Social Exchange Theory: Application to Advance Nursing Anita Thigpen Perry School of Nursing Texas Tech University Health Sciences Center Social Exchange Theory: Application to Advance Nursing 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 those interactions. The purpose of this paper is to look at how Social Exchange theory relates to advance practice nursing.

I will discuss George C. Homans social exchange theory (Homans, 1958, p. 597) and how it applies to small groups. I will also discuss the theorist’s background, the studies and articles that led to his development of this theory, the application of the theory to advance practice nursing as well as the components of the theory. History Long before George Homans penned his articles and books on social exchange, “…attention should be called to Albert Chavannes who wrote on the subject of exchange in 1884” (Knox, 1963, p. 341).

Chavannes edited a magazine called The Sociologist and he wrote a section specifically for the editor in which he spoke of “…social laws, declaring: It is the mission of Sociology to demonstrate that man obeys in his conduct as fixed and unchangeable laws as the winds or rain…”(Knox, 1963, p. 342). One of these laws which he spoke of was “The Law of Exchange where he states boldly that profitable exchange is the foundation upon which men have built society” (Knox, 1963, p. 342). Theorist’s background. George C. Homans was born August 11, 1910 in Boston, Massachusetts and attended Harvard University as an English major (Trevino, 2009, p. ). “He became a junior fellow in sociology in 1934; was invited to become a professor of sociology in 1939…” (Trevino, 2009, p. 1). While not formally trained as a sociologist he became friends with several of the professors while a junior fellow. “None of us, for example, should advise aspiring sociologists to drift into the field untrained through personal connections, as George did, even if it resembled the way that George’s great-uncle Brooks Adams became professor of history at Harvard” (Tilly, 1990, para. 1).

He had co-authored a book with family friend and Boston lawyer Charles P. Curtis Jr. called “An Introduction to Pareto” (Homans, 1983, p. 1). This authorship was his ticket to becoming a junior fellow and bypassing the need to have his Ph. D. and was offered a teaching position in 1939. He was then “called to active duty in the U. S. Navy in May of 1941…until the beginning of 1946” (Homans, 1983, p. 16). Thereafter he returned to Harvard “where he remained a faculty member until he retired in 1970” (Trevino, 2009, p. 1).

Societal event impact on theory development. While I believe World War II contributed greatly to George Homans development of his theory I don’t believe it had the greatest impact on it. Having spent so much time on the campus of Harvard among the “great thinkers” of the time. “There I met as Junior Fellows young men who were later to make a big difference in my intellectual life: W. V. O Quine, logician; B. F. Skinner, psychologist; C. M. Arensberg, anthropologist; and W. F. Whyte, sociologist” (Homans, 1983, p. 2).

Spending time with these colleagues bouncing ideas off one another, listening to the professors talk about their research are the events that shaped Mr. Homans thinking and postulating on how society was to act. When he returned from the war he immediately penned an article called The Small Warship which shows that he was already thinking as a sociologist. Theory development history. While George Homans 1958 article Social Behavior as Exchange set the stage there were others making contributions to the fundamental idea behind the theory.

John Thibaut and Harold Kelley in 1959 were publishing “The Social Psychology of Groups” (Thibaut & Kelley, 1959) Social control plays a central part in the theory of social interaction developed throughout the book, especially the control one person has over another which is reconciled by their ability to affect the other person’s outcomes such as rewards, payoffs, and reinforcements. It is assumed that most socially significant behavior will not be repeated unless it is reinforced by being rewarded in some way. Then in 1964 Peter Blau published his book titled “Exchange and Power in Social Life” (Blau, 1964).

Peter Blau put more emphasis on technical economic analysis. “Groups are held together by exchange of benefits in a manner analogous to that in which an economy is held together by mutual advantage in exchange” (Spread, 1984, p. 157). George Homans theory focused upon the psychology of behavior. Before going off to war Mr. Homans began to work on a classification system of naming the variables of his model. “My first sketch of my three-fold classification first appeared in the last chapter of my English Villagers of the Thirteenth Century(1941), where it was wholly out of place…”(Homans, 1983, p. 6). He continued to work on this while in the Navy and during a lull in activity wrote them out “…interaction, sentiment, and activity. An intellectual boundary might be drawn around any social system such as a group. Within this boundary the three classes of variables were mutually dependent on one another in the behavior of the members”(Homans, 1983, p. 17). After the war Mr. Homans returned to Harvard, being offered an Associate Professorship prior to his leaving the service.

