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Biological bases of behaviour
Biological basis of behavior
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The Theory of Planned Behaviour: Nurses' Attitudes towards Older Patients
ABSTRACT
The Theory of Planned Behaviour was tested in a study for its ability to predict intention to behave in specific ways towards older patients. There were 172 subjects from 3 Scottish universities, Napier, Edinburgh and Abertay Dundee. The results gained from a questionnaire suggest that the Theory of Planned behaviour can be used to predict behavioural intentions of nurses when working with older patients. Nurses’ intention to behave was predicted by their attitudes mostly, perceived behavioural control also carried a significant beta weight although social norms were found to be non– significant. The underlying beliefs of attitudes, subjective norms and perceived behavioural controls were also investigated in terms of expectancy value models. Nurses with positive attitudes towards older patients were found to hold patient orientated values, and job satisfaction, more important than other relevant values. Nurses are also more motivated to comply with senior staff that may share their positive attitudes also. One consequence of the present findings is that greater levels of support by senior staff and ways of increasing job satisfaction will improve the levels of care and treatment for older patients.
Introduction
Last year, for the first time ever, the developed countries of the world had more people aged 60 and over than youths aged 14 and under. For the world as a whole, the same will be true by the year 2043. The percentage proportion of older people in Western Europe is predicted to increase by 14.8%, 8.8 in Japan and 2.7% in the U.S.(U.S Census bureau).
Two major forces drive the shift in age distribution. First, birth rates are declining in most parts of the world, but especially in the industrialized nations. and second, life expectancy is increasing almost everywhere. The U.K is a prime example of this phenomenon. In 1999 16 % of the population was 65 and over (DOH 1999). With the advent of new medicine and treatment for more and more illnesses and diseases the trend will increase. The implications of a human population that is both growing and aging are numerous and worrying. Advances in medical science, nutrition and fitness, and even bioengineering point to the day when many human beings will have the option of living well past the age of 100 (CSIS gl...
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...ch in health care has often over looked these variables. Certainly the high level of interpersonal care and contact in nurses day-to-day work is directly influenced by the nurses own self identity (Farley, Lehmann and Ryan 1981), so therefore attitudes are expected to be significantly predictive of behavioural intentions. Perceived behavioural control has been shown to be of greatest influence when a person has previous experience and knowledge of the target behaviour and environment ( Bentler & Speckart,1979; Fredricks & Dossett, 1983; Manstead et al. 1983). Gerontology is a large specialist field in healthcare and a large proportion of nursing education from the outset of 1st year training. The theory of planned behaviour offers a better architecture in which to incorporate these influencing factors.
Hypotheses
H1 = The theory of Planned Behaviour can be used to predict Nurses’ intentions to behave towards elderly people.
H2 = Behavioural beliefs and evaluations directly correlate with attitudes.
H3 = Normative beliefs and evaluations directly correlate with subjective norms.
H4 = Control beliefs and control power directly correlate with perceived behavioural controls.
I find The Behavioral model similar to the hospice philosophy, in which the focus is on holistic care. Johnson's model is influenced by the biological, psychological and social factors and focuses on the needs that are common to people. Therefore, the importance to maintain and restore the balance in stressful situations can be challenging! The model's subsystems, structural and functional components all integrate enabling the nurse to understand the patient's behavior. As an example, some dying patients will present hostility and resentment toward nurses and doctors. Then, it is obvious to understand that these dying patients are displacing a defense mechanism as a protection for the fears that they cannot express.
Jacobsen, L. A., Kent, M., Lee, M., & Mather, M. (2001). America's aging population. Population Bulletin, 66(1).
Reynolds, W., & Cormack, D. (1991). An evaluation of the johnson behavioural system model of nursing. Journal of Advanced Nursing, (16), 1122-1130.
An aging population is indeed a problem for the society and will possibly cause many social and economic difficulties in the future. According to David Foot (2003), professor of Economics at University of Toronto, an effective birth rate of 2.2% against current 1.75% will be necessary to replace the current work force in the near future and the government’s policy of bringing in more immigrants will eventually fail (Foot, 2003, 2). However some people predict that the increased size of an aging population will drive growth in the home, health care, and many other industries resulting in job creation and economic growth (Marketwire, 2013, 1). Majority of the people are of the opinion that the issue will be mainly in the health care and economic activity. As humans age, they start to develop health problems, leading to more visits to a medical clinic putting extra burden on health care system.
In order to be effective as a health care educator, a basic knowledge and understanding of health behavior theories is crucial to working with patients, students and colleagues alike. Theories help the advanced practice registered nurse (APRN) to assess the basic educational needs of the client and develop interventions to address those needs. The behavioral and social sciences have contributed much to the development of health behavior theories. (O'Connell, p. 33). Several models will be discussed here.
Choose a caring theory or nurse-patient relationship theory. Provide an overview of the selected theory.
