Page 543 - alligood 8th edition_Neat

524 UNIT IV Nursing Theories

awkward and anonymous terms distract readers from
thinking in terms of real people within the context of Health
a particular situation. Therefore, they chose to refer to The authors do not address or define health directly.
individuals as he, in the case of patients, and she, in The entire theory is driven by the concept of health in
the case of health care professionals in particular situ- the broadest, most holistic sense. Health is a concept
ations and examples. This chapter will continue with applicable to every potential of a person’s life. Health
this practice. involves not only thriving of the physical body, but
also happiness. Happiness is realized as individuals
pursue and progress toward the goals of their chosen
Major Assumptions life plan (Husted & Husted, 2001). Health is evident
The assumptions from this theory arise from the when individuals experience, express, and engage in
practical reasoning. The model is meant to provide the fundamental bioethical standards.
nurses and other health care professionals with a
logical method of determining appropriate ethical ac- Environment or Agreement
tions. Although many of the terms are familiar to The environment established by Symphonology is
nurses and health care professionals, some have been formed by agreement. “Agreement is a shared state of
redefined to support the reality of human interaction awareness on the basis of which interaction occurs”
and ethical delivery of health care. (Husted & Husted, 2001, p. 61). Agreement creates
the realm in which nursing and all other human in-
Nursing teractions occur. Every agreement is aimed toward a
Symphonology holds that a nurse or any other health final value to be attained through interactions made
care professional acts as the agent of the patient. Using possible by understanding.
her education and experience, a nurse does for her The health care professional–patient agreement
patient what he would do for himself if he were able. is formed by a meeting of the professional’s and the
Nursing cannot occur without both nurse and patient. patient’s needs. Their agreement is one in which the
“A nurse takes no actions that are not interactions” needs and desires of the patient are central. The pro-
(Husted & Husted, 2001, p. 37). The nurse’s ethical fessional’s commitment is defined in terms of the
responsibility is to encourage and strengthen those qual- patient’s needs. Without this agreement, there would
ities in the patient that serve life, health, and well-being be no context for interaction between the two. The
through their interaction (Fedorka & Husted, 2004). relationship would be unintelligible to both (Husted
Agency is the capacity of an agent to take action & Husted, 1999).
toward a chosen goal. A nurse as agent takes action Symphonology Theory is not a compilation of tra-
for a patient, one who cannot act on his own behalf. ditional cultural platitudes. It is a method of deter-
The shared goal of a nurse and a patient is to restore mining what is practical and justifiable in the ethical
the patient’s agency. The nurse acts with and for the dimensions of professional practice. Symphonology
patient toward this end. recognizes that what is possible and desirable in the
agreement is dependent on the context.
Person or Patient The context is the interweaving of the relevant facts
The Husteds define a person as an individual with a of a situation—the facts that are necessary to act upon
unique character structure possessing the right to pur- to bring about a desired result (Husted & Husted,
sue vital goals as he chooses (Husted & Husted, 2001). 2001). There are three interrelated elements of context:
Vital goals are concerned with survival and the en- the context of the situation, the context of knowledge,
hancement of life. A person takes on the role of patient and the context of awareness. The context of the situa-
when he has lost or experienced a decrease in agency tion includes all facts relevant to the situation that
resulting in his inability to take the actions required for provide understanding of the situation and promote
survival or happiness. The inability to take action may the ability to act effectively within it. The context of
result from physical or mental problems, or from a lack knowledge is an agent’s preexisting knowledge of the
of knowledge or experience (Husted & Husted, 1998). relevant facts of the situation. The context of awareness