He had decided by that time to write another book with his new framework and was on his way to a conference in Chicago via train when he met “Conrad Arensberg, coming from Columbia…he let fall the remark that he planned to write a general book on social organization”(Homans, 1983, p. 20). It was this meeting that made him decide to focus on small groups rather than larger more generalized groups for his book. Application to the Master’s Prepared Nursing Role Mr. Homans theory can be seen in every role that the advance practice nurse has contact with patients as a give and take relationship.

In these following paragraphs I will show the application of the exchange theory and how it relates to the advance nursing role and the expected outcomes from the theory’s application. Application of the theory to the MSN nursing role. Initially I would like to start with some definitions or explanations. Each area of nursing practice has a particular clinical emphasis. This emphasis doesn’t overshadow all the other aspects of that role. Medical-surgical nursing emphasizes technical care, while public health nurses focus more on teaching. These roles can be further expanded by advanced education.

An Acute Care Nurse Practitioner is first of all and expert clinician. He may also be a teacher, supervisor, or researcher. In each of these roles he/she will exchange information in the form of advice, opinions, or instructions. He may exchange service in the form of calling a patient with lab or x-ray results. A patient may in turn exchange status or an evaluative judgment that conveys prestige, regard, or esteem upon the nurse. Goods may be exchanged in the form of books, pamphlets, or other tangible products. “Men are anxious to receive social approval for their decisions and actions, for their opinions and suggestions.

The approving agreement of others helps to confirm their judgments to justify their conduct, and to validate their beliefs…”(Blau, 1964, p. 64). As advance practice nurses another exchange that is evident is building mutual trust and a client/patient relationship. One way we go about this is in showing our caring side to the patient. “A commanding officer had to do everything possible to see that the men were getting what they rated, and what is much more important, show that he was doing it…”(Homans, 1946, p. 297) Expected outcomes of application of the theory by the MSN prepared nurse.

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. Another study done by Rebecca Koeniger-Donohue (Koeniger-Donohue, 2007) looked at what the Nurse Practitioner expected from the clients during visits to “explain the specific nature of resources NPs expect to provide and actually provide” (Koeniger-Donohue, 2007, p. 1050). Dr Koeniger-Donohue believes social exchange theory can “provide a starting point for APRN’s to view the essential nature of their own therapeutic interactions with clients” (Koeniger-Donohue, 2007, p. 058). She goes on to mention that this is an area that has not been explored much in the past but does mention Dr Byrd’s research as I have previously in this paper. Relevant Research George Homans in his book The Human Group discusses his conceptual scheme and “applies it to a complex body of data on five closely observed concrete field studies of small groups that had appeared before and during the War”(Trevino, 2009, p. 5). The cases listed in order are “The Bank Wiring Observation Room, Norton Street Gang, Family in Tikopia, Hilltown a tudy of New England community at mid-twentieth century and lastly Electrical Equipment Company” (Homans, 1950). In each of these he applied his five propositions that was the basis of his theory. The first being “The success proposition” (Homans, 1950, Chapter 4) which he says is the principle of reward. If a past activity was rewarded, an individual is more likely to repeat that activity. The shorter the interval between behavior and reward, the more likely the individual will repeat that action and the more often an action is rewarded, the more likely that individual will repeat said action.

His next proposition he named “The stimulus proposition” (Homans, 1950, Chapter 4) or the principle of experience. If a similar stimulus presents itself and it is similar to a previously rewarded activity, that individual is likely to repeat their course of action. The third he called “The value proposition” (Homans, 1950, Chapter 4) or reward and punishment. This is the principle of value of outcomes. The more valuable an activity that another gives, the more an individual will repeat that activity rewarded by the activity of the other person.

As an example if you like someone’s company, you will engage in behavior that the other person finds desirable. His fourth proposition he called “The deprivation-satiation proposition” (Homans, 1950, Chapter 4) or principle of diminishing returns. The more often a reward has recently been received, the less valuable further rewards become. If forced for a long time to go without a certain reward, individuals will then lose interest and stop the behavior. His last proposition was “The principle of distributive justice” (Homans, 1950, Chapter 4) where when a behavior does not receive the expected reward, then the response is anger.

