What concepts from the various theories could be used in planning her care?

What concepts from the various theories could be used in planning her care?

What concepts from the various theories could be used in planning her care? 150 150 Nyagu

Discussion Response 1

[Consider the following case: A 65-year-old woman is being admitted for a mastectomy due to cancer. She expresses fear and depression during the nursing assessment. What concepts from the various theories could be used in planning her care? How might her care be changed if the woman were 25 years old or 45 years old? How have the social psychology theories been used in promoting breast cancer awareness?]

What concepts from the various theories could be used in planning the 65-year-old woman’s care? How have social psychology theories been used in your clinical practice area? Provide at least one example to support your response.

A sociological theory that could be used in planning the 65-year old woman’s care is the study of social networks. Social networks look at the well-being of an individual and their support system or available resources (McEwin & Wills, 2019). For the 65-year-old woman being admitted for a mastectomy due to cancer it would be important to know if she has support at home to take her to follow up appointments and/or care for her if her condition deteriorates. In care management, we often use the sociological theory of social networks to build collaborative discharge plans for patients admitted. As a discharge planner, a nurse highly skilled in critical thinking assesses the patient using a holistic lens to provide longitudinal nursing care post discharge. This is one example of how social psychology theories been used in my clinical practice area of care management.

In this week’s learning resources Conrad and Barker (2010) discussed how some illnesses are embedded with cultural meaning. For example, the authors discuss how some cultures have a negative context around cancer and that its evil or those who have it are diseased (Conrad & Barker, 2010). This type of sociological theory could be used by the nurse to identify the root of the woman’s depression, impacting her overall wellness.

Rational Emotive Theory by Albert Ellis is a behavior theory that hones in on the connection between thoughts, feelings, and actions (McEwin & Wills, 2019). This behavioral theory could be used by the nurse to monitor or manage the patient’s behavior. The patient is likely experiencing feelings of anger, worthlessness, and/or self-blame for their cancer diagnosis. Perhaps they are concerned about a family they would leave behind. It could be that the patient felt a lump in their breast some time ago, but thought it was benign and waited to have it evaluated by a provider. The nurse can use a behavioral theory to talk with the patient, pointing out positive qualities they have and working with them to navigate emotions related to a diagnosis of breast cancer. This allows the patient to become more engaged in their care and develops buy-in.

How might her care be changed if the woman were 25 years old or 45 years old? How have social psychology theories been used in promoting breast cancer awareness? Provide at least one example to support your response.

In this week’s learning resources, Ryan (2009) discussed how nurses can use the integrated theory of health behavior change to engage patients in self-management behaviors improving their outcomes. A 25 or 45-year-old woman would be at a different developmental stage in their life which would change what type of sociological theory or behavior theory the nurse uses.

One example of how social psychology theories have been used in promoting breast cancer awareness is through the social exchange perspective. This theory emphasizes the motivation of an individual (McEwin & Wills, 2019). Marketing that promotes self-interest with early detection of breast cancer has saved lives by improving self-diagnosis of lumps and increasing preventative access to care. Through early detection, the 25-year-old woman might not need an aggressive mastectomy.

References

Conrad, P., & Barker, K. (2010). The social construction of illness: Key Insights and policy implications. Journal of Health and Social Behavior: Special Issue, 51, S67-S79. doi:10.1177/0022146510383495
McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing. (5th ed.) Philadelphia, PA: Wolters Kluwer Health.
Ryan, P. (2009). Integrated Theory of Health Behavior Change. Clinical Nurse Specialist, 23(3), 161-170. doi: 10.1097/NUR.0b013e3181a42373

Discussion Post 1

Week 8 Discussion .docx (17.94 KBMany theories shape the care that we provide as nurses. It is critical to consider not only the physical portion of a patient’s care, but the social, emotional, and behavioral aspects of their care. Looking at the case study of a 65-year-old woman being admitted after a mastectomy due to cancer. She is expressing fear and depression during the nursing assessment. Many theories, and parts of theories can help plan care for this patient. The Stress, Coping, and Adaptation Theory helps the nurse understand how and why a person may react a certain way in a stressful situation. This theory specifically looks at personality traits as well as a person’s support system, surroundings, coping mechanisms, cultural factors, and other social dynamics (McEwen & Wills, 2019). If these factors are not considered, one may wonder why patients react very differently in similar situations. A patient may also react differently at different times in their life as well as with other stressors. There are multiple stress theories which all have aspects that can be used to provide appropriate care. Knowing that stress reactions are different due to social and environmental factors, a nurse is better equipped to assist the patient. Fear and depression are appropriate and real reactions to a cancer diagnosis and a body altering surgery. Talking through the fears and concerns may help ease some concern. This would look differently for a 65-year-old patient and a 25-year-old patient. The 25-year-old may have more fears in terms of starting a family, living, and meeting goals, and body concerns. While a 65-year-old may already have a family and grandchildren and have less worry about body image. They may have additional stressors such as other health concerns, less social support or an ill spouse. Looking at a 45-year-old patient, we can see a combination of these concerns. Maybe they are still concerned about the body alterations, but more-so the cancer diagnosis. The 45-year-old patient is still young and typically working and raising a family. They may be more stressed financially if they had to take time off work and are still trying to support a family. This is not to say that the same worries could not fit every age group.
The Human Needs Theory and self-actualization also are pertinent in this case study. Self-acceptance is a consideration for a patient undergoing a major body altering surgery. The nurse can help the patient face their fears and talk through positives to alleviate some concern with the changes they see.
Commitment to Health Theory and Health Behavior Change theories can be used to promote breast cancer awareness. Both of these theories help patient’s identify at-risk behaviors and genetic make-up that may predispose them to diseases. The patient then is walked through developing a plan to assess for and mitigate the risks. This can help prevent disease and promotes early detection. The Commitment to Health Theory really looks at the behaviors and commitment needed to make a change. The Health Behavior Change Theory takes a role in assessing for chronic conditions and continually assessing risks so that the patient remains in control of their own health (Kelly, 2008; Ryan, 2009).
Each of these theories have helped me navigate patient care and experiences throughout my career. I see many patients who are dealing with chronic pain. The stress adaptation theory is of great significance in my patient care. Pain is a stressor on it’s own but adding this to social and environmental factors can create an environment where a patient is really struggling. I must assess the entire situation of each of my patients. If their symptoms or responses are atypical or not lining up with known pathology, there may be additional components influence their behaviors. Many times, when I assess further I find that they have an ill loved one, having financial difficulties, or don’t feel they can share their pain experiences with their family as they are afraid to appear weak.

References
Kelly, C. (2008). Commitment to health theory. Research and Theory for Nursing Practice, 22(2),
148-60.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing. (5th ed.) Philadelphia, PA: Wolters Kluwer Health.
Ryan, P. (2009). Integrated Theory of Health Behavior Change. Clinical Nurse Specialist, 23(3),
161-170.