Katharine Kolcaba’s Theory: Strengths And Limitations University Essay Example

Strengths

One of the main strengths one can identify in Kolcaba’s theory is its logical presentation. The original 1994 article contained the major concepts outlined in a grid at the top of which were the forms of comfort sought by the clients (Kolcaba, 1994). Since its inception, therefore, the theory was aiming at being understandable and applicable.

The author insists that the theory applies to a multitude of disciplines, with nursing as its major focus (Kolcaba, 1994). For that sake, she has provided a clear definition of nursing and the role of nurses in addressing the patients’ comfort needs. She unambiguously described what is expected from nurses at every stage of treatment within the framework of her theory. At that, the theory correctly states that the underlying purpose of medicine as an applied science is to willingly handle the clients’ comfort needs. From an ethical point, the assumptions of the theory are relevant.

Another and more evident advantage of the theory is its perfect applicability for clinical research. Clinical trials are facilitated by the fact that the Comfort theory operates with the clients’ responses to various stimuli alternating their physical, spiritual, socio-cultural, and environmental experiences. Such variables are observable and measurable, which means that the design and implementation of new interventions can be fully controlled and the generated data is used for future research.

Lastly, definitions – any definitions provided by any theory – have a tendency to change with time. The fact that Katharine Kolcaba is currently active and is capable of alternating and expanding her doctrine is yet another strong point to the Comfort theory.

Limitations

What one would expect from a nursing theory such as this is the notion of comfort intertwined with the basic notions of health. One of the main weaknesses of the Comfort theory, therefore, is that the conceptual framework is not entirely intact. That is to say, the concepts and definitions are rather poorly aligned. For instance, the definition of health that the author provides does not agree with other components of the theory. To take another example, the concept of “functioning” is nowhere to be seen in Kolcaba’s reasoning (Alligood & Tomey, 2013).

The notion of the patient provided by the theory is another instance to potentially cause misunderstanding. The author defines “patient” as the one to receive healthcare. Considering the major assumption of the theory (that people’s comfort is consistent with their physical, spiritual, socio-cultural, and environmental experiences), it seems that the patient is likely to seek medical help. From the definition provided by Kolcaba, however, it is unclear if a patient is going to participate in their care or not (Alligood & Tomey, 2013). Neither does the definition specify if the patient is going to interact with the surroundings, allotting them the role of a passive observer. That human beings are basing their experience primarily on what they perceive is not regarded by the theory.

A final weak point concerns the relationship between addressing the client’s comfort needs and promoting health-seeking on institutional levels. Kolcaba specifies that experiences leading to comfort motivate clients to seek medical help, which makes sense. The author, however, fails to provide a detailed account of how health-seeking behaviors can be promoted on insurance, workplace, and other levels. Thus, despite the author’s assurance of the wide applicability of the theory, it does not subsume any ways to use it outside of the nursing practice.

References

Alligood, M. R., & Tomey, A. M. (2013). Nursing Theorists and Their Work. (7th ed.). Maryland Heights, MO: Elsevier.

Kolcaba, K. Y. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(6), 1178-1184.

The History Of Slavery And Contemporary Society

Introduction

Slavery is one of the most harmful concepts devised by humans. It strips people of their identity and uses them as property, rather than human beings. Throughout history, this practice took many forms. From the earliest recorded examples in Mesopotamia to modern examples of human trafficking and dictatorial rule. Nevertheless, this practice does not exist anymore in most societies. However, its effects have had a lasting effect on the modern world. Racial and economic inequality, prejudice, and other issues can be seen as aftershocks of slavery. This paper will provide an overview of the history of slavery, as well as the effects it has on modern society.

History of Slavery

The earliest record of slavery dates back to 2100 BC Sumerian Code of Ur-Nammu. It is the oldest surviving tablet that contained codes of law, including laws that concerned slavery. The Babylonian Code of Hammurabi from 1700 BC also contains laws that define slavery, free people, and how slaves can be legally freed. Likely, such laws date even earlier, but no concrete documents have been found so far. The text of the tablets suggests that it was possible for slaves to not only legally regain freedom, but also escape into neighboring kingdoms that would not consider the person a slave. Slavery was practiced as a punishment for crime, the inability to pay off debt or enslavement of people during and after wars (Craig, 2014). This led some civilizations to rely on a conquest to gain more slaves and therefore a larger workforce.

