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Introduction
Educated: BSN, University of Colorado, 1964, MS, University of Colorado, 1966, PhD,
University of Colorado, 1973
Dr. Jean Watson is Distinguished Professor of Nursing and holds an endowed Chair in
Caring Science at the University of Colorado Health Sciences Center.
She is founder of the original Center for Human Caring in Colorado and is a Fellow of
the American Academy of Nursing. She previously served as Dean of Nursing at the
University Health Sciences Center and is a Past President of the National League for
Nursing
Dr. Watson has earned undergraduate and graduate degrees in nursing and psychiatricmental health nursing and holds her PhD in educational psychology and counseling.
She is a widely published author and recipient of several awards and honors, including an
international Kellogg Fellowship in Australia, a Fulbright Research Award in Sweden and
six (6) Honorary Doctoral Degrees, including 3 International Honorary Doctorates
(Sweden, United Kingdom, Quebec, Canada).
Her research has been in the area of human caring and loss.
The foundation of Jean Watsons theory of nursing was published in 1979 in nursing:
The philosophy and science of caring
In 1988, her theory was published in nursing: human science and human care.
Watson believes that the main focus in nursing is on carative factors. She believes that for
nurses to develop humanistic philosophies and value system, a strong liberal arts
background is necessary.
This philosophy and value system provide a solid foundation for the science of caring. A
humanistic value system thus under grids her construction of the science of caring.
She asserts that the caring stance that nursing has always held is being threatened by the
tasks and technology demands of the curative factors.
Watson proposes even assumptions about the science of caring. The basic assumptions are:
Caring consists of carative factors that result in the satisfaction of certain human needs.
Caring responses accept 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 himself or herself at a given point in time.
The first three carative factors form the philosophical foundation for the science of caring. The
remaining seven carative factors spring from the foundation laid by these first three.
Begins developmentally at an early age with values shared with the parents.
Mediated through ones own life experiences, the learning one gains and exposure to the
humanities.
Is perceived as necessary to the nurses own maturation which then promotes altruistic
behavior towards others.
2. Faith-hope
When modern science has nothing further to offer the person, the nurse can continue to
use faith-hope to provide a sense of well-being through beliefs which are meaningful to
the individual.
Explores the need of the nurse to begin to feel an emotion as it presents itself.
Development of ones own feeling is needed to interact genuinely and sensitively with
others.
Striving to become sensitive, makes the nurse more authentic, which encourages selfgrowth and self-actualization, in both the nurse and those with whom the nurse interacts.
The nurses promote health and higher level functioning only when they form person to
person relationship.
Strongest tool is the mode of communication, which establishes rapport and caring.
She has defined the characteristics needed to in the helping-trust relationship. These are:
o Congruence
o Empathy
o Warmth
According to Watson, feelings alter thoughts and behavior, and they need to be
considered and allowed for in a caring relationship.
According to Watson, the scientific problem- solving method is the only method that
allows for control and prediction, and that permits self-correction.
She also values the relative nature of nursing and supports the need to examine and
develop the other methods of knowing to provide an holistic perspective.
The caring nurse must focus on the learning process as much as the teaching process.
Understanding the persons perception of the situation assist the nurse to prepare a
cognitive plan.
Watson divides these into eternal and internal variables, which the nurse manipulates in
order to provide support and protection for the persons mental and physical well-being.
Watson suggests that the nurse also must provide comfort, privacy and safety as a part of
this carative factor.
She has created a hierarchy which she believes is relevant to the science of caring in
nursing.
According to her each need is equally important for quality nursing care and the
promotion of optimal health. All the needs deserve to be attended to and valued.
Research findings have established a correlation between emotional distress and illness.
According to Watson, the current thinking of holistic care emphasizes that:
o Factors of the etiological component interact and produce change through
complex neuro-physiological and neuro-chemical pathways
o Each psychological function has a physiological correlate
o Each physiological component has a psychological correlate
Example:
Bulemia, anorexia and gastro-intestinal ulcers are a just few of the disorders that indicate a
complex interaction between the physiological and psychological.
Phenomenology is a way of understanding people from the way things appear to them,
from their frame of reference.
This factor helps the nurse to reconcile and mediate the incongruity of viewing the person
holistically while at the same time attending to the hierarchical ordering of needs.
Thus the nurse assists the person to find the strength or courage to confront life or death.
1.
Human being
2.
She adopts a view of the human being as: .. a valued person in and of him or herself
to be cared for, respected, nurtured, understood and assisted; in general a philosophical
view of a person as a fully functional integrated self. He, human is viewed as greater than
and different from, the sum of his or her parts.
Health
Watson believes that there are other factors that are needed to be included in the WHO
definition of health. She adds the following three elements:
The absence of illness (or the presence of efforts that leads its absence)
3.
