Application of “Swanson’s Middle Range Caring Theory” in Sweden after miscarriage

Objective: The aim of this study was to apply Swanson’s Middle Range Caring Theory to the follow-up visit with a midwife for Swedish women who have suffered early miscarriage or received care for late missed miscarriage in preg-nancy week 18-20. Methods: Twenty-five tape recorded interviews with women four weeks after their early miscarriages and thirteen tape recorded semi-structured interviews with midwives and nurses who had the experience of caring for women who have been diagnosed with a missed miscarriage during a routine ultrasound scan. The interviews were transcribed verbatim and interpreted deductively from the text using the theory. Results: Each woman described her personal experience of miscarriage in the relative terms of a human experience. The midwives and nurses described their experiences with women who received care for missed miscarriage. The interviews included information about the treatment provided by the caregivers during the period afterward of the diagnosis. The caregiver attitude was formed from Swanson’s caring categories: “Maintaining belief”, “knowing”, “being with”, “doing for”, “enabling”. Conclusions: Swanson’s Middle Range Caring Theory as applied to the caregiver includes being emotionally present, giving support with respect for the woman’s dignity, being competent, meeting each woman’s own individual needs. Given the proper care after a miscarriage every woman has the power within herself to improve their wellbeing.

Theory Critique of Kristen Swanson’s Theory of Caring

Theory is considered essential for integral assessment, adopting its foundations and concepts is of great utility. The theory provides different templates to help nurses provide care that respects patients and improves outcomes. Through understanding the intersection of nursing, patients, health, and the environment, theories aim to simplify the complicated, ever-evolving relationship that nurses have with their profession. Nursing theory helps distinguish nursing as a separate discipline from medicine and related sciences, and assists nurses in understanding their patients and their needs. The behaviors of healthcare providers affect how patients participate in and experience care situations. In the nursing discipline, the theoretical structures of caring have been established as the core concept of guidance in all nurses’ work. The aim of this paper is to develop a critique of Kristen Swanson’s theory of caring—a theory structured around five caring principles (maintaining belief, knowing, being with, doing for, and enabling) by applying it to nursing practice. When applied to nursing practice, each of these five stages stimulates the caregiver’s attitude, which in turn improves the overall patient’s well-being. Implications to nursing practice are mentioned [1] [2].

基于Swanson关怀理论的护理干预在早产儿母亲中的应用

目的:探讨以Swanson关怀理论为框架的护理干预在早产儿母亲中的应用效果。方法:采取便利抽样法选取2022年1月-5月入住百色市某三级甲等医院新生儿重症监护室(NICU)治愈出院的40例早产儿母亲作为对照组,选取2022年6月-10月入住百色市某三级甲等医院NICU治愈出院的40例早产儿母亲作为试验组。对照组实施NICU常规护理,试验组在对照组干预的基础上实施基于Swanson关怀理论的护理干预,比较两组早产儿母亲干预前后疾病不确定感、希望水平、育儿胜任感得分情况。结果:干预后试验组早产儿母亲疾病不确定感得分明显低于对照组(P<0.001),希望水平得分明显高于对照组(P<0.001);出院时及出院1个月后试验组早产儿母亲育儿胜任感得分明显高于对照组(P<0.001)。结论:基于Swanson关怀理论的护理干预可有效降低早产儿母亲疾病不确定感水平,提高其希望水平,增强其育儿胜任感,有利于早产儿顺利从医院过渡至家庭。

基于Swanson关怀理论的肺康复训练对肺癌患者的影响

目的 探讨基于Swanson关怀理论的肺康复训练在肺癌根治术患者中的应用效果。方法 将104例肺癌根治术患者按住院时间分成对照组和干预组各52例,分别实施常规肺康复训练和基于Swanson关怀理论的肺康复训练。比较两组干预后肺功能指标及护患关系信任度改善情况。结果 93例患者完成研究,干预后两组6 min步行试验评分、护患关系信任度评分比较,差异有统计学意义(均P<0.05)。结论 基于Swanson关怀理论的肺康复训练,可提升患者对护士的信任度,有利于患者术后康复。

Empirical Verification of Swanson’s Caring Processes Found in Nursing Actions: Systematic Review