One such civilization in Ancient Egypt were prisoners of war and peasants made up the majority of the slave labor. Egypt had a relatively positive outlook on slavery, with a great variety of tasks that slaves could be assigned to outside of manual labor. Due to the difficulty of agriculture in the area, peasants often lived in worse conditions than slaves who often caused them to sell themselves into slavery as the only means of survival. Those who possessed certain skills such as writing could achieve a higher status in a managerial position. Slaves were often used in domestic jobs and were only rarely traded internationally. In later years of Ancient Egypt, slave contracts even required the consent of the slave to be sold off. Nevertheless, slaves were looked down upon. Harsh punishments and poor working conditions were common.

Slavery continued to be practiced in countries of medieval Europe such as the Byzantine Empire, the Holy Roman Empire, Spain, and Portugal. Slavery was mostly driven by conquest at the time, which led to more situations where people of one culture were enslaved by people of another. The practice did not change in the modern era, as technological advances, wars, and the discovery of new regions created new markets and demand for slavery. Perhaps the most famous example of the modern era slavery comes from the transatlantic slave trade which brought slaves from Africa to the American Colonies. The trade began in 1526, as the first transatlantic Portuguese voyage came to the shores of Brazil to trade slaves. Slaves were used to working on plantations, gather ore in mines, work the rice fields, construct buildings, cut lumber, and as domestic servants. The difference in appearance served to create a divide between slaves and free people of the country, which made the treatment of slaves in America especially harsh. In Western Europe, slavery was almost completely gone by the 1500s. However, European colonies and Americas utilized forced labor until the 1800s. America abolished slavery in 1865 after the American Civil War (Miller, 2014).

America was not the last country to abolish slavery as Cuba and Brazil abolished it only in the 1880s and some countries in Africa still practiced it until foreign pressure forced them to abolish it. Forced labor is still utilized in some countries as a measure of punishment for criminals. Another type of slavery still exists in a semi-legal form, as North Korean citizens are sent out to work through shell companies in Europe. They are not free to leave the premises they stay outside of work, and if someone attempts to escape, their family is sent to labor camps or is in danger of execution. The illegal slave trade also exists in the form of human trafficking (Miller, 2014).

Effects on Contemporary Society

In modern society, the effects of slavery can be seen especially strongly in racial discrimination. In the United States, even though slavery was abolished, racial inequality and segregation continued to persist for decades to come. People of color were treated worse, especially in the south of the country (Nathans, 2017). Interracial relationships were looked down upon, and some businesses refused to serve people of color. Children of African Americans were not allowed to study in the same schools as white children in some regions and worst cases, people were lynched by angry mobs of people. Often such events caused deaths of multiple innocent people, including those who opposed them. With time, racial discrimination lessened, however. Segregation was disallowed, people could not refuse to hire a person based on their race, and interracial couples were not persecuted anymore.

Nevertheless, discrimination is still common. In recent years, a large number of cases where police shot at black people, including unarmed and non-resisting individuals have gained public attention. Aside from fatal incidents, police in regions such as New York are tasked with stopping and “patting down” people of color. They do not need a provocation to do so and resisting such acts could lead to arrests. Even if white people do not associate people of color with slavery, they are still informed by ideas and opinions that were formed not long after slavery was abolished. Any crime committed by a person of color is seen as a confirmation that they are a dangerous group of people that need to be overseen (Reich, 2017).

The way the international economy works not dissimilar to slavery, as international companies often outsource their labor to countries where the cost of labor is lower. While this is a basic tactic of capitalism, it perpetuates low labor standards in those countries. People often work too many hours in poor working conditions. They are paid much less than a worker would be paid domestically. Companies like Nike and Apple have gotten a lot of negative attention for using such practices, but many organizations still outsource their labor.

Conclusion

Slavery is a terrible practice. It has dominated the world for centuries and caused many cultures to suffer. Its effects can still be felt today in the way through racial discrimination persists and how the international economy exploits the low working standards of developing countries.

References

Craig, G. (2014). Modern slavery in the UK: The contribution of research. Journal of Poverty & Social Justice, 22(2), 159-164.

Nathans, H. S. (2017). Crooked histories: Re-presenting race, slavery, and Alexander Hamilton onstage. Journal of the Early Republic, 37(2), 271-278.

Reich, M. (2017). Racial inequality: A political-economic analysis. Princeton, NJ: Princeton University Press.

The Affordable Care Act And Healthcare Improvement

The Affordable Care Act (ACA), also known as the Obamacare, sparked off a lot of controversy dividing the people into two sides; some sing the praises to the act while others take a dim view believing that it has more cons than pros. With all the pros and cons, the Obamacare act should not be judged on political merits, and one will need to acknowledge that the act has brought an array of changes into the overall medical system. The changes are affecting every American citizen, and it is worth discussing the advantages and disadvantages of the Obamacare based on sound reasoning.

