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Leininger’s Theory of Culture Care Diversity and Universality 319 or indigenous) knowledge often has rich care data holistic knowledge base about care discount 3ml careprost with amex. Generic care ideas need dicts the health and well-being of people and fo- to be appropriately integrated into the three modes cuses on the totality of lifeways of individuals 3 ml careprost free shipping, of action and decision for congruent care out- families 3 ml careprost otc, groups 3ml careprost with visa, communities, and/or institutions comes. Both generic and professional care are inte- related to culture and care phenomena. It gives a grated together so the clients benefit from both comprehensive picture of care knowledge and often types of care. Some The Sunrise Enabler was developed with the nurse researchers have studied care with limited idea to “let the sun enter the researcher’s mind” and variables or in regard to medical symptoms and discover largely unknown care factors of cultures. Discovering the totality of living Generally, a wealth of new and unexpected nursing with a caring ethos in a culture has provided a care knowledge is discovered that has never been wealth of new knowledge about clients’ lifeworld known and used in present-day nursing and med- and care. This characteristic helps nurse re- searchers to discover what exists, or has the poten- Current Status of the Theory tial to be known and used for human caring and health practices. What exists and does not exist is Currently, the theory of culture care diversity and important to discover, as is the potential for future universality is being studied and used in many discoveries. Some theories deal only with abstract schools of nursing within the United States and phenomena, but this theory has both abstract and other countries (Leininger & McFarland, 2002). The theory has grown in recognition and value for Sixth, the theory of culture care is a synthesized several reasons. First, the theory is the only nursing concept; integrated with the ethnonursing method, theory that focuses explicitly and in depth on it has already provided a wealth of many new in- discovering the meaning, uses, and patterns of sights, knowledge areas, and valuable ways to work culture care within and between specific cultures. Thus, it has greatly expanded nurses’ are the new knowledge holdings that support the knowledge about care so essential for nurses to new discipline of transcultural nursing. Third, the theory has the “gold nuggets” to change or transform health a “built-in” and tailor-made ethnonursing nursing care to realize therapeutic outcomes for different research method that helps to realize the theory cultures. It is different from ethnography and other been reported in the Journal of Transcultural research methods. The ethnonursing method is a Nursing and other transcultural nursing books and qualitative method and is valuable in discover- journals since 1980. They substantiate the theory ing largely covert, complex, and generally hidden (Leininger, 1991, 1995, 1997a, 1997b). It was Seventh, the theory and its research findings are the first specific research method designed so that stimulating nursing faculty and clinicians to use the theory and method fit together. This has culture specific care appropriate and safe for cul- brought forth a wealth of new data. Thus, transcultural nursing knowledge is to data methods were not helpful to find hidden be used in clinical and community settings. Nursing administrators in service and academia Fourth, the theory of culture care is the only the- need to be active change leaders to use transcultural ory that searches for comprehensive and holistic nursing findings. Nursing faculty members need to care data relying on social structure, worldview, promote and teach ways to be effective with cul- and multiple factors in a culture in order to get a tures (Leininger, 1998). The theory is being used a lot to trism and racial biases and prejudices are being re- do culturalogical–health care assessments. Many nurses transcultural nursing concepts, findings, policies, also like to discover the differences and similarities and standards of care are being developed and used among cultures as it expands their worldviews and from findings (Leininger, 1991). Interdisciplinary deepens their appreciation of human beings of di- health personnel are finding the theory and trans- verse cultures. Learning to become immersed in a cultural nursing concepts and are finding help in culture has been a major benefit. This has been the most rewarding benefit of be used in any culture and at any time and with the theory. The consumer also likes the ethno- the theory slightly to fit their major and unique in- nursing method as they can “tell their story” and terest and goals of their discipline.

