This chapter illustrates the different paths of the author’s research program took as it turned from a quantitative to a qualitative study and back again. In the author’s first study, she quantitatively investigated the relationship between maternity blues and postpartum depression. The meta-analysis revealed a large adverse effect size of postpartum depression on maternal-infant interaction during the first year of life. The research question centered on exploring the caring experiences of postpartum depressed women with nurses. The author conducted six qualitative studies on birth trauma. The author conducted a phenomenological study on the resulting posttraumatic stress disorder (PTSD) due to childbirth. The author focuses on the mothers’ experiences of eye movement desensitization reprocessing (EMDR) treatment for their elevated posttraumatic stress symptoms. Research is confirming that survivors of traumatic events, such as cancer, experience posttraumatic growth. Metasynthesis can help qualitative research to take its rightful place in the hierarchy of evidence.
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Nurse workarounds start when the nurse is faced with a block or hurdle to expected processes. With escalating integration of technology in health care systems, the need for nurse workarounds has surged. This is an anticipated phase of technology integration and eventual evolution. The defining attributes of nurse workarounds are the modification or circumvention of standard care or protocol, patient care directed to increase efficiency, and the issue temporarily addressed but not resolved. Nurse workarounds are informal, temporary, and many times spontaneous in origin. The bar code medication administration (BCMA) system presents many opportunities for nurse workarounds. The antecedents to nurse workarounds include nurse’s perceived obstacle or dysfunction, system introduction or design, policy, procedure and work flow and workload and time. Institutional and unit policy and procedure can create blocks for the nurse’s workflow. The consequences of nurse workarounds include destabilization of the system, error, and evolution of the system.
Cultural competence is described in the health care literature as an essential component of contemporary nursing practice, given the increased cultural diversity of patients. It has also been suggested that cultural competence is fundamentally nursing competence, because it reflects the nurse’s ability to provide individualized patient care regardless of the patient’s social or cultural background. Despite definitional differences, common themes associated with cultural competence are that it is associated with individual characteristics and reflects an ongoing process. In addition, higher scores of self-reported cultural competence among primary care providers in outpatient HIV care settings were associated with more equitable care, medication self-efficacy, and viral suppression across racial/ethnic groups. The primary empirical referents for measuring cultural competence are self-assessment instruments that measure at the provider level. Cultural competence continues to be an important construct in contemporary nursing practice.
Nurses, especially as they grow into an advanced practice role, use physiological theory in many varied ways, from predicting short- and long-term disease processes to predicting outcomes of prescription medication and other therapies. The nurse is cautioned to use a mindset that is open to diverse frameworks and evaluate research that tests physiological phenomena and its application to clinical practice, thereby assisting the patient in attaining optimum wellness. This chapter reviews a selection of physiological theories that may be used by nurses, especially those in advanced practice roles. It helps introducing the nurse to a broad scope of physiological frameworks that can be used to guide nursing care and enhance the wellness possibilities for patients. The physiological frameworks discussed include: genetic and genomic frameworks; disease causation frameworks; immunological frameworks; motor and skeletal stress frameworks; frameworks for understanding pain mechanisms; and sleep disturbance and fatigue frameworks.
One does not accidentally blend Watson’s Human Caring Science theory with a Yoga theory. This chapter and the merging of these two theories is the culmination of the many pathways the author have followed, pathways that have diverged and converged over nearly 20 years of nursing education and Yoga teaching. It explores how the author came about interweaving Watson’s Human Caring Science theory with a medieval Yoga model to underpin a first year’s, first semester bachelor of nursing course in Australia. With this background contextualized, the author describes the traditional Yogic Kosha Model, its adaptation, and then author’s blending of it with Watson’s Caritas Processes®. The chapter concludes with a discussion on the adaptation of Watson’s Caring Science to construct new knowledge (epistemology) and ways of being (ontology), while upholding the imperative of values (axiology) such as caring in nursing and society.
