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JEAN WATSON’S THEORY
By:
Raimee Schertzberg
Jacqueline Swanton
Cindy Thornton
JEAN WATSON’S THEORY
• http://www.youtube.com/watch?v=UGhpqcQfS7A
• Follow the link to view a video of Jean Watson.
JEAN WATSON’S THEORY
HISTORY:
Born in West Virginia
PHD: University Colorado, 1973
Educational Psychology and Counseling
BSN: University Colorado, 1964
MSN: University Colorado , 1966
Published author and recipient of awards and honors:
International Kellogg Fellowship
Fulbright Research Award
(6) Honorary Doctoral Degrees
JEAN WATSON’S THEORY
HISTORY CONTINUED…
• A distinguished Professor of Nursing
• Holds an endowed Chair in Caring Science at the
University of Colorado Health Science Center
• Founder of the original Center for Human Caring in
Colorado and is a fellow of the American Academy
of Nursing
• Previous Dean of Nursing at the University Health
Science Center
• Past President of the National League for Nursing
•
(
http://currentnursing.com/nursing_theory/Watson.html
JEAN WATSON’S THEORY
PHILOSOPHY & THEORY OF TRANSPERSONAL CARING:
• 1979 Published in “The
• SELF
Philosophy and science of
caring”
• PHENOMENAL FIELD
• 1988 Published in
“Nursing human science
and human care”
• INTERSUBJECTIVITY
http://currentnursing.com/nursing_theory/Watson.html
(Kearney-Nunnery, (2008), p. 73)
JEAN WATSON’S THEORY
CARE HEALING PERSPECTIVE:
• “It embraces both a physical embodiment and
metaphysical transcendent dimension of
nursing and the caring healing process; it is
concerned with preserving human dignity and
restoring and preserving humanity in the
fragmented, technological, medical cure
dominated systems.”
(Parker, 1990, p. 278)
JEAN WATSON’S THEORY
DEVELOPMENT OF THEORY:
•
•
•
•
•
•
•
MAIN FOCUS:
Carative factors that are derived from a humanistic perspective
combined with a scientific knowledge base
Focus on health promotion rather than cure of disease
BELIEFS:
A strong liberal arts background is necessary for nurses to develop
humanistic philosophies and value systems
Philosophies and Value Systems in turn provide the foundation for the
science of caring.
Nursing is being threatened by the tasks and technology demands of the
curative factors
Caring is the most valuable attribute nursing has to offer
Caring receives less emphasis than other aspects of nursing practice
(George, 1995, p. 317)
JEAN WATSON’S THEORY
FRAMEWORK OF THEORY:
7 ASSUMPTIONS
• Caring can be effectively demonstrated and practiced only interpersonally.
•
Caring consists of carative factors that result in the satisfaction of certain
human needs.
•
Effective caring promotes health and individual or family growth.
•
Caring responses accept a person not only as he or she is now but as what he or
she may become.
•
A caring environment is one that offers the development of potential while
allowing the person to choose the best action for self at a given point in time.
•
Caring is more “healthogenic” than is curing. The practice of caring integrates
biophysical knowledge with knowledge of human behavior to generate or
promote health and to provide ministrations to those who are ill. A science of
caring is therefore complementary to the science of curing.
•
The practice of caring is central to nursing.
(George, 1995, pp. 318-319)
JEAN WATSON’S THEORY
FRAMEWORK CONTINUED…
THE 10 CARATIVE FACTORS
• The formation of a humanistic-altruistic system of values.
• The instillation of faith-hope.
• The cultivation of sensitivity to one’s self and to others.
• The development of a helping-trust relationship.
• The promotion and acceptance of the expression of positive
and negative feelings.
• The systematic use of the scientific problem-solving method
for decision making.
• The promotion of interpersonal teaching-learning.
• The provision for a supportive, protective, and (or)
corrective mental, physical, socio-cultural, and spiritual
environment.
• Assistance with the gratification of human needs.
• The allowance for existential-Phenomenological forces.
(George, 1995, pp. 318-319)
JEAN WATSON’S THEORY
METAPARADIGM OF THEORY:
• PERSON- Unity of mind/body/spirit/nature.
• HEALTH- Unity and harmony within the mind/body/soul.
• ENVIRONMENT- Healing spaces.
• NURSING- Noun and Verb.
(Alligood, 2010, pp. 98-99)
JEAN WATSON’S THEORY
• PERSON:
ENVIRONMENT:
“PERSONHOOD IS TIED TO
NOTIONS THAT ONE’S SOUL
POSSESS A BODY THAT IS
NOT CONFINED BY
OBJECTIVE TIME AND
SPACE.”
