JEAN WATSON

THEORY OF
HUMAN
CARING
Jean Watson, PhD,
RN, AHB-BC, FAAN
EVOLUTION OF TRANSPERSONAL CARING THEORY
 Margaret Jean Harman Watson was born and raised in a small West Virginia town
in the Appalachian Mountains named Welch.

 Being the youngest of eight siblings, she was surrounded by a large extended
family.

 She moved to Colorado after marrying Douglas, had two daughters and five
grandchildren.
 Watson established the Center for Human Caring at the University of Colorado in
the 1980’s.
 It was described as the “first interdisciplinary center committed to using human
caring knowledge that forms the moral and scientific bases for clinical practice,
scholarship, and administration and leadership”. (Watson, 1986)
 Watson’s first book, Nursing: The philosophy and science of caring (1979),
developed from her notes for an undergraduate course taught at the
University of Colorado (Alligood, 2010).
 Yaloms’ eleven curative factors stimulated Watsons’ thinking about her ten
carative factors (Alligood, 2010).
 Caratives were described as the organizing framework for her book.
 Her early work embraced the ten carative factors but has evolved to include
“caritas” that make connections between caring and love (Alligood, 2010).

 She added “spiritual aspects and believes that the core of nursing is seen in
those nurse-patient relationships that result in a therapeutic outcome
(Alligood, 2010, p. 102).
Metaparadigms

 Nursing theories embrace the concept

that they all have elements that address
four major paradigms:
 Environment
 Person
 Health
 Nursing
Environment

 In her original caratives, she refers to the nurses role in

the environment as “attending to supportive, protective,
and or corrective mental, physical, societal, and
spiritual environments” (Watson, 1979, p. 10).
 In her later work, she describes that “healing space can
be used to help others transcend illness, pain, and
suffering” (Watson, 2003, p. 200).
 She also emphasizes that environment and person are
connected: “when the nurse enters the patients’ room, a
magnetic field of expectation is created” (Watson,
2003, p. 200).
 Her broad view of environment is:
The caring science is not only for sustaining
humanity, but also for sustaining the plan-
et…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, 2010, p. 99)
 Person

 Watson uses the words human being, person, life, and

self interchangeably. She views the person as “unity
of mind/body/spirit/nature” (Alligood, 2010, p. 99).
 Shefeels that “personhood is tied to notions that
one’s soul possess a body that is not confined by
objective time and space..” (Alligood, 2010, p. 99).
 Health

 Herdefinition of health is “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 further states “illness in not necessarily disease;
instead it is a subjective turmoil or disharmony within
a person’s inner self or soul”
Nursing

 Nursing consists of “knowledge,

thought, values, philosophy,
commitment, and action, with some
degree of passion” (Watson, 1988, p.
53).
 Nurses go beyond procedures, tasks, and
techniques used in practice settings.
(Watson, 1988, p. 53).
“Care for the Journey”
Jean Watson

http://www.watsoncaringscience.org/media/cari
ng_moment.mp3
 Uniqueness of Concepts

 New to nursing in 1979 with “deep roots in philosophy

and ethics and become more closely aligned with
Rogerian science of unitary human beings” (Foster,
2006).

 Basic assumptions of Caring Science.

 Carative Factors to Caritas Processes.

 Basic Assumptions
• Caring Science
• Caring

• Humanity

• Carative Factors/Caritas Processes

• Effective Caring

• Acceptance

• Relationship

• Curing Science

(Watson, 2008)
 Carative/Caritas
#1
Factor Process

Humanistic-Altruistic Cultivating the Practice of

System of Values Loving-Kindness and
Equanimity Toward Self
and Other as Foundational
to Caritas Consciousness

(“Jean Watson’s Philosophy”, 2010) (Watson, 2008)

 Carative/Caritas
#2
Factor Process

Being Authentically
Installation of Faith and Present: Enabling,
Hope sustaining, and Honoring
the Faith, hope, and Deep
Belief System and the
Inner-Subjective Life World
(“Jean Watson’s Philosophy”, 2010) of Self/Other
(Watson, 2008)
 Carative/Caritas
#3
Factor Process
Cultivation of One’s Own
Cultivation of Sensitivity to Spiritual Practices and
Oneself and Others Transpersonal Self, Going
Beyond Ego-Self
(“Jean Watson’s Philosophy”, 2010) (Watson, 2008)
 Carative/Caritas
#4
Factor Process

