Caring

Many nurse scientists consider caring to be the core concept of nursing practice. This article describes the caring process that occurs when a nurse and a client interact in a nursing care situation. This interactional process has five integrating phases: co-presence, experience-sharing, caring acts, caring-perception, and mutual care-receiving. The authors provide a specific example that illustrates this caring process. The difficulties inherent in the caring process relate to one, or a combination of, three factors: the nurse, the client, and/or the circumstances. Nurses must be cognizant of the client's expression of subtle clues that indicate the need for caring. They also need to learn to recognize their own personal signals that might prevent them from engaging in the caring process. For caring, in its full context, can only occur when nurses know how to care for themselves. Nurses face unpredictability and challenges in their practice on a daily basis. In order to promote caring they must learn to promote an environment that nurtures this process. The authors discuss the essential characteristics of a favorable caring environment and present the conditions that can enhance quality nursing. The challenges that caring nurses face are counterbalanced by the value they attribute to this basic human need and the profound human benefits that caring brings.     

The dancer and the dance: Methods in the study of living control systems.

This article describes methods for studying behavior when organisms are viewed as living control systems. These methods are aimed at determining the variables that organisms control when they are engaged in various observable behaviors. Controlled variables are perceptual representations of the environment that are protected from the effects of disturbance by the responses of the organism. It is possible to detect controlled variables by applying disturbances to aspects of the environment that might be under control and looking for lack of an effect of these disturbances. This Test for Controlled Variables makes it possible to see the "dance" of behavior from the perspective of the behaving organism (the "dancer") rather than from that of the observer who sees only the dance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unconscious pregnancy fantasies as an underlying dynamism in panic disorder

Rural child and adolescent psychiatry offers many challenges, a varied and interesting practice, and the satisfaction of performing needed and important work in an environment in which one's presence is valued. The successful psychiatrist can expect to be an integrated and appreciated member of the community. The fit is not a good one for every practitioner, however. Not only are incomes lower, although the cost of living is low as well, but practitioners may find they have only exchanged urban stresses for rural pressures. The characteristics important for the child and adolescent psychiatrist are the same for rural and urban settings: flexibility, creativity and innovation, competence, self confidence, a good sense of boundaries, a good balance between personal and private life, supportive personal relationships, and a sense of humor. One must be a child advocate, have a willingness to give of one's self and one's time, and be down to earth, comfortable with oneself, and capable of self entertainment. Training programs with access to rural populations can introduce residents to rural child and adolescent psychiatry while supporting those who are already in practice. The authors hope that this article will promote a dialogue with psychiatrists considering relocation to a rural area and encourage training programs to prepare residents for rural practice.     

The relevance of Aristotle’s conception of eudaimonia for the psychological study of happiness.

According to the ethical system of eudaimonism, a philosophy that predates Aristotle, individuals have a responsibility to recognize and live in accordance with their daimon or "true self." The daimon refers to the potentialities of each person, the realization of which represents the greatest fulfillment in living of which each is capable. The daimon is an ideal in the sense of being an excellence, a perfection toward which one strives and, hence, it can give meaning and direction to one's life. Eudaimonia, then, is activity in accordance with one's daimon. This is what is considered worth having in life. Since Aristotle in the Nicomachean Ethics is concerned with the proper ends of human functioning, he rejects the view of eudaimonia as a subjective state equivalent to, or similar to, hedonic enjoyment. But if psychologists are to be able to make productive use of the Aristotle's conception of eudaimonia, it must be rendered in a form more congenial to the field. In pursuing this goal, I have found it necessary to take several significant departures from the Aristotelian perspective, while I have endeavored to remain true to Aristotle's ethical objectives. The most important of these departures is to consider eudaimonia to have a subjective component embodying the experiences that flow from efforts to live in truth to one's daimon by striving to develop one's aptitudes and talents for purposes deemed worth having in life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Considering nursing resource as "caring time'