“HEALING SPACES
CAN BE USED TO
HELP OTHERS
TRANSCEND
ILLNESS, PAIN,
AND SUFFERING.”
(Alligood, 2010, p. 99)
JEAN WATSON’S THEORY
HEALTH:
• “Health refers to the unity and harmony within the mind, body, and
soul. Health is also associated with the degree of congruence
between self as perceived and the self as experienced.”
• Watson adds:
– 1) “A high level of overall physical, mental, and social
functioning.”
– 2) “A general adaptive-maintenance level of daily functioning.”
– 3) “The absence of illness.”
(George, 1995, p. 324)
JEAN WATSON’S THEORY
NURSING:
• Nursing’s goal: Help people gain harmony within the self to
promote self knowledge, self healing, or to gain insight into the
meaning of the happenings in life.
• Reinforcing humanistic studies.
• Believe in dignity and worth.
• Focus on health promotion as well as treatment of disease.
• Rooted in humanities as well as the natural sciences.
(George, 1995, pg. 325)
JEAN WATSON’S THEORY
UNIQUE:
• Continues to revise theory:
– Carative factors changed to Caratas processes
• Carative = Latin for “caring”
• Curative = Latin for “elimination of disease”
• First three carative factors form the “philosophical
foundation for the science of caring”
• Caring is both philosophical and scientific
• Caring is placed in the hierarchical lower order biophysical
needs toward higher psychosocial and interpersonal need
-Focus on physiological rather than pathophysiological
aspects of nursing
(Alligood, 2010, p. 95, 101)
(George, 1995 p. 319)
JEAN WATSON’S THEORY
EXAMPLE OF CLINICAL PRACTICE:
• Disturbances of the biophysical need for
food and fluid demonstrates the
requirement for holistic care.
– BULEMIA
– ANOREXIA
– GASTROINTESTINAL ULCERS
(George, 1995, p. 323)
JEAN WATSONS THEORY
HOW TO INTEGRATE THE THEORY:
•
Establish a caring relationship with patients.
•
Be open and receptive to patient need and perception of need. Let patients know
that you are interested in their complete care by communicating thoroughly.
Listen to patient concerns--this will reinforce your role as a caring individual in
tune to the patient's needs.
•
Treat patients as holistic beings.
•
Be aware of and sensitive to the patient's emotional and mental health in
addition to his physical health. Ask questions and listen closely to physical as
well as immaterial concerns. Embrace non-medical concerns or psychological or
emotional concerns as valid needs within the patient and respond accordingly.
•
Display unconditional acceptance.
•
Be sensitive to the patient's insecurities that are due to her vulnerable position.
Extend acceptance by maintaining an even level of acceptance and caring
regardless of the patient's physical appearance, emotional need or level of
compliance with you or the doctor.
•
Treat patients with positive regard.
• Extend respect through positivity and encouragement. Be open and
show caring, regardless of patient attitude or degree of positivity.
• Promote health through knowledge and intervention.
JEAN WATSON’S THEORY
• Communicate with patients honestly about their medical condition.
Encourage the patient to understand and explore his health through
HOW
TO INTEGRATE
THEORY
CONT…
education
and research.
Show health practices
through
modeling.
Intervene in a patient's health routine to redirect the patient to
healthier patterns.
• Spend uninterrupted time with the patient.
• Stay with a patient until her questions are answered or until the task
you must accomplish is done thoroughly. Listen to patient concerns
without looking at your watch. Maintain eye contact--even if you only
have five minutes alone with a patient before performing other duties,
allow that patient to feel singular and important in those five minutes
by truly devoting all of your attention to her.
To read more: How to Integrate Jean Watson's Theory of Caring Into Nursing Practice | eHow.com
http://www.ehow.com/how_6644521_intergrate-theory-caring-nursing-practice.html#ixzz1331NDj5b
JEAN WATSON’S THEORY
• CARITAS
• Created to support the personal and professional
journey of "Being and Becoming".
• Transpersonal Caring
• Concern for the inner life world and subjective
meaning of another who is fully embodied, going
beyond the ego self and the given moment, reaching to
the deeper connections to spirit and with the broader
universe.
Watson, 2009
JEAN WATSON’S THEORY
“The nurse attempts to enter into and stay within the
other’s frame of reference for connecting with the inner
life world of meaning and spirit of the other; together
they join in mutual search for meaning and wholeness of
being and becoming to potentiate comfort measures,
pain control, a sense of well-being, wholeness, or even
spiritual transcendence of suffering. The person is
viewed as a whole and complete, regardless of illness or
disease.”
