THEORY OF CARING

IKA YUNI WIDYAWATI

 NURSING THEORY
(CARING)

Philosophy & Science of Caring (Jane Watson)

PHYLOSOPHICAL Theory of Bureaucratic Caring (Marilyn Anne Ray)
THEORY Philosophy of Caring (Kari Martinsen)
Theory of Caritative Caring (Katie Eriksson)
NURSING Nursing as Caring: A Model for Transforming Practice (Anne
MODELS/THEORIES Boykin & Savina O. Schoenhofer)
MIDDLE RANGE
Theory of Caring (Kristen M. Swanson)
THEORIES
GRAND THEORY
 DEFINISI CARING

Nightingale (1860): caring tindakan pemanfaatan lingkungan pasien dalam membantu

proses penyembuhan dan pemulihan kesehatan pasien secara optimal
Leininger (1978): caring aspek dasar dalam mewujudkan kesejahteraan, kesehatan,
perkembangan dan kemampuan bertahan dalam menghadapi masalah kehidupan
Watson (1985): caring hubungan interpersonal untuk membantu manusia sebagai
individu untuk mengambil keputusan dan mencapai keharmonisan mind, body & soul
Swanson (1991): caring memelihara komitmen dan tanggung jawab dalam berhubungan
dengan orang lain (asuhan keperawatan)
CARING THEORY (JEAN WATSON)
 RIWAYAT HIDUP JANE WATSON
(Tomey & Alligood, 2006)

Lahir dan dibesarkan di Virginia Barat

Riwayat Pendidikan:
Bachelor of Science in Nursing, University of Colorado (1964)
Masters Degree of Science, University of Colorado (1966)
Doctor of Philosophy, University of Colorado (1973)

Riwayat Publikasi:
Book: The Philosophy and Science of Caring (1979)
Artikel Jurnal:
New Dimensions of Human Caring Theory (1988)
Caring Theory as An Ethical Guide to Administrative and Clinical Practices (2006)
Watson's Theory of Human Caring and Subjective Living Experiences: Carative Factors/Caritas Processes as A Disciplinary
Guide to The Professional Nursing Practice (2007)
 THEORY OF CARING
(Tomey & Alligood, 2006)

Pengembangan teori:
1970: Model Caring mulai dikembangkan
1979: Nursing: The Philosophy and Science of Caring
1985: Human Science & Human Care penjelasan ttg pemberian asuhan dalam keperawatan
dengan menekankan pada manusia (sbg individu yang unik dalam ilmu keperawatan) dan
kontribusi terbaik untuk masyarakat
1999: Postmodern transpersonal caring-healing paradigm >> aplikatif, menekankan pada:
Model praktik perawatan dan penyembuhan yang holistic yang tidak hanya menggunakan obat
modern namun juga mempertimbangkan perawatan dan obat-obatan pengobatan tradisional* yang
diyakini oleh klien
Hubungan yang saling menguntungkan manusia-teknologi-alam spiritual aspects of health & healing
 THEORY OF CARING
(Tomey & Alligood, 2006; Black, 2014)

The Caritas Processes

The Transpersonal Caring Relationship

The Caring Occasion/Caring Moment

Caring and Healing Model

 THEORY OF CARING
(Tomey & Alligood, 2006)

Teori lain yang melatarbelakangi: Nightingale, Henderson, Leinenger, Gadow & Peplau
Asumsi utama Caring (Jane Watson): (1979)
Caring efektif terlihat pada proses interpersonal
Caring memiliki faktor carative kepuasan atas pemenuhan kebutuhan manusia
Caring yang efektif mewujudkan kesehatan dan perkembangan optimal individu/keluarga
Lingkungan caring perkembangan potensial dimana individu didalamnya untuk
menentukan pilihan terbaik
Caring is more healthogenic than curing
Aplikasi caring merupakan inti sentral (ruh) dari keperawatan
 THEORY OF CARING
(Tomey & Alligood, 2006)

Asumsi utama Caring (Jane Watson): (1985)

Care & Love energi utama & universal dlm kehidupan
Care & Love pilar kemanusiaan
Mempertahankan caring dalam praktik peradaban kontribusi perawat dalam
masyarakat akan semakin jelas
Bersikap caring pada diri sendiri prasyarat caring to others
Keperawatan memberikan pelayanan pada klien & memastikan caring menjadi landasan
pemberian asuhan keperawatan pada klien dengan gangguan kesehatan
Caring merupakan focus utama dalam pelayanan keperawatan
 THEORY OF CARING
(Tomey & Alligood, 2006)