This introductory chapter presents the ontology, epistemology, and the lived experience of Caring Science. It provides section overviews. The purpose of the overview is to give a brief synopsis of the focus of the chapters in each section. There are ten sections - the disciplinary discourse: theories and frameworks evolving to unitary caring science; converging paradigms: constructing new worldviews; caritas science literacy: from caritas to global communitas; caritas literacy as a foundation for nursing education; authenticating caring science through scholarly inquiry; touching the space of praxis; redefining healthcare through heart-centered wisdom; global caring science; emerging inquiry: the evolution of a science; and journeys into the transpersonal: aesthetic ways of knowing. Sections I through IX include 38 chapters. Section X features personal journeys illuminating the power of aesthetic knowing in Caring Science, and is composed of 10 shorter pieces. These sections reflect substantive areas of disciplinary-specific knowledge in Caring Science.
This chapter uncovers the synchrony of Caring Science theory with research and methods of Heart Science. It introduces an evolved method of CaritasHeart Praxis as a foundational guide, unifying intellectual-experiential ways of Being and Becoming. The chapter helps the caring-healing nurse to develop an evidence-informed heart-centered praxis of Caritas, informed by a new synthesis of Heart Science–Caring Science, philosophy, and theory. Evidence-informed, theory-guided nursing praxis is required for true healthcare reform. Caring Science Theory of Human Caring is deepened and extended by integration of heart-science healing practices. The CaritasHeart methodology generates a healing environment and contributes to person-center, caring-healing relationships. It is one-way forward toward evidence-informed Caritas Praxis. In addition, CaritasHeart methodology provides a Praxis Protocol for converging and translating Caring Science/Heart Science into exemplary, professional, authentic care, consistent with the public’s desire for whole person healthcare.
- Go to chapter: Caring Science–Native Science: Paving Pathways of Courageous Authenticity, Advocacy, and Agency
Caring Science is a sacred science, a way of knowing, doing, being, and becoming that recognizes the divine and embraces the vulnerability of self and other. This chapter defines values and constructs that encapsulate a Native Science worldview. It helps the caring-healing nurse to recognize the expansive power and possibilities that arise from within a Caring Science–Native Science sphere of consciousness. The chapter helps the caring-healing nurse to develop a broader sense of self that reinforces an intrinsic value of being in relationship with the people, places, and (living and inanimate) things that exist in the world. At a level of universal consciousness, Native Science embodies an ethereal vastness as much as an intricate root system, whereas Caring Science embodies the energetic fields of connection that fill the spaces in between. The chapter identifies pathways of courageous authenticity, advocacy, and agency within a professional and personal context.
Caring is a universal principle. Traditionally, the African concept of caring involves all the members of the village or community, family, relatives, tribe, and ancestors. This chapter looks at Watson’s Caring Theory (WCT) through an African lens and an African ontology, namely ubuntu. Ubuntu epitomizes the promotion of standards of moral behavior while living the central philosophy of interaction between people and how relationships are manifested. The chapter compares the values and ethics of ubuntu with those of WCT to show how the principles of ubuntu can be integrated with WCT to develop an African ontology of caring. This is done through a critical discussion and critique of the general concepts, values, and ethics of WCT compared with ubuntu. The chapter helps the caring-healing nurse to develop an individualized plan for caring based on ubuntu and Watson’s Caritas Theory.
Nursing, by definition, is a profession that calls for clear ethical and moral standards. This chapter begins with an overview of the evolution of ethical thought that appears in the literature since the time of Florence Nightingale and the establishment of nursing as a profession. The discussion then explains how nursing came to embrace an ethic of caring as central to the discipline. The chapter describes the ways in which this ethic defines nursing as a unique discipline while contributing to the broader knowledge of caring in the realm of human relationships. It helps to identify the necessity of caring ethics as central to creating healing encounters and environments. Finally, the chapter concludes with a discussion of the primary determinants of moral choice derived from a nursing ethic of caring.