Development of the theory of human caring took place between 1975 and 1979, when Jean was working at the University of Colorado as a lecturer. The theory resulted from her view of nursing in combination with doctoral studies that she was doing in educational-clinical, as well as social psychology. The development of the human caring theory came in as her first attempt to add meaning and focus to the field of nursing. This came at a point when nursing was an emerging discipline, which came out as a distinct health profession that has its unique knowledge, value and practices, and possess distinct ethics and mission to the society. The theory was also influenced by the involvement that Jean had with the development of an integrated academic curriculum in the nursing curriculum as well as the effort s to get a common order and meaning to nursing. This order and meaning needed to be able to transcend settings, specialty, population, as well as subspecialty areas (Watson, 2013).
In developing this theory, Jean was trying to develop explicit values, practices and knowledge that are aimed at towards providing an inner healing process that required a unique art of caring-healing and a framework that is known as carative factors. These factors are necessary in complementing the conventional medicine and at the same time stand in blunt contrast to the curative factors. In addition, the theory and philosophy were aimed at balancing the orientation that is taken by the curative medicine and, therefore, provide nursing with a unique scientific, disciplinary, as well as professional standing specifically with itself, and generally with its public. (Cara, 2003)
Jean Watson who is a nursing professor and an American nurse theorist was born in 1940, in West Virginia, in the United States. She did her bachelors’ degree in 1964 and masters’ degree 1966 in the University of Colorado. She later did her PhD in 1973, in the same university. She is a distinguished Professor of Nursing at the University of Colorado and Chair in Caring Science at the Health Sciences Center (Saint Joseph and Flaget, 2012).
The theory has three major conceptual elements which are the carative factors, caring moments or occasions and the transpersonal caring relationship. The transpersonal caring relationship in most cases defines a special care relationship for human and depends on the moral commitment of the nurse in offering protection and enhancement to human dignity. It also depends on the caring consciousness of the nurse. A caring occasion or moment refers to the moment when the nurse and a different person come together to create a moment for human caring. This offers the individuals the possibility to be into a human-to-human transaction (Cara, 2003).
The theory was developed on seven major assumptions. These assumptions include the fact that caring can be demonstrated effectively and be interpersonally practiced. The second assumption is that caring is made up of carative factors, which lead to the satisfaction of several human needs. The third assumption is that having an effective caring may help in promoting health, as well as individual or even family growth. The fourth assumption is that responses of caring accept individuals not just as they are currently but also as what they may become afterwards. The fifth assumption is that an environment that is caring is the one that provides development of potentials and at the same time enables the individual to choose the actions that are best for them at any given point in time. The sixth assumption is that the act of caring is more of a healthogenic issue that is a curing issue. This means that caring science complements the curing science. Finally, the practice of caring is assumed to take the central part in nursing (Current Nursing, 2012).
The theory of caring as developed by Jean is composed of ten major carative factors. The first carative factors acted as a guide to the core of nursing and are in contrast to the trim of nursing. Core indicated to the nursing aspects that offer potential to the therapeutic healing processes, as well as the relationships. These factors affect the person who is being cared for and the one who is caring. The carative is the larger and deeper nursing dimension that exceeds the trim of changing settings, time, treatment, technology, and functional tasks. Although trim is important and is not easily expendable, nursing cannot be defined through its trim and the things it does in a given time at a specific setting. It is not also possible for the trim of nursing to define and offer clarification to its bigger professional ethic and the mission that it has to the society. This necessitates the nursing theory to provide another way that differs from and at the same time complements the modern nursing, as well as the conventional frameworks of medical-nursing (Ryan, 2005).
The ten carative factors include the creation of a humanistic-altruistic value system, faith-hope installation, sensitivity cultivation for one’s self and that of the others, helping-trust relationship development, the acceptance and promotion of the expression of feelings either positive or negative, employing scientific methods of solving problems in a systematic way especially in making decisions, interpersonal teaching-learning promotion, the provision for a protective, supportive and corrective physical, mental, spiritual and cultural environment, help with human need gratification, and existential-phenomenological forces allowance. The initial three carative factors are the ones that make up the philosophical foundation in the science of caring while the other seven factors form from the foundation that is laid down by the first three carative factors (Ryan, 2005).
The first carative factor, which is the creation of a humanistic-altruistic value system, starts in a developmental way at an early age with the values that are shared with parents. The system is mediated through individual life experiences, the learning that an individual earns and the exposure that people get to the humanities. The factor is perceived to be essential to the maturation of a nurse and may be involved in promoting behaviors that are altruistic towards other people (Current Nursing, 2012).
The faith-hope carative factor is necessary to the curative and carative processes. In a time when the modern science does not have anything more to offer to an individual, the nurse may go on to use the faith-hope in providing a sense of well-being using beliefs that have a meaning to the individual. The third carative factors, which is sensitivity cultivation for one’s self, and that of the others explores the necessity of the nurse to start the feeling of an emotion as the emotion presents itself. The development of the individual feelings is necessary in offering interaction with other nurses in a genuine and sensitive manner. This factor also enables the nurse to strive in becoming sensitive and makes the nurse to be more authentic and thus encouraging self-actualization and self-growth in the nurse as well as the other people with whom nurses interact. Through this factor, the nurses are able to promote health only when the nurses form a person to person relationship (Current Nursing, 2012).
The fourth carative factor, which is the helping-trust relationship development, and it help the nurses to have the strongest tool that is the mode of communication. This enables the nurses to establish a good rapport and caring with other people. Some of the characteristics that are necessary in a good helping-trust relationship are empathy, warmth and congruence. Communication may involve the verbal, listening and nonverbal means which implies an empathetic understanding.
