DNP 8114 Discussion Applying Interdisciplinary Theories to Nursing Practice

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DNP 8114 Discussion Applying Interdisciplinary Theories to Nursing Practice

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Applying theory to knowledge as it pertains to a practice issue deserves awareness. As concerns arise, the use of evidence-based practice and research takes aim. The purpose of this entry is to explore the interdisciplinary theory of change, usage of assigned theory, and logic.

Change theory in nursing is an effort that is used in leadership practice. A change agent is a person skilled in the theory and implementation of planned change (Marquis & Huston, 2015, p. 163). Applying this theory to has its advantages and disadvantages. Various forces that drive change in health care include rising costs of treatment, new technologies, advances in science, workforce shortages, and an aging population (Udod & Wagner, n.d., para. 2). Leaders take on the task as it relates to research and functionality.

Use of change theory has several concepts to apply to the user’s preference. The rational change approach, with its origins in economic theory, assumes that those involved in the change will have full information act reasonably and sensibly, use sound judgement and good sense, and that the change process is predictable, linear, and static (White et al., 2019, p. 60). Some of the theorists are Lewin, Lippitt., Havelot, and Howes & Quinn. They all have theories that pertain to planned focus of research.  A DNP prepared administrator is well served by the study of the concepts explored in change theories and the knowledge gained through DNP coursework (Zaccagnini & Pechacek, 2021, p. 299). The theory that best aligns with my practice issue is Lippitt’s Model of Change, that entails a seven-step model:

Develop need for change by diagnosing the change.
Establish change relationship and assess the motivation and capacity to change.
Clarify assessment for change and determine resources.
Establish goals and intentions for an action plan.

DNP 8114 Discussion Applying Interdisciplinary Theories to Nursing Practice

Examine alternatives.
Transform intentions into actual change and maintain the change.
Generalize and stabilize change and end the helping relationship of the change agent (White et al., 2019, pp. 61–62).

Becoming a change agent takes diligence and a broad knowledge base. When adopting a practice quandary, this is a vital step. Gaining knowledge in this field will be an asset to research process.

References

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Lippincott, Williams&Wilkins.

Udod, S., & Wagner, J. (n.d.). Leadership and Influencing Change In Nursing [E-book]. PRESSBOOKS. https://doi.org/https://leadershipandinfluencingchangeinnursing.peressbooks.com/chapter/chapter-9-common-change-theories-and-application-to-different-nursing-situations/

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2019). Translation of evidence into nursing and healthcare (3rd ed.) [Eds]. Springer.

Zaccagnini, M., & Pechacek, J. M. (2021). The doctorate of nursing practice essentials; A new model for advanced practice nursing (4th ed.). Jones & Bartlett.

Discussion: Applying Interdisciplinary Theories to Nursing Practice

Using the same practice issue from the Week 2 Discussion and an interdisciplinary theory you will be assigned, you will research your assigned theory for applications in addressing your practice issue. Although your focus is exploring one theory in depth, as you engage with colleagues, consider other theories that also apply to your practice issue. Learning from colleagues is particularly important and encouraged with this Discussion.

Photo Credit: steheap / Adobe Stock

To prepare:
Your Instructor will assign you an interdisciplinary theory from among the following:
Health Belief
Health Promotion
Change
Disease Causation
Transformational Leadership in Nursing and in Health Care
Patient-focused Care/Patient-centered Care
Problem-based Learning
Simulation (Jeffries/NLN)
Cultural Competence/Diversity
Review the Learning Resources, with particular attention to information on your assigned theory.
In addition, search the Walden Library for at least two scholarly articles published within the previous 5 years on your assigned theory. Identify examples and insight for applying this theory to your practice issue.
Consider how to explain your assigned theory and its applications to nursing practice and the specific issue you are addressing.

Note: Your initial post is due by Day 3. Contact your Instructor if you have not received your assigned theory on Day 1.

With these thoughts in mind …

By Day 3 of Week 3

Post a brief description of your assigned theory and your practice issue. Then, explain how you would apply your assigned theory to your practice issue and explain your reasoning. Be specific and provide examples. Cite your sources in your post.

Read a selection of your colleagues’ posts.

By Day 6 of Week 3

Respond to at least two colleagues on 2 different days. Choose colleagues who were assigned different theories than your own. Respond to their posts in one or more of the following ways:

Critique their application of theory to their practice issue and either explain why you support their thinking or recommend a different theory to consider, which may be the theory you were assigned. Explain your thinking.
Drawing on their explanation of their assigned theory, describe how this theory applies to your practice issue and explain your reasoning.
Compare and contrast their assigned theory with your own for application to practice issues. Support your reasoning.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Applying the Culture Care Theory to Medical Non-Compliance
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The Culture Care Theory

The Culture Care Theory was developed by Madeleine Leininger in response to identifying gaps in caring and culture when it came to healthcare provision. Through her own observations of healthcare prvision, Leininger noticed a lack of knowledge among herself and colleagues when confronted with issues on culture as well as caring (McFarland, 2019). As she believed that both were essential to developing a holistic approach to healthcare, Leininger developed the culture care theory. The theory provides a framework that all practitioners can use to understand variations in nursing practice that they can apply so as to support their compliance to the treatment plan, their well-being, and their healing.