Developing a Helping- Developing and Sustaining

Trusting Relationship a Helping-Trusting Caring
Relationship
(“Jean Watson’s Philosophy”, 2010) (Watson, 2008)
 Carative/Caritas
#5
Factor Process
Promotion and Acceptance Being Present to, and
of the Expression of Supportive of, the
Positive and Negative Expression of Positive and
Feelings Negative Feelings

(Watson, 2008)
(“Jean Watson’s Philosophy”, 2010)
 Carative/Caritas
#6
Factor Process
Systematic Use of the Creative Use of Self and All
Scientific Problem-Solving Ways of Knowing as Part of
Method for Decision the Caring Process; Engage
Making in the Artistry of Caritas
Nursing
(“Jean Watson’s Philosophy”, 2010)
(Watson, 2008)
 Carative/Caritas
#7
Factor Process
Promotion of Interpersonal Engage in Genuine
Teaching and Learning Teaching-Learning
(“Jean Watson’s Philosophy”, 2010). Experience That Attends to
Unity of Being and
Subjective meaning-
Attempting to Stay Within
the Other’s Frame of
Reference
(Watson, 2008)
 Carative/Caritas
#8
Factor Process
Attending to a supportive, Creating a Healing
Protective, and/or Environment at All levels
Corrective Mental, Physical,
(Watson, 2008)
Societal, and Spiritual
Environment

(“Jean Watson’s Philosophy”, 2010).

 Carative/Caritas
#9
Factor
Assistance with
Gratification of Human
Needs
(“Jean Watson’s Philosophy”, 2010).
(Watson, 2008)
Intrapersonal-
interpersonal need
(self-actualization)
──────
Psychosocial Needs
(achievement, affiliation)
───────
Psychophysical Needs (activity-
rest, sexuality)
───────
Biophysical Needs (food, water,
elimination, ventilation
Process
Administering Sacred
Nursing Acts of Caring-
Healing by Tending to
Basic Human Needs
Watson’s additional needs:
Knowledge, beauty-aesthetics, evolving
self-actualization that is spiritually
meaningful, and “need to connect with
that which is greater than self--to
surrender to a higher source with a sense
of awe toward the mystery and wonder
of life, whether humanity itself, nature,
God, Spirit, or a Divine universe”
(Watson, 2008, p. 147).
 Carative/Caritas
#10
Factor Process
Allowance for Existential- Opening and Attending to
Phenomenological Forces Spiritual/Mysterious and
(“Jean Watson’s Philosophy”, 2010). Existential Unknowns of
Life-Death

(Watson, 2008)
Watson’s theory in clinical
practice.
The nurse considers the patient as a
whole.
 “The nurse makes a moral
commitment and direct
intentionality and consciousness to
the protection, enhancement, and
potentiation of human dignity,
wholeness, and healing, such that a
person creates or co-creates his or
her own meaning for existence,
healing, wholeness, and caring”
(Kearney, 2008, p. 74).
 The nurse is able to “connect with the inner condition (spirit)
of another” (Kearney, 2008, p. 74) and create caring moments.
 The nurse uses the healing modalities to
help bring harmony to a patient.

 The healing modalities include:

 The use of auditory, visual and tactile therapies.
 Gustatory
 Mental/cognitive
 Kinesthetic
 Caring consciousness
 Understanding own life history
The nurse should “potentiate comfort measures, pain control, a
sense of well-being or spiritual transcendence of suffering”
(Kearney, 2008, p. 74).
Framework for patient assessment.
Watson’s theory challenges nurses to go beyond the tasks and
procedures of nursing and really dig for the core of nursing
(Tomey, 2010, p. 98)
 Ways to incorporate Watson’s theory into
nursing assessment

 Do an emotional and spiritual assessment

 Sit down while talking with patient and give them your undivided
attention
 Actively listen to patient
 Ask open ended questions that will allow the patient to share their
feelings on their views on things such as health and situation
 Instill hope and faith (Watson, 2007)
“TRANSPERSONAL
CARING”
In
Nursing Education
 Definition of Nursing Practice

“ In the practice setting, nursing theory

clearly defines the unique contribution of
nurses to health care and helps distinguish
nursing as a professional discipline with its
own body of knowledge that is separate
from the medical model of care” (Marckx,
1995, p. 49).
 Carative-a Definition
“Carative is the philosophy and theory of human caring.
Dr. Jean Watson uses the term “carative” instead of
“curative” to distinguish between nursing and medicine”.
“Whereas curative factors aim at curing the patient of
disease, carative factors aim at the caring process that helps
the person attain (or maintain) health or die a peaceful
death” (Watson, 1979).