The present constrained economic climate faced by health care agencies underscores the need for nurse administrators to have an in-depth appreciation of how nursing services are being used. The purpose of this investigation was to increase the understanding of nursing as a resource. Using phenomenological research methodology, the investigator purposefully selected six patients and a chain sample of 14 professionals responsible for their care, including nurses, nurse managers and physicians. Data collection methods included in-depth interviews, document reviews, and participant observation. The inductive interpretation depicts the nature of nursing resource to be "caring time'. Caring was understood primarily in terms of time and was experienced by all participants as "spending time'. Caring time was spent through "being with' and "doing to/doing for' the patient. Study participants experienced tension with regard to how best to spend precious "caring time'. Nursing resource was inextricably linked to both quantitative and qualitative expressions of nursing, and "being with' patients was a highly valued, under-allocated, and unintentionally provided component of nursing resource. The researcher concluded that nursing administrators, nurse managers and practitioners all have leadership roles to play in achieving recognition, allocation and promotion of caring time within their agencies.     

The dark side of nursing: impact of stigmatizing responses on patients

The current emphasis in nursing is on caring, what it involves and why it is the profession's responsibility. This article focuses on the opposite behaviors--the "dark side of nursing" (Jameton, 1992). By developing a fuller understanding of nurse behaviors labeled the "dark side of nursing," the profession can better comprehend what caring involves and develop innovative ways to reduce dark-side behaviors. Although marginalizing, labeling and stereotyping, and stigmatizing are related, the focus will be on stigmatizing responses to patients. A number of investigators document nurse stereotyping of suicidal patients, persons with AIDS, racial/ethnic groups, and sex offenders and the impact on patients. Social psychological theories on stereotyping and deviant behavior provide some explanation for the nurse's behavior. The organizational perspective, however, has not been employed to enhance our understanding of nor to eliminate this phenomenon. Combining an organizational perspective with the social psychological theory of negative stereotyping (stigmatizing) and philosophical theory involving ethics provides a more comprehensive theory for understanding the "dark side of nursing" and designing interventions to reduce the occurrence of this damaging behavior.     

Application of caring theory in primary care: a challenge for advanced practice

That caring is central to nursing is now axiomatic. But has this concept been transferred to advanced nursing practice in primary care? The following article will present reflections on the use of caring in advanced practice in primary care. It is suggested that the nurse practitioner's and other advanced practice nurses' (APNs') use of caring sets nursing's contributions to primary care apart from other providers' practice. A vision is discussed in which professional caring frames the delivery of primary care's nursing therapeutics. How-tos are suggested for delivering professional caring in today's hectic health care environment. Ways the APN can create strategies for renewing caring energy are presented.     

One With the Wind: A Comment on Strenger's (2004) "Of Potholes and Bends: A Meditation on Psychoanalysis and Motorcycle Riding".

Rightly, I believe, does Carlo Strenger (see record 2004-21113-014) focus on the need, in life and in psychoanalysis, to look forward and not backward, to trust that good and competent teachers will guide individuals until they can guide themselves. In motorcycle riding, such guidance, as Strenger makes clear, has its roots in a caring desire to help the neophyte motorcyclist--not unlike what a therapist must bring to his or her work. And, as is obvious, whom one selects as a coach, or analyst, is crucial; in motorcycling, one trusts one's very life to a teacher. Rightly does Strenger relate this capacity to trust to Winnicott's (and, I might add, Erikson's) understanding of a child's earliest relationships. In this short yet interesting meditation, Strenger takes us through the developmental stages of learning to master the motorcycle. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The language of the body: Allusions to self-experience in women's poetry.