The fifth carative factor, the acceptance and promotion of the expression of feelings either positive or negative, helps the nurses to have a better understanding of their feelings. This is important since feelings are known to alter behavior and thoughts are thus required and must be allowed in a caring relationship. Being aware of the feelings also enables the understanding of the behaviors that it engenders.
The sixth carative factor, which is the use of scientific methods of solving problems in a systematic way especially in making decisions, offers the only method that enables for controls, as well as predictions, and at the same time permits self-correction. This helps to avoid the science of caring from being always objective and neutral. The seventh carative factor, which is the interpersonal teaching-learning promotion, ensures that the caring nurse pays attention on the process of learning as much as the process of teaching. In understanding the perception of an individual, this factor may help the nurse in the preparation of cognitive plan (Current Nursing, 2012).
The eighth carative factor, the provision for a protective, supportive and corrective physical, mental, spiritual and cultural environment, is necessary for a nurse to offer protection and support to the well-being of the person. The nurse is also needed to provide privacy, comfort and safety as a part of the carative factor. Both the external and internal environments depend on one another.
The other carative factor involves helping with human need gratification. This is founded on the hierarchy of need that is similar to the one of Maslow. Each and every need are classified as equally important in order to offer quality nursing care as well as in promoting optimal health to individuals. There is also need to have all the needs attached to and offered the value they deserve. Watson has divided the needs into two major classifications lower order, and higher order needs classifications. The lower order needs may either be biophysical needs such as the need for food and fluids, ventilation and elimination, or psychophysical needs such as the need for sexuality and activity-inactivity. The higher order needs are also divided into two intrapersonal-interpersonal needs and psychosocial needs. The psychosocial needs include the need for affiliation and achievement while the intrapersonal-interpersonal needs include the need for self-actualization as well as the growth-seeking needs (Basavanthappa, 2007).
The last carative factor is the existential-phenomenological forces allowance. Phenomenology refers to the way through which people understand others. This is mainly in the manner in which things seem to other people from one’s point of view. The existential psychology, on the other hand, refers to the study of the existence of human through the use of phenomenological analysis. This carative factor enables the nurse to have a reconciliation and mediation of the incongruity of the way they view people in a holistic manner while attending to the ordering of the needs in a hierarchical manner. Therefore, the nurse is able to assist an individual in finding the courage and strength to face life or even death (Current Nursing, 2012).
The concept of nursing is also described by Watson as an act that is concerned with the promotion of health, illness prevention, caring of those who are sick and in the restoration of health. Nursing is described to be focused on the promotion of health and disease treatment. In her theory, Watson divides the process of nursing into similar steps as those that are involved in the process of scientific research. The process offers a framework through which decision making is done. The steps include assessment, plan, intervention and evaluation. The assessment step is involved with observing, identifying and reviewing the problem. This is usually done by the use of the knowledge that applicable in the literature. This step also involves the use of conceptual knowledge in formulating and conceptualizing the framework. The step includes hypothesis formulation, definition of the variables that are going to be examined while solving the problem (Current Nursing, 2012).
The second step in the nursing process is planning, which helps in the determination of the way the variables will be measured or examined. This includes the conceptual design for solving the problem. This helps in determining the kind of data that will be collected, how and on whom. The third step is the intervention and refers to the direct action taken in implementing the plan. The step also involves data collection.
The fourth step is the evaluation part where data is analyzed. The effect of the interventions is also examined based on the data collected. The evaluation step also involves result interpretation, determination of the degree to which the occurrence of a positive outcome has taken place and whether the results obtained can be generalized. The step may also lead to generation of other hypothesis or generation of a theory.
Some of the characteristics that the Watson’s theory has include being logical in nature, generalizable, relatively simple, useful in guiding and improving practice, based on phenomenological studies and is supported by the theoretical work of other philosophers, humanists and psychologists.
The major strengths that the theory enjoy are the facts that the theory puts the client in the family, society and community context and that the theory puts the client rather than the technology as the focus of the practice. However, the theory also has limitations which include giving less importance to the biophysical needs of an individual, delineation of the needs of an individual through the ten carative factors and the fact that the theory requires further research for it to be applied in practice. The theory is developed basically to be practiced within infirmity and disease context. It is thus not able to work in implementing nursing initiatives that focus on a big population (Rafael, 2000).
Reference List
Basavanthappa, B. T. (2007). Nursing Theories. New Delhi: Jaypee Brothers Publishers.
Cara, C. (2003). A Pragmatic View of Jean Watson’s Caring Theory. International Journal for Human Caring, 7(3), 51-61.
Current Nursing. (2012). Jean Watson's Philosophy of Nursing. Retrieved August 8, 2013, from http://currentnursing.com/nursing_theory/Watson.html
Rafael, A. R. (2000). Watson's Philosophy, Science, and Theory of Human Caring as a Conceptual Framework for Guiding Community Health Nursing Practice. Advances in Nursing Science, 23(2), 34-49.
Ryan, L. A. (2005). The Journey to Integrate Watson’s Caring Theory with Clinical Practice. International Journal for Human Caring, 9(3), 26-34.
Saint Joseph and Flaget. (2012). Jean Watson’s Theory of Human Caring. Retrieved August 8, 2013, from http://www.sjhlex.org/documents/Nursing/Jean%20Watson%27s%20Final%20Rev.pdf
Watson, J. (2013). The Theory of Human Caring. Retrieved August 8, 2013, from Watson Caring Science Institute. : http://watsoncaringscience.org/images/features/library/THEORY%20OF%20HUMAN%20CARING_Website.pdf
