Jean Watson’s Jean Watson’s Philosophy and Science Philosophy and Science

of Caringof Caring

Megan AndrewsJulia Arnerich

Tonight we will discuss Tonight we will discuss the. . . the. . . History Breakdown Importance Examples ApplicationEvaluation of the theory

BackgroundBackground

Born in southern West Virginia in 1940

Attended the Lewis Gale School of Nursing in Roanoke, Virginia from which she graduated in 1961

BackgroundBackgroundIn 1961, moved to Colorado with

her husband, Douglas

Earned her BSN in 1964

MSN in psychiatric-mental health nursing in 1966

Doctorate in educational psychology and counseling in 1973

Theory OverviewTheory OverviewThe philosophy of caring and

science examines the relatedness of ALL and includes, human science, human caring processes, experiences, and phenomena.

Key Concept: Caring is a moral ideal: mind-body-

soul, engagement with another

Evolution of TheoryEvolution of TheoryThe foundation for this theory

was first published in 1979

The original theory included 10 Carative Factors

Carative FactorsCarative Factors1) Formation of a Humanistic-

altruistic system of values

2) Instillation of faith-hope

3) Cultivation of sensitivity to one's self and to others

4) Development of a helping-trusting, human caring relationship

Carative Factors Carative Factors continued…continued…5) Promotion and acceptance of

the expression of positive and negative feelings

6) Systematic use of a scientific problem-solving caring process

7) Promotion of transpersonal teaching-learning

Carative Factors Carative Factors continued…continued…8) Provision for a supportive,

protective, and/or corrective mental, physical, societal, and spiritual environment

9) Assistance with gratification of human needs

10) Allowance for existential-phenomenological-spiritual forces

Clinical Caritas ProcessClinical Caritas ProcessAs the theory evolved ,the

carative factors evolved into the caritas process

Caritas means ‘to cherish’

Caritas Process Caritas Process continued . . . continued . . . Formation of humanistic-altruistic system of

values, becomes: "Practice of loving-kindness and equanimity within context of caring consciousness

Instillation of faith-hope, becomes: "Being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and one-being-cared- for“

Cultivation of sensitivity to one's self and to others, becomes: "Cultivation of one's own spiritual practices and transpersonal self, going beyond ego self"

Caritas Process Caritas Process continued…continued…Development of a helping-trusting, human caring

relationship, becomes: "Developing and sustaining a helping-trusting, authentic caring relationship“

Promotion and acceptance of the expression of positive and negative feelings, becomes: "Being present to, and supportive of the expression of positive and negative feelings as a connection with deeper spirit of self and the one-being-cared-for"

Systematic use of a creative problem-solving caring process, becomes: "creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices"

Caritas Process Caritas Process continued . . . continued . . . Promotion of transpersonal teaching-

learning, becomes: "Engaging in genuine teaching-learning experience that attends to unity of being and meaning attempting to stay within other's frame of reference“

Provision for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment, becomes: "Creating healing environment at all levels, (physical as well as non-physical, subtle environment of energy and consciousness, whereby wholeness, beauty, comfort, dignity, and peace are potentiated"

Caritas Process Caritas Process continued . . . continued . . . Assistance with gratification of human

needs, becomes: "assisting with basic needs, with an intentional caring consciousness, administering ‘human care essentials', which potentiate alignment of mind-body-spirit, wholeness, and unity of being in all aspects of care“

Allowance for existential-phenomenological-spiritual forces, becomes: "opening and attending to spiritual-mysterious, and existential dimensions of one's own life-death; soul care for self and the one-being-cared-for

AssumptionsAssumptionsThis theory makes the following

assumptions:

1) Caring can be effectively demonstrated and practice only interpersonally

2) Caring involves carative factors that result in the satisfaction of human needs

3) Effective caring promotes health and individual family growth

Assumptions continued…Assumptions continued…4) Caring responses accept the person as

they are now and as what they may become

5) A caring environment is one that offers the development of potential while allowing the person to choose the best action for his or herself at a given point in time.

6) Caring is more “healthogenic” than it is curing.

7) The practice of caring is central to nursing.

Internal CriticismInternal Criticism

Clarity: use of nontechnical yet sophisticated language

Simplicity: theory draws on a variety of disciplines, more easily understood with a broad or liberal arts background

Internal CriticismInternal Criticism

Generality: it encompasses all aspects of the health-illness continuum increasing its generality

Accessibility: Difficulty to study empirically, though it does draw from other disciplines

Internal CriticismInternal Criticism

Scope: Grand Theory

Level: Situation Relating

The CommonplacesThe CommonplacesPerson: a valued person to be

cared for, respected, nurtured and understood and assisted

Health: overall physical, mental and social functioning, adaptability and the absence of illness

CommonplacesCommonplacesEnvironment: caring exists in all

societies and is passed by the profession as a unique way of coping with the environment

Nursing: “ a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human transactions”

Importance to NursingImportance to NursingThis theory is important to

nursing due to the central concept of caring

This theory is grounded in the discipline of nursing and nursing science but has evolved to include a variety of other disciplines increasing its relevance in a variety of fields

Circle of ContagiousnessCircle of ContagiousnessCurrently this theory is being

validated in many clinical settings

Though many healthcare settings are trying to incorporate the concepts of this theory it is application is complicated by hospital acuity, length of stay and technology

Do we like this TheoryDo we like this TheoryThe framework and key concepts

are critical to compassionate nursing care, however the complexity, abstract qualities and lack of structure make this theory difficult to apply to a wide variety of healthcare settings

Application of Theory to Application of Theory to PracticePracticeCase study:

◦A 48 year old woman has recently been diagnosed with breast cancer. It is her first evening in the hospital and she is scheduled for a mastectomy in the morning. She is single and her family lives out of state. A friend came with her today to check in but had to leave to take care of her own family.

Case study continued . . .Case study continued . . .

You are assuming care of the patient, after reading the chart and getting report what 3 carative factors would you anticipate using?

(click on sound clip for answers )

Case Study continued . . . Case Study continued . . . You walk into the room and find

the patient crying, what carative factors would you apply?

(click on sound clip for answers )

SummarySummaryKey concept:

◦Caring is a moral ideal: mind-body-soul, engagement with another

There are 10 carative factors that evolved into the clinical caritas process

Jean Watson believes that “the core of nursing is those nurse-patient relationships that result in a therapeutic outcome”

Web CT QuestionWeb CT Question

What is your overall opinion of this theory?

Describe a situation in which you used or could use the caritas process in practice.

ReferencesReferencesChinn, P.L. & Kramer, M.K. (2008). Theory

and nursing: Integrated knowledge development (7th ed.). St. Louis, MO: Mosby.

Tomey, A.M. & Alligood, M.R. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby.

Current Nursing:◦http://

currentnursing.com/nursing_theory/Watson.htm

ReferencesReferencesUniversity of Colorado, Jean Watson

◦http://www.nursing.ucdenver.edu/faculty/caring.htm

Nurses Info:◦http://

www.nurses.info/nursing_theory_person_watson_jean.htm