POST 1

Malene

What concepts from the various theories be used in planning the 65-year-old woman’s care?

     According to McEwen & Wills (2019), the Health Belief Model (HBM) model and concepts were early models that predicted health behaviors.  McEwen & Wills (2019) describe HBM originating by psychologists whose aim was to increase preventative services.  HBM also defines how a patient perceives the threat of cancer and how she will manage the threat.  They list concepts that apply to this scenario of this patient-facing surgery of perceived anxiety, perceived susceptibility, and perceived anxiety (McEwen & Wills, 2019).  The patient would be concerned about the mastectomy, the potential difficulties, and what life will be like after the surgery.  A concept of self-esteem is another consideration when planning for the patient’s care in that the patient may have a sense of not being whole after the mastectomy, as described by Maslow’s theory.  The most urgent concepts may be pain control and symptom control after the surgery.  The nurse must assess these before the psychosocial issues can be addressed as these would fall higher on Maslow’s hierarchy of basic needs (McEwen & Wills, 2019).      

How might her care be changed if the woman were 25 years old or 45 years old?

     Maslow’s theory of growth development and self-actualization (McEwen & Wills, 2019) is different for women aged 25 years, 45 years, and 65.  According to McEwen & Wills (2019), Maslow describes B motives and D motives (p. 312) where D motives must be met like the patient’s physical needs over the higher-level needs or B needs of self-esteem and self-actualization.   Also applicable to this scenario is Erikson’s Psychosocial Developmental Theory as each of these women fall into distinct stages of development in their adult years (McEwen & Wills (2019).  This theory is important to nursing practice and approach to patient care and affects treatment outcomes.

How have social psychology theories been used in promoting breast cancer awareness? Provide at least one example to support your response.

     O’Neill et al. (2008) utilized the Theory of Planned Behavior (TPB) as a framework for their study on behavioral intentions to adhere to regular mammogram schedules.  According to the study (O’Neill et al. 2008), the barriers out-weigh motivational factors and are better predictors of whether the participants were adherent to a mammogram schedule. This study and similar ones can help determine the social movement of breast cancer awareness. Using the theory of planned behavior provides conceptual frames for interview questions, qualitative content analyses, and data codebooks, according to O’Neill et al. (2008). The strongest predictor, according to TPB, is the intention and is informed by attitude toward breast cancer awareness, including outcome expectations (McEwen & Wills, 2019 and O’Neill, 2008) and whether their family expects them to comply with mammograms and their control over intentions to the behavior, in this case, going for the mammogram consistently as a responsible preventative health measure.

How have social psychology theories been used in your clinical practice area? Provide at least one example to support your response.

      Hospice care provides high-quality care at the end of life for patients and their families; nevertheless, hospice is underutilized in the United States.  Many patients delay admission and are not knowledgeable about the benefits of hospice care.  As most older adults will qualify for hospice during their lifetime, it is important to evaluate the predictors of their intentions to use hospice before they become terminally ill.  Although hospice offers important benefits, the decision to enroll sometimes requires that patients and their families understand a good amount of information in a short timeframe and under high anxiety conditions. The Theory of Planned Behavior (TPB) was studied by Nahapetyan, L. et al. (2019) and how it relates to the timely admission to hospice care.  They (Nahapetyan 2019) describe that older adults make better-informed decisions if they and their families are informed about hospice before they need it.  The TPB informed the selection of predictors as it proposes that behavioral intention is the most important determinant of behavior and that behavioral intention is determined by positive attitudes toward performing the behavior, subjective norms that support the behavior, and perceived control over the behavior (Nahapetyan, L., et al., 2019

References

McEwen, M., & Wills, E. M. (2019).  Theoretical basis for nursing.  (5th ed.) Philadelphia, PA:

            Wolters Kluwer Health.

O’Neill, S., Bowling, J., Brewer, N. et al. (2008).  Intentions to maintain adherence to

mammography.  Journal of Women’s Health.  17, 7. DOI:10.1089/jwh.2007.0600.

Nahapetyan, L., Orpinas, P., Glass, A., & Song, X. (2019).  Planning ahead:  Using the theory of

planned behavior to predict older adults’ intentions to use hospice if faced with terminal illness. Journal of Applied Gerontology, 38(4), 572–591. https://doi-org.ezp.waldenulibrary.org/10.1177/0733464817690678

Padela, A. I., Vu, M., Muhammad, H., Marfani, F., Mallick, S., Peek, M., & Quinn, M. T.

