Middle Range Theories
How long does chronic sorrow last?
- As long as the desparity of the loss remains, can be forever
How is chronic sorrow clearly different from prevalent, traditional time-bound models of grief and clearly different from pathological depression?
- Considered a normal response - Normal for this sorrow to continue as long as the loss remains, which can be forever
Why are Middle Range theories attractive to nurse researchers?
- Easier to understand - More applicable
Who is Friedrich Nietzsche?
- Existentialism
What are some interventions that are congruent with comfort theory?
- Guided imagery - Progressive muscular relaxation - Meditation - Music or art therapies - Massage - Therapeutic touch
Events antecedent to chronic sorrow?
- Involvement in a circumscribed or single loss event - Recognized negative disparity between the past and the present - The occurrence of events that bring the negative disparity into focus
Why is it important to understand and be sensitive to the mechanisms of trigger events?
- The context of nursing work may become a trigger event for you, your patients, or your patients' families.
What is the theory of comfort?
- The declining significance of comfort for patients - 3 forms in each of the 4 contexts - nursing research provides the public and the decision-makers rationale why nurses and other health care providers should focus on patient comfort beyond altruistic reasons - provision of comfort requires knowledge and skills, and individualized attention
What is mastery of stress?
- The product of the reactions, the anguish, the suffering, the stress, the coping and the efforts to overcome
What is not mastery of stress?
- absence of anguish, suffering, and stress - no reactions to stress - coping with stressful events with ease - coping in any form - efforts to deal with the situation
A concept analysis?
- critical and essential step in theory development - means to trace the origins and evolution of a word in an extensive literature search of usage of the word in nursing, medicine, theology, ergonomics, psychology, and psychiatry - compare current use to obsolete
What are professional interventions for chronic sorrow?
- helpful to ask what helps. helps patients and families realize that they are coping - if nothing helps, suggest some of the coping strategies - must be based on the conceptualization of chronic sorrow as normal rather than pathological
What is the theory of chronic sorrow?
- helping nurses work with and understand the responses of patients and families who have experienced a significant loss - includes a concept analysis (analysis for the concept of chronic sorrow as documented in the literature by multiple disciplines) & 10 qualitative studies designed to explore/investigate the experiences of ppl who experience chronic sorrow - a normal response, universally experienced by those who suffer a significant loss - continues as long as the disparity created by the loss remains
What is the theory of mastery of stress?
- how individuals master difficulties and bad circumstances - goal of this: those who have suffered can emerge healthier and possibly stronger
What are some of the items explored on the comfort questionnaire?
- i don't want to exercise - my body is relaxed right now - i am inspired to do my best
Middle range theory?
- less abstract than grand nursing theories - concerned with specific phenomena found in nursing practice - useful to nurse researchers who want to test interventions, develop practice guidelines, and improve specific conditions for patients, fams, and nurses. - easier to understand & more applicable
What are some coping strategies for chronic sorrow?
- maintaining involvement in personal activities and interests - seeking info - concentrating on positive aspects of life - talking with a trusted professional - having a good cry
Grand theory?
- provide a framework to organize nursing knowledge as a whole - allow us to differentiate the discipline of nursing from traditional approaches to diagnosis and treatment of illness as practiced by physicians ex: parse's, orem's, roy's, watson's - not very good for directing, explaining, and predicting nursing in particular situations - not easily verified experimentally - often difficult to understand
Why do researchers perform concept analyses?
- to become as familiar as possible with a concept - look at obsolete and current meanings to gain understanding
How do contemporary definitions of comfort differ from historical definitions of comfort?
Historical: to strengthen, encouragement, support, refreshing or invigorating influence Current: more pharmaceuticals, absence of extreme measures at the end of life