Case Study 2: Joanne Duffy's Quality Care Model©Safe labor and delivery depends on the successful interaction of the four Ps; one of these P represents the psyche. The psyche refers to “a woman’s emotional structure that can determine her entire response to work and influence her physiological and psychological functioning” (Silvestri, 2011, p. 298). Anxiety and fear are two common emotions experienced by women in labor, especially first-time mothers, and can adversely affect the labor and delivery process (Silvestri, 2011). In the situation described, Keisha begins to feel and express emotions that could be detrimental and complicate a safe and successful birth. Although Keisha has the support of her husband and extended family, it is imperative that the nurse implement the Quality Caring Model© in this situation. Through the implementation of the eight caring factors, the nurse must establish and maintain caring relationships with Keisha, her husband, their family, and other members of the care team in order to achieve the best possible outcome in this situation. The nursing process helps the nurse assess the patient and the situation; this includes diagnosing the problem, developing a plan, implementing the plan, and eventually evaluating the outcome. Keisha is a scared first-time mother who chose to forgo pain relief and other interventions during her labor; Currently, she becomes uncomfortable and doubts herself. The presence of pain and fear can cause a problem that will affect not only Keisha, but also the labor process. With his husband at the bedside, he may also begin to fear for his wife and unborn child and react accordingly. The...... middle of article ......caring in nursing: applying theory to clinical practice, education, and leadership. New York: Springer Publishing Company. Duffy, J.R. and Hoskins, L. (2003). The quality care model©: Blending two paradigms Advances in Nursing Science, 77-88. Retrieved from https://polk.desire2learn.com/d2l/le/content/98735/viewContent/2324948/ViewReferenceHeartland Health. (2012). Heartland Health Clinical Affiliation: Student Orientation 2012. [PowerPoint Slides]. Retrieved from https://www.mymosaiclifecare.org/PageFiles/5467/2012ClinicalStudentOrientation.pdf Jenko, M. (2013). The model of quality and kindness© Joanne Duffy. [PowerPoint slides]. Retrieved from https://polk.desire2learn.com/d2l/le/content/98735/viewContent/2324952/ViewSilvestri, L.A. (2011). Saunders' comprehensive review for the NCLEX-RN exam. (pp. 298-307). St. Louis, Missouri: Elsevier Saunders.