The author uses the work of 2 female poets to explore women's representations of self and body in their art. In these works, one can see how woman's ambivalent relationship with the body impedes the ability to know what can only be known through grounding in one's experience. Sylvia Plath, in her 1962 poem "Three Women" (S. Plath, 1981), uses the frames of 3 disparate women, each standing at the uneasy precipice of motherhood, to express her multiplicity and deep ambivalence regarding the body–self. In contrast, Adrienne Rich's work reflects a greater peace with the body, embodying the ongoing conflict between body becoming mind and mind becoming body. Poetry invites the reader into the text through the use of anomaly and disjunction, which deconstructs ostensible meanings and invites personalized and affectively charged readings. Rich's work, most particularly, invites the reader toward the kind of transformative journey referred to by W. R. Bion as "transformations in 'O.' " In this way, poetry, like analysis, helps to fragment occluded meanings, facilitating new, more cogent interpretations and integrations, thereby facilitating the task of becoming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Putting the Partner Within Reach: A Dyadic Perspective on Felt Security in Close Relationships.

The authors argue that felt insecurity in a partner's positive regard and caring stems from a specifically dyadic perception--the perception that a partner is out of one's league. A cross-sectional sample of dating couples revealed that people with low self-esteem feel inferior to their partner and that such feelings of relative inferiority undermine felt security in the partner's regard. Three experiments examined the consequences of reducing such perceived discrepancies by pointing to either strengths in the self or flaws in the partner. Low, but not high, self-esteem participants reacted to new strengths in the self or faults in the partner by reporting greater felt security in their specific partner's positive regard and commitment and more positive, general feelings about their own interpersonal worth. Thus, putting the partner more within the psychological grasp of low self-esteem people may effectively increase felt security in the partner's regard. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nursing personnel and the concept of care: a nursing administrative viewpoint

In this article the importance of caring in nursing management was researched. A survey was undertaken between 1992 and 1994 with the purpose to investigate viewpoints of nurse managers and experiences of nurses regarding caring concepts. The data was collected by means of a questionnaire consisting of an adjusted Nyberg Caring Assessment Scale (Nyberg 1989) and other caring concepts selected from the literature. The survey was conducted among respondents of private hospitals in Pretoria. It was clear from the data analysis that nurse managers and nurses regarded caring as an important concept in nursing management. Perceptions of nurse managers regarding caring concepts and the experiences of nurses on caring in nursing management, differed substantially. It was clear that nurse managers and nurses experienced a need for training with regard to caring in nursing management.     

Culture and egocentric perceptions of fairness in conflict and negotiation.

In this article, the authors advanced a cultural view of judgment biases in conflict and negotiation. The authors predicted that disputants' self-serving biases of fairness would be more prevalent in individualistic cultures, such as the United States, in which the self is served by focusing on one's positive attributes to "stand out" and be better than others, yet would be attenuated in collectivistic cultures, such as Japan, where the self is served by focusing on one's negative characteristics to "blend in" (S. J. Heine, D. R. Lehman, H. R. Markus, & S. Kitayama. 1999). Four studies that used different methodologies (free recall, scenarios, and a laboratory experiment) supported this notion. Implications for the science and practice of negotiation are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The importance of 2,3-dimercaptopropinol (British anti-lewisite, BAL) in the trypanocidal activity of topical melarsoprol

The author agrees with the critiques of moral theory offered by such writers as Bernard Williams and Alasdair MacIntyre, and uses ideas from Heidegger and Levinas to argue that caring is an ontological structure of human existence which takes two forms: caring about on self (which he calls our "self-project") and caring-about-others. This dual form of caring is expressed on four Aristotelian levels of human living which the author describes and illustrates with reference to the phenomenon of pain. It is concluded from this analysis that traditional notions of morality as imposing obligations should give way to an understanding of ethics as the social forms given to our caring for ourselves and for others. A number of implications for ethical theory are sketched out with the conclusion that virtue theory should be preferred and that the model could be worked out more fully to show that virtue theory can be internalist, particularist, pluralist, personalist and objectivist.     

Can the art of caring survive?

