To offer effective and patient-oriented practice, nursing professionals should develop an extensive understanding of theories at the various levels of abstraction. One case that highlights the importance of this knowledge refers to a 65-year-old patient’s adverse emotional reactions to the news regarding the need for a mastectomy. This discussion is aimed at analyzing nursing and social psychology theories’ applications to hypothetical cases and exemplifying their uses in managing mental health patients.
The Case and Theoretical Concepts
Multiple theoretical concepts might be helpful in planning the elderly cancer patient’s care. In the case, “fear and depression” during nursing diagnostic interventions present critical barriers to effective collaboration (McEwen & Wills, 2019, p. 309). Along with stress and coping mechanisms, these concepts can inform care planning. Particularly, the transactional model of stress conceptualizes coping as the combination of behavioral and cognitive responses to reduce internal/external stress factors (Gieselmann et al., 2020). The model’s application to care planning would require professionals to regard the woman’s immediate adverse emotional reactions as the primary appraisal of the heartbreaking news. It would be essential to assess the client’s history, life circumstances, and psychological condition to determine inner resources that would provide the basis for coping strategies, thus reducing the risks of post-mastectomy grief and even PTSD symptoms and paving the way for adaptation.
Concepts from Roy’s adaptation model, such as adaptive modes and behaviors, could also be applied to the scenario. The self-concept and interdependence adaptive modes would need to be emphasized by means of regular assessments and nursing interventions, ranging from post-operative care to patient education (Baksi & Dicle, 2017). The self-concept mode would be incorporated into care to promote an adequate body image after mastectomy, whereas the interdependence mode would stress interactions and significant social relationships to serve as the sources of psychological support.
Care Planning and Age
The patient’s age could impact the anticipated adverse outcomes, thus changing the priority areas in health promotion. As a young 25-year-old woman, aside from health, the patient would probably be more concerned about the opportunity to breastfeed in the future and the influences of perceived body deconstruction on her sex life and attractiveness for her current/potential partner (Notari et al., 2017). Since satisfying romantic bonds present a protective factor against body image disturbances in young mastectomy survivors, health promotion activities would involve the family/the partner (Notari et al., 2017). Education regarding single mastectomies and opportunities for breastfeeding would also be essential. If the patient was 45, there would probably be additional risk factors, including stress from the temporary inability to care for her family, the fear of reduced career prospects due to skill loss, and the combined detrimental effects of essential age-related changes in the reproductive function and mastectomy. In that situation, patient care would be aimed at promoting holistic health and explaining the various opportunities for breast reconstruction.
Social Psychology Theories and Breast Cancer Awareness
Aimed at understanding interpersonal/intergroup interactions, theoretical perspectives in social psychology, such as signaling theory and the health belief model (HBM), can shed light on approaches to maximizing breast cancer awareness (BCA). Signaling theory posits that signallers (those having access to valuable information) should produce “observable, costly to imitate, and credible” signals to inform recipients and reduce the risks of misinterpretation (Fletcher-Brown et al., 2018, p. 418). In the study by Fletcher-Brown et al. (2018), the theory is applied to explore barriers to BCA in developing economies, such as distrust towards the healthcare sector (perceived credibility), asymmetry in messages and resource distribution, and ineffective targeting strategies. The HBM states that individuals should understand that the absence of symptoms does not eliminate the risks of diseases, and this principle is widely applicable to interventions to raise BCA by promoting breast self-examination behaviors in adult women (Masoudiyekta et al., 2018). For instance, using this model, Masoudiyekta et al. (2018) designed and tested a 4-session population education program (lectures, self-examination modeling, pamphlets on early detection, etc.) in an Iranian city. Thus, both theories find extensive use in BCA-related interventions in culturally diverse populations.
Social Psychology Theories and Adult/Geriatric Mental Health
In my practice area, mental health nursing, the self-affirmation theory has been used to support adult and elderly clients with depression and minimize their tendency to engage in self-stigmatizing and self-deprecating behaviors. The theory posits that maintaining self-integrity is among the vital goals of an individual, and it can be achieved by “reiterating their value in one domain to counter threats from other domains” (Gu et al., 2019, p. 328). In my practice setting, safe leisure time opportunities (yoga classes, art activities, reading, etc.) and self-affirmation interventions (value essays, reflection activities, etc.) are available for inpatients without suicidal ideation and other critical risks. These measures support them in determining and reflecting on their individual strengths and interests, thus reinforcing the belief that the diagnosis does not undermine their value as individuals and the ability to contribute to society after health improvements.
Conclusion
Finally, social psychology and nursing theories play an essential role in determining critical concepts peculiar to care at an individual level. Social psychology theories have tremendous potential for raising disease awareness by pointing to the mechanisms of knowledge generation and dissemination in diverse social contexts. Mental health settings are not an exception, and different concepts, such as self-affirmation, can provide the basis for programs to improve self-image in depression.
References
Baksi, A., & Dicle, A. (2017). Examining the effect of education given by Roy’s adaptation model in patients with primary brain tumors on symptoms and coping with stress. International Journal of Caring Sciences, 10(2), 842-858.
Fletcher-Brown, J., Pereira, V., & Nyadzayo, M. W. (2018). Health marketing in an emerging market: The critical role of signaling theory in breast cancer awareness. Journal of Business Research, 86, 416-434.
Gieselmann, A., Elberich, N., Mathes, J., & Pietrowsky, R. (2020). Nightmare distress revisited: Cognitive appraisal of nightmares according to Lazarus’ transactional model of stress. Journal of Behavior Therapy and Experimental Psychiatry, 68, 1-37.
Gu, R., Yang, J., Yang, Z., Huang, Z., Wu, M., & Cai, H. (2019). Self-affirmation enhances the processing of uncertainty: An event-related potential study. Cognitive, Affective, & Behavioral Neuroscience, 19(2), 327-337.
Masoudiyekta, L., Rezaei-Bayatiyani, H., Dashtbozorgi, B., Gheibizadeh, M., Malehi, A. S., & Moradi, M. (2018). Effect of education based on health belief model on the behavior of breast cancer screening in women. Asia-Pacific Journal of Oncology Nursing, 5(1), 114-120.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer Health.
Notari, S. C., Notari, L., Favez, N., Delaloye, J. F., & Ghisletta, P. (2017). The protective effect of a satisfying romantic relationship on women’s body image after breast cancer: A longitudinal study. Psycho-Oncology, 26(6), 836-842.