from positively contributing to practice. Experience may be disseminated within the hospital, and beyond—for instance, are there hospital-wide forums where you work? If not, consider the mounting of study sessions/days, or the publication of articles. Extending practice should be part of each nurse’s professional development, and so relevant material, with written reflections on the process, can provide valuable additions to professional profiles. Implications for practice ■ change will occur, and the rate of change will increase ■ nurses can either proactively manage change or reactively be managed by others Intensive care nursing 454 ■ any change forced on people against their will is usually overturned at the earliest opportunity ■ change management should therefore seek to alter values ■ bottom-up approaches are more likely to succeed, as they adopt the norms of majorities ■ change is stressful for all concerned, and so should be carefully planned ■ detailed planning, with specific target dates and achievable goals, helps to prevent procrastination ■ change agents should facilitate informed decision making ■ change agents should acknowledge their own and others’ limitations ■ all staff are likely to need support through the stressful time of change ■ opposition to change can provide a forum for constructive debate ■ change agents should pre-plan how and when their initiative will be evaluated, and be prepared to modify plans where necessary Summary The pace of change is accelerating; nurses and nursing can choose between managing change or being managed by others. Other chapters in this book may have triggered ideas that readers wish to translate into practice. Changes are more likely to succeed if carefully planned, and so this chapter has described models and strategies to help them succeed in introducing change. Further reading Wright (1998) provides a practical description of change management; action research (Webb 1989) offers a way to develop change through practice. Toffler (1970) remains challenging, developing wider perspectives (although providing little immediate help for nurses wishing to make changes). The problems of ritualised nursing are illustrated by Walsh and Ford (1989) and Ford and Walsh (1994). Journals specialising in nursing management frequently include articles on change management (e. How are nurses or other members of healthcare teams (doctors, pharmacists, cleaners, porters) affected by these changes? Using your own example: (a) Identify the style and approaches used (top-down, bottom-up, etc. This chapter provides a trouble-shooting introduction for staff not normally in charge of their units (hence the direct address to readers). The terms manager and management in this chapter normally refer to the nurse-in-charge of the shift, rather than to more senior management; where appropriate, senior management is specifically identified. Some information may be factual, but much of it will be a matter of sharing experience and ideas in order to help others make clinical decisions. Hence, for the most part, options, rather than answers, are provided, and the issues will serve their purpose if they help readers to clarify their own values. Starting to manage Much has been written about management, mostly from industrial perspectives, although there is a growing body of literature on health service management. Vaughan and Pilmoor (1989) suggest that management is getting the work done through people. The nurse-in-charge should establish constructive working conditions at the start of the shift, enabling the development of the individual strengths and skills of staff, while recognising individual needs and limitations. Managers should individually assess and proactively plan and respond to needs for each shift, rather than seeking to impose their own agendas on staff. You may remember most patients from your previous shift; if not, briefly assess patients before taking handover. You may need to walk through your unit to take handover, but if not a brief look at the unit can suggest both the number and dependency of patients (high-dependency patients usually have more equipment and people at a bedspace). Since managers rely on their staff to achieve the work, staff are the manager’s most important resource. Staff numbers are important—are there enough staff for patients already on the unit and the expected/potential admissions? Some staff need more support than others; each has different experience, knowledge and skills to draw on. Most staff will probably be known to you and so scanning the off-duty roster helps your planning; with new or unfamiliar (e. Allocation of staff may be guided by managerial structures such as named and team nursing; specific allocation should consider: ■ the need to maintain patient safety ■ the optimisation of patient treatment ■ the development and support of staff. The most experienced member of staff may be able to give the best care to the sickest patient, but without gaining experience of nursing very sick patients, junior staff will be denied opportunities to develop their skills. If they are continually denied developmental experience, they may become demotivated and leave, or be unable to care safely for the sicker patients when more experienced staff are not available. Safety during break cover should also be considered: two junior nurses may safely manage adjacent patients when both are present, but become unsafe if caring for two patients when covering each other’s breaks.