Application of Concepts from Caring Science

Week 4: Assignment: Application of Concepts from Caring Science

Summary:

A theory can be used to guide practice. This assignment is an exercise in supporting a clinical practice with theory and evidence.

Directions:

Identify an outcome of nursing practice in your area of practice that can be improved. For example, if you work in home health, you may identify that throw rug use by fall risk patients is too prevalent. You may be able to use the problem that inspired the theory concepts that you developed in week two.

Briefly support why it is a problem with evidence from the literature. This is not the major focus of the assignment so do not elaborate.

 

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Create a clinical nursing (not medical) theory in the form Concept A | Proposition | Concept B. Think of the structure like two nouns and a verb. While the term proposition is much more complex in the dictionary, in our use it is the connecting term between the two concepts. Examples include Concept A improves Concept B, Concept A is related to Concept B, when Concept A increases then Concept B also increases, etc. When you get to research, you will explore this further as you develop independent and dependent variables. How to use these statistically will come in research and statistics courses.

This clinical theory is identified as an empirical theory when you get to the C-T-E model later in this course. It is empirical in that they can be measured.

Identify and define your concepts. Identify how they could be measured in a research study. Be careful that you do not use compound concepts. If you find the words “and” or “or” in your theory, you are probably too complex.

If you research your question and seek funding, you will need a theoretical model to guide the research. In our assignment, we are using Watson. You will identify the concepts in Watson’s theories that are represented by the concepts you are using in your clinical theory. Match the proposition in her theory with your proposition. To help, the 10 Caritas Processes are Concept A. Choose the one that matches your concept. To clarify, let’s look at Caritas 1 Embrace and use it in middle-range theory. Sustaining humanistic-altruistic values by the practice of loving-kindness, compassion, and equanimity with self/others (Concept A – Very complex and abstract) improves (Proposition) subjective inner healing (Concept B).

Remember that the paper is not about the problem. It is about constructing a clinical theory and matching it to a middle-range theory and conceptual model your clinical theory represents.

Present your outcome in an APA formatted paper that meets the University’s standards for a written assignment.

Expectations

References: 3 to 10. There should be enough to support the links between the concepts of the problem and the concepts of Wat

 

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Application of Concepts from Caring science

Caring is a phenomenon that refers to a feeling of kindness or concern for people in a manner that shows a high degree of sympathy. The phenomenon is used in various platforms including healthcare where it has taken very deep roots in the various revolutions that have been witnessed in nursing. Caring in nursing can be defined as the pillar that is responsible for improved patient outcomes. In nursing, caring science recognizes the connection between healing and the environment hence the need to harmonize patients as well as their environment (Rehnsfeldt, Arman & Lindström, 2017). The application of the various concepts from caring science in nursing has been utilized by several theorists and this has influenced healthcare practices and more so, the use of evidence-based practices in nursing to improve outcomes. the use of theories in nursing is essential in guiding effective healthcare practices aimed at meeting the various patient needs while underscoring the application of empathy in care provision. Nursing caring is a special aspect of healthcare because it embraces the various aspects of healthcare including the body, mind and soul in conjunction with the environment. This paper will highlight the various elements of theory in nursing which are concepts.

Nursing Practice that needs to be Improved

One issue in healthcare that is gaining significant attention is the prevalence of accidental falls among elderly patients. Accidental falls are common among patients in the intensive care units because the majority are frail, weak, lack self-recognition and lack the ability to control themselves. Accidental falls among patients above the age of 65 years can lead to negative outcomes including fatal injuries that can lead to permanent disabilities or even death. In addition, falls can increase the lengths of hospital stay as well as the cost of healthcare (Ishikuro et al., 2017). Because of the burden associated with accidental falls, it is important to implement effective measures in healthcare to help curb and reduce the prevalence of falls, especially among patients older than 65 years. Besides the direct impacts of patient falls on patients, healthcare facilities as well encounter huge burdens as a result of patient falls in the form of financial losses as a result of lawsuits filed against healthcare institutions.

There are several factors that are associated with the increase in the risk of patient falls and they include lack of balance due to old age, neurodegenerative disorders that cause challenges in cognitive ability and lack of balance as a result of illness. It is also important to note that the Centers for Medicare and Medicaid Services do not reimburse hospitals for patients who experienced accidental falls while admitted to hospitals.

Developing a Clinical Nursing Theory

The identified clinical issue is patient falls and the identified clinical theory is anchored on two main concepts; old age (65 years and above) and the risk of accidental falls. Concept A is elderly age and concept B is the risk of accidental falls. Concept A represents the elderly population which encompasses people with 65 years and above. Age is a critical factor in healthcare because the elderly population have conditions that are precisely associated with old age such as chronic conditions, muscle atrophy and reduced body physiology that lowers body functionality. The sum of these conditions increases the risk of falls among the elderly because they hinder the ability of one to control themselves and avoid chances of falls from the bed. The resulting effects of falls include body disorientation, fatal bodily fractures as well as loss of memory (Teixeira et al., 2019).

The second concept, B, is the risk of accidental falls which refers to an event where a person involuntarily falls to the floor from an elevated point either on a bed, chair or while standing. Among hospitalized patients, unintentional falls happen when a patient loses control while in bed and lands to the floor. In regard to this theory, the first concept, A, elderly age, is an independent variable while concept B, is a dependent variable.