There are three major problems facing the health care in the United States: first, millions of people go uninsured, second, health care costs are on the increase, third, the quality of health care leaves much to be desired (Wilensky, 2012). Wilensky (2012) argues that the Obamacare Act is addressing only the first and the simplest of the problems, promising to make insurances affordable (p. 1479). However, the act fails to offer solutions to the remaining two issues relating to the declining quality and increasing medical costs.

While it is true that the ACA increased access to more affordable health insurances, those improvements came at a price of increased taxes on people with high-income levels (Fulton, Hollingshead, Karaca-Mandic, & Scheffler, 2015). Medical and pharmaceutical companies also have to pay higher taxes, and the overall tax increase is likely to push them to increase the cost of medications and medical services (Fulton et al., 2015). While the ACA did reduce the cost of health insurances, some people have to pay more than they used to under prior, private plans (Kessler, 2014).

According to the new regulations built into the ACA, small businesses will have to provide insurances for the full-time employees, the refusal to insure the workers will result in a fine (Fulton et al., 2015). This provision is beneficial for the workers as they will feel more protected, however, this will come at a price that the employers will need to pay. As the provision requires that only full-time workers be insured, some businesses may choose to cut the workload of employees or hire fewer of them to cut costs. Another way for businesses to compensate for the insurances they’ll have to provide may be a cost increase for consumers, and the insurances will in the long run, be paid from the pockets of ordinary citizens.

Undoubtedly, a compelling argument in favor of Obamacare is the introduction of preventive measures into the health plan (Kessler, 2014). The preventive measures are targeted at preventing a disease at its incipient stage thus saving costs and the patient’s health. Before the ACA, people were reluctant to have medical checkups without an explicit reason, as a result, fewer diseases were identified and prevented. Currently, the screenings for a wide range of diseases are covered by the insurance. However, the free preventive measures are increasing the load on the hospitals and the medical staff, who need to process a large number of medical tests. The biggest shortfall of the ACA is that while it offers to provide medical care to all it does not offer ways in which it may be achieved. It is easy for politicians to impose new regulations; however, for hospitals it will mean an influx of patients thus creating the need for new medical staff and equipment. The increased number of patients is likely to make the medical system less effective and accessible contributing to the decline of health care quality.

The provision that sparked off a lot of controversy is the requirement for everyone to have insurance (Wilensky, 2012). Everyone choosing to opt out of insurance will be required to pay a penalty. This provision is targeted to encourage more people to obtain insurance. However, the penalty for not being insured is rather small, and a lot of young people choose to postpone buying it and save money for other purposes (Wilensky, 2012).

Due to differences in regulations, some states choose to opt out of the medical expansion program, this specifically relates to the Republican states which exhibit opposition to the ACA (Fulton et al., 2015). Furthermore, the Supreme Court made a ruling according to which states could voluntarily opt out of the Obamacare Medicaid expansion (Kessler, 2014). It means that the medical expansion remains inaccessible in the states opposing the ACA.

Despite all the controversy surrounding the ACA, it is admittedly an important step ahead. Nevertheless, it is yet too early to adequately evaluate its impact as the ACA is still insufficient and needs to be streamlined for all of the states. Before the Obamacare, the uninsured were running a risk of losing their property or becoming an economic burden to their families in case of a disease. Now, owing to the Obamacare, the middle-class and poor people have better access to health insurances. The opponents of the ACA, specifically the Republicans, who are saying that imposing a health insurance on people infringes their freedom are wrong. Following their logic, it is also wrong to impose auto insurances as people are free to drive without being insured. There exists an array of policies in the United States when people are required to follow a certain law or a regulation. The Obamacare should not be the exception, and people should treat it as their inalienable right to medical care.

Reference List

Fulton, B., Hollingshead, A., Karaca-Mandic, P., & Scheffler, R. (2015). Republican States Bolstered Their Health Insurance Rate Review Programs Using Incentives From the Affordable Care Act. The Journal of Health Care Organization, Provision, and Financing, 52(0), 1-10. Web.

Kessler, G. (2014). The GOP claim that more Americans have lost insurance than gained it under Obamacare. Web.

Wilensky, G. R. (2012). The Shortfalls of Obamacare. The New England Journal of Medicine, 367(16), 1479-1481. Web.

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