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Building and planning of a hospital takes into consideration on a number of factors. Other hospitals place a lot of emphasis on healing environment (Koss-Chioino & Hefner, 2006). This is an environment, which makes the patients feel comfortable and safe. This environment reminds the staff their line of work and the reason for its choices. While medication and treatment are important in healing, spirituality is of the same critical importance (Young & Koopsen, 2011).
A mention of the term healing environment elicits thoughts such as a spa or sauna. Healing environment incorporates more ideas such as environmental psychology, architecture, and landscape architecture in the general fabric of health care system. These factors help in preventing medical errors and infections resulting from the same.
Healing environment influence largely the healing process. Spirituality also influences greatly on the healing process. Spirituality is a multi-factor and has many facets such as love, gratitude, love, kindness towards the patient and other people, as well. Spiritual health incorporates the ability to demonstrate peace, compassion and developing insight. Spirituality is a force of experiencing the power and energy of God in healing. This paper then is an in-depth analysis of the healing environment, its components and relation to spirituality. Spiritual processes and a, positive healing, environment influence significantly the healing process.
Components he of Healing environment
A healing environment is based on love at is core. The healing environment takes into account the faith in God. This is by striking a balance between scientific advancements and spiritual demands. The healers and patients are connected through the spiritual demands and a, positive healing environment. A healing environment comprises three components;
a) Healing Physical Environment
This concept not only looks at caring for the patients but also the interaction of employees and healthcare providers with the families. Promoting and providing a compassionate aesthetic environment promote the healing process.
A true healing environment is constructed in a way that families and the patient can cope with illnesses. This environment should be quiet to allow proper sleep. This enables healing since cells have a large regeneration rate during sleep. Cleaning machines have silencers, which prevent noise generation during use. Medication errors result from noise generated distraction. Promoting a noise-free environment helps in reduction of these errors.
Integrating both Technology and Work Design
This is a key component of healing environment. Using work design, patients have additional privacy and security (Young & Koopsen, 2011). Incorporating technology promotes quick healing process. Technologically advanced medical equipment enables doctors and nurses to provide best results while treating the patient. The latest technology in radiology and cardiology help in quick healing process (Koss-Chioino & Hefner, 2006).
The latest technology in both diagnosis and prognosis of the disease helps to expedite the decision-making process in the treatment. Medical equipment provides real time results assists in quick response. Patients can listen to soothing music that promotes laughter, which stimulate the healing process (Young & Koopsen, 2011). Providing this calm and relaxing environment is the quick way to promote better healing.
Inculcating the Radical Loving Care Culture
This is the third component of the healing environment. Promoting good infrastructural design, technology, beautiful gardens, and artwork are not enough in healing. Compassionate care and having people committed to the same philosophy influence the process of healing. Compassionate care should be based on the philosophy Radical Loving Care. This philosophy reminds the healthcare providers their calling. This promotes not only quick healing but also caters for the emotional and physical needs.
This component also looks into hiring of the employees basing on their gifts of showing this tender love. Employees need orientation on the philosophy of Radical Loving Care. The hospital should offer awards to the staff that make a significant change in the life of the patient.
Creating a healing environment remains to be a challenge since all patients reign from different cultures and age sets. For instance, the healing environment adopted for a child should be different for adults. Offering quality care is increasingly important with attractiveness of this environment (Young & Koopsen, 2011). The research into healing environment and design are expensive. While creating a healing environment, it becomes difficult to predict the patients’ preferences.
Creating this environment involves using similarity of what many people admire. Procurement of the high-tech diagnostic medical appliances is an expensive endeavor (Koss-Chioino & Hefner, 2006). Many patient would not advocates some therapeutic treatment offered such as spas. The use of designs such as natural lighting and skylights throughout the hospital is a challenging especially in places where weather keeps on changing.
Determining the satisfaction of the patients while incorporating healing environment in the hospital is challenging. Most patients may not come into terms with this advocacy. The basis of spirituality is a different challenge altogether because of belief systems. A patient who is a Muslim and hospitalized in a health facility where care providers are Christians may find it difficult when taught such doctrines.
