LEININGER’S AND WATSON’S THEORY

Case Details

In this case study, the patient, Mrs. Franklin-Jones, had been admitted to the Cardiac Intensive Care following a diagnosis of acute myocardial infarction. Her recovery processes had been going on well and she was expected to move to the cardiac step-down unit. Her conversation with Nurse Julie Hernandez, reveals more information about her condition. She indicates that it all started as chest pain. The patient has high blood pressure but did not expect it to be worse to that extent. She reveals her commitment to adhering to the medication regimen prescribed to her but at times, she forgets taking her medicine. She has some papers on the appropriate nutrition, which she admits that she needed to study them. She reveals that her mother died of high blood pressure. Her way of cooking is based on her Jamaican culture. Her caregiver at home, Tomas had just lost his job and the patient indicated that she might let him do the cooking. The patient reveals having not enough time between her jobs at the school cafeteria and her housecleaning job. The patient indicated that her sister would be coming from Jamaica and would bring her some bush tea, which expects work well on her. This paper seeks to analyze this case study using the Leininger’s Culture Care Model. 

Factors to Consider When Planning for the Patient’s Discharge

The Leininger’s Culture Care Theory provides a culturally compatible care plan that is supportive, facilitative, and within the parameters of the cultural values, beliefs, and lifeways. This theory is applied through a collaborative pattern between the nurse and the client, where the two work together to develop a patient care lifestyle that will enhance the promotion of the health status of the client. The theory requires the inclusion of general and professional knowledge. This makes the Leininger’s Culture Care Theory applicable to develop a discharge plan for the patient. 

The theory requires that the socioeconomic conditions of the patient be addressed. The patient, Mrs. Franklin-Jones, does not get enough rest time as she juggles between her two jobs, in the school cafeteria, and as a housecleaner. This situation implies that she has limited time to engage in tasks ensuring that she lives a healthy life, which may include proper nutrition, adherence to medication regimen, and exercising. The patient has more tasks on her hands as Tomas lost his job and will, therefore, be staying at home. The nurse needs to account for these factors to ensure the development of the most appropriate discharge plan.

Importance of the Theory of Culture Care Diversity 

The theory of Culture Care Diversity informs the nurse on the best way to offer care to the patients. The theory provides a guideline that is essential in enhancing the health and the well-being of the patient. The theory highlights that nursing care is critical to attaining nursing practice with an aim of achieving health, well-being, healing, recovering, proper growth, and survival of the patient (George, 2011). The theory indicates that difference in culture leads to differences in possible solutions, knowledge, and preferred care practices. This theory makes a call to the nurses on the need to collaborate with the patient in developing a care plan that is developed in line with cultural factors. The theory notes that patients are at the center of the care system. It highlights that the patient is subject to factors such as language, religion, social, political, economic, technology, historical, and environmental factors (Leininger, 2008).

Mrs. Franklin-Jones Care Plan

The first element of the care plan for Mrs. Jones will be based on cultural preservation and maintenance. This will consider the nutritional aspect of the care plan. For Mrs. Jones, it is not mandatory for the patient to learn new ways of cooking as she had indicated. The plan will consider the most appropriate type of foods, even within the Jamaican culture that will meet the nutrition requirement for an individual with her condition. The care plan should highlight the food types that she should avoid to ensure her blood pressure levels do not escalate. 

Another element that will be considered is on culture care restructuring. The care plan will require that the patient seeks more time for rest. This highlights the need to seek jobs that allow her some time to rest and relax. This might even call on her to hold on just one job at a time to ease the pressure on her.

Strengths and Weaknesses of Leininger’s Theory

This theory is very informative in making a care plan as it considers the needs and requirements of different patients. It takes into account the constraints of the culture where the patient hails from. This theory takes into account the fact that patients exist within a certain culture. These factors affect the healing, recovery, and well-being of the patient. The theory allows the nurses to develop a care plan that is acceptable to the patients and thereby the patients are able to adhere to the prescriptions (Leininger, 2008).

The Leininger’s theory has limitations in that it can lead to errors when coming up with the clinical decisions. This results from the misperception of the patient’s condition and the cultural values of the patients. In a case where the nurse fails to correctly capture the cultural factors of the human needs, it may cause the dissatisfaction of care provided (Andrews & Boyle, 2008). The theory is unable to identify the power relations that may be present between groups, which may end up affecting the patient’s perception of the care plan. 

Case Study 2: Watson’s Theory

The case considers a patient, Claude Jean-Baptiste, who happens to be in a recovery process after a post-hip replacement surgery. He had been transferred to the Rehabilitation Institute located next to the hospital. In the health facility, the signage is provided in multiple languages including his own, Creole. The nurses can only speak to him through a translator. The nurse makes enquires on Haitian cultural customs and beliefs that the patient would like to consider. The patient is encouraged to bring food and spiritual items.

