Paper Example on Stress: Potential Middle-Range Theory

The nursing profession is fulfilling but the work environment and requirements can be stressing for the nurse. Stress is the bodys response to internal and external demanding situations in an attempt to cope. Excess and persistent stressful conditions may render a nurse vulnerable to burnouts. Burnouts manifest in the form of emotional exhaustion, loss of interest in personal goals and loosing a sense of accomplishment and depersonalization. For the nursing profession, stress and burnouts prove to be futile for both the patients and the practitioner (Gomez-Urquiza, Vargas, De la Fuente, Fernandez-Castillo, & Canadas-De la Fuente, 2016). Nurses who work at the bedside are exposed to a high-stress environment and are compelled to spend a considerable amount of time walking around the wards to offer assistance with medications, and toileting. The emotional impact of the job can be intense and exhausting as well. Given the nature of stress impacts, various studies have been carried out in the field and composed theories that propose mechanisms of coping with stress.

The middle range theories offer a pool of solutions to the challenge of stressed nurses. Among these theories is the Neumans Model Theory. The theory takes environmental factors into consideration targeting to examine how these factors increase or decrease stress. Research carried out using Neumans theory in an intensive care unit considered highly stressful suggested the use of three level of prevention approach. The approach divided the levels into two organizational and an individual level to enhance effectiveness in reducing stress and burnouts (Gigliotti, 2012). The research proposed to shift attention to the structure of the organization to create a working structure that gives nurses realistic patient care duties. This way, the structure will enhance job satisfaction and help nurses manage stress better. At the individual level, nurses should pay attention to personal stressors, triggers and signs that indicate stress is setting in.

The History of The Borrowed Theory's Origins

Borrowed theory were introduced into nursing by the disciplines habitual borrowing of knowledge, theoretical concepts and procedures advanced in other fields advanced in other fields and applying the theories to guide providence of nursing health care. Often researchers argue that borrowed theories should be examined first to determine if they fit in nursing specialty or not.

Borrowed theory formed a basis for theory development in nursing as researchers attempted to adjust the theories to fit the nursing practice. In their work, Johnson and Webber (2015) refer to the borrowed theory as supporting theory arguing that the borrowed concepts form an integral part as the basis for nursing theories (Maruyama, Suzuki, & Takayama, 2015).

In the development of nursing as an independent discipline, researchers have noted that there is not much progress recorded before 1950s except the notes written by Nightingale (Gigliotti, 2012). The work was an attempt to develop a nursing specific theory and focused on four metaparadigm concepts in nursing. However, the work didnt cover all phenomena present in nursing. To complement the deficiencies nurses used theories developed from other fields and customized them to serve nursing needs. The basic foundation of the borrowed theories was used to develop concepts and definitions during the development of nursing specific theories. As such many of the theories used to guide nursing practice were not regionally developed for the nursing profession. Practitioners and academicians have in the nursing field have been noticed to widely use borrowed theory to inform and guide their research and nursing dissertations. Some of the most common theories borrowed from other disciplines include; general adaptation theory, stress and coping theory, developmental theories, the health belief model and social cognitive theories. This paper will examine the use of health belief model ot manage stress in nursing.

The Health Belief Model

Among the borrowed theories mostly used in nursing, the researcher settled on using the health belief model to treat stress and its effects on nurses. The health belief model is usually used by practitioners to help patients get better and improve the quality of care they accord them. The Health Belief Model was developed in the 1950s in the field of sociology.

As shown in the figure above, the model is structured such that the persons perceived susceptibility or seriousness of the illness directly influence how a person apprehends or perceives the threat of the disease. The level of seriousness accorded to the perceived threat direct determine the likelihood that a person will change their behaviors. However other factors influence the perception of the threat(disease). These factors include age, sex, ethnicity, personality, level of knowledge of the persons and socio-economic status. These factors also impact how the person perceives the benefits versus the barriers, and they determine whether or not a person will seek medical attention. At the same time, the symptoms which are also referred to as the cues to action. Cues to action may come from the media, education, and individuals boy changes that prompt one to seek medical attention.

A Description of The Health Belief Model and Its Applicability to Stress Management in General

The theory operates under the principle that if a person can apprehend the level of susceptibility they have to a health problem and understand the severity of the consequences, such a person is more inclined to seek medical attention and have measures that will overcome the barriers that would hinder them from seeking professional attention. The concept is relevant and has been incorporated into the nursing profession. The health belief model is a crucial tool in nursing as it offers a theoretical framework that helps with management of stress among patients who suffer from chronic illnesses or other diseases whose management and appropriate behavior change would change the quality of life.

