+

Kristen M. Swanson
1953-Present Theory of Caring

Caring is a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility

Kristen Sheldon
Kaplan University

Theory of Caring
Background of the Development


Swanson began her career studying the effects of miscarriage on mothers, identifying the human experience and response of this event During her career she emphasized caring as an interested and was mentored by a few nursing theorists for models of caring In the NICU, as a nurse, Swanson identified the similarities of caring for mothers after miscarriage and parents of children in the NICU

Theory of Caring
Description of Theory
 Good

nursing is caring for the clients biopsychosocial and spiritual well-being by  Knowing the clients reality  Being emotionally and physically present  By doing for and enabling the client

Theory of Caring
Description of Theory All-inclusive care in a complex environment embraces balance among caring, attaching, managing responsibilities, and avoiding bad outcomes

Maintaining Belief

Knowing

Being With

Doing For

Enabling

Well Being

Theory of Caring
Kristen M. Swanson


Ph.D. in nursing at University of Colorado

 

Psychosocial nursing Emphasis on exploring the concepts of loss, stress, coping, interpersonal relationships, person and personhood, environments, and caring Caring and miscarriage were the focus of her doctoral dissertation and program of research

Found joy in being entrusted to give care to patients during hard times

Theory of Caring
Kristen M. Swanson


Swanson began her Ph.D. career focusing on caring by working with women who had experienced loss by miscarriage Chose Dr. Jean Watson as a mentor
 

Watsons Theory of Human Caring Both assert that compatibility of findings on caring adds credibility to their theoretical assertions

D. Kathryn E. Barnard encouraged her to make the transition from the interpretive to contemporary empiricist paradigm While a postdoctoral fellow, she found that caring for women who miscarried was very similar to caring for parents and health care providers taking care of infants in the NICU

Theory of Caring
Concepts of the Theory


The five basic processes (knowing, being with, doing for, enabling, and maintaining belief) give meaning to acts labeled as caring Knowledge about caring is categorized into 4 hierarchical domains
    

Persons capacity to deliver caring Individuals concerns and commitments that lead to caring actions The conditions that enhance or diminish the likelihood of delivering caring Actions of caring Consequences or the intentional and unintentional outcomes of caring for both the client and provider

Theory of Caring
Concepts of the Theory


Caring: a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility Knowing: attempting to understand the meaning of an event in the life of the other, avoiding assumptions, focusing on the person cared for, seeking cues, assessing meticulously, and engaging both the one caring and the one cared for in the process of knowing Doing for: to do for others what one would do for self if at all possible

Theory of Caring
Concepts of the Theory


Enabling: facilitating the others passage through life transitions and unfamiliar events Maintaining belief: sustaining faith in the others capacity to get through an event or transition and face a future with meaning, believing in others capacity and holding him or her high in esteem, maintaining a hope-filled attitude, offering realistic optimism, helping to find meaning, and understanding by the one cared for no matter what the situation

Theory of Caring
Concepts of the Theory & Metaparadigm


Identifies person as dynamic, growing, self-reflecting, yearning to be connected with others, and spiritual beings Defines environment as any context that influences or is influenced by the designed client
 

Many different types: cultural, social, biophysical, political, economical, ect. Environment and person-client are used interchangeably

Health and well-being is to experience wholeness where all facets of being are free to be expressed


Spirituality, thoughts, feelings, intelligence, creativity, relatedness, femininity, masculinity, and sexuality to name a few

Well-being is a complex process of curing and healing by including releasing inner pain, establishing new meanings, restoring integration, and emerging into a sense of renewed wholeness

Theory of Caring
Concepts of the Theory & Metaparadigm


Nursing is informed caring for the well-being of others

 

Using empirical knowledge from nursing and other disciplines Ethical personal and aesthetic knowledge derived from the humanities, clinical experience, and personal and societal values and expectations

Nurses must be leaders in fighting for human rights, equal access to health care, and other humanitarian causes The goal of nursing is to promote the well-being of others

Theory of Caring
Strengths and Weaknesses


Strengths
  

  

Provides a sense of understanding and applicability in practice Caring may be manifested in a variety of ways and in many practice contexts Offers teachers of modern day nursing a simple way of initating students into the profession by immersing them in the language of what it means to be caring and cared for to promote, restore, or maintain optimal wellness Can be used in many disciplines such as teaching, social work, and medicine The concept is clearly defined and arranged in a logical sequence Simple

Theory of Caring
Strengths and Weaknesses


Weaknesses


Tested and applied mainly with women; needs to be tested on several populations within nursing It does not differentiate caring as solely within the domain of nursing

Theory of Caring
Central Values and Beliefs
 

The goal of nursing is to promote the well-being of others Caring is grounded in maintenance of a basic belief in human beings, supported by knowing the clients reality, conveyed by being emotionally and physically present, and enacted by doing for and enabling the client Caring is delivered as a set of sequential processes that are created by the nurses
    

Own philosophical attitude Understanding Verbal and nonverbal messages conveyed to the client Therapeutic actions Consequences of caring

Theory of Caring
Use in Clinical Practice


Scenario  A 30 week baby is delivered and admitted to the NICU for respiratory distress, IV fluids, and prophylaxis for infection. This is mom and dads first baby, and they are coming to visit for the first time. What do you do?

Introduce yourself as the nurse when they come in and physically go to the infants bedside, ensuring that you do not appear too busy or unavailable to care for the infant or answer questions Take a few minutes to explain the monitoring equipment, as this infant is probably with an umbilical line to provide nutrition and cardio respiratory monitors Ask mom and dad if they would like to change the infants diaper, assisting and teaching as necessary. If mom is unable to or dad does not want to participate, offer to show them how to do it the first time. Allow mom to touch infants hands and feet during the diaper change. Also take this time to explain cluster-care and the importance to not over stimulate the infant. Keep a smile on your face as you are performing care, compliment how cute the infant is and what a wonderful job they are doing as parents. This time can be especially difficult, as parents tend to feel powerless.

References
Alligood, M. R. & Tomey, A. M. (2010). Nursing theorists and their work (7th ed.). Maryland Heights, MO: Mosby Elsevier University of Washington (2010). Faculty Directory. School of Nursing: University of Washington. Retrieved from http://www.son.washington.edu/faculty/faculty_bio.asp?id= 103