Watson, 1996, Blueprint: p.153
JEAN WATSON’S THEORY
• Entering the other’s frame of reference & “becoming one”
JEAN WATSON’S THEORY
• Assessment
• The “caring occasion”
• “The moment of coming together and the opportunity to
decide how to be in the moment and in the relationship.”
– “If the caring moment is transpersonal, each feels a
connection with the other opening up new possibilities
for healing and human connection at a deeper level than
physical interaction.”
– “We learn from one another how to be human by
identifying ourselves with others and finding their
dilemmas in ourselves.”
– “How the nurse chooses to be with the patient/family in
any given moment influences the “caring-healing
relationship.”
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
Assessment:
– What is meaningful for the patient and their
quality of life.
– Listen attentively to what people say about
themselves and their lives.
– “Reflect on what is meaningful for them and how
their experiences are influencing their quality of
life and peace of mind, body, and soul.”
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
• Assessment
• “Allow clients and family members to reveal extensive
information about themselves within the context of
their health situations.”
• “Be fully present, respectful, and open to dialogue that
is shaped by the patient’s perspective.”
• “Be supportive of the person’s wishes and priorities.”
• “Discover that within the patient stories there are
hidden common themes that shape and direct caring
practices.”
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
• Assessment of Environment
• Jean Watson places a high regard on the environment
in influencing the caring-healing process.
– “Environment can influence a person’s sense of
connective, energy, and inner harmony.”
– “Factors to consider during assessment include:
noise, privacy, light, access to nature, color, space
and smells.”
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
• Assessment
• “Through discussion about day-to-day needs such as
mobility, comfort, continence care, activities, rest and
sleep, medications, skin care, nutrition, mood, and
mental well-being.”
• “Other areas that may be revealed are suffering,
loneliness, powerlessness, living with chronic illness,
dealing with loss, living with risk, meaningful
relationships, hope, and fighting to maintain
independence.”
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
• Assessment
• “The past medical history, medication review and
systems review are explored only after the story and
dialogue has emerged that provides valuable
information about the person as an individual, his/her
desires, wishes, strengths, and fears.”
• “The physical assessment and review of medical
history would be considered the “trim” of the
assessment. The “core” of the assessment focuses on
the essence of the person.”
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
• Watson’s opinion of nursing education within her model during a
one-on-one interview published in Nursing Science Quarterly:
• Watson states that “although the bachelor’s degree is considered
still (unresolved and impossible to implement) minimal entry
into the professional practice of nursing, the mature practice of
nursing, as a career health professional, ideally should be at the
professional doctoral level, or at least the graduate level.”
• “It is so ironic and amazing to me that, even as we enter the 21st
century, we who are the oldest of the caring/health/healing
professions, and we, who deal with the most complex human
experiences and health-related phenomena, have never made the
connection for the need for additional education to deal with
these complex, technological, and evolving human phenomena”
(Watson, 2002).
Nursing Science Quarterly, 2002
JEAN WATSON’S THEORY
• Continuation of one-on-one interview regarding Watson’s
opinion on education.
• “If I had my way, I think every major academic health
science center nursing program should convert its
baccalaureate nursing programs into non-practice degrees
in caring science and health, or at least make that degree a
major in the field” (Watson, 2002).
• “Rather than dribbling away our resources through the
continuing layers of nursing education and practice, we
should put all of our mature knowledge, energy, passion,
inspiration, excitement, and joy into preparing the finest
nurses, at the doctoral level [ND and PhD]” (Watson,
2002).
Nursing Science Quarterly, 2002
JEAN WATSON’S THEORY
• Education
• “Watson is adamant in her support for nursing
education that incorporates holistic education that
incorporates holistic knowledge from many disciplines
and integrates the humanities, arts, and sciences.
She believes that the increasingly complex
requirements of the healthcare system and patient
needs require nurses to have a broad, liberal
education.”
Alligood & Tomey, 2010, p .99
JEAN WATSON’S THEORY
• Research
• “There is a growing body of national and international
research that tests, expands, and evaluates Watson’s
theory.”
• Published studies revealed four major categories of
research related to Watson’s theory.
• These are:
– (a) The nature of nurse caring;
– (b) nurse caring behaviors as perceived by clients and
nurses;
– (c) human experiences and caring needs;
– (d) evaluating outcomes of caring in nursing practice
and education.