(2016).  Religious beliefs and mammography intention: findings from a qualitative study of a diverse group of American Muslim women.  Psycho-Oncology, 25(10), 1175–1182. https://doi-org.ezp.waldenulibrary.org/10.1002/pon.4216

Steele, S., & Porche, D. (n.d.). Testing the theory of planned behavior to predict mammography

 intention.  NURSING RESEARCH, 54(5), 332–338.

POST 2

Natalia

• What concepts from the various theories could be used in planning the 65-year-old woman’s care?

The 65-year-old woman undergoing a mastectomy is in the middle of the crisis. Her health care needs can be viewed through the Social Construction of the Illness theory described by Conrad and Barker (2010). According to this theory, a medical provider diagnoses the disease, but a patient creates a social meaning of the condition and creates an illness. Therefore, one of the most critical intervention is to evaluate the meaning of breast cancer and mastectomy for this patient. Nurses cannot assume that the patient will suffer from disturbed body image because they usually do. Some of the breast cancer patients are trading their body part (breast) for the freedom of the disease and feel empowered by doing so.

Furthermore, the patient will be engaging in the identity reconstruction going from being a cancer patient to a cancer survivor (Conrad & Barker, 2010). It may help facilitate this transition by educating the patient about available community support and activities they do. For example, sharing information about the fight against breast cancer powered by actual survivors may create hope and a new meaning of life for the patient.  Furthermore, the nurses can use Social-Ecological Theory by developing a model of an individual within a series of contextual systems (McEwin & Wills, 2019, p.277). By visualizing herself in the macrosystem center, the patient can feel more connected and responsible for the whole. Finally, the Social Network theory can be used to map a network pattern for the patient and evaluate the strengths and weaknesses of the available connections (McEwin & Wills, 2019, p.279).

• How might her care be changed if the woman were 25 years old or 45 years old?

If the woman were of different age, the social meaning of the disease would be different because it depends on the patient’s social role at each stage of her life. It may be helpful to use feminist theory for a younger woman because it highlights a person’s value without attachment to sexual characteristics. It dictates that gender is a social construction and can be alterable (Conrad & Barker, 2010). Therefore, it can empower women to look beyond sexual characteristics and pay more attention to their personal values.      

• How have social psychology theories been used in promoting breast cancer awareness? Provide at least one example to support your response.

Social theories guide the public to change the focus from individual suffering to the public structure that creates or adds to the particular illnesses (Carnegie & Kiger, 2009). In the case of breast cancer, a preventable disease when detected earlier, the communities’ social actions should be directed on the widespread access to the screening and genetic testing of women with a strong family history. For instance, the Critical Social Theory can be used to deal with the unequal access to mammogram screening. Some medical centers developed free screening mammograms during breast cancer awareness month for any women independently of her insurance status or citizenship. Another example is that a woman can undergo a preventive mastectomy by choice if she has BRACA1 and BRACA2 mutations. It can be viewed as an application of Feminist Theory that empowers women to make their own independent decisions about their health and body, disregarding social norms that support women’s oppression ( McEwin & Wills, 2019, p.291). 

• How have social psychology theories been used in your clinical practice area? Provide at least one example to support your response.

One of the social theories that have been applied to my work environment is the General System Theory. Our Reliance Medical Group is a system that includes 11 medical offices, and each office has its structure with an office manager, providers, and medical assistants. The group works according to the Open System Theory Principles as described by McEwin and Wills (2019, p.277). As a result, the group is greater than the sum of its parts (separate offices) and can share the resources and the goals. At the same time, each office works as an autonomous unit with its structure, problems, and accomplishments. The circular causality can be noted when one of the offices closed during the COVID pandemic, so the other office absorbed the patient load, and it created a change in the whole system. Finally, the system uses equifinality and can reach the goals in different ways (McEwin and Wills, 2019, p.277). For instance, one office can increase the patients’ volume to improve profit; another office can add different services and improve profit. Finally, the whole organization’s mission to provide accessible care for all is shared between the offices.      

Resources:

Carnegie, E., & Kiger, A. (2009). Being and doing politics: An outdated model or 21st

century reality? Journal of Advanced Nursing, 65(9), 1976–1984. doi:

10.1111/j.1365-2648.2009.05084.x

Conrad, P., & Barker, K. (2010). The social construction of illness: Key Insights and policy implications. Journal of Health and Social Behavior: Special Issue, 51, S67–S79. doi: 10.1177/0022146510383495

McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Philadelphia, PA: Wolters Kluwer Health.