JEAN WATSONS THEORY By Raimee Schertzberg Jacqueline Swanton

JEAN WATSON’S THEORY By: Raimee Schertzberg Jacqueline Swanton Cindy Thornton

JEAN WATSON’S THEORY • http: //www. youtube. com/watch? v=UGhpqc. Qf. S 7 A • Follow the link to view a video of Jean Watson.

JEAN WATSON’S THEORY HISTORY: Born in West Virginia PHD: University Colorado, 1973 Educational Psychology and Counseling BSN: University Colorado, 1964 MSN: University Colorado , 1966 Published author and recipient of awards and honors: International Kellogg Fellowship Fulbright Research Award (6) Honorary Doctoral Degrees

JEAN WATSON’S THEORY HISTORY CONTINUED… • A distinguished Professor of Nursing • Holds an endowed Chair in Caring Science at the University of Colorado Health Science Center • Founder of the original Center for Human Caring in Colorado and is a fellow of the American Academy of Nursing • Previous Dean of Nursing at the University Health Science Center • Past President of the National League for Nursing • http: //currentnursing. com/nursing_theory/Watson. html (

JEAN WATSON’S THEORY PHILOSOPHY & THEORY OF TRANSPERSONAL CARING: • 1979 Published in “The • SELF Philosophy and science of caring” • PHENOMENAL FIELD • 1988 Published in “Nursing human science and human care” • INTERSUBJECTIVITY http: //currentnursing. com/nursing_theory/Watson. html (Kearney-Nunnery, (2008), p. 73)

JEAN WATSON’S THEORY CARE HEALING PERSPECTIVE: • “It embraces both a physical embodiment and metaphysical transcendent dimension of nursing and the caring healing process; it is concerned with preserving human dignity and restoring and preserving humanity in the fragmented, technological, medical cure dominated systems. ” (Parker, 1990, p. 278)

JEAN WATSON’S THEORY DEVELOPMENT OF THEORY: • • MAIN FOCUS: Carative factors that are derived from a humanistic perspective combined with a scientific knowledge base Focus on health promotion rather than cure of disease BELIEFS: A strong liberal arts background is necessary for nurses to develop humanistic philosophies and value systems Philosophies and Value Systems in turn provide the foundation for the science of caring. Nursing is being threatened by the tasks and technology demands of the curative factors Caring is the most valuable attribute nursing has to offer Caring receives less emphasis than other aspects of nursing practice (George, 1995, p. 317)

JEAN WATSON’S THEORY FRAMEWORK OF THEORY: 7 ASSUMPTIONS • Caring can be effectively demonstrated and practiced only interpersonally. • Caring consists of carative factors that result in the satisfaction of certain human needs. • Effective caring promotes health and individual or family growth. • Caring responses accept a 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 self at a given point in time. • Caring is more “healthogenic” than is curing. The practice of caring integrates biophysical knowledge with knowledge of human behavior to generate or promote health and to provide ministrations to those who are ill. A science of caring is therefore complementary to the science of curing. • The practice of caring is central to nursing. (George, 1995, pp. 318 -319)

JEAN WATSON’S THEORY FRAMEWORK CONTINUED… THE 10 CARATIVE FACTORS • • The formation of a humanistic-altruistic system of values. The instillation of faith-hope. • The cultivation of sensitivity to one’s self and to others. • The development of a helping-trust relationship. • The promotion and acceptance of the expression of positive and negative feelings. • The systematic use of the scientific problem-solving method for decision making. • The promotion of interpersonal teaching-learning. • The provision for a supportive, protective, and (or) corrective mental, physical, socio-cultural, and spiritual environment. • Assistance with the gratification of human needs. • The allowance for existential-Phenomenological forces. (George, 1995, pp. 318 -319)

JEAN WATSON’S THEORY METAPARADIGM OF THEORY: • PERSON- Unity of mind/body/spirit/nature. • HEALTH- Unity and harmony within the mind/body/soul. • ENVIRONMENT- Healing spaces. • NURSING- Noun and Verb. (Alligood, 2010, pp. 98 -99)

JEAN WATSON’S THEORY • PERSON: ENVIRONMENT: “PERSONHOOD IS TIED TO NOTIONS THAT ONE’S SOUL POSSESS A BODY THAT IS NOT CONFINED BY OBJECTIVE TIME AND SPACE. ” “HEALING SPACES CAN BE USED TO HELP OTHERS TRANSCEND ILLNESS, PAIN, AND SUFFERING. ” (Alligood, 2010, p. 99)

