Nursing and Caring Principles Quiz

Caring & Therapeutic Relationship Body Image

• Objectives: Define caring, discuss two caring theories, discuss therapeutic relationship principles, describe therapeutic nurse-client relationship phases
• Quote (Martin Luther King Jr.): "Our lives begin to end the day we become silent about things that matter."
• Definition of Caring: Caring is a process, an essential feature and expression of human being, essential in nursing to help nurses connect with patients for best medical treatment. It involves sharing deep and genuine concern for another person's welfare.
• Alternative Definition of Caring: Caring is assisting and supporting a client using science and art, showing emotional inclination to help. It requires a commitment, demonstrating helping with great intensity. This involves sympathy, empathy, compassion, interest, and a positive attitude toward the sick.
• Nursing and Caring: Nursing cannot exist without caring; it's an integral part of the profession. Caring is central to all helping professions, crucial for the healing process. Excellent nursing necessitates knowledge, skills, and compassion. Two domains of caring are: caring for others who cannot care for themselves, and compassionate actions of a caring nurse.

Leininger's Culture Care Diversity and Universality

• Culture Care Diversity and Universality: Identifies care as a distinct, dominant, unifying, and central focus of nursing. Nurses must understand various cultures for effective practice.
• Transcultural Nursing: Transcultural nursing focuses on differences and similarities in various cultures, needing nurses to understand these differences to appropriately give care congruent with cultural beliefs, values, and practices.
• Lack of Cultural Understanding: Lack of knowledge about one's culture can lead to conflict, non-compliance, and stress.
• Culturally Congruent Care: This involves providing care to patients while being mindful and inclusive of cultural practices, values, and beliefs. It includes a thorough understanding of how culture influences health beliefs, practices, and communication patterns during the nursing process. Culturally congruent care occurs when nurses understand and accept differences in various cultures.

Jean Watson's Theory

• Essence of Caring: Caring is the essence and moral ideal of nursing; it protects, enhances, and preserves human dignity.
• Nursing's Contribution: Nursing's contribution to society is its moral commitment to human care.
• Relational Caring: Caring is relational, valuing nurse effectiveness, ability to perform tasks, and the attitude/demeanor while performing the tasks. Patients are more likely to participate if they feel cared about.
• Transpersonal Caring: Transpersonal caring goes beyond one's ego, seeking deeper spiritual connection while comforting a patient. Human caring occurs when the nurse and patient share a collective experience.
• Caring Occasion/Moment: A moment created between the nurse and patient, characterized by caring and sharing of a particular time in history, known as the caring moment.

Peplau's Interpersonal Relationship

• Phases of Interpersonal Relationship: Orientation, working, resolution (or termination)
• Preinteraction phase: Similar to planning before an interview, nurses acquire information about patients (e.g., name, age, address, medical and social history) before meeting them. This information comes from charts, close contacts, or the healthcare team.
• Orientation phase: Nurse and client set the tone for the therapeutic relationship by observing each other and making judgments about one another's behavior. The nurse's goal is to build trust and security. The phase begins when the nurse meets the client, ends when identified problems are identified. Roles and the purpose of the meeting are established, parameters of future meetings are planned, problems are identified, and expectations are clarified. The nurse also formulates nursing diagnoses, sets mutually acceptable goals, develops a realistic action plan, and explores feelings of both the client and nurse.
• Working phase: Clients and nurses view each other as unique, appreciating this uniqueness, and caring about one another. The working phase has two major stages. The first stage involves exploring and understanding the thoughts and feelings of both the client and nurse; the second stage is facilitating and taking action. This phase includes maintaining the therapeutic relationship, gathering additional data, exploring perceptions of reality, developing adaptive coping mechanisms, promoting a positive self-concept, encouraging verbalization, facilitating behavior change, working through possible resistance, evaluating progress, defining or redefining goals as needed, providing opportunities to try new behaviors, and promoting independence.
• Resolution or Termination phase: This phase begins when problems are resolved and ends when the relationship terminates. Progress has been made towards client goals; a plan is in place for more effective coping with future stressful situations; and feelings associated with termination are acknowledged and explored.

