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Caring Concept Analysis

     In the development of a theory, concept analysis is very essential in nursing as a profession. Concepts represent meaning and ideas of human experience according to Watson and Nelson (2012). concept analysis provides a clear view of a concept as it tells more about a theory and nursing practice as a profession. According to Sargent, (2012), in order to develop new theories, concept analysis is used in the development of new concepts and in mending the existing ones. Concepts are vital in provision of a foundation both of scientific knowledge and theoretical contexts for any course. The degree of concept analysis gives strength to theories that are involved in any discipline. this concept was derived from jean Watson’s theory of human caring. Limiting myself to jeans Watson’s theory, I will do an analysis on the concept of caring on the basis of the care that nurses give to patients. The consequent sectors of this analysis are: definition of caring as a concept, literature review, definition of caring attributes, antecedent and consequences of caring, the empirical referents, construct cases, theoretical applications of the concept and conclusion.

 Definition/Explanation of the Caring

     Caring can be demarcated as either a noun or an adjective as seen from oxford dictionary (2016). As a noun, it is the act of taking care of those who are unable to look after themselves. From an adjective point of view, caring is the practice of showing concern or kindness to others. In nursing profession caring encompasses doing, knowing and being (Di Napoli, Turkel, Nelson and Watson, 2010). Caring forms the basis of the relationship between the patient and the nurse. According to Stizman (2007) caring does not comprise execution of caring involvements to gain certain outcomes and treatment of the patient but somewhat stresses on all the requirements of the patient which involve physical, psychological and spiritual. In reference to Watson’s theory of human caring, understanding, relieving grief and suffering, and enhancement of the well-being of the patient are the some of the things that concept of caring is involved with. Caring is the course of morally pledging to defend, improve and reserve a person’s humanity all of which are aimed at enhancing healing of a patient.  Watson, describes caring as a science: “Caring is a science that encompasses a humanitarian, human science orientation, human caring processes, phenomena, and experiences”

Literature Review

Article 1: Registered nurses’ description of caring

      In this study, the experience of individual nurses was projected to give a general view of all nurses. Four common themes arose after analyzing the data collected; caring as safeguarding the patient’s best interests, caring as nursing intervention, caring as person-centeredness and caring as contextually intertwined (Anderson et al, 2015).

Article 2: Caring from the male perspective

      In this article we look at nursing from a perspective of a male nurse. The question of research on this was, “what is the essence of nursing as perceived by practicing registered nurses who are male”. After the research was complete, results indicated that the level of caring delivered was high from nurse’s responses but low from patient responses.  Patients said nurses were good on interpersonal relationships and behaviors but they rated them lowest on how good they responded to call lights, checking on patients and pain management. On interpretation of results, Sossong and Poinier, (2013) indicated that care according to the patient is the response given toward each situation, for example a painful patient will take care to be medication while a long-term patient will see care as relationship and amount of time the nurse spends with them. clarity of perceptions about care allows the nurse o be able to give the right care to the patient being cared for.

Article 3: How trauma patients perceive nurses’ caring behaviors

     This research was carried out on trauma patients and measured using CBI. Being able to care for both physical and psychological needs of a patient is an art of caring (Merrill et al, 2012). Trauma patients rated nurses care high giving them credit on meeting both stated and unstated needs efficiently and giving medications in time. The trauma patients valued behaviors that showed tolerance and courtesy to separate needs in a nurturing condition. 

Article 4: Perceptions of caring in china

      CBI was used in this study. There was a great difference between nurses and patients on their ratings. Researchers concluded that the big rift in perception could be as a result of staff shortages and said that different cultures have different views on caring.

Article 5: Patient and nurse perceptions of caring in rural united states

      The comparison between these two was carried out using Caring Behaviors Inventory-elderly (CBI-E). the level of caring delivered was rated high by the nurses contrary to the patients. The perception of care according to patient was highly centered on what a patient need at a particular moment of his/her need.

Article 6: Exploring pre-nursing students’ perception of caring and nursing

     In this research seven themes about nursing care were obtained, the first one was caring language which entailed the choice of words to show kindness and compassion. Sharing of information was a theme that showed that a nurse was the informer of both patient and family members. Giving findings and assessment results to providers is also an aspect of information sharing. Building relationship is a theme that made it clear that a nurse should treat the patient as an individual and create a good rapport with the patient at a personal level. Role modelling, provision of competent nursing care and delivering care actions were other themes discovered during this research.

Defining Attributes

      From the literature, some attributes of caring that we can derive are presence, respect and action. Presence is the act of being there for the patient. It is being able to preserve time for you to create a nurse-patient time. This helps the nurse understand and to be subtle to patients understanding and interpretation of their situation. Through presence, a nurse should be open and sensitive to the patient and make the the patience the main focus. According to Anderson et al, (2015), presence includes realization of the nurse that they the means by which caring takes place. Presence is the art of caring and showing love for mankind. Respect entails the response of the nurse towards patient’s illness bearing in mind that it is the patient who understands the sickness more than the nurse. The nurse should show respect by maintaining the patient’s dignity and privacy, respecting patient’s decisions and their care plan while working in conjunction with other health teams and close involvement of family members and relatives is a show of respect to the patient. The steps taken in realization of patient’s recovery are the actions. They include all interventions involved when taking care of patient. It encompasses assessments, documentations, treatments both pharmacological and non-pharmacological.

