The Module on Nurse Scholars in Theory Assignment

Directions

Reflecting on Chapter 10, the models listed on the table in Meleis (Table 10-1, p. 177) (SEE TABLE BELOW AND DESCRIPTION) and the module on Nurse Scholars in Theory  (SEE MODULE BELOW), succinctly evaluate the theory you have selected to present.

THE THEORY I AM PRESENTING IS BY PAO-FENG TSAI AND HER THEORY ON CAREGIVER STRESS.

NEED REFRENCES FROM: The Module on Nurse Scholars in Theory Assignment

“A MIDDLE RANGE THEORY OF CAREGIVER STRESS” BY PAO-FENG TSAI.

“THE RELATIONSHIP BETWEEN DEPRESSION AND OTHER OUTCOMES OF CHRONIC ILLNESS CAREGIVING” BY PAO-FENG TSAI

“IMPROVING THE PROCESS OF PAIN CARE IN NURSING HOMES: A LITERATURE SYNTHESIS” BY SWAFFORD, ET AL.

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Include four paragraphs with the following headings: Theory Description, Analysis, Evaluation, and Development.

• In the description, include and discuss origins, influences, historical context, scope, purpose, main concepts, and structure of the theory.
• In the analysis, include and discuss assumptions, clarity, accessibility, generalizability, context, and importance.
• In the evaluation, include and discuss how the theory can be used to direct general and/or advanced nursing practice and how it contributes to favorable patient and/or family outcomes.
• In the development area, discuss if the theory is testable, its application to research, support for the theory among scholars, and if you feel your theory requires further development, additional research, and/or refinement. The Module on Nurse Scholars in Theory Assignment

Theory Description

• The initial step in the evaluation process
• Works of the theorist are reviewed with a focus on the historical context of the theory
• Related works are examined to gain further understanding

Theory Analysis

• Second phase of the evaluation process
• Refers to a systematic process by objectively examining content, structure, and function of a theory
• Is non-judgmental with the primary aim to understand the theory

Theory Evaluation/Critique

• Also called theory critique
• Final step in the process
• Evaluation follows analysis and assesses the theory’s potential contribution to the discipline’s knowledge base
• How is the theory used to direct nursing practice and does it contribute to favorable outcomes
• The whole theory must be studied as parts of the theory without the whole will not be fully meaningful and may lead to misunderstanding
• Need to consider level and scope of theory The Module on Nurse Scholars in Theory Assignment

The model proposed here considers these trends, draws on many of the previously delineated criteria, and further acknowledges that even when systematic criteria are advanced to ensure objective analysis and critique, objectivity is not guaranteed or required in critiquing theories for one’s use in research or practice. Furthermore, individuals may differ on how they use the critique criteria, and the perceptions of the meaning of each of these criteria may be influenced by individual variations and by context variations. It is also acknowledged here that some criteria may be conflicting; that to enhance simplicity, complexity may suffer; and that to advocate a wider scope, accuracy for deviant cases or opposing situations may be jeopardized and generalization may not be as desirable as it once was. The Module on Nurse Scholars in Theory Assignment

The proposed model defines evaluation as encompassing description, analyses, critique, testing, and support. By using this model, a reviewer acknowledges extant evaluations that have been completed by nurse theorists, researchers, and clinicians, among others. The model is also based philosophically more on a historical view of science than on an empirical view. Therefore, the model proposes to analyze the central questions that are solved by the theory. It considers the background of the theorist in the development of the theory and the sociocultural context of the theory (the theorist’s education, previous work, etc.), the evaluator as an agent for knowledge development, and the discipline’s level of development. In other words, human processes are considered an integral part of theory description, analysis, critique, testing (Laudan, 1977), and support (Meleis, 1995).

Various middle-range theories guide nurses in their clinical practices. Incorporating theories in nursing practice improves the quality of patient care, overall health outcomes, and patient’s quality of life and well-being. This discussion focuses on Pao Feng Tsai’s Caregiver Stress Theory, including a description of the theory, analysis, evaluation, and development.