Therapeutic Nurse-Client Relationship

• Principles of Therapeutic Relationships: Respect, genuineness, empathy, active listening, trust, and confidentiality.
• Respect in Relationships: Important ways to show respect include introducing oneself, asking clients how they would like to be addressed, ensuring comfort with modesty and privacy, and communicating in ways that foster listening, understanding, and help.
• Genuineness in Relationships: Being true to oneself in a professional role; for example, acknowledging when a client is struggling to quit smoking.
• Empathy in Relationships: Understanding a patient's experience from their perspective and communicating this understanding.
• Trust: Listen carefully to patients' concerns, treat them with respect, be honest and consistent, follow engagements, have sincere acceptance, to allow for shared trust and care.
• Acceptance: Avoid judgments of patients no matter their behaviors, demonstrating tolerance of patient's outbursts, anger, or acting out. Being clear and firm while not expressing anger or judging a patient allows them to feel intact while showing that behavior is unacceptable.
• Positive Regard: The nurse appreciates clients, calls patients by names, spends time with them, listens openly, understands client preferences to design care.
• Therapeutic Communication Skills: Include effective communication techniques, steps involved in therapeutic communication (e.g., open-ended questions, focusing on feelings, stating observed behaviors, reflecting, restating, rephrasing what the patient says, neutral/non-judgmental responses). Avoiding communication types, like telling a patient they're wrong, giving advice, creating false hope, using clichés, seeking justification, giving approval, using "I" and "me," changing subjects, or defending colleagues.
• Components of Therapeutic Relationship: Trust, respect, professional intimacy, empathy, power, therapeutic communication, client-centred care, maintaining boundaries, giving and accepting gifts, protecting the client from abuse.
• Open-Ended Questions: Examples of such questions include: How are you?, Tell me about your day, Do you have any questions?, What questions do you have?, Have I answered all your questions?, What else can I help with today?
• Active Listening Techniques (SOLER): S-sit facing the client, O-open posture, L-lean forward, E-establish eye contact, R-relaxed.

Body Image

• Body Image Definition: Body image refers to a person's perception of their own body, encompassing affective, cognitive, and behavioral elements. It's a complex psychosocial concept. It encompasses the physical appearance, height, shape, weight, functioning, and aging aspects of oneself.
• Aspects of Body Image: Perceptual: how you see your body; Affective: how you feel about your body; Cognitive: how you think about your body; Behavioral: how your behaviors are shaped by your body image
• Development of Body Image: Established before age 6; continues to develop during early adolescence, often with significant changes in weight (e.g., among girls, experiencing gains due to fat deposits).
• Factors Influencing Body Image: Sociocultural factors, past and present experiences, interpersonal interactions, physical changes, and personality traits.
• Behavioral Defenses to Altered Body Image: Passivity, denial, reassurance, isolation, and hostility
• Enhancing Body Image: Actions such as being active, wearing clothes that feel good, taking care of the skin, connecting with friends, family, change negative thoughts, eating healthy foods, addressing grief and loss. Beauty enhancement and items (makeup, hairstyles, jewelry, prostheses), functioning enhancements (wheelchairs, eyeglasses, walkers). theories of body image, like sociocultural and developmental are also part of the process.

Factors Enhancing Interpersonal Relationships

• Patience and Meaningful Communication: Patience in listening and engaging in meaningful conversation. Avoid hasty judgements, judging unemotionally avoid gossiping and avoid negative criticism.
• Communication Skills: Developing important communication skills.
• Respect and Acceptance: Showing respect and acceptance of other people and their input. Respecting others and accepting constructive criticism.

Test your understanding of essential nursing concepts including the importance of caring, therapeutic relationships, and spirituality in patient care. This quiz covers key theories and practices that define effective nursing relationships and the act of caring. Challenge your knowledge and enhance your skills as a nurse.