Psychology for Nursing and Healthcare Professionals

Developing Compassionate Care

Sue Barker

• Publisher: SAGE Publications Ltd
• Year: 2016
• ISBN:
  9781473984936
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

Focusing in particular on compassionate care, this practical textbook covers all aspects of psychology relevant to nursing and healthcare students. Key features include:

• Coverage of the most important core psychology concepts for students, directly linked to relevant practice contexts.
• Case studies and scenarios from service users, carers, students and practitioners to help readers relate theory to practice.
• Reflective activities to develop critical thinking with outline answers at the end of each chapter.
• A glossary with definitions of key terms to further understanding.

1 Introduction to Psychological Theory

Sue Barker

I experience, I feel; I am human

I notice your suffering, I feel your suffering; I am sympathy

I sense your suffering, we share your suffering; I am empathy

Your pain is my pain, your comfort is my comfort; we share kindness

Together we are compassion!

Learning objectives

This chapter will introduce five perspectives of psychology and will explore how these perspectives offer differing understandings of the way people think, feel, behave and interact with others and their environment. These perspectives provide a basis for the subsequent chapters in order to develop a psychological understanding of compassionate care as experienced by care practitioners so as to enhance their performance of compassionate care. This chapter’s learning objectives are to:

• Describe the five perspectives in psychology
• Identify a variety of research methods used in psychology
• Recognise the role of psychology in order to understand and explore care

Activity 1.1 Critical thinking

Take a few minutes to consider why an understanding of psychology might be useful in your development of your caring skills.

Some suggestions are made at the end of the chapter.

Introduction

This chapter initially explores the five dominant psychological perspectives and considers how each of them may offer an explanation of caring practices. These will be referred to throughout the book. It will establish definitions of psychology and the research methods used to develop an understanding of people, particularly how and why they think, feel, behave and interact with others and how this differs between individuals. Research methods will be concisely described, identifying the major research approaches in psychology.

In order to explore any concept, a definition is required. So, despite psychology being explored throughout this book, an initial definition needs to be identified. I previously defined psychology in the following way:

Psychology is a seeking to understand why people behave, think and feel the way they do, individually and in groups, in all areas of life including health. Psychologists seek not only to predict behaviour but also to change behaviours to enhance wellbeing and quality of life. (Barker, 2007: 2)

This is a simplistic definition but it can be used as a working definition. Many other authors have developed their own definitions but all have until recently been very similar, for example:

Psychology is the study of behaviour and mental processes. Behaviour includes all of our outward or overt actions and reaction, such as talking, facial expressions and movements. Mental processes refer to all the internal, covert activity of our minds, such as thinking, feeling and remembering. (Ciccarelli and Myer, 2006: 4)

The most recent definition I could find, whilst identifying a focus on behaviour, extends my initial definition to include wider phenomenological experiences:

The study of the nature, functions, and phenomena of behaviour and mental experience. The etymology of the word implies that it is simply the study of the mind, but much of modern psychology focuses on behaviour rather than the mind, and some aspects of psychology have little to do with the mind. (Colman, 2015: 724)

In the past, we have seen a move from philosophy exploring the nature of people through the Enlightenment and the development of scientific psychology to psychology stretching to include elements of philosophy. I believe that psychology (understanding people) and philosophy (the love of wisdom) have always been intimately related – and we are moving towards a greater acceptance of this.

Psychology has a number of different ways of trying to understand the person, which can support practitioners in their compassionate care practice. One of the methods used is termed perspectives. These perspectives have changed over the years but the most commonly used now are:

• Biological
• Psychodynamic
• Behavioural
• Cognitive
• Humanistic

Each of these perspectives has a different explanation or theory related to a person and their behaviour. These influence not only psychological understanding but also how this understanding can be developed (research) and applied to acts of care.