The direction that health care has taken in the past few years indicates an urgent need for new models of thinking and new interventions in health care institutions. Despite all of the changes, the nurse remains the one social being the patient can rely on for interpersonal relationships. Can the art of caring, which is at the root of nursing, survive present-day economic pressures? Is it still a useful, accessible and important tool for therapeutic contact? This article, written as a testimonial, gives the author's insights, examples and a short case history on the subject of caring. The author discusses organizational frameworks of health care institutions and encourages readers to review their own nursing practice as a means of improving within their own institutions. Key elements of caring such as altruistic values, sensibility to oneself and others, and the trust-hope relationship are presented. The author's objective is to invite further discussion and promote awareness of the threat to the art of caring.     

Concealed lung abscess in critically ill, mechanically ventilated patients

This article reports on phenomenological research designed to discover how caring was taught in a nursing education program. The basic questions were: 1) What is the meaning of caring to the faculty and students; 2) How do the faculty communicate this meaning to the students; and 3) How does this meaning shape the experience of the students? Data were collected from a small associate degree nursing program using: a) semi-structured interviews with all faculty and a selected group of students, b) classroom observations, and c) review of documents. Data were analyzed for and found to have content explaining the meaning of caring, how caring was being taught, and what students were learning about caring as the essence of nursing. Implications derived speak to the need for faculty and administrators to have caring as a way of being if they wish to communicate caring as the essence of nursing to students.     

Videothoracoscopy for diagnosis and treatment of respiratory tract diseases

Orthopaedic nurses often are well-educated in dealing with patients' physical and psychologic needs but lack education in caring for the spiritual needs of man. Nurses must realize they, themselves, have spiritual needs and must invest in clarifying their own values and beliefs as well as their patients. To perform a complete spiritual assessment, nurses need to become familiar with the concept of spirituality and what it means in the care of patients. Providing spiritual care is individualized and often complex. The nursing process enables the nurse to plan patient care. Providing spiritual care is a challenge orthopaedic nurses must recognize and assume responsibility for.     

Review of Retelling a life: Narration and dialogue in psychoanalysis.

Reviews the book, Retelling a life: Narration and dialogue in psychoanalysis by Roy Schafer (see record 1992-97655-000). Although most of the chapters in Retelling a life have been printed previously, they have been edited so that the work reads seamlessly, even as it covers an extraordinary range of topics of interest to analysts: self-interest; female psychology; training analysis; theories of the "self; projective identification and enactment; Freud's legacy; the differences between psychoanalysis and psychotherapy; the desirability of talking directly to patients; and the larger issues of metapsychology, epistemology, and narration that give the book its title and backbone. It is always clearly written with useful clinical illustrations so that it may prove accessible to a lay reader looking to sample the work of a sophisticated, contemporary psychoanalyst. For the experienced therapist or analyst, the advantage of reading this book all the way through is that one ends up knowing pretty well how Schafer would approach a particular problem; he becomes a familiar voice in one's mind. Schafer's discussion of "the self" is well worth reading. Summarizing greatly, he thinks we do best to consider one "person" who narrates multiple self narratives. Order is brought to bear by reducing the narrative data to "storylines" so that particular narrations can be recognized as "versions of the same basic story" (e.g., of imprisonment, rebirth, odyssey, or oedipal rivalry). What Schafer is attempting to do--as before in A new language for psychoanalysis (1976)--is to provide a modern, philosophically correct basis for psychoanalytic practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigations of antisense oligonucleotides targeted against bcl-2 RNAs

The purpose of this article is to describe how nurse instructors understand nursing and the necessary conditions for high quality nursing care. The approach of the study was inductive and based on phenomenology and a sociological field research method, i.e. grounded theory. It emerged that the core of nursing is a process, termed here caring, with three stages. Three types of caring emerged. Understanding the client, the art of nursing, co-operation between the nurse and other health care professionals were found to be necessary conditions for a high quality nursing care and it was also found that it is not possible to separate caring from the society and its history.