Caring has long been recognized as central to nursing and is increasingly posited as a core concept although developing a theoretical description of caring which is adequate in the 21st. century continues to be a difficult task for nursing scholars. Consequently, verifying existing theoretical structures of caring remains an ongoing challenge. The aim of this article is to provide empirical verification of the caring processes of “knowing,” “being with,” “doing for,” “enabling” and “maintaining belief” from Swanson’s Middle Range Caring Theory based on the categorization of nursing actions from a systematic literature review on care. Methods: A systematic literature review was conducted in the fields of nursing sciences, medicine and psychology. Purposeful sampling was carried out covering a period from 2003-2013. The final sample included 25 articles. Results: Major themes of nursing actions included “knowing” which consisted of centering, nurturing, informed understanding, assessment skills, communication and respect for individual differences. “Being with” was characterized by intimate relationship, connecting, presencing, emotional adaptability awareness of self/other and decentering. “Doing for” included competence, knowledge, professional/technical skills, helping actions, anticipatory, multidisciplinary and preserving dignity. “Enabling” was characterized by self care, commitment, complexity of care, appropriate communication, information/education, sharing power, enabling choice and ongoing validation. Finally, “maintaining belief” was characterized by spiritual being, humanistic view, harmonious balance, hope, love, and compassion, meaning, and religious and spiritual orientation. Conclusion: Empirical verification was shown for the caring processes described in Swanson’s Caring Theory grounded in concrete nursing actions.

基于Swanson关怀理论的人文关怀照护模式在中晚期异常妊娠引产患者中的应用

目的探讨基于Swanson关怀理论的人文关怀照护模式在中晚期异常妊娠引产患者中的应用价值。方法选取2022年1月至8月宜春市妇幼保健院的80例中晚期异常妊娠引产患者作为研究对象,根据随机数字表法将其分为对照组和观察组,每组各40例。对照组患者采取常规护理模式,观察组采用Swanson关怀理论的人文关怀照护模式。比较两组患者的心理状态、产程、对护理效果的满意度。结果护理前,两组患者的汉密尔顿抑郁(HAMD)和汉密尔顿焦虑(HAMA)评分比较,差异无统计学意义(P>0.05);护理后,两组患者的HAMD、HAMA评分均低于本组护理前,且观察组患者的HAMD、HAMA评分低于对照组,差异有统计学意义(P<0.05);观察组患者的第一、二、三产程和总产程均短于对照组,差异有统计学意义(P<0.05);观察组患者的护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论基于Swanson关怀理论的人文关怀照护模式在中晚期异常妊娠引产患者中应用,可改善患者的心理状态、缩短产程、提高护理满意度,提升护理服务质量,值得临床推广应用。

Swanson关怀理论对母婴分离产妇乳汁分泌情况的影响

目的分析Swanson关怀理论对母婴分离产妇乳汁分泌情况的影响。方法将2017年1月~2018年12月重庆市妇幼保健院产科分娩的327例母婴分离产妇,根据随机数字表法分为Swanson组(163例)及对照组(164例),对照组产后予常规护理,Swanson组根据Swanson关怀理论进行照拂。对两组产妇的一般资料、乳汁分泌情况及产后72 h内的泌乳量进行比较,并根据产妇72 h内乳汁分泌量分为≥50 mL及<50 mL两组,对影响乳汁分泌的因素进行比较及Logistic回归分析。结果两组产妇一般资料比较,差异均无统计学意义(均P>0.05);Swanson组的乳汁始动时间、产后3 d乳房肿痛人数、状态-特质焦虑问卷(STAI)及爱丁堡产后抑郁量表(EPDS)评分均明显低于对照组,产后24 h、>24~48 h及>48~72 h泌乳量及产后42 d母乳喂养率均明显多于对照组(均P<0.05),分娩方式、产后24 h睡眠时间、产后2 h乳头刺激、24 h内挤奶次数、夜间挤奶次数、每次挤奶时间及EPDS评分、Swanson关怀理论均对乳汁分泌有显著影响(均P<0.05)。且logistic回归分析示Swanson关怀理论是促进产妇乳汁分泌的独立保护因素(OR=0.454,95%CI:0.221~0.932,P=0.031)。结论Swanson关怀理论能有效增加母婴分离产妇的乳汁分泌量,提高其产后母乳喂养率,有效改善产妇焦虑、紧张情绪。