Biological psychology

Biopsychologists are often accused of reductionism, which means that they reduce the person by examining their individual biological components in order to understand them and their behaviour, instead of attempting to understand them as an embodied whole. Their explanations of human behaviours are through anatomical or physiological changes such as chemical reactions in the nervous and endocrine systems.

Figure 1.1 Sense of reduced body

An understanding of biological functioning or the physiological influence on behaviour is important for most caring practitioners. Not responding to a physiologically produced behaviour could lead to death: for example, a person clutching their chest struggling to stand up, walk or talk may be having a ‘heart attack’ (myocardial infarction) which requires urgent attention.

Case study Miriam Walker – student nurse

I was asked to monitor the well-being of an elderly lady, Mrs Beverley Crosland, who had just been admitted to an assessment ward. Her husband was with her. Mrs Crosland appeared confused and agitated and she was saying she wanted to go home. Her husband was very worried. He said Beverley’s concentration, attention and memory had deteriorated dramatically over the past week. Mrs Crosland was also groaning at times as if she was in pain. Whilst monitoring Mrs Crosland, her pulse rate appeared a little raised, along with her temperature, breathing and blood pressure. Mrs Crosland and her husband were unable to explain what they thought was wrong, although Mr Crosland implied he was concerned that his wife was developing dementia as he had heard about it on the television.

Despite my concerns, as the signs may have been indicative of dementia, I explained to both of them that I needed to ask a few more questions and she may need to have some tests before a decision could be made. Mr Crosland remained anxious and Mrs Crosland was becoming more confused with each question I asked.

At this point, I stopped following the assessment questions in the order they were set out and sat down next to Mrs Crosland rather than the other side of the table where I had been sitting to write down their answers. I passed the assessment questions to Mr Crosland and asked him to complete them as best he could. He appeared pleased to have a role to undertake and conscientiously started filling in the forms.

I then asked Mrs Crosland to tell me what she would like to be doing at the moment whilst holding her hand. She tried to think and then started to clutch her abdomen. I said ‘Does your tummy hurt?’ and I reached to touch her abdomen. I asked ‘Do you need to go to the toilet?’ She then said she could not go. I asked if Mr and Mrs Crosland thought she could be constipated and they both agreed she could be. They both were happy with a doctor conducting an examination to check.

After a physical examination, it was found that Mrs Crosland was constipated and she was offered an enema to allow some rapid relief. Mrs Crosland’s agitation reduced and her mental functioning slowly returned to what was normal for her. She was also prescribed a laxative for a couple of weeks and given information on diet, exercise and her other medications.

In the case study of Miriam Walker, in which she believed she offered compassionate care, it can clearly be seen that what are understood to be psychologically important mental processes, such as attention, concentration and memory, are strongly influenced by biological functioning.

Biopsychologists, like human biologists, identify biological functions that produce certain behaviours but their focus is different to biologists. Biopsychologists seek to understand psychological issues: issues related to the mind or spirit. It could be said that the biopsychologists are interested in how biology supports and influences a person’s thoughts, feelings and behaviour to produce individual differences whereas a biologist’s focus is on describing or understanding the structure and function of the biological apparatus of the individual. Both can use an empirical, positivist, scientific approach to gaining knowledge (research).

Therefore biopsychologists and biologists explore the following but examine them through different ‘lenses’ – to use an optical analogy:

• Genes
• Anatomical differences
• Development through the lifespan
• Biological systems such as...

Table of contents

• Cover
• Half Title
• Publisher Note
• Title Page
• Copyright Page
• Contents
• About the Authors
• Publisher’s Acknowledgements
• Foreword
• Introduction
• 1 Introduction to Psychological Theory
• 2 Lifespan Development
• 3 Understanding Suffering
• 4 Compassionate Care
• 5 Person-Centred Approaches
• 6 The Care Practitioner
• 7 Therapeutic Relationships
• 8 Emotional Intelligence
• 9 Emotional Labour
• 10 Maintaining a Culture of Compassionate Care
• Glossary
• Index