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504 UNIT IV Nursing Theories

dementia who experienced theory-based nursing Studies have also been used to explore perceived
using the Modeling and Role-Modeling Theory per- enactment of autonomy and life satisfaction in older
ceived that their needs were met and were healthier adults (Anschutz, 2000), self-care knowledge in infor-
(Hopkins, 1995), and they were encouraged, which mants in the hospital (Erickson, 1985), developmen-
helped them accept the situation and transcend the tal growth in adults with heart failure (Baas, Beery,
experience of caregiving (Hopkins, 1995). Self-care Fontana, & Wagoner, 1999), the ability to mobilize
resources, measured as needs, are related to perceived coping resources and basic needs (Barnfather, 1990a),
support and coping in women with breast cancer the relationship between basic needs satisfaction and
(Keck, 1989), physical well-being in persons with emotionally motivated eating (Timmerman & Acton,
chronic obstructive pulmonary disease (Leidy, 1990; 2001; Cleary, & Crafti, 2007), and relations among
Kline,1988), and anxiety in hospitalized patients hostility, self-esteem, self-concept, and psychosocial
who have had cardiac surgery and their families residual in persons with coronary heart disease
(Holl, 1992). Finally, when AI was tested as a buffer (Sofhauser, 1996, 2003). Research has also been con-
between stress and well-being, a mediation effect ducted that explores the relationship between spiritual
was found (Acton, 1997; Acton, 1993; Acton, Irvin, well-being and heart failure (Beery, Baas, Fowler, &
Jensen, et al., 1997). Allen, 2002); spirituality in caregivers of family mem-
Additional studies that operationalize self-care bers with dementia (Acton & Miller, 1996); the imple-
resources by measuring developmental residuals have mentation of a mind, body, spirit self-empowerment
shown that identity resolution in adolescents with program for adolescents (Nash, 2007a); and spiritual-
facial disfiguration can be predicted by previous ity in women with breast cancer (Kinney, Rodgers,
developmental residual (Miller, 1986). Chen (1996) Nash, & Bray, 2003). Baas (2004) studied self-care
found that feelings of control over one’s health (health resources and quality of life in patients following myo-
control orientation) status in older adults with hyper- cardial infarction and self-care resources and well-
tension correlated highly with self-efficacy and self- being in clients with cardiac disorders (2011). She and
care. In addition, her work supported that health colleagues also examined the psychosocial aspects of
control orientation, self-efficacy, and self-care were heart failure management (Baas & Conway, 2004),
associated with well-being. Through interviews of explored body awareness in heart failure or transplant
older adults living independently, Hertz, Rossetti, and patients (Baas, Beery, Allen, et al., 2004), and reported
Nelson (2006) were able to identify categories of self- patient adjustments to the cardiac devices (Beery,
care actions that encompassed important self-care Baas, & Henthorn, 2007).
activities. Tools that have been developed to test the Model-
Other researchers found that trust predicts for ing and Role-Modeling Theory include the Basic
adolescent clients’ involvement in the prescribed Needs Satisfaction Inventory (Kline, 1988), the Erikson
medical regimen (Finch, 1987); perceived support Psychosocial Stage Inventory (Darling-Fisher &
and adaptation are related to developmental residual Leidy, 1988), the Perceived Enactment of Autonomy
in families with newborn infants (Darling-Fisher, tool designed to measure a prerequisite to self-care
1987; Darling-Fisher & Leidy 1988); and mistrust actions in the elderly (Hertz, 1991, 1999; Hertz &
predicts length of hospital stay, and positive residual Anschutz, 2002), the Self-Care Resource Inventory
serves as a buffer (Finch, 1987). Positive residual (Baas, 1992, 2011), an adjustment scale designed
in the intimacy stage of healthy adults predicts to measure self-report with implanted devices in car-
for health behaviors (MacLean, 1987, 1990, 1992). diac patients (Beery, Baas, Mathews, et al., 2005), the
Developmental residual predicts for hope, trust- Robinson Self-Appraisal Inventory designed to mea-
mistrust residual predicts for generalized hope, sure denial (the first stage in the grief process) in
autonomy-shame and doubt residual predicts for patients after myocardial infarction (Robinson, 1992),
particularized hope in the elderly (Curl, 1992); and the Erickson Maternal Bonding-Attachment Tool
negative residual is related to speed and impatience designed to measure self-care knowledge as motiva-
behaviors in a healthy sample of military personnel tional style (deficit or being motivated) and self-care
(Kinney, 1992). resource (maternal need satisfaction) (Erickson, 1996b),