Watson's Caring Theory on Postpartum Disorder - Essay Example

?Watson’s Caring Theory in Postpartum Disorder Introduction Nursing theories explain phenomena relating to clinical practice particularly in providing care. It may define or describe concepts, health-related events and propose something about them either by explaining functions, relationships, associations and performance, among other related concepts (Rich, 2011, p.606). The idea is to inform nursing practice and to ensure the best possible care for patients. This paper will explore Jane Watson’s philosophy and science of caring theory. The structure of this paper will begin with the description of the medical condition and is followed by a discussion of the nursing theory and its application. Medical Condition: The Postpartum Disorder The postpartum depression also called as Baby Blues (depending on the severity of the condition) was one of the topics considered for this paper along with other conditions relating to newborn infants. The decision to focus on the disorder stem from the fact that it is quite prevalent but often left untreated or undiagnosed, hence, often misunderstood from the point of view of healthcare providers. Recent statistics show that at least 400,000 women in the United States suffer from postpartum disorder annually and that one in four first time mothers experience the illness (Johnson, 2003, p.141) The problem is that the current system does not have appropriate mechanisms in place that would address the problem immediately, which could aggravate the condition in the process. According to Rosenfield (2006), "after their follow-up gynecologist examination, the only contact most women will have with medical providers during the postpartum year is at their baby's well child examination," and that "the concept of pediatricians screening for postpartum depression has not caught on widely so diagnosis at these visits is unlikely" (p.61). In addition, postpartum symptoms are often considered subclinical, cross-cultural and are associated or misunderstood as other medical and psychological conditions such as "marital dissatisfaction, lack of social support, personality characteristics, family history of depression, and autoimmune thyroid disease" (Cooper, 2007, p.35). So what exactly is postpartum disorder? To illustrate the experience, severity and trends about postpartum disorder, a mother's experience and view is cited below: PPP (postpartum psychosis) was the worse experience of my life... I lost the joy of new motherhood. I lost "me" for the first two years of my daughter's life and even longer to put the pieces together (Twomey, 2009, p.xv). The above account demonstrates the impact of postpartum disorder. This is highlighted by the fact that, for years, the condition has been largely ignored. Today, it is considered and widely known as a mental disease that could endanger the lives of both the mother and the baby. There is no specific or standard definition for postpartum disorder. This is at least true according to the available literature on the subject. There are those who identify the depression experienced by women after giving birth as the basic symptom for the disorder. Out of these, Taeusch et al., (2005) offered a comprehensive definition by explaining that postpartum depression is characterized by "significant distress or impairment in all areas of functioning" that are not medically induced or caused by a loss of a loved one (p.96). Heath further cited that the disorder manifests within 3 to 6 months after giving birth (p.96). Some studies have recorded longer periods such as the previous example cited by Twomey. Postpartum disorder is classified into several types. The classification, which varies according to researcher or expert, is commonly based on the degree of its severity. For the purposes set by this paper, Ahuja's (1999) classification will be used, which categorized postpartum disorder into three. These are: 1) Type I: Postpartum psychosis also known as brief reactive psychosis; 2) Type II: Adjustment reaction with depressed mood (e.g. postpartum blues, maternal blues, or postpartum blues); and, 3) Type III: Postpartum major mood disorder, which includes severe depression, neurosis, and psychosis (p.370). Ahuja cited that the Type I is the most common, occurring in up to 50% of women suffering from the disorder whereas the severe cases of postpartum depression occur in at least 10% of women (p.370). The most severe disorder, according to the study by Taeusch et al., is rare, experienced by 1 to 4 in 1000 postpartum disorder sufferers (p.96). The condition is serious since the patient is supposedly unable to identify what is real from their delirium (Taeusch et al., p.96).The classification of postpartum disorder is especially significant for clinical nurses because it informs and guides the way they interact with postpartum disorder patients and help in the effective treatment. Clinical Nursing Situation Today, the conventional approach to providing nursing care to patients diagnosed with postpartum disorder is pretty straightforward. It is mainly composed of routine activities such as the encouragement and engagement with patients in order to achieve healthy diet, adequate fluid intake and self-care practices that include those about personal hygiene, home remedies as well as physical activities (Andrews and Boyle, 2008, p. 104). Also, there is the recommendation that postpartum disorder should treated outpatient, which means care and support are provided at home. Heath explained that hospital admission could aggravate the condition because it puts strain on the patient and could damage further the relationship between mother and child (Heath, 2005, p. 237). These variables make it particularly hard for nurses to care for the postpartum patients. The situation is delicate and requires knowledge, experience and strategy in approaching service provision. Furthermore, there is now medical technology available that can accurately screen for postpartum disorder as well as systems in place that allows health providers to take action (Twomey, p. xvi). For example, in the United States, an emergent system include the routine screening for depression among the general adult population using a framework that is composed of three core mechanisms: improved detection; increased referral or treatment utilization; and, reduced morbidity (Rosenfield, p. 54). The current trends and systems in place available to nurses are still inadequate especially in the context of care delivery. The tools and frameworks available are mostly structural, providing guidelines and information in regard to approaching care on a general context. For example, a depression disorder detection technology can be employed but its capability could be constrained by a generalized conception of the disorder and might not be effective in individualized setting. This is now the main issue that can be addressed by the Watson’s theory. Caring Theory Jean Watson introduced her landmark theory in nursing back in 1979. It was called the philosophy and science of caring. Essentially, the theory provides nurses deep insights about the nature of caring, hence allowing deep understanding of the concept. This is because caring is supposed as the core element in nursing practice. Dossey and Keegan (2012) characterized the theory as a humanist approach to nursing since the framework focuses on the "professional, personal, scientific, esthetic and ethical human interactions" (p.122). It is clear that Watson considered individuals from a holistic point of view. She stressed that patients and their care should be approached from the perspective that puts greater emphasis on the sum rather than all individual parts (Dossey and Keegan, p.122). This is the rationale behind the concept of holistic care. A combination of elements are found in the framework wherein science and philosophy and humanism are integrated, complementing each other while the paradigm focuses on the person, the environment, health and the profession itself. Central to Watson's philosophy and science of caring are several carative elements that are considered inherent in the provision of appropriate, professional and holistic care. These are characteristics that should typify nurses. Some examples, as cited by Masters (2009), include: kindness and equanimity displayed in the context of caring consciousness; the sustenance of a strong caring belief system; strong religious values, particularly those that lead to being selfless; the capacity for being truly helpful, trusting, loving and supportive (p.50). All in all, there were ten identified carative factors that guide nursing practitioners embrace the philosophy and science of caring. Those that fail to satisfy the carative factors will inevitably become noncaring nurses and would be clueless about transpersonal caring. These professionals have the tendency to feel humiliated, fearful, out of control, desperate, helpless, alienated and worn down (Watson, 2008, p.21). On the one hand, those that apply Watson's theory display a love for nursing and the ability to live out their own philosophy while attaining a sense of satisfaction out of their work (Watson, p. 21). Application There are so many ways by which Watson's theory can be applied in the case of postpartum disorder. Say, a patient would experience severe mood problems and display unreasonable behavior. A novice nurse, or a professional without any knowledge of Watson's theory can fail in this circumstance. A patient could simply refuse to take medication, then, she would accede to an admonition to take a bath or some other task but would not actually do them afterwards. Encouraging to perform other activities such as eating the right diet or performing regular exercises would be even more difficult. Understandably, this situation is frustrating. It does not only involve incredible patience and self-control but also professionalism and knowledge in order to be in control of the situation. Watson's theory allows nurses to have more empathy, caring capabilities and knowledge so that nurses are able to cultivate a personal desire, motivation and commitment to provide care to difficult patients. In the previously cited situation, a nurse could simply give up or, worse, become combative and aggravate the patient’s condition in the process. Practitioners that understand Watson's theory, however, would begin a kind of care based on interpersonal relationship. These professionals could take advantage of caring moments in order to swap stories, exchange ideas, or simply make small talk. As a consequence, the postpartum disorder patient and the carer are able to create a relationship and often, a bond, so that caring becomes collaborative afterwards. The amount of trust gained from this caring condition provides the groundwork for a highly effective and meaningful treatment for postpartum disorder, which often includes an input from the patient herself. The nurse can also be appropriately proactive in developing treatment regimen for the postpartum patient. In addition to medications to be instituted, the nurse could volunteer to the caring team activities such as listening, conversation, music, massage and relaxation therapy, appropriate to the patient’s case. This could account for the holistic healing that matches Watson's caring framework. The nurse, hence, is able to adapt and tailor caring practices specific to a patient’s needs and requirements of treatment, unlike more traditional framework, which rely on interventions and care strategies that are based on general theories about the nature of postpartum disorder. This is extremely significant, for example, in postpartum treatment in a cross-cultural environment. Using Watson’s theory, a nurse - through her excellent caring sentiment - could determine cultural underpinnings of treatment and provide the appropriate nursing strategy, that features the kind of care Funnell, Koutoukidis and Lawrence (2008) called as appropriate to the client’s beliefs, values and worldview (p. 101). Watson’s theory allows nurses to do this because of the amount and quality of interaction, engagement and commitment required in the caring process. The outcome of this aspect in caring is particularly desirable since a major orientation of treatment for the postpartum disorder looks at the psychological characteristics of the patients as well as their personal history (Harkness, 1987, p.195). This is supported by another study by Musters, McDonald and Jones (2008), which found that non-pharmacological treatments such as psychosocial intervention and interpersonal therapy, are proven to be more effective treatments (p. 399). Unarguably, caring nurses understand not only the medical condition of postpartum disorder but also the social and psychological circumstances and conditions. Conclusion Postpartum disorder is a serious mental disorder, afflicting many women, and can be very difficult to handle. Improper understanding of the condition could aggravate the situation, which is critical because it can endanger the lives of both the mother and the baby. It is important for nurses to be able to determine the appropriate care needed. This is problematic because each postpartum disorder case may be different from one another, hence, textbook approaches may not be applicable. Watson’s theory addresses this dilemma. It provides nurses a framework of meaningful care provision. The core element of the theory is holistic caring. It guides nursing practitioners to make a meaningful impact not just on the treatment but also on the general well being of the postpartum disorder patient. Through this model, nurses are in a better position to deliver the right approach of care. References Ahuja, V. (1999). Textbook of Postgraduate Psychiatry. New Delhi: Jaypee Brothers Publishers. Andrews, M. and Boyle, J. (2008). Transcultural Concepts in Nursing Care. 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins. Cooper, H. (2007). The Transformation of a Woman's Sense of Self After the Birth of Her First Child. Ann Arbor, MI: ProQuest. Dossey, B. and Keegan, L. (2012). Holisticv Nursing: A Handbook for Practice. Jones and Bartlett Publishers. Funnell, R., Koutoukidis, G. and Lawrence, K. (2008). Tabbner's Nursing Care: Theory and Practice. Chatswood, NSW: Elsevier Australia. Harkness, S. (1987). The Cultural Mediation of Postpartum Depression. Medical Anthropology Quarterly, 1(2), 194-209. Heath, D. (2005). Home Treatment for Acute Mental Disorders: An Alternative to Hospitalization. London: Routledge. Johnson, S. (2003). 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