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Transpersonal Caring Relationship The nurse attempts to enter into and stay within the The terms transpersonal and a transpersonal caring other’s frame of reference for connecting with the relationship are foundational to the work discount 3 ml careprost overnight delivery. But transpersonal also goes beyond the ate comfort measures generic careprost 3ml without a prescription, pain control best 3ml careprost, a sense of well- ego self and beyond the given moment order careprost 3 ml with amex, reaching to being, wholeness, or even a spiritual transcendence the deeper connections to spirit and with the of suffering. Thus, a transpersonal caring rela- complete, regardless of illness or disease (Watson, tionship moves beyond ego self and radiates to 1996, p. Assumptions of Transpersonal Caring Relationship Transpersonal caring seeks to connect with The nurse’s moral commitment, intentionality, and and embrace the spirit or soul of the other caritas consciousness is to protect, enhance, pro- through the processes of caring and heal- mote, and potentiate human dignity, wholeness, ing and being in authentic relation, in the and healing, wherein a person creates or cocreates moment. Transpersonal caring seeks to connect with and The nurse’s will and consciousness affirm the embrace the spirit or soul of the other through the subjective-spiritual significance of the person while processes of caring and healing and being in au- seeking to sustain caring in the midst of threat and thentic relation, in the moment. Such a transpersonal relation is influenced by This honors the I-Thou relationship versus an I-It the caring consciousness and intentionality of the relationship. Actions, words, be- uniqueness of self and other and the uniqueness of haviors, cognition, body language, feelings, intu- the moment, wherein the coming together is mu- ition, thought, senses, the energy field, and so on, tual and reciprocal, each fully embodied in the mo- all contribute to transpersonal caring connection. The moment of by releasing some of the disharmony, the blocked energy that interferes with the natural healing A caring moment involves an action and processes. For example: nurse’s own life history and previous experiences, which provide opportunities for focused studies, [W]e learn from one another how to be human the nurse having lived through or experienced var- by identifying ourselves with others, finding their ious human conditions and having imagined oth- dilemmas in ourselves. We learn to degree, the necessary knowledge and consciousness recognize ourselves in others... Other facilitators include per- The dynamic of transpersonal caring (healing) sonal- growth experiences such as psychotherapy, within a caring moment is manifest in a field of transpersonal psychology, meditation, bioenerget- consciousness. The transpersonal dimensions of a ics work, and other models for spiritual awakening. The role of conscious- notion of health professionals as wounded healers ness with respect to a holographic view of science is acknowledged as part of the necessary growth has been discussed in earlier writings (Watson, and compassion called forth within this theory/ 1992, p. A caring occasion occurs whenever the nurse and • The one caring and the one being cared for are another come together with their unique life histo- interconnected; the caring-healing process is ries and phenomenal fields in a human-to-human connected with the other human(s) and with transaction. It • The caring-healing-loving consciousness of the becomes transcendent, whereby experience and nurse is communicated to the one being cared perception take place, but the actual caring occa- for. The process goes beyond itself yet arises from through and transcends time and space and can aspects of itself that become part of the life history be dominant over physical dimensions. It transcends clarify where one may locate self within the time, space, and physicality. The Caring Model or Theory can be considered a • Are those involved “conscious” of their caring philosophical and moral/ethical foundation for caritas or noncaring consciousness and inten- professional nursing and is part of the central focus tionally in a given moment, at individual and for nursing at the disciplinary level. It offers to expanding their caring consciousness and a framework that embraces and intersects with art, actions to self, other, environment, nature, and science, humanities, spirituality, and new dimen- wider universe? However, to truly “get it,” one has to experience This work, in both its original and evolving it personally. The model is both an invitation and forms, seeks to develop caring as an ontological- an opportunity to interact with the ideas, epistemological foundation for a theoretical- experiment with and grow within the philosophy, philosophical-ethical framework for the profession and to live it out in one’s personal/professional life. Nursing caring theory-based activi- 2004), provide us with a chance to assess, critique, ties as guides to practice, education, and research and see where or how, or even if, we may locate have developed throughout the United States ourselves within a framework of caring science as a and other parts of the world. The caring model is basis for the emerging ideas in relation to our own consistently one of the nursing caring theories used “theories and philosophies of professional nursing as a guide. Nursing thus ironically is interacting with the caring model to transform now challenged to stand and mature within and/or improve practice? The it mean to be human, caring, healing, becoming, future already reveals that all health-care growing, transforming, and so on? For example, practitioners will need to work within a in the words of Teilhard de Chardin:“Are we hu- shared framework of caring relationships and mans having a spiritual experience, or are we human-environment field modalities, pay at- spiritual beings having a human experience? Participants were invited to explore Transpersonal However, nursing’s future holds promises of Human Caring Theory (Caring Theory), as taught caring and healing mysteries and models yet and modeled by Dr.