Asumsi utama Caring (Jane Watson): (1985)

Caring ditumbuhkembangkan dalam sistem layanan kesehatan
Perkembangan teknologi dan kendala yang bersifat institusional menjadi dasar pengembangan
caring keperawatan
Trend isu terkini dalam keperawatan menjadi pertimbangan
Pelayanan dengan menekankan pada hubungan interpersonal efektif
Kontribusi sosial, moral dan keilmuan dari keperawatan terletak pada komitmen pemberian
layanan keperawatan (teori, praktis & riset)
 METAPARADIGMA THEORY OF CARING WATSON
(Tomey & Alligood, 2006; Black, 2014)

KEPERAWATAN MANUSIA LINGKUNGAN KESEHATAN

Caring moral ideal Memiliki 3 elemen: Tempat berinteraksi Kondisi yang

Perawat: mrpk individu yang terlibat dan mind, body & soul yang harus berubah dipersepsikan oleh
kerjasama dengan pasien dalam mencapai proses yang dipengaruhi secara alamiah klien sebagai suatu
Caring pasien dapat menggali pengetahuan oleh diri pencapaian dalam
Mrpk makhluk fisik bentuk keseimbangan
baru yang akan mengarahkan pada proses
dan spiritual, dengan
penyembuhan dan mencapai keseimbangan
pengalaman dan
Keperawatan adalah penerapan art dan human kekuatan yang sangat
science (komponen moral, spiritual dan individual
metafisika) dalam membangun hubungan antar
individu untuk membantu manusia mencapai
keharmonisan pikiran, jiwa dan raga yang
menimbulkan self knowlegde, self-control, self-care,
dan self healing
 Humanistic-
Existential Altruistic
Phenomenologi
Faith-Hope
calSpiritual
Forces

Gratificatio
n of human Sensitivity
needs 10
Supportive,
Carative Acceptance the
protective, and/or
corrective mental,
physical, societal,
Factors expression of
positive and
& spiritual negative
environment feelings
Transperso
nal Helping-
Teaching Trusting
Learning Creative
Problem Solving

(Tomey & Alligood, 2006; Watson, 2006; Black, 2014)

 10 CARATIVE FACTORS CARITAS PROCESS
(Tomey & Alligood, 2006; Watson, 2006; Black, 2014)

10 CARATIVE FACTORS CARITAS PROCESS

Formation of a humanisticaltruistic system of The practice of loving
values
Instillation of faithhope 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 ones self and to Cultivation of ones own spiritual practices and
others transpersonal self, going beyond ego self, opening
to others with sensitivity and compassion
Development of a helpingtrusting, human caring Developing and sustaining a helpingtrusting,
relationship authentic caring relationship
 10 CARATIVE FACTORS CARITAS PROCESS
(Tomey & Alligood, 2006; Watson, 2006; Black, 2014)

10 CARATIVE FACTORS CARITAS PROCESS

Promotion and acceptance of the expression of Being present to, and supportive of, the
positive and negative feelings)
Systematic use of a creative problem solving
caring process
Promotion of transpersonal teaching learning
expression of positive and negative feelings as a
connection with deeper spirit of self and the one
being cared for (authentically listening to
anothers story
Creative use of self and all ways of knowing as
part of the caring process; to engage in the
artistry of caring-healing practices
Engaging in genuine teaching-learning experience
that attends to unity of being and meaning,
attempting to stay within others frames of
reference
 10 CARATIVE FACTORS CARITAS PROCESS
(Tomey & Alligood, 2006; Watson, 2006; Black, 2014)

10 CARATIVE FACTORS CARITAS PROCESS

Provision for a supportive, protective,
and/or corrective mental, physical,
societal, and spiritual environment
Assistance with gratification of human
needs
Allowance for existential Opening and attending to spiritual-mysterious and
phenomenologicalspiritual forces
Creating a healing environment at all levels(a physical and
nonphysical, subtle environment of energy and
consciousness, whereby wholeness, beauty, comfort, dignity,
and peace are potentiated)
Assisting with basic needs, with an intentional caring
consciousness, administering human care essentials, which
potentiate wholeness and unity of being in all aspects of
care; sacred acts of basic care; touching embodied spirit and
evolving spiritual emergence
existential dimensions of ones own life-death; soul care for
self and the one being cared for.Allowing for miracles.
 THE TRANSPERSONAL CARING RELATIONSHIP
(Tomey & Alligood, 2006; Black, 2014)