Providing the holistic approach to the patient in the hospital becomes challenging especially when the patient is non-responsive to such services. The care providers may feel downcast and need constant motivation (Young & Koopsen, 2011). Care providers need to be advised on patient handling. This is because care providers are humans and thus, prone to emotions. This becomes difficult especially in hospitals that do not have enough funds. Another challenging part in instituting a healing environment is the policies adopted especially by most government hospitals. These policies dictate how the hospitals are run, and introduction of changes will be a violation of the same.
A biblical passage that illustrates the healing environment is the story of Naaman, who was an army commander of King of Aram. Naaman was highly regarded in the sight of his master. Despite his prowess an incurables disease known leprosy inflicted him. In second Kings Chapter five verse 13, Prophet Elisha commanded Naaman to go and take a birth in river Jordan seven times (Koss-Chioino & Hefner, 2006). The rationale of Prophet Elisha commanding Naaman to take a birth in a river illustrates healing environment due to serenity and quietness of the river environment (Young & Koopsen, 2011). This serenity enabled Naaman to restore his health to the extent of his skin being smooth like that of a young baby.
Koss-Chioino, J., & Hefner, P. J. (2006). Spiritual transformation and healing: Anthropological, theological, neuroscientific, and clinical perspectives. Lanham, MD: AltaMira Press.
Young, C., & Koopsen, C. (2011). Spirituality, health, and healing: An integrative approach. Sudbury, Mass: Jones and Bartlett.
Concept analysis of the concept of attachment as related to nursing refers to the mechanism of understanding the steps and as well mechanisms used in the connection between the child and the mother. In nursing, the term attachment places more emphasis on the maternal behavior encountered by the mother and the child during pregnancy (Condon, 2001). Approach and emphasis laid on attachment differs according to doctors and as well authors. In nursing, the concept of attachment refers to adaption that human beings have on their stimuli environment.
That is cybernetic behavioral changes and as well as their biological imprinted behaviors before birth. According to the attachment theory of human beings, these patterns are derivatives of their biological systems, and as well their cybernetic behavioral systems and have a basis on an individual’s early interaction that he has with their primary caregiver. On the other hand, their response and adaptability to the external stimuli depends on the individuals, ability and inability to gain or regain their proximity with their caregivers when having unsafe feelings.
In addition, individual’s pattern behavior (originating from their attachment with both external and internal stimuli) have their activation from feelings such as pain, fatigue, and frightening feelings and as well feelings of joy. Lastly, in the concept of attachment according to nursing, there lies a need of determining the interaction that lies between caregivers and their infants especially during separation and as well caregiver’s accessibility to the infant (Koniak-Griffin, 1988). The paper is an analysis of the concept of attachment as applied to nursing.
Case analysis of the concept of attachment in clients
During the analysis of the concept of attachment, there is an intention of using different individuals with the aim of developing the underlying relation, model and as well contrary cases involved in the experiment involving staff members and their attachment to their manager. In the study, staff members underwent through a Psychiatric Well-Being (PWB) scale and as well a Relationship Questionnaire (RQ) with the aim of determining their attachment with their manager and their response to their clients. The scales were valid, reliable and consistent and the findings were to play an important role in determining the correlation between the attachment theories (Muller, 1996).
Before looking at the staff scores in the PWB and RQ, it is important to have a deep understanding of the attachment theory as stated by Ainsworth and Bowlby. As stated earlier, the theory makes an attempt of formulating the concept of a secure base providing an explanation to the development of secure behaviors that play a role in characterizing the adult interpersonal relationships (Bowlby, 1980). The theory lays more concern on the relationship lying between the primary caregivers and the infant during his/her early and the child’s personality and behavior development. This theory demonstrates the internal working model when it highlights the systems within the child’s body leading to the drive of the behavioral attachment.
