Structure of

Nursing
Knowledge
Structure level!
Fawcett called the holarchy a theory of the structure of
nursing knowledge. It consists of a metaparadigm,
philosophies, conceptual models, theories, and empirical
indicators in a holarchy organized by decreasing levels of
abstraction.

Metaparadigm
Four major concepts are frequently interrelated and
fundamental to nursing theory: person, environment,
health, and nursing. These four are collectively
referred to as metaparadigm for nursing.

Person
Jean Watson refers to 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. Human is viewed as greater
than and different from the sum of his or her parts.”

Health
"Unity and harmony within the mind, body, and soul",
"the degree of congruence between the self as
perceived and the self as experienced" (Alligood,
2010, p. 99)

She also further states "illness is not necessarily

disease; instead it is a subjective turmoil or
disharmony within a person's inner self or soul"

Environment
In Jean Watson's original caratives, it states that nurses role in
the environment is "attending to supportive, protective, and
corrective mental, physical, societal, and spiritual
environments."

Is described to be a "healing space" which "can be used to

help others transcend illness, pain, and suffering"

Has emphasized that environment and person are connected:

"when nurse enters the patients' room, a magnetic field of
expectation is created"

The caring science is not only for sustaining humanity, but also
for sustaining the planet...Belonging is to an infinite universal
spirit world of nature and all living things; it is the primordial
link of humanity and life itself, across time and space,
boundaries and nationalities (Alligood, 2021, p.99)

Nursing
Nursing consist of "knowledge, thought, values,
philosophy, commitment, and action, with some
degree of passion" (Watson, 1988, p. 53).

Reference: _jean_watson recorded lec.pptx. (2021). Retrieved 25 September

2021, from https://docs.google.com/presentation/d/1kjUMl4-
PmjaSkNHQJB4-SUgMEdE-my87/mobilepresent?
fbclid=IwAR2M0Evt0ruI1NSBklUNbzjCIbiGLvlJ2Ag8vECuPPVmbRB1mR
o5RNGy0Vk&slide=id.p1
 Philosophy
It is the most abstract type and sets forth the meaning
of nursing phenomena through analysis, reasoning,
and logical presentation.

Caring is central to nursing practice, and it promotes

health more effectively than a mere medical
treatment. She feels that a holistic approach to
health care is essential to nursing practice.

Conceptual Models
These are comprehensive nursing theories that are regarded by some as pioneers
in nursing. These theories address the nursing metaparadigm and explain the
relationship between them.

Carative factors
1. Practicing loving kindness via a humanistic system of values.
2. Sustaining the faith, hope, and belief system of oneself and those of others.
3. Having awareness or sensitivity to self and others.
4. Developing trusting relationships.
5. Being supportive to the positive or negative feelings felt by self or others.
6. Engaged in healing practice.
7. Teaching and learning within a transpersonal caring relationship.
8. Carative factor is creating a healing environment.
9. Assisting with the basic needs.
10. Opening to spiritual-mysterious.

A transpersonal caring relationship

Caring occasion or caring moment

Theory
Are works derived from nursing philosophies,
conceptual models, and other grand theories that are
generally not as specific as middle-range theories.

There are three main conceptual elements in both

the original and evolving theory. The concepts are
evolved based on Dr. Watson’s experience and
background. The three concepts of Watson’s Theory
of Human Caring include carative factors, a caring
relationship, and caring moments.

Middle range theory

Are precise and answer specific nursing practice
questions. They address the specifics of nursing situations
within the model’s perspective or theory from which they
are derived.

Watson’s goal was to distinguish nursing from other

professions. She created Theory of Human Caring based
on her personal view. Watson’s theory was widely utilized
in clinical practice and research. Even though the theory
is complex and abstract, it is suitable as a middle range
theory for future nursing discipline. “When human caring is
applied in interprofessional teams, healthcare
professionals find a caring consciousness to care for
oneself and each other, and thus promote patient care”
(Wei & Watson, 2019, p. 23)

Reference:
Nursing Theories and Theorists: An Ultimate Guide for Nurses.
Then (2021). Retrieved 23 September 2021, from
https://nurseslabs.com/nursing-
theories/#the_nursing_metaparadigm

Metaparadigm Concepts | Department of Nursing. (2021).

Retrieved 23 September 2021, from
https://nursing.tcnj.edu/about/meta-concepts/

Nursing: The Philosophy and Science of Caring by Jean Watson -

PDF Drive. (2021). Retrieved 25 September 2021, from
https://www.pdfdrive.com/nursing-the-philosophy-and-science-of-
caring-e190120750.html

Prepared by: Vianne Clare A. Goyena

Course & Block: BSN-1B