JEAN WATSON’S THEORY HEALTH: • “Health refers to the unity and harmony within the mind, body, and soul. Health is also associated with the degree of congruence between self as perceived and the self as experienced. ” • Watson adds: – 1) “A high level of overall physical, mental, and social functioning. ” – 2) “A general adaptive-maintenance level of daily functioning. ” – 3) “The absence of illness. ” (George, 1995, p. 324)

JEAN WATSON’S THEORY NURSING: • Nursing’s goal: Help people gain harmony within the self to promote self knowledge, self healing, or to gain insight into the meaning of the happenings in life. • Reinforcing humanistic studies. • Believe in dignity and worth. • Focus on health promotion as well as treatment of disease. • Rooted in humanities as well as the natural sciences. (George, 1995, pg. 325)

JEAN WATSON’S THEORY UNIQUE: • Continues to revise theory: – Carative factors changed to Caratas processes • Carative = Latin for “caring” • Curative = Latin for “elimination of disease” • First three carative factors form the “philosophical foundation for the science of caring” • Caring is both philosophical and scientific • Caring is placed in the hierarchical lower order biophysical needs toward higher psychosocial and interpersonal need -Focus on physiological rather than pathophysiological aspects of nursing (Alligood, 2010, p. 95, 101) (George, 1995 p. 319)

JEAN WATSON’S THEORY EXAMPLE OF CLINICAL PRACTICE: • Disturbances of the biophysical need for food and fluid demonstrates the requirement for holistic care. – BULEMIA – ANOREXIA – GASTROINTESTINAL ULCERS (George, 1995, p. 323)

JEAN WATSONS THEORY HOW TO INTEGRATE THEORY: • Establish a caring relationship with patients. • Be open and receptive to patient need and perception of need. Let patients know that you are interested in their complete care by communicating thoroughly. Listen to patient concerns--this will reinforce your role as a caring individual in tune to the patient's needs. • Treat patients as holistic beings. • Be aware of and sensitive to the patient's emotional and mental health in addition to his physical health. Ask questions and listen closely to physical as well as immaterial concerns. Embrace non-medical concerns or psychological or emotional concerns as valid needs within the patient and respond accordingly. • Display unconditional acceptance. • Be sensitive to the patient's insecurities that are due to her vulnerable position. Extend acceptance by maintaining an even level of acceptance and caring regardless of the patient's physical appearance, emotional need or level of compliance with you or the doctor. • Treat patients with positive regard.

• Extend respect through positivity and encouragement. Be open and show caring, regardless of patient attitude or degree of positivity. • Promote health through knowledge and intervention. • Communicate with patients honestly about their medical condition. Encourage the patient to understand explore his health through HOW TO INTEGRATE THEORY CONT… education and research. Show health practices through modeling. Intervene in a patient's health routine to redirect the patient to healthier patterns. • Spend uninterrupted time with the patient. • Stay with a patient until her questions are answered or until the task you must accomplish is done thoroughly. Listen to patient concerns without looking at your watch. Maintain eye contact--even if you only have five minutes alone with a patient before performing other duties, allow that patient to feel singular and important in those five minutes by truly devoting all of your attention to her. JEAN WATSON’S THEORY To read more: How to Integrate Jean Watson's Theory of Caring Into Nursing Practice | e. How. com http: //www. ehow. com/how_6644521_intergrate-theory-caring-nursing-practice. html#ixzz 1331 NDj 5 b

JEAN WATSON’S THEORY • CARITAS • Created to support the personal and professional journey of "Being and Becoming". • Transpersonal Caring • Concern for the inner life world and subjective meaning of another who is fully embodied, going beyond the ego self and the given moment, reaching to the deeper connections to spirit and with the broader universe. Watson, 2009

JEAN WATSON’S THEORY “The nurse attempts to enter into and stay within the other’s frame of reference for connecting with the inner life world of meaning and spirit of the other; together they join in mutual search for meaning and wholeness of being and becoming to potentiate comfort measures, pain control, a sense of well-being, wholeness, or even spiritual transcendence of suffering. The person is viewed as a whole and complete, regardless of illness or disease. ” Watson, 1996, Blueprint: p. 153