In turn when an individual receives a greater reward than expected, or does not receive expected punishment then that person will be pleased. As I read through Homans work I could see the parallels between himself and his friend B. F. Skinner. Homans treated the social exchange between Skinner and his work with pigeons as a paradigm of all social exchanges. Homans version of sociology is an attempt to build a theory about social life from the basic behaviorism propositions that Skinner used in his studies with operant conditioning. Another paper Homans penned deals with his experiment shortly before leaving for the war. I wanted to get further systematic information on social organizations” (Homans, 1954, p. 725). In this study he watched a small group of girls working in accounting and how they socialized throughout the workday. “Who talked to who and for how long” (Homans, 1954, p. 725). Their job consisted of moving around the office quite frequently and even working in small groups even more frequently. This particular floor consisted of approx. 60 clerical employees but Homans concentrated on the ten girls who accounted for the customers who paid their bills to the company.

After a two week observation period he interviewed the management and the girls to find out more about them. Who they considered their friends, who they didn’t associate with, if they liked their job, if they liked the boss. “The characteristics of the cash posting job should be now clear. It was an exceedingly routine and repetitive clerical job…it required no cooperation among the girls but allowed much social interaction” (Homans, 1954, p. 727). He then compared the girls on who had the highest output per hour even though there was no reward for going over the stated quota by the company.

His study showed the girls who interacted more frequently had higher outputs than the girls who did not interact as much. In his summary of this study he states “…on social organization is that certain familiar relationships between the distributions of interaction, interpersonal sentiment, and differences in off-the-job activity have turned up here as they turn up in many observational studies of working groups. Theory Component Assessment Today, social exchange theory exists in several different forms, but all of them are driven by the same central concept of actors exchanging resources via a social exchange relationship.

The following sections will describe the purpose, important concepts and concept relationships of Homans exchange theory. Theory Purpose Homan states that “…he is out to rehabilitate the economic man and give him a wider range of values, including the non-material” (Homans, 1961, p. 79) as he speaks of his theory explicitly. In later work he also explicitly states “…the use of psychological theory to explain social behavior” (Homans, 1983, p. 35). I believe Homans does explicitly state a sub-purpose, “is to study elementary social behavior”(Homans, 1958, p. 597). Theory Concepts

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. 2) 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) Theory Concept Relationships

Concept relationships as applied to this theory are explicitly stated by “Profits = Rewards – Costs” (Homans, 1958, p. 603). Individuals are all in competition for rewards, and will attempt to minimize competition by any means necessary due to the desire to be rewarded. This is most similar to the value concept previously mentioned. Another concept relationship that was not explicitly stated is the more of something an individual has the less interested they will be in obtaining more of it. This is closest to the satiation concept that was explicitly stated. Theory Assumptions

While not explicitly stated Homans treated the social exchange between B. F. Skinner and his pigeons as the paradigm of all social exchange. In formulating his version of exchange theory, Homans turned to behavioral school of experimental psychology founded by his friend Skinner. Also not explicitly stated I believe Homans sociology is an attempt to build a theory about social life from the basic behavior propositions he derived from Skinner’s psychology of operant conditioning. Another assumption not explicitly mentioned but is implicit is the concept of balance-imbalance eading to the concept of power, dependence, and harmony between or in small groups. Lastly, another assumption not explicitly stated is Homans theory combines the principles of psychological behaviorism, economics and utilitarianism, with a focus on interactions between humans. Conclusion This paper has looked at the history of social exchange theory, the theorist background. The research that was relevant to the theory and application of the theory to advance practice nursing roles and the theories purpose, concepts, relationships and lastly assumptions.

The main focus of the theory which is exchange of good, services, information, status applies well to advance practice nursing as was stated by Dr Koeniger-Donohue. “Previous empirical evidence supports the notion that receiving specific types of information from the NP during a health care visit is valued highly and creates a rewarding and reinforcing encounter from the client’s viewpoint”(Koeniger-Donohue, 2007, p. 1051). Yet it is difficult to apply this theory to large groups as Homan did state his decision did “make me a small group man” (Homans, 1983, p. 20).

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