Summary: A theory can be used to guide practice. This assignment is an exercise in supporting a clinical practice with theory and evidence.
Directions: Identify an outcome of nursing practice in your area of practice that can be improved. For example, if you work in home health, you may identify that throw rug use by fall risk patients is too prevalent. You may be able to use the problem that inspired the theory concepts that you developed in week two. Identify the concept in Watson’s Theory of Caring that could represent or include the outcome. In our example, the outcome would be the changes in self through the change in the patient’s floor covering practice. Identify a practice that can be changed or implemented that may influence the outcome. Identify the concept in Watson’s Theory of Caring that includes the practice. In our example, the practice could be to improve the understanding of fall hazards through the engagement in a teaching-learning experience, one of Watson’s Caritas Processes. Identify exactly how these two concepts will be measured with their operational definitions. Develop a proposition between the two. Present your outcome in an APA formatted paper meeting the University’s standards for a written assignment.
Expectations: Length: 5 to 7 pages including title and reference pages
References: 5 to 10. There should be enough to support the links between the concepts of the problem and the concepts of Watson’s Theory of Caring.
Nursing Practice area: PLEASE USE EMERGENCY DEPARTMENT as the area of practice NOT home health
This is what I wrote in a discussion previously in class, the professor said we could use this concept for the paper.
Working in the Emergency Department (ED), I see many patients throughout my shift that come in for chest pain. Very few of them are having chest pain due to a cardiac-related event. Most of them are having chest pain due to psychosocial stressors. My theory is that psychosocial stress increases the risk of developing cardiovascular disease. Psychosocial stress (Concept A) is associated with (Proposition) increased risk of developing cardiovascular diseases (CVDs) (Concept B).
The concept of psychosocial stress refers to the mental and emotional stresses due to social and environmental factors, such as work and family life. Psychosocial factors, such as stress, adversity, socioeconomic status, depression, and anxiety, are associated with overall health and with cardiovascular health in particular (Peterson, 2020). Everyday emotional stress seems to be a common occurrence. For example, American adults report negative stressful occurrences on at least 40% of days (Zawadzki, et al., 2019; Marcusson-Clavertz, et al., 2022).
The World Health Organization defines CVDs as a group of disorders of the heart and blood vessels (World Health Organization, 2021). According to the World Health Organization 8.9 million deaths are attributed to ischemic heart disease (IHD), the world’s leading cause of death, in 2019 (World Health Organization, n.d.).
The proposition between the two concepts is that psychosocial stress can increase the risk of developing cardiovascular diseases or worsening current cardiovascular condition. Current literature supports this relationship, with studies showing that psychosocial stress has been linked to higher levels of inflammation and stress, which can lead to the development/and or increase of cardiovascular diseases. Psychological distress, including depression, anxiety, and perceived stress, is not only prevalent among CHD patients, but it also predicts adverse clinical outcomes (Shen, et al., 2019).
After performing cardiac workups on patients that complained about chest pain in the ED, most test results come back negative. Therefore, many patients are left feeling confused as to why they are experiencing chest discomfort. The providers and nurses then educate the patients about how certain psychosocial stressors can become triggers and make our bodies raise cortisol levels, make us feel chest discomfort, lose sleep, etc. Furthermore, educating the patients on healthy coping mechanisms can help reduce stress and prevent further visits to the ED and reduce CVDs.
References
Dulin, A. J., Park, J. W., Scarpaci, M. M., Dionne, L. A., Sims, M., Needham, B. L., Fava, J. L., Eaton, C. B., Kanaya, A. M., Kandula, N. R., Loucks, E. B., & Howe, C. J. (2022). Examining relationships between perceived neighborhood social cohesion and ideal cardiovascular health and whether psychosocial stressors modify observed relationships among JHS, MESA, and MASALA participants. BMC Public Health, 22(1), 1–11. https://doi- org.usu.idm.oclc.org/10.1186/s12889-022-14270-x
(n.d.). Global Health Estimates: Life expectancy and leading causes of death and disability [Review of Global Health Estimates: Life expectancy and leading causes of death and disability]. World Health Organization. Retrieved April 5, 2023, from https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates
Peterson, P. N. (2020). JAHA Spotlight on Psychosocial Factors and Cardiovascular Disease. Journal of the American Heart Association. https://doi.org/10.1161/jaha.120.017112
Marcusson-Clavertz, D., Sliwinski, M. J., Buxton, O. M., Kim, J., Almeida, D. M., & Smyth, J. M. (2022). Relationships between daily stress responses in everyday life and nightly sleep. Journal of Behavioral Medicine, 45(4), 518–532. https://doi- org.usu.idm.oclc.org/10.1007/s10865-021-00281-3
Shen, B.-J., Fan, Y., Lim, K. S. C., & Tay, H. Y. (2019). Depression, Anxiety, Perceived Stress, and Their Changes Predict Greater Decline in Physical Health Functioning over 12 Months Among Patients with Coronary Heart Disease. International Journal of Behavioral Medicine, 26(4), 352–364. https://doi- org.usu.idm.oclc.org/10.1007/s12529-019-09794-3
World Health Organization. (2021, June 11). Cardiovascular Diseases. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