JEAN WATSON’S THEORY • Entering the other’s frame of reference & “becoming one”

JEAN WATSON’S THEORY • Assessment • The “caring occasion” • “The moment of coming together and the opportunity to decide how to be in the moment and in the relationship. ” – “If the caring moment is transpersonal, each feels a connection with the other opening up new possibilities for healing and human connection at a deeper level than physical interaction. ” – “We learn from one another how to be human by identifying ourselves with others and finding their dilemmas in ourselves. ” – “How the nurse chooses to be with the patient/family in any given moment influences the “caring-healing relationship. ” Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY Assessment: – What is meaningful for the patient and their quality of life. – Listen attentively to what people say about themselves and their lives. – “Reflect on what is meaningful for them and how their experiences are influencing their quality of life and peace of mind, body, and soul. ” Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY • Assessment • “Allow clients and family members to reveal extensive information about themselves within the context of their health situations. ” • “Be fully present, respectful, and open to dialogue that is shaped by the patient’s perspective. ” • “Be supportive of the person’s wishes and priorities. ” • “Discover that within the patient stories there are hidden common themes that shape and direct caring practices. ” Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY • Assessment of Environment • Jean Watson places a high regard on the environment in influencing the caring-healing process. – “Environment can influence a person’s sense of connective, energy, and inner harmony. ” – “Factors to consider during assessment include: noise, privacy, light, access to nature, color, space and smells. ” Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY • Assessment • “Through discussion about day-to-day needs such as mobility, comfort, continence care, activities, rest and sleep, medications, skin care, nutrition, mood, and mental well-being. ” • “Other areas that may be revealed are suffering, loneliness, powerlessness, living with chronic illness, dealing with loss, living with risk, meaningful relationships, hope, and fighting to maintain independence. ” Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY • Assessment • “The past medical history, medication review and systems review are explored only after the story and dialogue has emerged that provides valuable information about the person as an individual, his/her desires, wishes, strengths, and fears. ” • “The physical assessment and review of medical history would be considered the “trim” of the assessment. The “core” of the assessment focuses on the essence of the person. ” Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY • Watson’s opinion of nursing education within her model during a one -on-one interview published in Nursing Science Quarterly: • Watson states that “although the bachelor’s degree is considered still (unresolved and impossible to implement) minimal entry into the professional practice of nursing, the mature practice of nursing, as a career health professional, ideally should be at the professional doctoral level, or at least the graduate level. ” • “It is so ironic and amazing to me that, even as we enter the 21 st century, we who are the oldest of the caring/health/healing professions, and we, who deal with the most complex human experiences and health-related phenomena, have never made the connection for the need for additional education to deal with these complex, technological, and evolving human phenomena” (Watson, 2002). Nursing Science Quarterly, 2002

JEAN WATSON’S THEORY • Continuation of one-on-one interview regarding Watson’s opinion on education. • “If I had my way, I think every major academic health science center nursing program should convert its baccalaureate nursing programs into non-practice degrees in caring science and health, or at least make that degree a major in the field” (Watson, 2002). • “Rather than dribbling away our resources through the continuing layers of nursing education and practice, we should put all of our mature knowledge, energy, passion, inspiration, excitement, and joy into preparing the finest nurses, at the doctoral level [ND and Ph. D]” (Watson, 2002). Nursing Science Quarterly, 2002

JEAN WATSON’S THEORY • Education • “Watson is adamant in her support for nursing education that incorporates holistic knowledge from many disciplines and integrates the humanities, arts, and sciences. She believes that the increasingly complex requirements of the healthcare system and patient needs require nurses to have a broad, liberal education. ” Alligood & Tomey, 2010, p. 99

JEAN WATSON’S THEORY • Research • “There is a growing body of national and international research that tests, expands, and evaluates Watson’s theory. ” • Published studies revealed four major categories of research related to Watson’s theory. • These are: – (a) The nature of nurse caring; – (b) nurse caring behaviors as perceived by clients and nurses; – (c) human experiences and caring needs; – (d) evaluating outcomes of caring in nursing practice and education. Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY • Research • Research subjects of Watson’s Theory include: • • • The effects of caring for women who miscarried Pre-Surgery Practice model Experiences of growing up with cystic fibrosis Living in a nursing home Caring occasion for depressed women The caring needs of caregivers of newly disabled adults • Spouses caring for their dying loved one Nursing Science Quarterly, 2004

JEAN WATSON’S THEORY • Strength’s of Watson’s Theory: – Watson believes in focusing on the patients care and not on the technology needed to provide that care. – Provides a deeper way of healing a patient. – “Watson’s theory continues to provide a useful and important metaphysical orientation for the delivery of nursing care” (Alligood & Tomey, 2010, p. 102).