Through this model, Leininger places the focus of healthcare on cultural congruence. Cultural congruence allows for all practitioners to provide services that are facilitative, supportive, and enabling for a particular patient, by falling in line with their cultural values and beliefs, as well as their lifestyles (McFarland, 2019). The development of culturally congruent care is only possible when the practitioner makes an effort to collaborate with their patient, so that they may work together towards care interventions and plans that are acceptable and beneficial to all parties.

The focus that the Culture Care theory places on supporting patient compliance presents a solution to the medical issue that is the focus in this paper – medical non-compliance. Medical non-compliance is a common occurrence for patients being treated for mental health conditions or health concerns. Due to the frequency of its occurrence, it is also a major focus for research and evidence-based practice. In this paper, means of applying Culture Care theory to medical non-compliance for mental health patients will be explored. Using two scientific articles, the application of the Culture Care theory to healthcare practice will be studied. From these sources, means of applying the theory to the medical non-compliance issue will be developed and discussed.

Literature on the Culture Care Theory

One study by Chiatti (2018) outlines the application of the Culture Care theory to an immigrant group in the mid-Atlantic region of the United States, and the means through which it affected the provision of healthcare services. Due to the presence of various immigrant groups in the country, Chiatti focused on Ethiopian immigrants, who represent a large populatin of the total immigrants in the mid-Atlantic area. Ethiopians represent the second-largest group of African immigrants in the US, numbering up to almost a million, especially in the states of New York, and Washington D.C. Their presence in these areas presents an opportunity for healthcare workers to improve their cultural congruence with the local population by applying the Culture Care theory to understanding the values and beliefs of a minority group.

The findings exposed a number of relevant themes to keep in mind when dealing with this immigrant population, as well as a number of areas of concern. With regards to the themes relevant to healthcare, Chiatti (2018) found that 6 main themes emerged from research data, in addition to 14 patterns in care. These 6 themes were support for friends and family, the preservation of cultural heritage, a strong value for freedom, cultural care, the importance of spirituality, and therapeutic communication (Chiatti, 2018). The strong value that the population placed on these elements could be applied to healthcare practice by taking them into consideration during the formulation of treatment plans. For example, including the support system of a patient with a chronic illness in the treatment plan would have positive outcomes for a member of this population, as they place great importance on the support of family and friends.

In addition to these themes, the study found a number of potential barriers to healthcare. Chiatti (2018) found that a perceived lack of interest in cultural care was a barrier to healthcare for this population. The lack of availability of nurses interested in cultural care or learning cultural congruence with this population, as well as the lack of interpreters, had the effect of negatively affecting their access to care.

Another study making use of the Culture Care theory is a paper titled ‘Cultural and Practical Implications for Psychiatric Telehealth Services: A Response to COVID-19’ (Goldin et al, 2020). Published in 2020, this study took a closer look at cultural care in the context of COVID-19. It is particularly relevant to the health care issue in this paper as it addressed psychiatric health. It is also particularly relevant to the current healthcare landscape as it tackles the state of healthcare provision during the global pandemic. According to Goldin et al (2020), the collaborative process between the patients and the providers is an essential part of providing quality care, especially in the cultural context. Goldin et al (2020) take an interdisciplinary approach to the process, through including the involvement of physicians, nurses, and telehealth technicians in the paper, and their role in ensuring cultural competence. This paper highlights the importance of institution-wide cultural competence training, rather than simply having some practitioners focus on culture care.

Insight for Practical Application

The paper by Chiatti et al (2018) emphasizes the importance of understanding major themes in the culture of minority populations when it comes to increasing quality of care. The paper especially touches on how compliance to the treatment plan can be improved through cultural congruence. In applying the findings of Chiatti et al to medical non-compliance for mental health patients, a health practitioner can take the time to understand the cultural implications of mental health conditions for minority populations in their area of practice. By understanding major themes, incorporating elements such as family support, religious support, or emphasizing the confidentiality of their care, practitioners can not only avoid barriers to compliance, but increase the rapport and practitioner-patient trust.

