Introduction
Essentially, the Caring theory of Jean Watson is oriented towards human science and focuses on the humanitarian aspect of caring processes, occurrences and experiences. It also grounded on a unitary perspective and interconnectedness with elements such as an individual with its community. The caring theory embraces one-sided, philosophical and interpretative as well as objective-empirical analysis and integrates several epistemological approaches that clinical and empirical but at the same time is open to other avenues of acquiring vital information.
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(Watson, 1988, 1999).
On the theoretical framework, the caring theory of 1979 was founded on the ten carative factors.
These are essentially a formation of a Humanistic-altruistic system of values and cultivation of sensitivity to one’s self and to others. It has provisions for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment. Lastly the basic core is grounded on both caring philosophy and science (Watson, 1999).
Some suggestions on original carative factors into clinical caritas processes include the formation of humanistic-altruistic value system becomes practice of loving-kindness, Instillation of faith-hope becomes authentically present.
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Cultivation of sensitivity between the communities becomes going beyond ego self, Development of a human caring relationship becomes helping-trusting an authentic caring relationship, and Promotion and acceptance of the expression of positive and negative feelings becomes being supportive of the expression of positive and negative feelings (Watson, 2006).
Main Components
Originally, Watson’s theory revolved around three major elements, namely the carative factors, the transpersonal caring relationship, and the caring moment. She stated ten carative factors that served as guidelines for the nursing practice and basically centered on the principles of caring.
The transpersonal caring relationship describes how the nurse goes beyond an objective assessment, showing concerns toward the person’s subjective and deeper meaning regarding their own health care situation, while the caring moment is defined as the moment (focal point in space and time) when the nurse and another person come together in such a way that an occasion for human caring is created (Cara, 2003).
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In this context, the four essential concepts of nursing – person, environment, health, and nursing – are encompassed in the theory. Being holistic in nature, the theory presents its framework as a congregation of all these concepts, centering on the person.
Watson regards a person as an individual with unique qualities and unique needs. The person is recognized as a being capable of communicating with another beyond physical interaction. The person is viewed as whole and complete, regardless of illness of disease (Watson, 2006).
The environment is regarded as a healing space, where the person’s awareness and consciousness can expand and promote mindbodyspirit wholeness and healing (Watson, 1999). Inevitably, the state of a patient’s environment can influence an individual’s state of health. The physical environment can affect how the person can connect and exist in the spiritual environment created by transpersonal caring relationships, and could affect the effectiveness of the science of caring.
Health is referred to as the unity and harmony within the mind, body and soul. It is a state of complete physical, mental, and social well-being and functioning (Hagopian, 2007). The theory establishes that caring can promote a person’s health better than the curative means of conventional medicine. Through caring, the care giver recognizes the condition of the recipient at a deeper level, enabling him/her to sympathize as needed, and provide the appropriate care needed by the patient. With this means of understanding the patient better, there is greater chance of addressing the patient’s needs, creating the needed balance in his/her physical, mental, and social well-being (Watson, 1998).
Influence in My Delivery of Care
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Watson defines nursing “as a human science of persons and human health – illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human care transactions” (Watson, 1988). The theory also emphasizes caring as central to nursing, and is essentially what the theory wishes to achieve. Nursing is not just about curing an illness or disease – it is beyond that.
It is about the nurse being able to center consciousness on the entire being of the other in order to detect his/her inner condition, and impart genuine concern through caring moments communicated through “movements, gestures, facial expressions, procedures, information, touch, sound, verbal expressions and other scientific, technical, aesthetic, and human means of communication.” The role of consciousness is deemed greatly important, because then the nurse exhibits commitment and sincere intention to connect with the patient at a deeper level, thus becoming an effective aid in nursing the patient back to health, physically, emotionally, and spiritually (Watson, 2006).
I remember having to give care to a patient who is suffering from a terminal disease and have been placed in ICU care. In this case, the patient was not capable of communicating because he was already in a coma – an application of Jean Watson’s theory in this case would require me to treat not just the patient but his loved ones, holistically. That is, I do not merely stop at trying to address the needs of the patient but also of those who surround him. Concretely, I tried to build a humanistic-altruistic value system which is the core of Watson’s theory. I have dealt with her family as real people who have real needs that have to be addressed.