Nurses apply the model such that patients get clarifications that their behavior and health practices pose a threat to their wellbeing. The nurse urges such patients to make changes by using strategies that influence patients to effect these changes in their lifestyle. The model highlights that levels of stress can be influenced by sex, personality, and age. For instance, the model may be effective in the change process of a patient who is overweight, diabetic and eat a lot of over processed foods rich in sodium. Enlightening such a patient of the risk, they are putting their lives in and about the consequences using the health belief model will help them see the need to change their lifestyle behavior and adapt more health-seeking behaviors.

How the Health Belief Model Has Been Applied Previously in The Nursing Profession

Scientists developed this theory to aid their research and understanding of the dynamics surrounding the tuberculosis menace. Researchers hoped to understand why the tuberculosis campaign had such subtle response as only a handful were presenting themselves for screening. The theory helped the researcher establish that people were not aware of the symptoms associated with tuberculosis and neither did they apprehend the risk they exposed themselves to or the intensity of their susceptibility to contracting tuberculosis (Yao, Yao, Wang, Li, & Lan, 2013). The theory helped determine the cause of low turnout for TB screening. The uninformed perception of the patients was a barrier to tuberculosis screening because people felt that the work was too much. Since they didnt recognize the risk or susceptibility, the workload of seeking screening services didnt match the perceived benefits of accessing treatment in time in case one was infected with tuberculosis. The theory is used to aid treatment with other patients too including those who suffer from terminal illnesses. It provokes patients to adopt behaviors that are healthier.

The Application of The Health Belief Model for Nurses

Nurses are usually exposed to stress due to their work environment, and sometimes working arrangements. The health belief model can be applied to nurses as an intervention framework that would help curb stress in the profession. The mode of application of the health belief model should follow a protocol similar to that used with patients. Nurses are usually conditioned to be selfless because the profession is very demanding. Often most regard their personal needs as secondary to those of the patients (Maruyama, Suzuki, & Takayama, 2015). The model should focus on articulating to the nurses that lack of personal time to rest and pursue their interests is detrimental to their health, personal development as well as to the patients. The caring profession requires that a caregiver is healthy in all aspects of their lives to be in a position to extend care. Nurses should be taught to appreciate their role in healthcare as the most important and hence the acute need to have nurses in a healthy state.

When nurses appreciate that their role is threatened if they are not in a healthy state, it is more likely that they will be motivated to adjust their caregiving behaviors to reduce and manage stress levels. At the management level, the organizations will apprehend the role of nurses better and understand that nurses are bound to perform exceptionally when they are operating in a healthy state of balance (Yao, Yao, Wang, Li, & Lan, 2013.

Nurses should also learn to observe themselves to establish cues to actions. For different people, the symptoms may differ ranging from loss of interest in work to psychosomatic illnesses (Quaranta & Spencer, 2015). When one traces these changes, they should commit to refreshing themselves in ways that best work for them. The management should also consider hiring more nurses to distribute the workload and ensure that every nurse is tasked with the manageable workload.

How the organizations practice would change by incorporating the health belief model

Incorporating the health model as a conceptual framework for managing stress in nursing would be an effective way to improve performance in the organization. Having nurses who are intrinsically motivated would imply an increase in job satisfaction, more commitment, and better care services for the patients (Ward, 2011). However, to incorporate this model fully, the management would have to adjust its operations including commiseration of hiring more nurses, adjusting working hours and schedules for nurses and facilitating periodic talks in the institution to better condition nurses under the health belief model and its conceptual assumptions.

Application of both the borrowed theory and the middle-range theory integrated to create the most appropriate solution to stressing nursing

Application of both the health belief model and Neumans Model Theory would further improve the effects of stress for nurses. The health belief model advocates for a systematic change in behavior from unhealthy behaviors to more health-seeking behaviors. The theory believes that it is personal behaviors that complicate health issues and that these behaviors have the potential to improve the state of health. Neumans Model Theory takes environmental factors into consideration targeting to examine how these factors increase or decrease stress. The model suggests the use of three level of prevention approach. The approach divides the levels into two organizational and an individual level to enhance effectiveness in reducing stress and burnouts. Integrating the two models would...