Jean Watson's Theory of Caring

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Jean Watson's Theory of Caring

• Ashley Bridges
• Nicole Chambers
• Jennifer Hanson
• Chelsea Melrose

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Introduction

• Caring is the essence of nursing. - Jean Watson
•  
•     Jean Watson is a psychiatric and mental
  health nurse, who innovative views on nursing
  helped shape her nursing theory of caring. The
  following presentation will outline the origins
  and philosophy behind her theory, as well as
  present the four global concepts and how she
  incorporates each into her theory. Last, a case
  study will presented for student evaluation of
  understanding of Watson's theory.

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Origins and Philosophies

• Jean Watson specialized in psychiatric-mental
  health nursing which allowed her to recognize the
  needs of both the caregiver and the patient.
• Watson's work is recognized as a "Human Science"
  for this reason.
• Recognized human caring as the basis of nursing
  practice and placed a large emphasis on how the
  nurse and patient interact together to promote
  healing.
• She equated health with harmony, resulting from
  the unity of the body, mind and soul.
• Believed that nursing is based on human values
  and interest in the welfare of others therefore
  placing a large emphasis on the caregiver
  recognizing his/her own values as a nurse.
• Believed that nursing is concerned with health
  promotion, health restoration and illness
  prevention therefore placing a large emphasis on
  the development of a trusting patient-nurse
  relationship and providing a caring environment.

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Historical Background

• Jean Watson developed her Theory of Human Caring
  between 1975 and 1979 while she taught at the
  University of Colorado
• Theory evolved as she worked on a curriculum for
  a bachelor's of science in nursing program
• Was originally based on her beliefs about nursing
  and was augmented by her doctoral studies in
  psychology 
• Watson's goal in developing her theory was to
  bring meaning to nursing as a unique and distinct
  health profession with its own values and
  knowledge base
• Wanted to bridge the gap between the caring and
  focus on health of nursing and the focus on
  diagnosis and illness of medicine (Fawcett, 2002)
• Beliefs centered on the carative factors of
  nursing, which stood apart from the curative
  factors of medicine
• Original theory proposed ten carative factors of
  nursing
•  Wanted a body of work that was applicable to
  every area of nursing across time (Watson, n.d.)

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Philosophic Values About Nursing

• Watson's fundamental belief about nursing is that
  it is a human science (McCance, McKenna, Boore,
  1999)
•  Believes that the primary goal of nursing is to
  help individuals achieve harmony of mind, body,
  and soul through caring transactions
• Core of nursing is based on the essence of caring
• Goal of nursing is to guide the individual to
  find meaning in sickness and pain, which will
  improve human nature
• Nursing, as part of the transpersonal caring
  relationship, involves being present, showing
  kindness, developing trust, listening to the
  expression of feelings, and assisting in the
  meeting of basic needs (Watson, n.d.)

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Knowledge Development

• Believes that one has to experience the caring
  theory before one can learn about and research
  it, and ultimately, add to it
• Because the theory can be experienced, it
  provides the opportunity to grow the theory and
  practice its fundamentals in personal and
  professional life
•  Use of the theory is ever-changing
•  Believes what is meant by nursing discipline
  needs to be rethought so that nursing can
  continue to mature as a distinct
  profession (Fawcett, 2002)
• Nursing has generally borrowed knowledge from
  other disciplines, especially medicine
• Once nursing knowledge can guide its own
  practices, then other disciplines can draw from
  nursing knowledge
• Feels that caring should remain at the center of
  knowledge development and that all healthcare
  disciplines will have to incorporate a caring
  model into their practices to meet the public's
  expectations (Watson, n.d.)

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Influences on Nursing Philosophy

• The transpersonal caring relationship was the
  major influence on Watson's nursing philosophy
• Transpersonal caring relationship is defined by a
  spiritual connection that allows for the
  possibility of healing
• Transpersonal caring requires being involved in
  the moment, being authentic, providing a caring
  environment, and making a spiritual connection
• Believed that caring in nursing has been present
  in every society and could be transmitted through
  the nursing profession (Fawcett, 2002)
• Belief in holistic care was critical in the
  development of her caring philosophy

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Global Concepts According to Watson's Theory of
Caring

• Person, Environment, Health and Nursing

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Global Concepts Person

• One of the only theories involving the caregiver
  and the patient.
• Encourages the nurse and patient to develop a
  trusting relationship
• Requires nurse to be conscious of own morals and
  values
• Encourages going beyond ones "ego" to reach a
  spiritual connection in promoting the patients
  comfort and healing.
• The goal is to promote, protect, enhance, and
  preserve the patients dignity, humanity,
  wholeness and inner harmony.
• The art of caring provides compassion and eases
  patients and families suffering.
•  An individual who receives care, is respected,
  appreciated, cultivated and assisted with care
  while being viewed as an individual.

• Watson's Carative Factors related to this
  concept
• The formation of humanistic-altruistic system of
  values
• The cultivation of sensitivity to one's self and
  others
•  The development of a helping-trust relationship

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Global Concepts Environment

• Environment should support caring
• accepts an individual as they are or who they may
  become.
• A caring attitude is attained by ones culture to
  cope with its environment.

• Watson's Carative Factors related to this
  concept
•  
• The provision for a supportive, protective,
  and/or corrective mental, physical,
  sociocultural, and spiritual environment

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Global Concepts Health

• Applying caring values in our practice is
  essential to our own health, as healthcare
  providers.
• Encourages a teaching-learning environment that
  supports and promotes health.
• The spiritual strength of the patient is
  recognized and encouraged for its contribution to
  the health of the individual.
• Holistic approach to promote health and prevent
  illness
• Maintaining functions of daily living.