Building Knowledge: The Concept of Care

Aim and Objectives: The aim of this article is to explore whether the specific levels of caring described in Swanson’s Middle Range Caring Theory which include characteristics of caring, people’s concerns and commitments underlying caring, conditions that enhance/inhibit caring and consequences of caring and non-caring could be used in categorizing findings from two literature reviews investigating the concept of care. Background: Nursing has a long legacy as a caring/healing profession where caring is increasingly posited as one of the core concepts in modern nursing science. However, the meanings given to the concept of care remain elusive, ambiguous and unclear. Design: Two systematic literature reviews. Method: Twenty-nine articles based on strategic inclusion and exclusion criteria were synthesized. Data was retrieved from CINAHL, Medline, Embase and PsycInfo covering the period 2003-2016. The literature search used the key words care, concept analysis, systematic review, meta-synthesis, meta-analysis and narrative review. Results: Major themes found were related to the following characteristics of caring persons: compassionate, knowledgeable, positive and reflective. Concerns and commitments underlying caring were doing the right thing, connecting, focusing on the others’ experience, acknowledging individual dignity and worth and being present. Conditions that enhanced/inhibited caring were situational constraints, personality traits, communication skills, health problems and organizational features. Consequences of caring and non-caring actions included both positive and negative emotional, spiritual, physical, and social outcomes for patients, families and nurses. Conclusion: The specific levels of caring described in Swanson’s Middle Range Caring Theory are highly suitable for categorizing the findings from three literature reviews on the concept of care. Relevance to Clinical Practice: Swanson’s Middle Range Caring Theory can be used to guide clinical practice and encourage an individual approach to care. It has been shown to contain clear, comprehensible language in its theoretical basis;this encourages use in clinical practice.

中层理论及扎根于老中医经验的中医理论建构

从中医理论建构的方法学角度,探讨基于老中医经验的自下而上建构中医中层理论的研究思路。通过解读中层理论的概念与内涵,例举分析近年来名老中医经验传承研究的主要成果和问题,提出基于老中医经验开展中医中层理论建构的策略,包括提高自觉意识、资料收集阶段引入质的研究方法、在分析和建构阶段运用质性研究中扎根理论方法,探索系统化、程序化理论建构方法等。

自我护理中域理论发展及应用的文献研究

目的了解国内外自我护理中域理论的发展及在慢性病群体中的应用情况,为我国慢性病自我护理理论及实践研究提供参考。方法计算机检索Scopus、PubMed、Web of Science、PsycINFO、EMBASE、CINAHL、中国知网、万方等数据库,筛选关于自我护理中域理论的研究文献,并对所纳入的自我护理中域理论进行分析和汇总。结果研究共纳入11个自我护理中域理论研究,多数文献来源于北美洲地区,时间范围为2000-2021年。自我护理中域理论产生方法多涉及归纳法和演绎法,研究内容聚焦于某类特定群体的自我护理问题,且在慢性病群体自我护理干预中应用较为广泛,但有些理论尚需进一步开展实证研究进行验证。结论自我护理中域理论多以Orem自我护理理论为参考依据,按照概念-理论-实证框架发展,对慢性病自我护理研究和实践具有较好的指导和借鉴作用。

家庭护理和家庭关怀理论以及家庭同心球环境理论

概述以家庭为对象,有益于护理和关怀实践及研究的家庭护理和家庭关怀理论以及家庭同心球环境理论,旨在促进家庭护理学和关怀科学的发展。

基于罗伊模式的慢性病适应护理中域理论的构建

目的基于罗伊模式,在六步中域理论构建法的指导下,构建慢性病适应护理中域理论。方法在罗伊模式的基础上,通过检索文献、分类资料、归纳概念、形成图示、提出命题和建立实证证据,构建了慢性病适应护理中域理论。结果慢性病适应护理中域理论包括阐释慢性病适应现象;提炼刺激、认知适应过程、生理功能、自我概念、角色功能、互相依赖、适应/适应不良为核心概念并确立观察变量;建立了理论图示、理论命题和实证证据。结论基于罗伊模式慢性病适应护理中域理论的构建方法科学,实用性较好,为慢性病相关护理研究、教育和实践提供指导。