Fokus teori: the one caring and the one cared for
Perawat-pasien membangun hubungan professional yang saling mendukung kesehatan & kesejahteraan
Perawat memiliki kewajiban profesional dan pribadi untuk melindungi dan membantu meningkatkan
martabat pasien

Dalam proses hubungan yang terjadi, terdapat: actions, words, behaviors, cognition, body
language, feelings, intuition, thought, senses, and the energy field
Keahlian dan kemampuan professional Perawat u/ membangun bounding dan
memberikan asuhan
Perawat dan pasien belajar dan berubah (bertransformasi) secara bersamaan dalam
hubungan ini
 THE CARING OCCASION/CARING MOMENT
(Tomey & Alligood, 2006; Black, 2014)

Fokus: momen nyata perawat-pasien saat pemberian asuhan

The Caring Moment:
Muncul dalam bentuk perasaan, respons tubuh, pikiran
Dipengaruhi oleh keyakinan spiritual, tujuan, harapan, pertimbangan
lingkungan, dan persepsi seseorang
Dapat terjadi selama berbagai intervensi keperawatan dan interaksi
dengan masing-masing pasien
 CARING & HEALING MODEL OF THEORY
(Tomey & Alligood, 2006; Black, 2014)

Caring for Healing:

Perawat membantu pasien untuk melepaskan ketidakharmonisan (mind, body,
soul) dan energi yang terblokir
Perawat dapat mempengaruhi pasien melalui:
Listening
Sentuhan terapeutik
Promosi kesehatan, pemulihan kesehatan, dan pencegahan penyakit
 APLIKASI CARING WATSON

EDUKASI: soft skill (calon) Perawat)

RISET: pengembangan indicator penilaian caring, evaluasi caring perawat, pengembangan model dan
teori keperawatan baru

ASUHAN KEPERAWATAN: model asuhan keperawatan

MANAJEMEN ORGANISASI: kode etik ANA

 INSTRUMEN CARING
(Tomey & Alligood, 2006; Black, 2014)

01 02 03 04 05

Caring Caring Caring Caring Caring Efficacy

Assessment Behaviors Behavior Dimensions Scale (CES)
Instrument Assessment Inventory (CBI) Inventory
(CARE-Q) Tool (CBAT) (CDI)

01 02 03 04 05

Caring Behavior Caring Attributes Holistic Caring Caring Profesional

Checklist (CBC) Professional Self Intervention Profesional Scale Caring Behavior
Concept (HCI) (CPS) (PCB)
Technological
Influence
(CAPSTI)
CARING THEORY (KRISTEN M. SWANSON)
 RIWAYAT HIDUP KRISTEN M. SWANSON
(Tomey & Alligood, 2006)

Lahir dan dibesarkan di Rhode Island

Riwayat Pendidikan:
Bachelor of Science in Nursing, University of Rhode Island
College of Nursing (1975)
Masters Degree of Nursing, University of Pnnsylvania (1978)
Doctor of Philosophy, University of Colorado (1983)
 TEORI KRISTEN M. SWANSON
(Tomey & Alligood, 2006)

Teori Human Experience of Miscarriage Model

(1983)

The Caring Model (1991)

 METAPARADIGMA THEORY OF CARING SWANSON
(Tomey & Alligood, 2006)

KEPERAWATAN
Keperawatan adalah ilmu yang dibentuk dari ilmu pengetahuan keperawatan dan ilmu pengetahuan lain
seperti etika, kepribadian, estetika yang dijadikan nilai-nilai dan harapan individu dan social secara manusiawi
serta berdasarkan pengalaman
MANUSIA
Makhluk yang unik dan utuh serta bebas berperilaku yang dipengaruhi oleh pengalaman hidup (warisan
genetik, spiritual, pemikiran, kecerdasan, kreativitas, dan kebebasan berekspresi)
LINGKUNGAN
Tempat yang mempengaruhi atau yang dipengaruhi oleh klien. Pembentuk lingkungan meliputi budaya,
politik, ekonomi, sosial, biofisik, psikologi dan spiritual
KESEHATAN
Kondisi kesejahteraan adalah hidup sebagai subjek, memiliki arti, berpengalaman sebagai manusia
seutuhnya. Utuh melibatkan integrasi pengertian dan seluruh aspek secara bebas.
Aspek yang di maksud adalah : spiritualitas, pemikiran, perasaan, inteligen, kreativitas, hubungan, feminine,
maskulin dan seksualitas
(Tomey & Alligood, 2006)
 SWANSONS FRAMEWORK OF CARING
(Tomey & Alligood, 2006)
Maintaining Belief (Esteem)
Sustaining faith in the others capacity to get through an event/transition and face a future with meaning