The paper by Goldin et al emphasizes the importance of culture care in the context of COVID-19. As telehealth options are increasingly implemented due to pandemic restrictions, it has become necessary to have more staff involved in the process of scheduling and monitoring consultations. Training all staff involved in culture care, including all members of the interdisciplinary team, has been highlighted as an essential part of psychiatric care during this time. This study can be applied to medical non-compliance by informing members of interdisciplinary teams of elements of culture care for each patient, and emphasizing their need to understand the unique position of each patient with regards to their barriers to compliance.

References

Chiatti, B. D. (2019). Culture care beliefs and practices of Ethiopian immigrants. Journal of Transcultural Nursing, 30(4), 340-349. https://doi.org/10.1177/1043659618817589

Goldin, D., Maltseva, T., Scaccianoce, M., & Brenes, F. (2021). Cultural and Practical Implications for Psychiatric Telehealth Services: A Response to COVID-19. Journal of Transcultural Nursing, 32(2), 186-190.

McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s theory of culture care diversity and universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing, 30(6), 540-557.

NURS_8114_Week3_Discussion_Rubric
Grid View
List View

 

Excellent

90%–100%

 

Good

80%–89%

 

Fair

70%–79%

 

Poor

0%–69%

 

Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

 

Points Range: 40 (40%) – 44 (44%)

Thoroughly responds to the Discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least three current credible sources.

 

Points Range: 35 (35%) – 39 (39%)

Responds to most of the Discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least three credible references.

 

Points Range: 31 (31%) – 34 (34%)

Responds to some of the Discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Cited with fewer than two credible references.

 

Points Range: 0 (0%) – 30 (30%)

Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible references.

 

Main Posting:

Writing

 

Points Range: 6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

 

Points Range: 5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

 

Points Range: 4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

 

Points Range: 0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

 

Main Posting:

Timely and full participation

 

Points Range: 9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

 

Points Range: 8 (8%) – 8 (8%)

Meets requirements for full participation.

Posts main Discussion by due date.

 

Points Range: 7 (7%) – 7 (7%)
Posts main Discussion by due date.

Points Range: 0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main Discussion by due date.

 

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

 

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

 

Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth.

Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.

First Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

 

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

 

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

 

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

 

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

 

Points Range: 3 (3%) – 3 (3%)
Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

 

Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth.

Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.

Second Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

 

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

 

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

 

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

 

Points Range: 3 (3%) – 3 (3%)
Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100
Name: NURS_8114_Week3_Discussion_Rubric

RE: Interdisciplinary Theories: Patient-Centered Care

 Reynolds (2009) defined patient-centered care as a practice that focuses on the patient and the individual’s particular health care needs.

In their article, Grant and Johnson (2019) stated that patients and families should be allowed to fully participate at all levels of care decisions, learning, and interventions that promote quality health. They further stated the nurse leaders are in the particular position to promote this patient-and family-centered care since they have in-depth training and understanding of health systems and come in direct contact with patients, families, clinical staff, and administrators. And as an administrator in the home healthcare system, I connect with patients and their families every day and relate to the clinical staff of our team. Therefore, I often refer to this position as a ‘bridge.’

Gholamzadeh et al. (2021) identified patient preparedness as one of the main elements of patient-centered care. Teaching caregivers in preparing their care recipients on procedures does enhance acceptance and recovery, as I have observed in my own practice.

In the theory of symptom management, a symptom is defined as being subjective, making it imperative that the patients or/and caregivers are well familiarized with the identification and presentation of symptoms. Furthermore, symptom experience has been defined as a ‘simultaneous perception, evaluation, and response to a change in one’s usual feeling (Smith & Liehr, 2018), whereas the symptom management is designed to ward off, reduce or delay the symptom experience, obtainable by either minimizing the frequency, reducing the severity, or avoiding any distress related to the symptom experience.

Once the focus is on the patient,  the patient and/or caregiver is appropriately trained to observe any changes in health care needs, I believe as a nurse that I will be able to render appropriate care for the best outcome at that particular time.

 

References

Gholamzadeh, M., Abtahi, H., & Ghazisaeeidl, M. (2021). Applied techniques for putting pre-visit planning in clinical

practice to empower patient-centered care in the pandemic era: a systematic review framework suggestion. BMC

Health Services Research. 21(1), 458. https://doi-org-ezp.waldenulibrary.org/10.1186/s12913-021-06456-7

 

Grant, S.M., & Johnson, B.H. (2019). Advancing the practice of patient- and family-centered care: The central role of

nursing leadership. Nurse Leader. 17(4), 325-330.  https://doi.org/10.1016/j.mnl.2019.05.00

 

 

Reynolds, A. (2009). Patient-centered care. Radiol Technol. 81(2) 133-147.

 

Smith, M.J. & Liehr, P.R. (2018) Middle Range Theory for Nursing, 4th ed. ProQuest Ebook Central,

http://ebookcentral.proquest.com

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