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
• Research
• Research subjects of Watson’s Theory include:
• The effects of caring for women who miscarried
• Pre-Surgery Practice model
• Experiences of growing up with cystic fibrosis
• Living in a nursing home
• Caring occasion for depressed women
• The caring needs of caregivers of newly disabled
adults
• Spouses caring for their dying loved one
Nursing Science Quarterly, 2004
JEAN WATSON’S THEORY
• Strength’s of Watson’s Theory:
– Watson believes in focusing on the patients care
and not on the technology needed to provide that
care.
– Provides a deeper way of healing a patient.
– “Watson’s theory continues to provide a useful and
important metaphysical orientation for the delivery
of nursing care” (Alligood & Tomey, 2010, p. 102).
JEAN WATSON’S THEORY
• Weaknesses of Watson’s theory:
– Due to the higher level of care most patients require, it
may not be possible to provide such in depth care.
– The Ten Carative Factors focus mainly on the
psychosocial needs of the patient when many patients
need more physical care to be provided.
– It seems that the Carative Factors have a solid
foundation but further research could show how they
can apply to nursing practice.
– “The theory is more about being than doing, and it must
be internalized thoroughly by the nurse if it is to be
actualized in practice” (Alligood & Tomey, 2010, p. 102).
JEAN WATSON’S THEORY
•
•
•
•
Overview
Jean Watson developed the Philosophy and Theory of
Transpersonal Caring.
What started as the 10 Carative Factors has evolved
into the Caritas process to include a “spiritual
dimension of love and caring” (Watson, 2007) .
The major emphasis of the Caritas process is based on
the caring relationship of the patient and nurse
(becoming one).
Theory is based on caring versus curing.
Alligood & Tomey, 2010, p.95
JEAN WATSON’S THEORY
Overview (cont.)
• Watson’s theory “calls upon nurses to go beyond
procedures, tasks, and techniques” with the main
focus being on a therapeutic and transpersonal caring
process.
• “The theory is more about being than doing.”
• Patient stories verses disease (or illness) shape and
direct caring practices.
Alligood & Tomey, 2010, p.95
JEAN WATSON’S THEORY
Analysis
• Jean Watson believes in “deeper connections to spirit and
with the broader universe.”
• Implementing the “caritas processes” allows for nurses to
gain a better understanding of the “uniqueness of
individuals” and an “understanding of human responses to
health experiences” through “listening and reflecting on
what is meaningful for them.”
• The caring process, including attentive listening and
reflecting on what is important to the patient should be
part of the nurses initial introduction to the nurse-patient
relationship for the establishment of goals.
Nursing Quarterly, 2004
JEAN WATSON’S THEORY
• Analysis (cont.)
• Despite the type of care a patient is in need of, the
nurse can implement the ten carative factors by
showing kindness, faith and hope, sensitivity, trust,
acceptance of feelings, problem solving, teaching and
learning, a healing environment, assist with physical,
emotional, and spiritual needs, and being open to the
unknown.
• Although the nurse can implement the above listed
“factors”, how the patient chooses to respond to this
approach to care is individual and will not always be
conducive to “transpersonal caring relationships”.
JEAN WATSON’S THEORY
• Jean Watson continues to expand on her Theory of
Transpersonal Caring and “in 2008 created a non-profit
foundation: Watson Caring Science Institute, to further the
work of Caring Science in the world.”
www.watsoncaringscience.org
QUESTIONS:
• How can you apply Watson’s theory to the way that
you practice nursing?
• Out of all of the theorists we have discussed, would
you choose to follow Watson’s theory? Why or why
not?
• Name and give a definition to the three dimensions of
a transpersonal caring relationship.
REFERENCES:
• Alligood, M. R., & Tomey, A.M., (2006). Nursing theorists and their work.(6th
ed.). St. Louis, MO: Mosby Elsevier.
• Bernick, L. (2004). Caring for older adults: Practice guided by Watson’s
caring-healing model. Nursing Science Quarterly.
doi:10.1177/0894318404263374
• Fawcett, J. (2002). The Nurse Theorists: 21st-century updates-Jean Watson.
Nursing Science Quarterly. doi:10.1177/089431840201500307
• George, J. B. (Ed.), (1995). Nursing theories: The base for Professional
Nursing Practice. (4th ed.). Norwalk, Connecticut: Appleton & Lange
• Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional
nursing (4th ed.). Philadelphia, PA: F. A Davis Company
• Parker, M. E. (Ed.), (1990). Nursing Theories in Practice. New York, NY:
National League for Nursing
• www.watsoncaringscience.org
• http://currentnursing.com/nursing_theory/Watson.html
• http://www.ehow.com/how_6644521_intergrate-theory-caring-nursingpractice.html#ixzz1331NDj5b
• http://www.youtube.com/watch?v=UGhpqcQfS7A