With the study, participants went through the PWB scale three times during the study. That is at the beginning of the study, after three months and lastly after six months. This aimed at determining changes in the clients. This scale aimed at measuring the impact of the symptoms of the psychiatric conditions on the client’s social functioning while in the office (Koniak-Griffin, 1988). In addition, as stated earlier, study coordinators rewrote the RQ changing the language of referring to their clients in the study. They had a belief that such a change would not have any effect on the validity and as well reliability of the scale. Scores of the participant’s score in the study underwent summation and the average used in the determination of the correlation factor in the study. Variables of anxiety and avoidance remained as references to the analysis (Muller, 1996).
From the study, there were four cases of clients. Their groupings were as follows
With this group of clients, it includes clients who are comfortable with the closeness and their dependency with their managers (Rubin, 1972). With the secured clients, they have a sense of self-worth. On the other hand, they have higher scores in self-variable questions. This is a suggestion that they have a positive sense of themselves and as well others in their offices. In this group of clients used in the study, they have the ability of providing a secure base. More so, they have the capability of success while providing services to their clients in the office. In this case, it demonstrates that these staff members have a high attachment to their managers. More so, in a nursing perspective, there is a possibility that their managers are caring, protective and as well nurturing to their staff. Apparently, this has an influence on their attachment development. Consequently, this group of staff members have a secure base that enables them to interrelate with their clients in a friendly manner that engenders a sense of security in their clients (Koniak-Griffin, 1988).
As with the study, there were staff members with a negative score. This demonstrates a group of staff members who are uncomfortable in the closeness and dependency on their managers. This group of clients have many worries of getting hurt by their managers and as well losing their jobs (Laxton-Kane, 2002). With this staff members as in the study, there is a likelihood that their managers are not caring. More so, in a nursing application, there lies the possibility that they have a negative sense about themselves and as well their colleagues in the office. Their detachment originates from their interaction and negative attitude to themselves. These staff members as compared to the secured members do not create a sense of security in their clients and, therefore, demonstrates a negative attitude while dealing with their clients (Laxton-Kane, 2002).
As with the study, the preoccupied group of people refers to those staff members who have strong feelings of intimacy. More so, with the preoccupied staff members in the staff, they have a belief that others would not value them (Laxton-Kane, 2002). This group had a negative correlation. Apparently, preoccupied staff members have a negative self-worth. In a nursing analysis, this group of clients has their managers that are not motivating. On the other hand, they have a sense of reliance over other people’s ideas, as they believe others would not value theirs. Their detachment with their managers originates from their negative-self-worth view. As compared with other models of attachment, they have a negative attachment that is not as strong as compared to the fearful group. Consequently, they are not comfortable with their relationships with others in the office and as well their dependency on their managers.
Unlike with other client cases, dismissing case pattern has a characteristic of having both a negative self and as well a positive other. With the dismissing clients, they are independent and self-sufficient. This was in contrast with the secure, fearful and preoccupied cases of clients. As with the model of study, there is a demonstration that managers responsible to the dismissing clients are as well dismissing. More so, there is a likelihood that they do not promote teamwork in their departments, as their clients are independent (Lindgren, 2001).
Dismissing clients score stipulates that they have a positive self and sometimes have negative attitudes to others. In a nursing analysis and application, the dismissing staff have a combined interaction with their clients. Therefore, clients may offer different feedback on the services offered by the dismissing. The combined attachment and detachment with their managers and their clients is because of their different sense of themselves and others (Rubin, 1972).
Before the study, as a nurse carrying out the analysis of the concept of attachment in human beings, I had some assumptions (Lindgren, 2001). My assumptions before the paper were that an individual’s attachment could not develop from external stimuli especially while in the office (more specifically, the manager could not be an influence of client attachment). On the other hand, with the PWB and RQ used in the study, there was an assumption that other staff members in other organizations display the same correlation status.
Another assumption before the study in my nursing field was that infants under caregivers respond in a similar manner as with the sample population of staff used in the study. Attachment concept in individuals is a great phenomenon that develops as the individual interacts with the external environment. Individual’s sense of self-worth depends on their interaction with other people in the society who appreciate them and as well those who nurture them. Therefore, concept of attachment as applied to nursing depends on the individual’s systems (that is the biological and as well individual’s pattern behavior) (Condon, 2001).