Assumptions of the Transpersonal Caring Relationship

Among the key assumptions of the Transpersonal Care Relationship is that the patient has the right to care about morals and ethics. This mandates the nurse to be professional in the manner at which they develop the nurse-patient relationship. The theory assumes that care is effectively shown and practice at the interpersonal level. Care is comprised of curative factors that eventually lead to satisfaction of some human needs. Effective care seeks to enhance health and individual or family growth. The theory also believes that caring responses seek to accept a person as they are or how they would become. The caring environment should allow the development of the potential of an individual’s and lastly, caring is considered to be healthogenic as more that curing; and the practice of caring is the foundation of nursing. 

The transpersonal caring relationship is highlighted as a spiritual union. This is because it involves a connection that brings together the spirits of either party through a process demanding total, real and caring attention (Gomes, Silva, Lacerda, Mazza, Meier, & Merces, 2013). To provide the transpersonal caring relationship, nurses are excepted to portray a genuine urge to be present. The nurses should further put their focus on the interactions with their patients. A transpersonal nurse is defined as one who has the ability to focus their consciousness and intentionality on caring, healing, and wholeness as opposed to concentrating on the disease, illness, and pathology. To fulfill this, nurses are expected to focus their attention on assisting patients to attain a complete sense of harmony of the mind, body, and spirit. To achieve a transpersonal care relationship, the nurse is expected to collaborate with the patient and the two needs to identify and experience the reality of being interdependent and attain a sense of interconnectedness. To be in a position of reaching to the patient’s perspective, during the process of establishing the interpersonal relationship, a nurse is required to have a unique degree of awareness (Clark, 2016).

Love as Defined by Watson as per the Caring Moment

Watson considers that love requires to be unconditional and altruistic. It entails considering the patient’s needs rituals, wishes, beliefs, and routine. Using this definition, the patient in the case study received lots of love from the nursing community at the Rehabilitation Institute. The signage in the facility accommodates people of different language backgrounds. The patient is also allowed an opportunity to have a relative within the facility. It is clear the nurses in this facility are caring and accommodative as evidenced by how they make inquiries on the customs and beliefs that they would have wanted to be understood.

Using Self in Creating a Healing Environment 

Venes (2013) points out that “self” refers to the perspective of “I “and me to other people and through the interactions of different aspects of life. Evidence-based nursing requires nurses to be regarded as critical in the provision of patient care. The nurses may apply a unifying nursing mode and apply a healthcare practice that promotes patient safety. The theory of Human Caring, proposed by Watson requires the nurses to develop a caring consciousness that allows them to be loving and show kindness. Nurses need to create a personal spiritual practice and transpersonal self. This requires the nurses to come up with and sustain a helping-trust that could lead to a unique caring relationship (Lukose, 2013). The nurses are required to participate in the development of an environment for healing that considers wholeness, beauty, comfort, dignity, and peace (Caruso, Cisar, & Pipe, 2008).

Strengths and Limitations 

The theory takes an approach that considers the need to ensure that the nurses are knowledgeable concerning the art of caring and how the power of caring can be achieved. The theory understands the need of simplicity where a relationship of care is identified to be transpersonal. It is important to note that theory seeks to improve the ever-changing human world. A key weakness of this theory is founded on the assumption that it lays emphasis on biophysical needs of patients at the expense of psychosocial needs.

References

Andrews, M., & Boyle, J. (2008). Transcultural Concepts in Nursing Care. New York: Wolters Kluwer Health.

Caruso, E., Cisar, N., & Pipe, T. (2008). Creating a Healing Environment; An Innovative Educational Approach for Adopting Jean Watson’s Theory of Human Caring. Nurse Admin Quarterly, 32(2), 126-132.

Clark, C. S. (2016). Watson’s human caring theory: Pertinent transpersonal and humanities concepts for educators. Humanities, 5(2), 21.

George, J. (2011). Nursing theories: the base for professional nursing practice (6th edition). Saddle River, NJ: Pearson Education, Inc.

Gomes, I. M., Silva, D. I. D., Lacerda, M. R., Mazza, V. D. A., Meier, M. J., & Merces, N. N. A. D. (2013). Jean Watson’s theory of transpersonal caring in nursing home care to children: a reflection. Escola Anna Nery, 17(3), 555-561.

Leininger, M. (2008). Overview of Leininger’s Theory of Culture Care Diversity and Universality. Retrieved from http://www.madeleine-leininger.com/cc/overview.pdf

Lukose, A. (2011). Developing a practice model for Watson’s theory of caring. Nursing Science Quarterly, 24(1), 27-30.

Venes, D. (2013). Taber’s cyclopedia medical dictionary. FA Davis.Watson, J. (2002). Intentionality and caring-healing consciousness: A practice of transpersonal nursing. Holistic nursing practice, 16(4), 12-19.