Introduction
This presentation has been developed to meet the following objectives:
- Explore a current clinical practice problem in mental health nursing
- Analyze a middle-range nursing theory pertaining to the mental health field
- Apply the theory’s concepts to the practice problem
Problem Statement
Practice problem of interest:
- Stigma and internalized stigma of mental illness within ethnic and racial minority communities
- The intersectional impact: stigma – ethnicity status, migration, socio-economic conditions (Eylem et al., 2020; Memon et al., 2016)
- Effects on nursing care: barriers to seeking treatment, refusals to take medications, internalization of harmful stereotypes (Eylem et al., 2020; Memon et al., 2016)
Purpose Statement
Purpose: Applying Swanson’s theory of caring and healing to identify prerequisites to well-being in minority clients with mental disorders will assist nurses in developing strategies to prevent stigma from affecting patient care and outcomes
Kristen Swanson’s Theory of Caring and Healing: Background
- A middle-range theory developed in the 1990s
- Mental health nursing and patients with traumatic experiences (pregnancy issues, miscarriage, mental disease, nursing education, etc.)
- Swanson outlines caring as a sequence of five distinct categories, ranging from appropriate beliefs to actions (Mårtensson et al., 2020)
Kristen Swanson’s Theory: Key Components
- Caring
- Maintaining belief (offering a “hope-filled attitude” or “realistic optimism”) (Mårtensson et al., 2020, p. 2)
- Knowing (avoiding assumptions, centering on the person, seeking cues)
- Being with (conveying availability, sharing feelings)
- Doing for (protecting, preserving dignity)
- Enabling (supporting, explaining, giving feedback) (Mårtensson et al., 2020)
- Client’s well-being
Conclusion
Swanson’s theory of caring and healing can inform the creation of anti-stigma caring strategies.
Strengths:
- Adaptability to patients’ unique educational and care needs
- Addressing stigma-inducing beliefs in care providers and vulnerable clients
References
Campbell, R. D., & Mowbray, O. (2016). The stigma of depression: Black American experiences. Journal of Ethnic & Cultural Diversity in Social Work, 25(4), 253-269.
Eylem, O., de Wit, L., van Straten, A., Steubl, L., Melissourgaki, Z., Danısman, G. T., de Vries, R., Kerkhof, A. J. F. M., Bhui, K., & Cuijpers, P. (2020). Stigma for common mental disorders in racial minorities and majorities: A systematic review and meta-analysis.BMC Public Health, 20(1), 1-20. Web.
Hammer, J. H., & Toland, M. D. (2017). Internal structure and reliability of the Internalized Stigma of Mental Illness Scale (ISMI-29) and Brief Versions (ISMI-10, ISMI-9) among Americans with depression.Stigma and Health, 2(3), 159-174. Web.
Mårtensson, S., Hodges, E. A., Knutsson, S., Hjelm, C., Broström, A., Swanson, K. M., & Björk, M. (2020). Caring behavior coding scheme based on Swanson’s theory of caring: Development and testing among undergraduate nursing students. Scandinavian Journal of Caring Sciences, 1-11.
Memon, A., Taylor, K., Mohebati, L. M., Sundin, J., Cooper, M., Scanlon, T., & de Visser, R. (2016). Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: A qualitative study in Southeast England. BMJ Open, 6(11), 1-9.