Attachment concept is a concept that many researchers continually work on aiming at developing a clear analysis. Researchers demonstrate a difference and as well some similarities in their works and discussion of the attachment concept. Attachment concept analysis started with the parental attachment. In this stage, researchers demonstrate that attachment between the infant and the mother starts as early as during pregnancy.
Literature responding to attachment is developing and more advanced definitions of the concept of attachment developed by different researchers. Analysis of attachment concept started as early as in 1970s. In 1981, through Cranley, there was the development of more objective measure of quantifying this concept. Since then, considerable discussions and research developed on the definition of the term, its measurement, correlating variables, and as well the relationship between individual behavior and their parental attachment (Cranley, 1981). Mores so, there is the review of many articles on the expanding body of literature on the concept of attachment (Koniak-Griffin, 1988).
As with many authors, they have a difference in their definition of the concept. Cranley defines the concept of parental attachment as the extent at which pregnant mothers engage themselves in activities that present an affiliation and interaction with their unborn child (Rubin, 1972). In contrast, Muller, a researcher in concept of attachment, stated that attachment is the unique relationships that develop between a mother and her unborn child (Muller, 1996). He continued with his argument and stated that feelings on the unborn child do not depend on the feelings of the mother while she is pregnant.
Unlike the definitions developed by the two researchers, Condon and Corkindale developed another understanding of the concept of attachment where they stated that attachment is the underlying tie or bond between two people (Condon, 2001). More specifically, parental attachment is the bond that develops between the pregnant mother and the unborn infant before their interaction with the external environment. With the above definitions as from different researchers, it is clear that attachment concept has a concern with the bond and tie that develops between people as with their interaction with each other. More precisely, the authors lay more emphasis on parental attachment between the unborn child and the pregnant mother (Cranley, 1981).
According to Doan and Zimerman, he states that the parental attachment or else concept of attachment has some implications. Some of which are; pregnancy that is not just a stage of attachment but a developmental sequence. More so, he states that some cognitive skills of the mother affects parental attachment (Doan, 1998). Furthermore, emotional factors such as anger are potential determinants of attachment between the infant and the parent. Pregnancy as a developmental sequence of attachment implies that there is a continuity of some factors affecting the pregnant parent before pregnancy and as well after birth.
According to Pines, he states that some characteristics and attitudes of a woman prior to pregnancy has a significant influence on the infant (Pines, 1972). There is a strong belief that attachment concept starts as early as the fetus develops in the mother during pregnancy. Some characteristics prior to pregnancy have a great influence on the relationship between the infant and the mother. Therefore, attachment concept not only depends on the infant’s experiences while with the caregivers but also its experiences during the pregnancy (Doan, 1998).
With parental attachment developing as early as during pregnancy, it mostly influences the relationship between the infant and its parent. On the other hand, there is a link between attachment behaviors (attachment that develops as the infant interacts with its external stimuli including other people) and the parental attachment developing during pregnancy. According to researchers, they postulate that the parental attachment has a relationship with the behavior of the parent, before, during and after delivery. On the other hand, they speculate that maternal feelings to the infant after delivery, intention of breastfeeding, expected length of breastfeeding, infant’s feeding behavior, parental cue to the infant and as well postnatal parental involvement with the infant are some factors that determine the nature of the behavioral attachment in the infant (Pines, 1972).
Attachment between an infant and the caregiver (more specifically the parent) is dependent on the caregiver’s response to the child’s basic needs. This is because the caregiver’s response to the child’s needs contributes to the development of feelings of security and as well confidence in the infants. Unlike the demonstrated behavioral patterns demonstrated by infants as they are interacting with their environment, in an unfavorable environment, there is a possibility of a negative influence on the child’s development (Bowlby, 1980). This leads to insecure attachment with their caregivers.
This behavior attachment has its evidence on avoidance of the attachment. This is because of fear of rejection from their caregivers and as well continuous anxiety while facing the loss of their expectations. Research shows that the quality of the attachment between the child and the caregivers plays an important role in the development of social-emotional competence of the infant. Feelings of security and self-control developed by the infant while under the caregiver contribute significantly to emotional regulation and development of other social relationships with their environment (Cranley, 1981).