Measurement of Concepts identified

Concept measurement in healthcare is vital because it improves patient outcomes such as the risk of patient falls among elderly patients. The first concept which is old age can be assessed and identified based on the patient information that is part of the subjective information provided by the patient during hospital visits. Concept B on the other hand, which is the risk of patient fall can be measured objectively using various tools including the Tinetti Balance and Gait Scale which is designed to assess gait and balance hence, the risk of falls among elderly adults (Tramontano et al., 2020).

Applying Watson’s Theory of Human Caring to the Clinical Theory

Jean Watson is the founder of the nursing theory of human caring that has been significantly applied in healthcare to improve patient outcomes. Watson’s theory of human caring, and caring science enhances the positive flow of energy that makes use of the body, mind and soul to ensure a wholesome approach to treating patients. In addition, Watson’s theory of human caring emphasizes the need to strengthen the intrapersonal relationship between the patient and the caregiver, creating an emotional, psychological and spiritual connection with the healing process (Alharbi & Baker, 2020). The essence of the theory in healing is to induce healing from within the patient because the theory makes use of all the tenets that promote healing.

The theory is an example of a grand theory which is unlike the common simple theories and it highlights critical ideas and aspects as opposed to just highlighting specific interventions. Jean Watson explores the 10 Caritas Processes that include practising loving kindness to self and other; authentic presence; showing empathy and forgiving; enhancing a person’s spiritual practices and developing trusting interpersonal caring relationships (Perkins, 2021).

The problem-solving protocol using the caring process that is achieved through enhanced healing and caring processes created through the effective interpersonal relationship between the healthcare provider and their patients. The problem-solving technique helps to address the various patient needs, for instance, the prevention of patient falls among the elderly through the implementation of evidence-based practices such as the Performance-Oriented Mobility Scale to identify the potential risk among patients to fall (Parveen & Noohu, 2017).

Risk identification is followed with the implementation of appropriate measures that can help prevent such adverse events including the installation of bedside alarms as well as nurse staff education, both of which are essential approaches that can help overcome the risk of patient falls (Chu, 2017).

Discoveries and Impact on the Nursing Profession

There exist several mid-range theories that have gained intensive application in the field of nursing contributing significantly to the field of nursing education as well as direct patient care. One critical discovery from Watson’s Theory of Human Caring is that theory is essential in the implementation of evidence-based practices in healthcare. The theory forms the basis of assessing the applicability of evidence-based practices before their implementation in healthcare hence, improving patient outcomes. For instance, the capacity of healthcare providers to take care of patients has been proven through the implementation of theory and proving its applicability in a clinical setting. In addition, the capacity of healthcare providers to enhance care among their patients has been improved by promoting and recognizing the role of nurse leaders as patient advocates given that they understand better the various needs of patients. Therefore, healthcare providers can enhance the effectiveness of healthcare processes through policy implementation.

Conclusion

The use of theories in real-life situations is gaining momentum and more especially in healthcare. theories are used to test the credibility and other possible outcomes of actions on experimental standards. For instance, theories are applied in healthcare to inform best practices that can be used to improve patient outcomes and hence, improve the level of care among patients. The jean Watson theory of human caring is a special case in healthcare because it emphasizes human caring as a pillar for improved patient outcomes.

 

 

References

Alharbi, K., & Baker, O. G. (2020). Jean Watson’s middle range theory of human caring: A critique. International Journal of Advanced Multidisciplinary Scientific Research (IJAMSR) ISSN: 2581-4281, 3 (1), 1-14.: https://doi.org/10.31426/ijamsr.2020.3.1.3011

Chu, R. Z. (2017). Preventing in-patient falls: The nurse’s pivotal role. Nursing2022, 47(3), 24-30.

Ishikuro, M., Ubeda, S. R. G., Obara, T., Saga, T., Tanaka, N., Oikawa, C., & Fujimori, K. (2017). Exploring risk factors of patient falls: a retrospective hospital record study in Japan. The Tohoku journal of experimental medicine, 243(3), 195-203.

Parveen, H., & Noohu, M. M. (2017). Evaluation of psychometric properties of Tinetti performance-oriented mobility assessment scale in subjects with knee osteoarthritis. Hong Kong Physiotherapy Journal, 36, 25-32.

Perkins, J. B. (2021). Watson’s Ten Caritas Processes with the Lens of Unitary Human Caring Science. Nursing science quarterly, 34(2), 157-167. https://doi.org/10.1177/0894318420987176

Rehnsfeldt, A., Arman, M., & Lindström, U. Å. (2017). Clinical caring science as a scientific discipline. Scandinavian journal of caring sciences, 31(3), 641-646.

Teixeira, D. K. D. S., Andrade, L. M., Santos, J. L. P., & Caires, E. S. (2019). Falls among the elderly: environmental limitations and functional losses. Revista Brasileira de Geriatria e Gerontologia, 22. https://www.scielo.br/j/rbgg/a/59PJHnNNmwv8yZFdv5Gn6tM/?lang=en

Tramontano, M., Grasso, M. G., Soldi, S., Casula, E. P., Bonnì, S., Mastrogiacomo, S., … & Koch, G. (2020). Cerebellar intermittent theta-burst stimulation combined with vestibular rehabilitation improves gait and balance in patients with multiple sclerosis: a preliminary double-blind randomized controlled trial. The Cerebellum, 19(6), 897-901.