The original theory developed in 1979, was organized

around 10 carative factors:

Source: Nursing: The Philosophy and Science of Caring by Jean Watson, RN, Ph.D. Boston: Little, Brown and Co., 1979.
Abbreviations of Watson’s Carative
Factors

“They can be used as an expressive tool while

directing the assessment, interventions, charting
and full engagement of caring human dimensions
of nursing practice” (Rosenberg, 2006, p. 55)
 Implication to Nursing Education

“The carative factors, which represent the core of

nursing and the primary ingredients of effective
nursing practice, provide a language, structure, and
order for studying and understanding nursing
education and practice” (Wade & Kasper, 2006, p. 163).
  
 

The Watson Caring

Science Institute
Dr. Jean Watson, Founder, created
her international nonprofit Watson
Caring Science Institute in 2007
with the mission to restore the
profound nature of caring-healing
in today’s healthcare systems and
to retain its most precious resource,
caring professional nurses and
transdisciplinary care team
members

http://www.watsoncaringscience.org/
 Million Nurse
Global Caring Field http://
Project www.watsoncaringscience.org/jeanme
dpop.htm
(Right click, select open hyperlink)

Goal:
“Connect simultaneously with a million
nurses (or more) around the globe: to create
and radiate an energetic Caring Field of
Heart-Centered Love for Self, Others, and the
Planet Earth. This intentional focused
experience honors and extends the human
caring vibration of nurses into the universal
energy field of humanity facilitating healing
and health for all” (Watson, 2010)
HeartMath “Thousands of health
professionals in clinics,
hospitals, military facilities,
coaching, couples therapy, and
private practice are using the
emWave technologies with
clients. They have found that
with consistent practice, clients
can learn to reduce stress,
manage the emotions
associated with stress, expand
their coping skills, and create a
greater sense of well-being.”

http://www.heartmath.com/
 Jean Watson’s Philosophy and Theory
Strengths of this Model

a)Jean Watson’s theory is similar to the nursing process and follows

a similar path as the scientific research process. 1. Assessment 2.
Plan 3. Intervention 4. Evaluation, so it is familiar for nurses to
follow.

b)Watson’s work does follow logical steps.

c) Using the science of caring or the carative factors, shows how

nursing differs from other professions.

d)It advocates for the healing of the patient as opposed to the

technology needed.

e)Her philosophy is based on love/caring of the human being which is

why many nurses chose their profession.
 Jean Watson’s Philosophy and
Theory
Limitations of this Model
a)Watson’s theory is first and foremost a psychosocial
model. (Andrews, 2008.)
b)With shorter hospitalization stays it is difficult to evaluate
the effectiveness of the model in the hospital (Andrews,
2008).
c) It is a relatively new theory (published in 1979) and hasn’t
been utilized a lot; it needs more nursing research to
determine it’s effectiveness in nursing practice.
d) Her theory “language “can be difficult to understand.
*Evaluation of Jean Watson’s
Theory of Human Caring

* Is about much more than giving care to a

person.
* Is about caring for a person’s body, mind, and
spirit (soul) (Ryan, 2005).
* Is about the person giving care as well as the
one being cared for (Sitzman, 2011).
* Is a moment to moment experience.
* Is holistic
* Forgiveness
* Compassion
* Love
* Mind
* Body
* Soul
* Harmony
* Spiritual
* Mystical

*Caring Relationship
 * Evolved in the 1970’s

* Florence Nightingale

* Caring leads to healing

* “love, compassion, and forgiveness….”

*The Theory of Human Caring

* Carative Factors

* Caritas Processes

* Curative Factors

*Aspects of The Theory

of Caring
* Transpersonal caring relationship

* Caring moment

* Caring healing modalities.

*Transpersonal Caring
Relationship
* Recent Studies

* What patients view as important in caring

* Least important aspects of care

*Caring for Patients