JEAN WATSON’S THEORY • Weaknesses of Watson’s theory: – Due to the higher level of care most patients require, it may not be possible to provide such in depth care. – The Ten Carative Factors focus mainly on the psychosocial needs of the patient when many patients need more physical care to be provided. – It seems that the Carative Factors have a solid foundation but further research could show they can apply to nursing practice. – “The theory is more about being than doing, and it must be internalized thoroughly by the nurse if it is to be actualized in practice” (Alligood & Tomey, 2010, p. 102).

JEAN WATSON’S THEORY • • Overview Jean Watson developed the Philosophy and Theory of Transpersonal Caring. What started as the 10 Carative Factors has evolved into the Caritas process to include a “spiritual dimension of love and caring” (Watson, 2007). The major emphasis of the Caritas process is based on the caring relationship of the patient and nurse (becoming one). Theory is based on caring versus curing. Alligood & Tomey, 2010, p. 95

JEAN WATSON’S THEORY Overview (cont. ) • Watson’s theory “calls upon nurses to go beyond procedures, tasks, and techniques” with the main focus being on a therapeutic and transpersonal caring process. • “The theory is more about being than doing. ” • Patient stories verses disease (or illness) shape and direct caring practices. Alligood & Tomey, 2010, p. 95

JEAN WATSON’S THEORY Analysis • Jean Watson believes in “deeper connections to spirit and with the broader universe. ” • Implementing the “caritas processes” allows for nurses to gain a better understanding of the “uniqueness of individuals” and an “understanding of human responses to health experiences” through “listening and reflecting on what is meaningful for them. ” • The caring process, including attentive listening and reflecting on what is important to the patient should be part of the nurses initial introduction to the nurse-patient relationship for the establishment of goals. Nursing Quarterly, 2004

JEAN WATSON’S THEORY • Analysis (cont. ) • Despite the type of care a patient is in need of, the nurse can implement the ten carative factors by showing kindness, faith and hope, sensitivity, trust, acceptance of feelings, problem solving, teaching and learning, a healing environment, assist with physical, emotional, and spiritual needs, and being open to the unknown. • Although the nurse can implement the above listed “factors”, how the patient chooses to respond to this approach to care is individual and will not always be conducive to “transpersonal caring relationships”.

JEAN WATSON’S THEORY • Jean Watson continues to expand on her Theory of Transpersonal Caring and “in 2008 created a non-profit foundation: Watson Caring Science Institute, to further the work of Caring Science in the world. ” www. watsoncaringscience. org

QUESTIONS: • How can you apply Watson’s theory to the way that you practice nursing? • Out of all of theorists we have discussed, would you choose to follow Watson’s theory? Why or why not? • Name and give a definition to the three dimensions of a transpersonal caring relationship.

REFERENCES: • • • Alligood, M. R. , & Tomey, A. M. , (2006). Nursing theorists and their work. (6 th ed. ). St. Louis, MO: Mosby Elsevier. Bernick, L. (2004). Caring for older adults: Practice guided by Watson’s caringhealing model. Nursing Science Quarterly. doi: 10. 1177/0894318404263374 Fawcett, J. (2002). The Nurse Theorists: 21 st-century updates-Jean Watson. Nursing Science Quarterly. doi: 10. 1177/089431840201500307 George, J. B. (Ed. ), (1995). Nursing theories: The base for Professional Nursing Practice. (4 th ed. ). Norwalk, Connecticut: Appleton & Lange Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing (4 th ed. ). Philadelphia, PA: F. A Davis Company Parker, M. E. (Ed. ), (1990). Nursing Theories in Practice. New York, NY: National League for Nursing www. watsoncaringscience. org http: //currentnursing. com/nursing_theory/Watson. html http: //www. ehow. com/how_6644521_intergrate-theory-caring-nursingpractice. html#ixzz 1331 NDj 5 b http: //www. youtube. com/watch? v=UGhpqc. Qf. S 7 A