Antecedent and Consequence

      An antecedent means something that should be available for another thing to take place. For caring to take place, a nurse should have a candid concern for the patient and a want to aid or care for the people. A consequence is the outcome of caring; this would be enhancing patient fulfilment as caring has been recognized as a predicator of general gratification by hospitalized patients. (Merrill et al, 2012).

Empirical Referents

       Caring behaviors inventory and caring assessment report evaluation Q-sort (CARE-Q) are some of the empirical referents we have encountered in our literature. Though not used in the articles, CARE-Q was developed by Larson. This model was to be used to determine the patients view on the caring behaviors of the nurses which would consist of fifty items of behavior divided into six subscales. This emphasized on deeds such as provision of comfort. Caring behavioral inventory (CBI) was devised by Wolf. The patients rank caring word and phrases from nurses on a Likert scale.

Model Cases

     Catherine is carried to the emergency ward for fever and vomiting. On arrival he sees a nurse with beards and identifies him by the name Michael. The nurse brings her Zofran and as he enters the ward Catherine calls him Michael again. The nurse explains to the family of Catherine what Zofran is for and also prescribes popsicle to help Catherine’s fever come down. The nurse administers medication and sits next to Catherine as she continues calling him Michael of which the nurse smiles broadly anytime she calls him Michael. Catherine plays with Michael’s beards as they joke about Spiderman. she takes popsicle and her stomach relaxes. Catherine and ‘Michael’ then take a selfie and Catherine is discharged. She leaves smiling and satisfied as she waves bye to the nurse.

       From this model, presence of the nurse is seen by him taking time to stay with Catherine and talk about Spiderman. Dignity of the patient is preserved by the nurse not correcting Catherine about his real name while respect for the family is evidenced when the nurse explains the medication to the parents. Action is seen when administers medication and evaluates Catherine’s response to them. the nurse has antecedent of desire to care for the patient. We see consequence when Catherine is discharged and she shows satisfaction by smiling. It is through caring relations and caring instants as debated in Watsons human caring theory that care is delivered and healing can happen

Alternative Cases

Borderline Case

      Referring to the above model, if the nurse did not explain to the family about the medicines and corrected Catherine on his real name this would show lack of respect. In addition, if the nurse did not preserve time to chat with Catherine and refused to take a selfie with her the attribute of presence would not be there. In reference to Watsons theory, this case would lack the aspects of caring relationships and moments.

Contrary Case

      In the case above, if the nurse failed to administer Zofran to Catherine and gave her only popsicle, corrected Catherine immediately and never had time to talk with her, then this case would lack the aforementioned attributes, antecedents and consequences of caring. This case would represent nothing about Watsons theory.

Conclusion

       Caring is both an art and a science that can be applied in all cultures, genders, ethnicities and health situations. It is important for us as nurses to understand and practice all attributes of caring such as presence, respect and action. Genuine antecedent will always help us realize good consequences which will see us get patient satisfaction. Watsons theory on human caring teaches us to have a good patient relationship and this will help us get mutual benefits which will result to a holistic and humanistic event. To increase our patient satisfaction, sometimes all we need is a listening hear and a smile.

References

Anderson., Willman, A., Sjostrom-Stand, A., Borglin, G. (2015). Registered nurses’ descriptions of caring: a phenomenographic interview study. BMC Nursing, 14(1), 1-10.

Doi: 10.1186/s12912-015-0067-9

Grobbel, C. C., Rowe, L. (2014). Exploring pre-Nursing students’ perceptions of caring and nursing: A Phenomenological study. International journal for human caring, 18(1), 8-16

He, T., Du, Y., Zhong, Z., Ye, X., $ Liu, X. (2013). Perception of caring in china: patient and nurse questionnaire survey. International Nurse Review, 60(4) 487-493

Doi:10.1111/inr.12058

Sossong, A., $ Poirier, P. (2013). Patient and Nurse Perceptions of Caring in Rural United States. International journal for human caring, 17(1), 79-85

Shalaby, S. A., Janbi, N. F., Mohammed, K. K., & Al-harthi, K. M. (2018). Assessing the caring behaviors of critical care nurses. Journal of Nursing Education and Practice, 8(10), 77.

Benbenishty, J., & Hannink, J. R. (2017). Patient Perspectives on the Influence of Practice of Nurses Forming Therapeutic Relationships. International Journal for Human Caring, 21(4), 208-213.

Good, P. (2018). EVALUATING THE IMPACT OF INNOVATIVE TEACHING STRATEGIES TO IMPROVE NURSING STUDENTS’PERCEPTIONS OF COMPETENCE AND CONFIDENCE IN PROVIDING SPIRITUAL AND EMOTIONAL CARE.

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