For them to be able to cope with the situation, I have tried to show them empathy, as they express their feelings towards the condition of the patient. It is very difficult to have a dying loved one, but it is a reality that we all must face at one point or the other.
Having someone by your side during such a time of grief is very consoling and shall help you thresh out your feelings and cope with the situation. I have proven this many times in opportunities to care for patients placed in intensive care. The development of a caring relationship with the patient’s family helps them go through the ordeal with appropriate and well-expressed emotions, and even greater spiritual strength and maturity. I believe that the nurse has a critical role to play in such incidents.
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Applicability of Theory to Modern Nursing Practice
The effectiveness of Watson’s theory has been validated with its use as a guide in several studies centering on caring science. It has been “recommended as a guide to nursing patients with hypertension, as one means of decreasing blood pressure and increase in quality of life,” in a study made on its effectiveness on the quality of life and blood pressure of patients with hypertension in Turkey (Erci, Sayan, Tortumluoglu, Kilic, Sahin, & Gungormus, 2003). In another study on caring for old adults, it was established that the theory was effective in improving the quality of life and peace of mind, body, and soul of the older people, just by caring and listening attentively to what they have to say (Bernick, 2004).
The situation of caring for a patient in the intensive care unit has a more serious need for dedicated and focused care. Patients in intensive care in the intensive care unit (ICU) need more than mere treatment. They need assistance for themselves and their family who want to hear good news and encouraging words about the patient’s recovery, information that is not always quick in coming, if at all. In ICU situations, the patient and, equally as important, the patient’s family wants to know the patient’s chances for survival; possibility of permanent disability; and answers to their queries on the patient’s condition (Rafael, 2000). .
Although the attending doctor and nurses are the best sources for information to answer these questions, it is not always possible for them to accurately predict patient outcome, particularly in the first few hours or days of an ICU stay. Like the patient and the patient’s family, the attending doctors and nurses are also awaiting the initial outcome. This means that everyone—attending physicians, attending nurses, family, friends and the patient him/herself are involved.
All can and do contribute to the final outcome in one way or another. On my end, I try to answer all the questions that are posed to me by the patient’s loved ones to manage their expectations about the patient’s condition. And yet, I do this with caution, since it is still the physician who has the authority to inform them of these. The end goal was to try to assist the patient and his loved ones go through the ordeal, addressing their physical, emotional and spiritual needs in the context of a caring relationship.
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Conclusion
Overall, Jean Watson’s theory of transpersonal caring has very high utility in modern nursing practice. It has been shown to be strongly oriented towards human science and focuses on the humanitarian aspect of caring processes, occurrences and experiences and has been able to effectively encapsulate the science of arts and humanities. Moreover, it has been grounded on a unitary perspective and interconnectedness with elements such as an individual with its community.
However, one limitation may be its emphasis on being one-sided, philosophical and interpretative rather than on objective-empirical analysis. Moreover, it includes ontological, philosophical, ethical, historical inquiry and studies. Caring science is a new field that is evolving currently in the nursing industry and has truly evolved nursing theories and science and has contributed heavily to health, education, and human service fields and professions.
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References
Bernick, L. (2004). Caring for older adults: practice guided by Watson’s caring-healing model. Nursing Science Quarterly, 17(2):128-34.
Cara, C. (2003). A pragmatic view of Jean Watson’s caring theory. International Journal of Human Caring, 7(3), 51-61.
Erci, B., Sayan, A.,Tortumluoglu, G., Kilic, D., Sahin, O., & Gungormus Z. (2003). The effectiveness of Watson’s Caring Model on the quality of life and blood pressure of patients with hypertension. Journal of Advanced Nursing, 41(2), 130–139.
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Hagopian, G. (2007). Nursing theorists. Retrieved February 8, 2007 from www.nipissingu.ca/faculty/arohap/aphome/NURS3006/Resources/theorists.ppt
Rafael, AR. (2000). Watson’s philosophy, science, and theory of human caring as a conceptual framework for guiding community health nursing practice. ANS. Advances in Nursing Science, 23(2):34-49.
Watson, J. (1988). Nursing: Human science and human care. A theory of nursing (2nd printing). New York: National League for Nursing.
Watson, J. (1999). Postmodern nursing and beyond. Toronto, Canada: Churchill Livingstone.
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Watson, J. (2006). Dr. Jean Watson’s Theory of Human Caring. Retrieved February 8, 2007 from