Due to an ageing population , The Francis Report recommends the introduction of a new status of nurse, the “registered older persons nurse”. One of the illnesses linked in with this is dementia, and multiple factors relating to dementia are having an impact on how nurses are trained and their deliverance of services. In 2013, the Royal College of Nursing (RCN) began a new development program to transform dementia care for hospitals. There aim is to develop skills and knowledge related to dementia, the roles of all those who are involved, understanding the development of action plans that identify key changes.
workers (Weston, 2006). They value participative management, personal growth, and recognition in the work place (Murray, 2013, p. 38). Baby Boomer nurses view professionalism in nursing as an important aspect (Murray, 2013, p. 38). They are driven to succeed, willing to work long hours and they are good team players (Murray, 2013, p. 38). They are committed to their place of employment and enjoy meaningful work (Murray, 2013, p. 38). Boomers are often judgmental of those who see things differently, overly sensitive to feedback, uncomfortable with conflict (Murray, 2013, p. 38). Furthermore, they believe new staff members should pay their dues before moving up the career ladder (Murray, 2013, p.
I believe people are connected beings with fundamental pride and values. To appropriately care for a person, the patient must be considered as a whole package. In order to do this, the person’s physical, social, psychological, cultural, spiritual, and aspects of their life must be considered when creating a plan of care. Environment can be defined as “the aggregate of surrounding things, conditions, or influences; surrounding and the social and cultural forces that shape the life of a person or a population,” (n.d.). A person’s environment is such a large part of their life and such an influencing factor on their day-to-day decisions. Their environment includes their socio-economic status (can they afford their prescriptions? Is the test that’s being run really necessary or an undue burden on them financially?), demographics (what is their understanding of health? What are their religious beliefs? what are their race/are they more susceptible to certain conditions?), access of to health care (do they drive/have transportation? Do they have health insurance?), and social support (are they alone? Do they have too much support with too many opinions?). As a nurse, one must always know a person is in continuous contact with their environment and the stress that come along with it. An appropriate and relaxing environment can impact a patient’s adherence to their medications and treatments and reduce their recovery time. The third concept on which I based my philosophy is health, which is the absence of illness. As a nurse and/or practitioner, it is important to focus on the patient’s main health complaint as well as any associated symptoms, needs, and overall wellness of the patient. Nursing is the promotion, deterrence of sickness and harm, protection, optimization of wellbeing and abilities; and advocacy in the care of individuals, populations, communities,
When nurses were first began their careers, there was not as much writing. The work that the nurses completed was private care work. Therefore it was their decisions on how to handle the matters. After worl...
My philosophy of nursing is based on Erickson’s Theory of Modeling and Role-Modeling, which allows me to incorporate the patients’ needs into my plan of care. In order to have an effective and thorough plan of care, I must take the time to get to know the patient. Once I have built a rapport and trusting relationship, I can help meet the patients’ needs by implementing a plan of care with reachable goals. These reachable goals will be set and agreed upon by the nurse and patient. Not only is it important for the nurse and patient to establish individualized reachable goals, but it is important for the nurse to also have goals. The nurse may have personal and professional goals. My goals are to continually find, propose, and implement ways to make the
An important step to decrease an ageist attitude is to take a step back and recognize biases and preconceived ideas that one has about older adults (DeBrew, 2015). Recognizing biases in combination with furthering one’s education about the effects of aging and the specific needs of older adults will help increase compassionate care. To allow for effective interventions it is important that the nurse understand that illness and infection manifest differently in older adults than they do in the younger population (DeBrew, 2015). In addition, through ethnographic study it was found that when nurses spend time doing activities with older adults it helps strengthen relationships and sense of community between care providers and elderly patients (DeBrew, 2015). According to the article, “occupational therapists who worked with older adults felt ‘stigmatized’ by their peers because their work was viewed as less challenging and requiring less skill and intellect than caring for other populations” (DeBrew, 2015). To promote compassionate patient care it is important that nurses and other professionals get support from their peers to confirm that their work is not insignificant and looked down upon. Finally, include the older adult while creating the plan of care to show them that they are a valued part of their healthcare
The theory is complex throughout as four concepts, seven assumptions, and ten curative factors are discussed. The theory tends to describe multiple concepts, assumptions, and factors. The theory also predicts that these concepts, and factors impact the relationship of caring and need for a healthier behavior.
The first factor, Formation of a Humanistic Altruistic System of Values, is defined as satisfaction through giving and extension of the sense of self. Next, Instillation of Faith-Hope facilitates the promotion of holistic nursing care and positive health within the patient population (Jesse & Alligood, 2014). Third, Cultivation of Sensitivity to Self and Others expresses “the recognition of feelings leads to self-actualization through self-acceptance for both the nurse and patient” (Jesse & Alligood, 2014, p. 83). The Development of a Helping-Trust Relationship factor promotes and accepts the expression of both positive and negative feelings and involves congruence, empathy, non-possessive warmth, and effective communication. The fifth concept, Promotion and Acceptance of the Expression of Positive and Negative Feelings explains that the nurse must be prepared for either one and identify that intellectual and emotional understandings of a situation differ. Systematic use of the Scientific Problem-Solving Method for Decision Making brings a scientific problem-solving approach to nursing care dissipating the nurse as the doctor’s handmaiden image (Jesse & Alligood, 2014). The seventh concept, Promotion of Interpersonal Teaching-Learning, separates caring from curing and “allows the patient to be informed and shifts responsibility for wellness and health to the patient”
King, I. M. (1971). Toward a theory for nursing; general concepts of human behavior. New York: Wiley.