Believe in/holding in esteem

Offering a hope filled attitude
Maintaining realistic optimism
Helping to find meaning
Going to distance
 SWANSONS FRAMEWORK OF CARING
(Tomey & Alligood, 2006)
Knowing (Empathetic Understanding)
Striving to understand an event as it has meaning in the life of the other

Avoiding assumptions
Assessing thoroughly
Seeking clues
Centering on the one cared for
Engaging the self of both
 SWANSONS FRAMEWORK OF CARING
(Tomey & Alligood, 2006)

Being With (Emotionally Present)

Being emotionally present to the other

Conveying availability
Sharing feelings
Not burdening
Enduring with
 SWANSONS FRAMEWORK OF CARING
(Tomey & Alligood, 2006)
Doing For (Enact For)
Doing for the other as he/she would do for oneselfbut no more

Comforting
Performing competently/skillfully
Preserving dignity
Anticipating their needs
Protecting
 SWANSONS FRAMEWORK OF CARING
(Tomey & Alligood, 2006)
Enabling (Empowering)
Facilitating the others passage through life transitions and face a future with meaning

Validating
Informing/explaining
patient education
Supporting
Giving feedback
Generating alternatives-thinking it through
 EXPRESSIONS OF CARE

SPIRITUAL PRESENCE TOUCH LISTENING

Being aware of Being there Skin-to-skin Taking in patient

Honoring Physically Eye contact information
patients beliefs present (nonverbal) Interpreting what
Demonstrating Protective to has been taken in
understanding prevent injury
Being with
Sharing oneself
 Application in Clinical Setting
CLINICAL WEEK #1
I.Knowing (Empathetic Understanding) Striving to understand an event as it has meaning in the life of the other

Choose at least 2 to implement Nursing Caring Interventions Evaluation (Client Response)

1. Avoiding Assumptions

2. Centering on the one cared for
*Did my cares when time was best for client
*Allowed client quiet time with minimal interruptions
*Always verbalized to client what I was coming in for
next and told him if there was anything more I could help
him with to feel free to ask
*Allowed client to maintain sleep/rest
*Client did not feel like a burden when using
call light
*Felt that this conveyed trust between client
and nursing student

3. Assessing thoroughly

4. Seeking cues

5. Engaging of self
*After surgery I was conveying availability-this was
important for the client who was experiencing pain
*I was able to get warm blankets and ice water for my
client to ensure comfort
*I ensured the client that I was there and could help him
with anything he needed
*Client felt as if I really cared for him and that
he was not alone
*He felt that he could trust me and was a little
more relaxed to know someone was there
*Non-verbal cues-client was less anxious and
was able to remain comfortable to rest
 Application in Clinical Setting
II. Being With (Emotionally present) Being emotionally present to the other
Choose at least 2 to implement
1. Being there
2. Conveying availability
3. Sharing feelings
4. Not burdening
Nursing Caring Interventions
*Talking to client and sitting at eye level
*Placing a hand on the clients shoulder to let them know
that you care and are present
*Taking time to explain what you are doing and answer
questions and make sure client fully understands
*Allow pt. to express feelings without putting judgements
on them
*Stating, is there anything else I can do for youI have
time?
*Do not approach client in a rushed nature
*Periodically assessing client and asking how they are
doing without making them put on their call light and
feel like they are a burden
Evaluation (Client Response)
*Client was able to talk to me on a more
personal level
*Putting hand on shoulder was comforting and
caring-helped client realize I was there
*Client ws able to put trust in me and know
what to expect and let him know what was
next
*Client expressed sensitive topics with me
about being overweight and was able to
not worry about feeling judged
*Client gets needs met immediately and does
not feel rushed
*Client does not feel like they are being a pain
because they know that they are not
bugging you when you are busy
*Does not feel rushed and they feel that they
have time to ask questions or review
personal nature of self more readily
 APLIKASI CARING SWANSON

EDUKASI: soft skill (calon) Perawat)

RISET: pengembangan model dan teori keperawatan baru

ASUHAN KEPERAWATAN: model asuhan keperawatan

 REFERENCES
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 REFERENCES

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 REFERENCES

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