Environment/society
4.
According to Watson caring (and nursing) has existed in every society. A caring
attitude is not transmitted from generation to generation. It is transmitted by the
culture of the profession as a unique way of coping with its environment.
Nursing
It focuses on health promotion and treatment of disease. She believes that holistic health
care is central to the practice of caring in nursing.
Watson points out that nursing process contains the same steps as the scientific research
process. They both try to solve a problem. Both provide a framework for decision
making. Watson elaborates the two processes as:
1.
Assessment
2.
Plan
3.
Intervention
4.
Evaluation
Analysis of the data as well as the examination of the effects of interventions based on
the data. Includes the interpretation of the results, the degree to which positive outcome
has occurred and whether the result can be generalized.
It may also generate additional hypothesis or may even lead to the generation of a nursing
theory.
She suggests that nursing might want to develop its own science that would not be related
to the traditional sciences but rather would develop its own concepts, relationships and
methodology.
Theories can interrelate concepts in such a way as to create a different way of looking at a
particular phenomenon
The basic assumptions for the science of caring in nursing and the ten carative factors
that form the structure for that concept is unique in Watsons theory.
The science of caring suggests that the nurse recognize and assist with each of the
interrelated needs in order to reach the highest order need of self-actualization.
Watsons work is logical in that the factors are based on broad assumptions which
provide a supportive framework.
With these carative factors she delineates nursing from other professions
These carative factors are logically derived from the assumptions and related to he
hierarchy of needs.
The theory is relatively simple as it does not use theories from other disciplines that are
familiar to nursing.
The theory is simple relatively but the fact that it de-emphasizes the pathophysiological
for the psychosocial diminishes its ability to be generalizable.
She discusses this in the preface of her book when she speaks of the trim and the
core of nursing.
She defines trim as the clinical focus, the procedure and the techniques.
The core of the nursing is that which is intrinsic to the nurse-client interaction that
produces a therapeutic result. Core mechanisms are the carative factors.
Watsons theory is based on phenomenological studies that generally ask questions rather
than state hypotheses. Its purpose is to describe the phenomena, to analyze and to gain an
understanding.
Theories contribute to and assist in increasing the general body within the discipline
through research implemented to validate them
According to Watson the best method to test this theory is through field study.
An example is her work in the area of loss and caring that took place in Cundeelee,
Western Australia and involved a tribe of aborigines.
It can provide the nurse with the most satisfying aspects of practice and can provide the
client with the holistic care so necessary for human growth and development.
Theories must be consistent with other validated theories, laws and principles but will
leave open unanswered questions that need to be investigated
She clearly designates the theories of stress, development, communication, teachinglearning, humanistic psychology and existential phenomenology which provide the
foundation for the science of caring.
Strengths
Besides assisting in providing the quality of care that client ought to receive, it also
provides the soul satisfying care for which many nurses enter the profession.
As the science of caring ranges from the biophysical through the intrapersonal, each
nurse becomes an active coparticipant in the clients struggle towards self-actualization.
The client is placed in the context of the family, the community and the culture.
It places the client as the focus of practice rather than the technology.
Limitations
Given the acuity of illness that leads to hospitalization, the short length stay , and the
increasing complex technology, such quality of care may be deemed impossible to give in
the hospital.
While Watson acknowledges the need for biophysical base to nursing, this area receives
little attention in her writings.
The ten caratiive factors primarily delineate the psychosocial needs of the person.
While the carative factors have a sound foundation based on other disciplines, they need
further research in nursing to demonstrate their application to practice.
Summary
Watsons theory
Strengths
Limitations
Saint Joseph Hospital in Orange, California has selected Jean Watsons theory of human
caring as the framework base for nursing practice.
The effectiveness of Watson's Caring Model on the quality of life and blood pressure of
patients with hypertension. J Adv Nurs. 2003 Jan;41(2):130-9.
This study demonstrated a relationship between care given according to Watson's Caring
model and increased quality of life of the patients with hypertension. Further, in those
patients for whom the caring model was practised, there was a relationship between the
Caring model and a decrease in patient's blood pressure. The Watson Caring Model is
recommended as a guide to nursing patients with hypertension, as one means of
decreasing blood pressure and increase in quality of life.
Martin, L. S. (1991). Using Watsons theory to explore the dimensions of adult polycystic
kidney disease . ANNA Journal, 18, 403-406 .
Martin, L. S. (1991). Using Watsons theory to explore the dimensions of adult polycystic
kidney disease . ANNA Journal, 18, 403-406
Conclusion
She ties together many theories commonly used in nursing education and does so in a
manner helpful to practioners of the art and science of nursing.
The detailed descriptions of the carative factors can give guidance to those who wish to
employ them in practice or research.
Using her theory can add a dimension to practice that is both satisfying and challenging.
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