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A layperson may define stress in terms of pressure discount careprost 3ml, tension 3 ml careprost overnight delivery, unpleasant external forces or an emotional response purchase 3 ml careprost. Contemporary definitions of stress regard the external environmental stress as a stressor (e buy careprost 3ml fast delivery. Researchers have also differentiated between stress that is harmful and damaging (distress) and stress that is positive and beneficial (eustress). In addition, researchers differentiate between acute stress such as an exam or having to give a public talk and chronic stress such as job stress and poverty. The most commonly used definition of stress was developed by Lazarus and Launier (1978), who regarded stress as a transaction between people and the environment and described stress in terms of ‘person environment fit’. If a person is faced with a potentially difficult stressor such as an exam or having to give a public talk the degree of stress they experience is determined first by their appraisal of the event (‘is it stressful? A good person environment fit results in no or low stress and a poor fit results in higher stress. Cannon’s fight or flight model One of the earliest models of stress was developed by Cannon (1932). This was called the fight or flight model of stress, which suggested that external threats elicited the fight or flight response involving an increased activity rate and increased arousal. He suggested that these physiological changes enabled the individual to either escape from the source of stress or fight. Within Cannon’s model, stress was defined as a response to external stressors, which was predominantly seen as physiological. Cannon considered stress to be an adaptive response as it enabled the individual to manage a stressful event. However, he also recognized that prolonged stress could result in medical problems. The initial stage was called the ‘alarm’ stage, which described an increase in activity, and occurred immediately the individual was exposed to a stressful situation. The second stage was called ‘resistance’, which involved coping and attempts to reverse the effects of the alarm stage. They there- fore did not address the issue of individual variability and psychological factors were given only a minimal role. For example, whilst an exam could be seen as stressful for one person it might be seen as an opportunity to shine to another. This response is seen as non specific in that the changes in physiology are the same regardless of the nature of the stressor. This is reflected in the use of the term ‘arousal’ which has been criticized by more recent researchers. Therefore, these two models described individuals as passive and as responding automatically to their external world. Life events theory In an attempt to depart from both Selye’s and Cannon’s models of stress, which emphasized physiological changes, the life events theory was developed to examine stress and stress-related changes as a response to life experiences. These ranged in supposed objective severity from events such as ‘death of a spouse’, ‘death of a close family member’ and ‘jail term’ to more moderate events such as ‘son or daughter leaving home’ and ‘pregnancy’ to minor events such as ‘vacation’, ‘change in eating habits’, ‘change in sleeping habits’ and ‘change in number of family get-togethers’. However, this obviously crude method of measurement was later replaced by a variety of others, including a weighting system whereby each potential life event was weighted by a panel creating a degree of differentiation between the different life experiences. The individual’s own rating of the event is important It has been argued by many researchers that life experiences should not be seen as either objectively stressful or benign, but that this interpretation of the event should be left to the individual. For example, a divorce for one individual may be regarded as extremely upsetting, whereas for another it may be a relief from an unpleasant situation. They reported that a useful means of assessing the potential impact of life events is to evaluate the individual’s own ratings of the life experience in terms of (1) the desirability of the event (was the event regarded as positive or negative); (2) how much control they had over the event (was the outcome of the event determined by the individual or others); and (3) the degree of required adjustment following the event. This methodology would enable the individual’s own evaluation of the events to be taken into consideration. The problem of retrospective assessment Most ratings of life experiences or life events are completed retrospectively, at the time when the individual has become ill or has come into contact with the health profession. This has obvious implications for understanding the causal link between life events and subsequent stress and stress- related illnesses. For example, if an individual has developed cancer and is asked to rate their life experiences over the last year, their present state of mind will influence their recollection of that year.

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