The influence of consequential ethics as an ethical framework (the greatest good for the greatest number) opposes the ethical principle of deontology (i.e., the rightness of an act itself determines what is right). Both of these impact the nursing profession. Modern social exchange theories are based on the principle of utility. Read the assumptions of social exchange theory and consider how these would affect the nurse-patient relationship, compared to how these impact the nurse within the health care environment. To what extent are all theories ethical? Is social exchange theory compatible with the values of the nursing profession? Social exchange theory is a social psychological and sociological perspective that explains social change and stability as a process of negotiated exchanges between parties. Social exchange theory posts that all human relationships are formed by the use of a subjective cost-benefit analysis and the comparison of alternatives. Both sociology and psychology try to explain why human beings do what they do, and act in the manner in which they do.
Social Exchange theory attempts to explain how we interact with one another and what we get from that interaction. According to Bielkiewicz (McEwen &Wills2014) theories known as exchange theories have their basis in philosophical perspective called utilitarianism. Three basic assumptions about individuals and exchange relations are added from economic theories. Some of the assumptions of social exchange theories as outlined by Turner (2013) are 1. Humans do not seek to maximize profits but attempts to make some profit in their social transactions with others. 2. Humans are not perfectly rational; they engage in calculations of cost and benefit transactions. 3. Humans do not have perfect information on all alternatives. The father of exchange theory, George Homans (1910 – 1989), dealt primarily with the psychological principles underlying social behavior. Although psychology was concerned primarily with individual behavior, Homans felt that the rules governing individual behavior were sufficient to explain all of social behavior.
At the heart of his theory was the idea that people acted to maximize their rewards in their social action. Social exchange theory includes the following concepts: success, stimulus, value, deprivation, satiation, aggression, and approval. Homans defined each of these concepts explicitly in his book and various articles. The success concept which he defines is the principle of reward. (Homans, 1983, p. 33) While stimulus is defined when a stimulus presents itself and it resembles a previously rewarded activity, that individual is likely to repeat that action again. (Homans, 1950, Chapter 4) Homans defined value as a system of rewards and punishments. (Homans, 1983, p. 32) Deprivation and satiation was defined as the more often a reward has recently been received, the less valuable further rewards become. And if forced for a long time to go without a certain reward, an individual will lose interest and move on. (Homans, 1983, p. 33)
Lastly, aggression and approval falls under the principle of distributive justice. When behavior does not receive the expected reward the response is anger. Yet, when the individual receives a greater reward than what is expected or does not receive punishment he will be pleased. (Homans, 1950, Chapter 4). One of the expected outcomes by the application of this theory would be “linking client-nurse interactive phenomena with client outcomes” (Byrd, 2006, p. 271). During this research Dr Byrd noted instances where the mothers were very engaging during the visits and were very much a part of the exchange where the “clients provided time for the visit, access to the home, physical space within the home to conduct the visit, attentiveness and receptivity, opportunities to observe maternal-child interaction, access to the infant…” (Byrd, 2006, p. 273).
While other mothers needed added incentives to provide these exchanges usually in the form of education, referrals to outside services, or even material goods. Social exchange perspective started in American sociology with the work of Homan (1961) and Blau (1964).There are two divisions of social exchange theories, individualistic or collectivist. Exchange theories that are commonly used by nurses include system theory and social networks. General systems theory is one type of exchange theory introduced in 1930 by Ludwig von Bertalanffy (1901-1972).In general systems theory, systems are composed of both structural and functional components that interact within a boundary.
Systems theory was applied to nursing practice, generally in administration and in management and in research. A system is a unit that is greater than the sum of its parts. Communication and feedback mechanisms between system parts are essential for system function. General Systems Theory implies that an environment exists and it affects and is affected by feedback systems. General Systems Theory includes thinking about open and closed systems. An open system has greater exchange of information, energy and material between it and its environment, while a closed system is more isolated and has fewer exchanges. (McEwen & Willis2014).
Social networks theory
According to Bielkiewicz, (McEwen & Willis2014) study of networks can be a productive approach to understanding systems in nursing. In terms of health and wellbeing of individuals, social support networks, are very relevant. Social networks should examine the underlying patterns of social relationships. Studies done by (Christakis and Fowler in 2008) as reported in New England Journal of medicine shown that network phenomena appear relevant to smoking cessation. Smoking behavior spreads across close and distant social ties; groups of inter-connected people quit together; and smokers are increasingly marginalized socially. Support from social networks is widely regarded as mediating the adverse effects of stressful events. (McEwen & Willis2014). Health care providers can assess the capability of individuals observed social support networks and can plan involvements for those who lack them. Concepts include in network analysis as points, sociograms and actors and ties that are involved (Carolan2014).
Conclusion-Theories from sociologic sciences have influenced nursing, Exchange theories apply to human interactions in social context, general system theory and social networks are examples. Duty theories of ethics emphasize the need to follow moral rules that we know instinctively and discover through human reasoning. (McEwen & Willis2014). Duty theories of ethics are also called deontological theories, from the Greek word deon, for duty. According to the code of ethics as described by American nurses association has set of nine provisions. Nurse can work within the framework of nursing code of ethics and sometimes all social exchange theories are not applicable.
Nurses when doing research or practice and education should look at the situation and should choose which social theories are applicable and that agree with the code of ethics and according to policy of institution. Nurses should be able to articulate with other disciplines and for creation of theories for professional growth of nursing Nurses should not recklessly adopt theories from other disciplines, but should use systematic assessment of the theories from other disciplines.
Brian V. Carolan. (2014). 1: The Social Network Perspective and Educational Research Introduction. In Social Network Analysis and Education: Theory, Methods & Applications. (pp. 3-23). Thousand Oaks, CA: SAGE Publications, Inc. doi: http://dx.doi.org.library.gcu.edu:2048/10.4135/9781452270104.n1 Christakis, N. A., & Fowler, J. H. (2008). The Collective Dynamics of Smoking in a Large Social Network. New England Journal Of Medicine, 358(21), 2249-2258. doi:10.1056/NEJMsa0706154 Homans, George C. (1950) The Human Group. New York: Harcourt, Brace and Company Homans, George C. (1983) “Steps to a Theory of Social Behaviour: An Autobiographical Account.” Theory and Society 12, 1: 1-45. McEwen, M., & Wills, E. (2014). 3. In Theoretical Basis for nursing (4th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkins. Wiley. Byrd, M. E. (2006, May-June). Social Exchange as a framework for client-nurse interaction during public health nursing maternal-child home visits. Public Health Nursing, 23, 271-276. Retrieved from www.cinahl.com/cgi-bin/refsvc?jid=399&accno=2009239647.