Mary Hefferan Ferris State University Objectives Overview of the theory Metaparadigm concepts Person environment health and nursing as defined by theory Brief analysis Basic concepts and description of components ID: 433654
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Slide1
Theory of Unpleasant Symptoms
Mary HefferanFerris State UniversitySlide2
Objectives
Overview of the theoryMetaparadigm concepts
Person, environment, health, and nursing as defined by theory
Brief analysis
Basic concepts and description of components Slide3
Objectives
Exploration of theory through research
Description of research article
How the theory is reflected in research
What the theory adds to the study
Application to nursing practice
Importance of theory to nursing practice Slide4
Overview
Theory of Unpleasant SymptomsCreated by Elizabeth Lenz and Linda Pugh in 1995
Objective is to “integrate existing knowledge about a variety of symptoms”
(Lenz, Pugh, Milligan, Gift, &
Suppe, 1997, p. 14)
Improve understanding of the experience of symptoms in various contexts
Three major concepts:
The actual symptoms
Influencing factors
Performance outcomesSlide5
Metaparadigm Concepts: Defined by the Theory
Person: the patient who is exhibiting the symptoms and to whom the nurse is giving care
May also include family and/or friends
Environment
: where the care is taking place and situational factors that contribute to the symptom experienceEmployment status, marital status, social support, access to health careSlide6
Metaparadigm Concepts: Defined by the Theory
Health: absence of unpleasant symptoms
Symptoms are: “perceived indicators of change in normal functioning as experienced by patients”
(Lenz, Pugh, Milligan, Gift, &
Suppe
, 1997, p. 14
)
Nursing
: care taker and evaluator of symptoms and contributing factors
Establishes a relationship with the patient to better evaluate symptomsSlide7
Analysis of the Theory of Unpleasant Symptoms
Three Major Concepts: Symptoms, influencing factors, and performance outcomes
1. The symptoms:
Change in normal functioning
More often occur simultaneouslyMultiple symptoms occurring together results in a multiplying effect
Measured by their intensity, timing, and level of distress perceivedSlide8
Analysis of the Theory of Unpleasant Symptoms
Influencing factors: Physiological, psychological, and situational Influence the symptoms alone or in concurrence
Performance outcomes:
Results of the symptom experience
Impact on ability to perform activities of daily livingSlide9
Theory in Research
Application of the Theory of Unpleasant Symptoms (TOUS) in Bariatric SurgeryUses the TOUS during the management of patient post bariatric surgery
Case study of a 29 year old woman post bariatric surgery
Explored how the influencing factors affected her post-op outcomes
Showed that her situational factors contributed greatly to her overall healthSlide10
Theory in Research
TOUS in ApplicationEvaluated the factors
Physiological
Dehydration, malnutrition
Gastrointestinal
dysmotility
Psychological
Adjustment to dietary changes
Situational
Lack of social support, work stressors, finances
In concurrence prolonged her recovery periodSlide11
Source: https
://fsulearn.ferris.edu/courses/1/XLIST_81147.201308/groups/_10477_1//_492347_1/Theory%20of%20unpleasant%20symptoms%20bariatric%20surgery.pdfSlide12
Theory in Research
Differences the TOUS Made
Created a framework for the evaluation of symptoms and their contributing factors
Helped in the approach to alleviating her unpleasant symptoms
Created a new method for treating symptoms rather than medication or hospitalizationSlide13
Theory in Research
Differences the TOUS Made
Once the factors were addressed
Symptoms improved
Assessment of entire pictureCreated awareness to approach willingness to change
“Understanding where patients are in their willingness to change those factors…will assist clinician in understanding expectations and moving patients to healthier levels of recovery” (
Tyler, R., & Pugh, C. L
., 2009, p. 276
)
Manages expectations of health outcomesSlide14
Use in Practice
Neonatal N
ursing Environment
Evaluation of family impact on health outcomes
Nervousness, uncomfortable with their babyCould have a negative physiological impact
Aids nurse with appropriate interventionsSlide15
Use in Practice
Neonatal Nursing Environment
Manages
expectations
of outcomesLess social support may change health outcomes
Guides appropriate creation of goals
Allows for a different perspective on assessing symptoms
“Symptom clusters”
Catalyzing effect of symptomsSlide16
Source: http
://rnspeak.com/fundamentals-of-nursing/what-is-a-nursing-theory/Slide17
Importance to Nursing
Nurses assess and approach symptoms differently than other members of the healthcare fieldHolistic approach
Guides nurse-patient interactions
View patients in
an interactive-integrative view versus isolated cause effect health interactionsSlide18
Importance to Nursing
Broad but focused theoryCan be used as a base for designing interventions
Uses subjective symptom experience data
Creates connections between social environments and symptom experienceSlide19
References
1, Haworth, K. S., & Dluhy
, M. N. (2001). Holistic symptom management: Modeling the interaction phase.
Journal of Advanced Nursing 36
(2), 302-310. Retrieved from: http://0-onlinelibrary.wiley.com.libcat.ferris.edu/doi/10.1046/j.1365-2648.2001.01972.x/pdf
2. Lenz, R. E., Pugh, L., Milligan, A. R., Gift, A.,
Suppe
, F. (1997). The middle range theory of unpleasant symptoms: An update.
Advances in Nursing Science, 19
(3), 14-27. Retrieved from: http://0-ovidsp.tx.ovid.com.libcat.ferris.edu/sp-3.10.0b/ovidweb.cgi
3
.
Liehr
, P. (2005). Looking at symptoms with a middle-range theory lens.
Advance Studies in Nursing, 3
(5), 152-157.
Retrieved from: http://
www.snjourney.com/PDFs/asin_3_5_p152_157.pdf
4.
Tourville
, C., & Ingalls, K. (2003). The living tree of nursing theories.
Nursing Forum, 38
(3), 21-36.
Retrieved
from: http
://ferris.libguides.com/er.php?ecid=9581
5
. Tyler, R., & Pugh, C. L. (2009). Application of the theory of unpleasant symptoms in bariatric surgery.
Bariatric Nursing and Surgical Patient Care. 4
(4), 271-276.
d
oi
: 10.1089/bar.2009.9953