Health Care System and Resourcefulness
Whats is Resourcefulness
Resourcefulness involves the ability to maintain independence in daily tasks despite potentially adverse situations (ie, personal resourcefulness or self-help) (Rosenbaum, 1990) and to seek help from others when unable to function independently (ie, social resourcefulness or help-seeking) (Nadler, 1990).
Thus, two forms of resourcefulness exist, and the skills comprising the two are complementary and equally important for health promotion. Both the self-help skills constituting personal resourcefulness and the help-seeking skills constituting social resourcefulness are believed to be learned through either formal or informal instruction.
Since resourcefulness is thought to be learned (Rosenbaum), the self-help and help-seeking skills that comprise it can be taught. Numerous studies since the early 1980s have suggested that teaching personal and social resourcefulness skills is beneficial in promoting and maintaining healthy physical, psychological, and social functioning across the life span.
Factors Affecting Resourcefulness
Contextual factors affecting personal and social resourcefulness are both intrinsic and extrinsic, intrinsic factors that have been identified from empirical research are demographic characteristics (eg, age, gender, race/ethnicity), number of chronic conditions, presence of illness symptoms, and perceived stress (Fingerman, Gallagher-Thompson, Lovett, & Rose, 1996; LeFort, Gray Donald, Rowat, & Jeans, 1998; Zauszniewski, & Chung, 2001; Zauszniewski, Chung, & Krafcik, 2001).
Extrinsic factors include social network size, social support, and health care orientation (Dirksen, 2000; Rapp, SR, Schumaker, Schmidt, Naughton, & Anderson, 1998).
Association Between Personal ad Social Resourcefulness
Zauszniewski (1996) reported significant associations between depressive cognitions and lower self-help (personal resourcefulness) and help-seeking (social resourcefulness) behaviors in healthy, community dwelling elders. Self-esteem, an effective regulator, has also been reported to be significantly associated with personal resourcefulness and well being in women survivors of breast cancer (Dirksen, 2000).
Health self-determinism, a motivational regulator, was found to be a significant predictor of self-help (personal resourcefulness) and informal help-seeking (social resourcefulness) in chronically ill elders (Zauszniewski et al., 2001).
Although studies have identified uncertainty as an antecedent of personal resourcefulness (Dirksen: LeFort et al., 1998), uncertainty may also function as a motivational process regulator, which intervenes between contextual variables and resourcefulness. To date, no published studies have examined the effects of energy as a process regulator.
Yet studies of concepts related to resourcefulness and quality of
life suggest that energy level may play a mediating or moderating role in the
relationships between contextual variables and resourcefulness or quality of
life. The specific roles played by various process regulators in affecting personal
and social resourcefulness need more systematic examination.
Positive Outcomes of Resourcefulness
Positive health outcomes of personal and social resourcefulness have been well-documented through empirical research.
These outcomes, including adaptive functioning in depressed adults (Zauszniewski, 1995, 1996), life satisfaction in persons with chronic pain and in healthy elders (LeFort et al., 1998; Zauszniewski, 1996), perceived health in caregivers and in diabetic women ( Rapp et al., 1998; Zauszniewski et al., 2001), psychological well being in women survivors of breast cancer and in elders (Dirksen, 2000; Zauszniewski et al., 2001), and health practices in women with type 2 diabetes (Zauszniewski & Chung, 2001), fall under the “umbrella” concept called quality of life.
Self-rated health and caregiver well-being, which are also indicators of quality of life, have been reported as outcomes of social resourcefulness in primary caregivers of persons with dementia (Rapp et al.).
However, while significant associations between both personal and social resourcefulness and indicators of quality of life have been consistently reported in the literature, few studies have examined personal and social resourcefulness simultaneously in relation to quality-of-life indicators.
In one of the few studies, Zauszniewski (1996) found that in healthy elder's life satisfaction was a significant outcome of both forms of resourcefulness.
Measure for Resourcefulness
However, both forms of resourcefulness in a study of chronically ill elders found that only personal resourcefulness significantly predicted physical functioning and psychosocial well-being (Zauszniewski, Chung, & Krafcik, 2001). There are reliable and valid measures of both personal and social resourcefulness.
Personal resourcefulness, also termed learned resourcefulness, has been measured using Rosenbaum's (1990) Self-Control Schedule. The Self-Control Schedule (SCS) consists of 36 Likert type items using a six point scale.
Subjects indicate the degree to which each item describes their behavior, ranging from extremely descriptive to extremely nondescriptive; a higher composite score indicates greater personal resourcefulness. Internal consistency estimates have ranged from .78 to .85 in adults, including elders (Rosenbaum).
As would be expected, the SCS is moderately related to locus of control, religious orientation, anxiety, and depressive symptoms, supporting its construct validity (Rosenbaum). The Social Resourcefulness Scale (SRS) developed by Rapp and colleagues (1998) consists of 20 Likert type items using a five-point scale.
Subjects indicate the frequency of use of behaviors to obtain and maintain help from others, ranging from never to always. Higher composite scores indicate greater social resourcefulness.
An internal consistency estimate was found with
elders (Rapp et al.), and construct validity was supported by significant
correlations with social support and self-control (Rapp et al.).
Maintenance of Resourcefulness
Fostering the development and maintenance of both personal and
social resourcefulness is well within the purview of nursing interventions.
Clinical trials are currently examining various methods for teaching personal
and social resourcefulness skills to elders with chronic conditions. Additional
research with children, adolescents, and ethnically diverse populations is
needed.
Give your opinion if have any.