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Jean Watsons Theory of Caring

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Title: Jean Watsons Theory of Caring


1
Jean Watsons Theory of Caring
Alyson Conway, Sally Erickson, Patty Lynch,
Kimberly Myers Sarah Palmer
2
Current Works
  • Nursing The Philosophy and Science of Caring
    (1979,1985)
  • Nursing Human Science and Human Caring
    (1985,1988, 1999)
  • Postmodern Nursing and Beyond (1999)
  • Assessing and Measuring Caring in Nursing and
    Health Sciences (2002)

3
Theory in Our Words
  • Caring
  • Is the essence of nursing
  • Compliments curative medicine
  • Gives nursing unique standing
  • Relationship occurs when the nurse and patient
    come together
  • Transpersonal moment
  • Results in transcendence, harmony healing.

4
Phenomenon of Concern
  • Watsons Theory attempts to
  • Define nursing as a distinct health profession
  • Make explicit nursing's values, knowledge
    practices
  • Inner healing process
  • Experiencing the person
  • Three major elements of the theory
  • Carative factors
  • Transpersonal caring relationship
  • Caring occasion/caring moment

5
Context Significant Events
  • Education Undergraduate Graduate Degrees in
    Nursing psych-mental health nursing
  • PhD in Educational psych counseling
  • Extensive travels to Asia Australia
  • Years in private practice
  • Nursing - Carl Rogers, Nightingale Leininger
  • Psychology - Maslow, Giorgi, Johnson Koch
  • 1970s Feminism
  • Quantum Physics
  • Wisdom tradition
  • Eastern Philosophy
  • New Age, Metaphysics

6
Theory Development
  • With 1979 publication of first book, developed
    ideas created 10 Carative factors
  • Developed theory 1979-1985
  • 1985 publication of actual theory, further
    developed nursing curriculum
  • Inductive
  • Set out to prove theory through research
  • Deductive
  • Writing of original theory based on experience

7
Assumptions Implicit
  • Humans cannot be treated as objects
  • Humans cannot be separated from self, other,
    nature, or the larger universe
  • There is a sacredness of life and all living
    things (Marriner-Tomey, et al 2006)

8
Assumptions Explicit
  • Care and Love
  • Comprise primal and universal energy
  • Often overlooked, but humanness requires both
    to survive
  • Our sense of humanity requires that the practice
    of human care be an interpersonal endeavor
  • Nursing has always held a human-care stance in
    health-illness concerns
  • Nurses must treat themselves with gentleness and
    dignity before they are capable of providing the
    same to others

9
Assumptions Explicit contd.
  • Care is the essence of nursing, and serves as the
    professions unifying factor.
  • Ability of nurses to sustain their caring ideal
    will determine nursings contribution to society,
    practice and research.
  • Health care delivery system has placed less
    emphasis on human care, threatening the caring
    ideology in practice.
  • Care environment offers development of potential,
    while enabling person to make choices for health.
  • Theory recognition that the science of caring is
    complementary to the science of curing.

10
Assumptions World View
  • Holistic view of patient and the nurse
  • Human science orientation to nursing
  • of unity and connectedness of All
  • Transpersonal view acknowledges unity of life
  • Concentric circles of caring
  • Individuals, others, community, state, nation,
    universe

11
Metaparadigm
  • Person
  • Humans have needs that are valued, respected,
    supported cared for
  • Environment
  • Should be conducive to holistic healing
  • Health
  • Holistic approach to health is necessary to
    function as a whole being
  • Nursing
  • Nurse-patient relationship is foundational to
    nursing

12
Concepts
  • The Carative Factors
  • Originally created 1979 as framework for
    providing a format and focus for nursing
    phenomena
  • Still current terminology for "core" of nursing,
    but term "factor" is too stagnant
  • Trim of nursing (time, setting, procedure) is
    outside the core potentiates therapeutic
    healing processes and relationships
  • Evolved concept today is "clinical caritas" and
    "caritas processes"
  • Explicit nursing values, knowledge, and practices
    of human caring geared toward subjective inner
    healing process unique to caring as healing arts
  • (Watson, 2007)

13
Concepts
  • Transpersonal Caring Relationship
  • Foundation of the work
  • Shows concern for inner life world of another
    fully embodied person
  • Goes beyond ego self, reaching to the deeper
    connections to spirit broader universe
  • Nurse uses caring consciousness to preserve
    honor embodied spirit heal as experience,
    perception, and intentional connection take place
  • Be an authentic being, in the moment
  • (Watson, 2007)

14
Concepts
  • Caring Occasion - Caring Moment
  • Occurs when nurse another come together with
    unique life histories phenomenal fields in
    a human-to-human transaction
  • Transcendent experience perception take place
    greater field potentiated
  • Involves action choice by both participants
  • Becomes part of life history of each person as
    well as stamp on history of time
  • Consistency Watson uses terms interchangably
  • (Watson, 2007)

15
Propositions - Diagram
16
World View - Diagram
17
Application Clarity
  • Lack of Definition
  • Concept of intersubjective ideal
  • Concept of Transcendence
  • Conflicts
  • Care Theory vs. concepts of ones wholeness,
    their intention and freewill, and the nature of
    reality
  • Use of Language
  • Care moment/caring transaction/caring occasion
    Terms used interchangeably
  • Concept of soul
  • Watsons language inaccessible to many nurses

18
Application Congruence
  • Theory is internally congruent up to the outcomes
    aspect of theory
  • Terms are not clearly defined
  • achieving outcomes is difficult
  • Each nursing encounter does not offer an
    opportunity for transcendence

19
Application Level
  • Predictive - Weak
  • Positive changes are potential occurrences, which
    cannot be predicted with certainty.
  • Watson acknowledges that different expressions of
    caring in different situations may result in
    unpredictable outcomes.
  • Explanatory, Descriptive Strong
  • Explains importance of care to nursing profession
    and patient outcomes
  • Explains complementary relationship between care
    and cure
  • Explains inter-relationship of care and
    transpersonal moment, leading to transcendence,
    harmony, and healing outcomes.

20
Use Application to Nursing Practice
  • Application of clinical caritas to care
    situations
  • Recognition of caring moment
  • Take time to be present in the moment
  • Respect persons choices and decisions
  • View the persons health through Watsons caring
    lens a persons health is a subjective
    experience (Cara, 2004)
  • The nurses moral commitment, intentionality,
    and personal use of the clinical caritas
    protects, enhances and potentiates human dignity,
    wholeness, and healing this encourages the
    patient to create (or really, co-create) a
    meaning of a disease and treatment.
  • The Art of Caring as a Philosophical Model for
    Nurse Practitioner Praxis, retrieved from
    http//www.medscape.com/viewarticle/496372_2

21
Application Testability
  • Difficult to assess caring due to it being a
    dynamic process (Coates, 2002)
  • Studies have linked Watsons carative factors to
    improved health outcomes (Nyman Lutzen, 1999
    Eric et al., 2003)
  • Does not control for other factors that could
    improve health outcomes
  • Watson not sole variable
  • Multiple scales for measuring caring, not all
    theoretically based
  • Healthcare Environment Caring Factor Survey
    (Handout)

22
Application Future
  • Is this a theory for the future?
  • The theory is one for the present and the future
  • Huge non-profit, University of Colorado Center
    for Caring, integrated into curricula and
    organizations
  • Thousands of followers, speaks globally
  • Hundreds of research articles and studies
    undertaken
  • Examples of Practice theory that have been
    developed based on Theory of Caring
  • Perinatal loss
  • Hospice
  • Geriatrics
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