Tsai derived the Caregiver Stress Theory from the Roy Adaptation Model, which proposes that nursing care primarily aims at promoting patient adaption. This theory was developed following a dramatic increase in perceived stress and depression among caregivers handling chronically ill patients (Tsai et al., 2018). It evaluates relationships among three key factors, including g stimuli, coping mechanisms, and adaptive modes (Tsai et al., 2018). The theory was mainly developed to indicate the relationship between caregivers and their perceived stress and depression. Feng proposes that the burden of caregiving is the most significant factor contributing to perceived caregiver stress and depression (Tsai et al., 2018). Therefore, perceived caregiver stress and depression are caregivers’ coping mechanisms with depression being an immediate outcome of stress. The theory is structured into three parts, including inputs, control process, and output (Tsai et al., 2018). Input includes patient and caregiver stressors that contribute to perceived caregiver stress. They include factors such as stressful life events, social support, and social roles. The control process includes perceiving caregivers’ stress and depression, which are major coping mechanisms among caregivers. Lastly, output, including improved physical functioning, high self-esteem, role enjoyment, and marital satisfaction among caregivers are outcomes of stress coping mechanisms. The Module on Nurse Scholars in Theory Assignment

In the Caregiver Stress Theory, Tsai assumed that the caregiving role exposes all individuals taking care of chronically ill patients to stress. This model did not consider the level of caregiving burden that results in caregivers’ perceived stress and depression. Therefore, this model should be developed further to indicate the level of caregivers’ workload that expose them to stress and depression. However, the model presents the relationship between caregivers’ roles and stress. The objective burden is presented as stimuli or environmental factors that expose caregivers to stress (Tsai et al., 2018). Caregivers experience perceived stress while responding to the stimuli. The context of this theory is accessible since it is published in several scholarly materials, including books and peer-reviewed journal articles. The model’s context can be generalized and can be applied in various nursing disciplines since it focuses on caregivers’ stress and contributing factors in general. The context presented in this theory is important since it captures caregivers’ stress, contributing factors, and coping mechanisms. This theory is important since it enables caregivers, especially those handling chronically ill patients to cope with stress and prevent potential mental health issues such as depression.

The Caregiver Stress Theory illustrates the relationship between caregivers’ burden and perceived stress and depression, and stress-coping strategies. This theory can be applied in the general and/or advanced nursing practice to enable nurses to cope with stress related to their caregivers’ responsibilities. First, caregivers can cope with stress by responding to environmental changes (Tsai, 2003). Caregivers’ perceptions also influence their response to environmental stimuli (Tsai, 2003). Thus, advanced nurse practitioners can cope with work-related stress by responding to environmental changes or perceiving environmental stimuli positively. Managing stress and depression in chronic illness caregiving results in positive health outcomes (Tsai & Jirovec, 2005). Thus, incorporating the Caregiver Stress Theory into advanced nursing practice will result in positive patient and/or family outcomes. The Module on Nurse Scholars in Theory Assignment

The Caregiver Stress Theory is testable. Researchers can conduct studies to evaluate the relationship between caregivers’ workload and perceive stress. During the study, caregivers’ perceived stress can be measured through their physical functioning capacity, self-esteem, and stability of their marriages. Other scholars present The Caregiver Stress Theory as a significant source of support for caregivers dealing with chronically ill patients in different settings. However, I feel that this theory requires further development to specify the extent of workload that expose caregivers to stress. Consequently, stress among caregivers can be prevented by allocating individual caregivers’ workload that does not expose them to stress. The Module on Nurse Scholars in Theory Assignment

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References

Tsai, P. F. (2003). A middle-range theory of caregiver stress. Nursing Science Quarterly, 16(2), 137-145.

Tsai, P. F., & Jirovec, M. M. (2005). The relationships between depression and other outcomes of chronic illness caregiving. BMC nursing, 4(1), 1-10.

Tsai, P. F., Kitch, S., Chang, J. Y., James, G. A., Dubbert, P., Roca, J. V., & Powers, C. H. (2018). Tai chi for posttraumatic stress disorder and chronic musculoskeletal pain: a pilot study. Journal of Holistic Nursing, 36(2), 147-158. The Module on Nurse Scholars in Theory Assignment