On the other hand, infant attachment with their caregivers plays another role in determining the manner in which the child copes with other subsequent development challenges they face. Children developing a positive attachment with their caregiver and external environment have the ability of exploring their environment with confidence and as well security (Muller, 1996). As a result, they get an opportunity of enhancing their competence and autonomy in their environment and while dealing with others in the society (Pines, 1972). More so, these infants have the ability of allowing positive and efficient strategies of motivation in their lives.
Unlike children developing with a negative attachment with their environment, children having a positive attachment have the ability of coping with challenging situations by relying on their attachment. In their development, insecure children do not have the ability of using their attachment while faced by challenging situations. Most of develop a tendency of ignoring their attachment status and concentrate on the objects facing them. Detached children who are insecure-ambivalent do not have an exploratory behavior. More so, they seemingly avoid challenging tasks facing them. This was in contrast with secure children who explore their environments and do not evade challenging tasks (Pines, 1972).
Research on attachment concept demonstrates several findings. According to some researchers, they state that the motivation has a direct linkage with attachment. More so, characteristics such as attention for long spans develop because of secure attachment that the child has with his environment (Rubin, 1972). During the development process, there are changes that the child experiences. During adolescence transition, there is development of cognitive and emotional attachment and understanding. It is during this time that the child understands the relationship between attachment and motivation (Condon, 2001).
Attachment measures refer to the methods used by researchers while determining the quality of attachment relationships between different people. Studies show that there is a link between adult attachment and their lifestyle. As with the study, there are lies a challenge while determining attachment in individuals. There is no precise method of determining attachment between people. Researchers use a variety of methods with the most common measure being interviews about the individual’s attachment (Doan, 1998).
Other researchers use objective measures of assessing the current attachments. Despite the different methods used in measuring attachment levels between individuals, there lies a moderate association between their scores. Correlation is the quantitative analysis method used in determining the attachment. With the methods used by researchers, they have their assumptions while carrying out their studies. Some assumptions include; individual’s degree of security, comfort with intimacy and anger depend on the individual’s interaction with the external environment of the individual (Muller, 1996).
There lies the difference between literatures in the concept of attachment. However, all researchers demonstrate that attachment is an important aspect in the social life of an individual. In nursing, attachment as a factor influences the social life of an individual. The findings in the research paper demonstrate that attachment begins before pregnancy and develops after birth. Attachment affects cooperation between people and more so people’s self-worth and security while with others. Caregivers and parents are key role players in determining the nature of attachment developed by children.
Condon, J. T., Donovan, J., & Corkindale- C.J. (2001). Adolescents' attitudes and beliefs about pregnancy and parenthood: Results from a school-based intervention program. International Journal of Adolescence and Youth, 9, 245-256.
Cranley, M. S. (1981). Development of a tool for the measurement of maternal attachment during pregnancy. Nursing Research, 30, 281-284.
Bowlby, J. (1980) Attachment and loss: Vol. 3. Loss: Sadness and depression. New York: Basic Books.
Doan, H. M., Zimerman, A., & Howell, S. (1998). Antecedents to parenthood. Poster session presented at the meeting of the Canadian Psychological Association, Edmonton, Alberta.
Muller, M. E. (1996). Prenatal and postnatal attachment: A modest correlation. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 25, 161-166.
Pines, D. (1972). Pregnancy and motherhood: Interaction between fantasy and reality. British Journal of Medical Psychology, 46, 333-343.
Lindgren, K. (2001). Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing and Health, 24, 203-217.
Laxton-Kane, M., & Slade, P. (2002). The role of maternal prenatal attachment in a woman's experience of pregnancy and implications for the process of care. Journal of Reproductive and Infant Psychology, 20, 253-266.
Koniak-Griffin, D. (1988). The relationship between social support, self-esteem, and maternal-fetal attachment in adolescents. Research in Nursing and Health, 11, 269-278
Rubin, R. (1972). Fantasy and object constancy in maternal relationships. Maternal Child Nursing Journal, 1, 101-111.
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