• Watson's Carative Factors related to this
  concept
• The systematic use of the scientific
  problem-solving method for decision making
• The promotion of interpersonal teaching-learning
• Assistance with the gratification of human needs

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Global Concepts Nursing

• Encourages nurses to practice the "art of caring"
  and provide compassion to ease patient and
  families suffering.
• Promotes healing and dignity but it can also
  expand to help nurses reach their own
  self-actualization.
• Believes that holistic health is central to the
  practice of caring in nursing.
• Encourages nurses to be their genuine selves with
  their patients, which allows for development of a
  trusting relationship between the nurse and
  patient.
• Nursing is the science of humans with experiences
  of health promotion and illness preventions
• Nursing provides care for patients and
  facilitates health in a professional, ethical and
  personal interaction.

• Watson's Carative Factors related to this
  concept
• The promotion and acceptance of the expression of
  positive and negative feelings
• The cultivation of sensitivity to one's self and
  others
• The development of a helping-trust relationships
• The instilation of faith and hope
• The allowence for existential phenomenological
  forces

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Evaluation of Watson's theory

• Watson's background in mental health nursing
  helped her recognize the needs of both the
  caregiver and the patient, which directly
  influenced her views on nursing and development
  of her theory.
• Theory was started while Watson was working
  towards a BSN, and evolved while in her doctorate
  program.
• Theory originally began as Watson's definition of
  nursing.
• Theory is unique to nursing, however, Watson
  established the carative factors in hopes that
  her theory could be applied to all areas of
  nursing.

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Theory of Human Caring Where, When and How?

• Can be applied to all areas of nursing, including
  both ambulatory and acute care
• A guide to articulate what nursing is and does,
  beyond task orientation
• A guide for all nursing roles and specialities
• Framework that helps build awarenss of how our
  values guide moment to moment practice
•  

• Theory of Human Caring can be applied to
  interdisciplinary relationships within
  healthcare, as well as with nurse colleagues.
• Two main elements of the theory are human caring
  and being sensitive to others, which can be
  applied to all interpersonal relationships
  (within family units, work, etc)

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Case Study

• Mrs. Doubtfire is a 43 year old female who is
  admitted to your oncology unit to receive
   chemotherapy and radiation for stage 2 breast
  cancer. She has been told that in order to
  adequately treat her cancer she must undergo a
  double mastectomy. As a mother of three teenage
  daughters, she voices concern to you that she
  will no longer feel feminine after already losing
  her hair and potentially both of her breasts. 
• Using Jean Watson's theory of caring, answer the
  following questions related to Mrs. Doubtfire's
  situation.

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1. Using Watson's caring philosophy, what would
your nursing care interventions be?

• a. Convince Mrs. Doubtfire to have her breasts
  removed so that she will not die and leave her
  daughters behind.
• b. Tell her that her daughters will still see her
  as a woman.
• c. Sit down with the patient and allow her to
  express her positive and negative feelings about
  having the bilateral mastectomy.
• d. Tell her that you will give her time to
  rethink her decision and go see your next patient.

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2. Inspired by Watson's theory, what question
would help Mrs. Doubtfire share her feelings?

• a."Tell me about your spiritual and cultural
  beliefs regarding feminity."
• b. Don't ask questions, let her sleep and go
  review her chart.
• c. Don't ask questions, put in a social work
  consult and have them come talk with her.
• d. "Do you feel that having this surgery will
  effect having a relationship with your daughters?"

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3. Identify the clinical carative factors that
you could apply to the situation with Mrs.
Doubtfire. Choose all that apply.

• a. Assistance with the gratification of human
  needs.
• b. The development of a helping-trust
  relationship.
• c. Work in such a way that there is a sense of
  accomplishment.
• d. Learn, discover, or satisfy the curiosity that
  leads to normal development and health and use
  the available health facilities.
• e. The promotion and acceptance of the expression
  of positive and negative feelings.

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References

• Caruso, E., Cisar, N., Pipe, T. (2008).
  Creating a healing environment an innovative
  educational approach for adopting jean watson's
  theory of human caring. Nursing Administration
  Quarterly,32(2), 126-132.
• Chitty, K.K., Black, B.P. (2011). Nursing
  theory the basis of professional
  nursing. M.,  Iannuzzi M., Zimmerman.
  (Eds.),  Professional Nursing Concepts and
  Challenges (pp.303-323). Maryland Heights,
  Missouri Saunders Elsevier.
• Fawcett, J. (2002). The nurse theorists
  21st-century updates- Jean Watson. Nursing
  Science Quarterly,15, 214-219. Doi 10.
  1177/089431840201500307
• Lukose, A. (2011). Developing a practice model
  for Watson's theory of caring. Nursing
  Science Quarterly, 24(1) 27-30. DOI
  10.1177/0894318410389073
• McCance, T.V., McKenna, H.P., Boore, J.R.P.
  (1999). Caring theoretical perspectives of
  relevance to nursing. Journal of Advanced
  Nursing, 30(6) 1388-1395.
•  
• Nursing Theories. (2012, Jan 26). Jean Watson's
  philosophy of nursing. Retrieved from 
•     http//currentnursing.com/nursing_theory/Watso
  n.html
• Vance, T. (2003, March 20). Caring and the
  professional practice of nursing. RN Journal.
  Retrieved from http//www.rnjournal.com/journal_o
  f_nursing/caring.htm  
• Watson, J. (n.d.). Theory of human caring.
  Retrieved from http//www.watsoncaringscience.org/
  index.cfm/feature/84_12/theory-of-human-caring.cfm
  
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