Where Did the Theory of Human Caring Model Come From?

The Theory of Human Caring Model

The theory of human caring was developed between 1975 and 1979 by Jean Watson while she was teaching in the University of Colorado. According to Smith, and Parker (2015), Jean was trying to bring meaning and focus to nursing as an emerging discipline and health profession with its own unique practices, values, knowledge, and mission towards the society. The development of the theory was also influenced by her involvement with an integrated nursing curriculum and efforts to find meaning and order to nursing. Another emerging perspective is that Jean tried to make clear that nursing knowledge, practices, and values are directed towards subjective inner healing. Accordingly, this discussion is focused on exploring the processes that the theory has passed through from its formation to the current application in the nursing field.

Theorizing

Caring is the core concept of the nursing profession. According to Pajnkihar, Štiglic, and Vrbnjak (2017), caring involves care for and care about patients, which are the basic domains in holistic nursing. Consequently, as Adams (2016) adds, caring as a universal human attribute that has stood the test of time has proven to be an integral part of the nursing practice. The philosophy of caring in nursing occurs through two primary domains – as a noun or as the act of caring for the other person when they are vulnerable or unable to care for themselves. The other context of concern is the adjective of being caring as a nurse, which happens when a nurse shows concern, compassion, and kindness towards the sick. However, the concept of caring is complex and the way it is perceived by many to explain the ontology and epistemology can be ambiguous. Jean Watson’s theory of human caring is one of the theories that is used to explain the nursing profession as a caring science. According to Smith, and Parker (2015), the theory of human caring views nursing from the perspective of caring science, where nursing and healing work is seen to be beyond conventional thinking. The model specifically acknowledges that, the one way to ensure caring is central to patient’s experience is by endorsing Jean Watson’s theory of human caring and use it as the basis or a guide for nursing practice. Watson theory further theorizes that human being is connected to each other through the caring process. When a nurse embraces humanity, he or she preserves the dignity of self and that of others, which is a holistic approach in the transpersonal caring relationship.

Development of Syntax

Watson’s theory of human caring is among the most popular theories of caring that has been used to guide the nursing practice, education, and research. According to Barry, Gordon, and King (2015), the theory is guided by major conceptual elements including 10 carative factors, transpersonal caring relationships, caring moments, and caring-healing modality. However, before arriving at the four major conceptual elements of the theory, Jean started by first focusing on the theory of human caring as the disciplinary foundation upon which nursing science, education, and practice is based.  The theoretical concepts were informed by Watson’s personal and professional experiences during her nursing practice. The early work was founded on her values, beliefs, perceptions, and experiences about the general human caring concept. Jean also developed ten carative factors that acted as the essential aspect of caring and without which nurses would probably not be practicing as professionals but as skilled workers or technicians in the dominant field medical science. After this, Jean expanded the theory upon the philosophical and transpersonal aspects of caring as the core framework. The focus placed the idea of caring in a wide range of ethics, art, and metaphysics spiritual, within which nursing dwells. To arrive at this expansion, Jean reasoned that a profession that does not have its language does not exist. It is, therefore to claim, articulate, and act upon the phenomena of nursing and caring if the nursing profession is expected to fulfill its mandate. After this, Jean focused on the professional paradigm grounded on the ontology of relations and ethical-ontological foundation before the epistemology of science and technology. Recently, Jean redesigned the carative factors into caritas processes or clinical caritas. As Barry et al. elaborates, the caritas concept represents love and advocates for allowing love and caring to be combined together to form transpersonal caring. It also advocates for the creation of caring moments by using caring-healing modalities. For nurses to form transpersonal relationships with patients, they must be able to overcome their ego and connect with the spiritual status to access the healing possibilities and potentials. Jean believes that when the nurse and the patient are connected through a transpersonal caring relationship, then it creates harmony, wholeness, and unites the healing process into a single caring-healing moment.

Theory Testing

Evidence-based studies are often referred to as the standard for determining inpatient nursing care models. The theory of human caring has been used in several qualitative and quantitative research to help answers questions that arise in practice. For instance, according to Nelson, and Watson (2012), caring has been shown to influence inpatient care. In order to assess the effectiveness of partners in care, Watson’s theory of human caring was used to determine the measurement tools for the project. The intention was to change the model of care delivery with Watson’s theory of human caring, to determine if it led to better patient care outcomes. The results indicated that at first after the implementation of the nursing model, patient and staff satisfaction decreased. However, three months post-implementation, there were positive results. The initial negative results could have been due to a number of limitations such as the size of the study, which limited generalizability.

Consequently, the theory of human caring was applied in transpersonal caring for families of neonates, who had been discharged from the ICU (Favero, Mazza, & Lacerda, 2012). The research was a qualitative research with a descriptive case study that was conducted in the NICU of a private hospital. The study criteria expected participants to be a parent or family member f a neonate discharged from the NICU. The results of the study indicated a positive influence of applying the theory of human caring.

Evaluation

Watson’s theory of human caring has been applied in a wide range of clinical nursing situation. More specifically, the principles of the human caring theory have been applied in intensive care units, mental health units, pediatric units, and public health centers among other clinical settings. Consistently, we provide at least five examples to demonstrate ways in which the theory is applied through evidence-based practice to provide nursing care.

Infertility is a physiological problem with the ability to initiate a life crisis experienced with social, cultural, and sometimes familial consequences. Due to problems physiological problems associated with the condition, couples often turn to in-vitro-fertilization (IVF) to try and get a child (Ozan, Okumus, & Lash, 2015). Unfortunately, the situation is not guaranteed and several women have suffered unsuccessful outcomes. Research indicates it is important for healthcare professionals to assess the women may adjust after the negative outcomes. Further studies show that in such a case, giving nursing care based on specific theories that provide holistic nursing care may be essential (Durgun, & Okumuş, 2017). The human caring theory has also been used to manage anxiety among infertility patients. While some researchers indicate that anxiety has no effect on the success of IVF others have confirmed that it has a significant effect. The human caring theory allows health care providers to take care of such patients in a holistic way through the four elements of the theory. A third example where the human caring theory has been used is in the pediatric critical care unit to care for children with chronic conditions. Jean’s theory is focused on ensuring a balance and harmony between health and illness experiences in children. applying this theory gives the children a comfortable, beautiful, and peaceful environment that is caring and enables the children to cope with the chronic illness. The fourth example is the application of the human caring theory in the emotional aspects of midwifery. Research shows that the public complains about the uncaring attitude in midwifery. However, a study by Choke, and Wright (2013) indicates that adopting the theory of human caring can help midwives show compassion, commitment, and care for expectant mothers. Another area that the human caring theory has been applied is in the care of families of pediatric inpatients (Dos, Baliza, & Misko, 2014). The theory was used to understand and care for families hospitalized in the pediatric unit.

Jean Watson’s theory of human caring believes in a spiritual and moral aspect of nursing practice. Jean believed that the nurse was responsible for creating an opportunity for the body to heal. Fr more than two decades, Jean has been dedicated to developing a culture within the nursing community where spirituality and caring are connected to the profession. Over the years, Jean has developed her theory from what it initially was to the current elements of human caring based on caritas process. The theory has also been applied in a wide range evidence-based care practice. Overall, the theory is so deeply ingrained into the nursing culture, to an extent it would be impossible to know how nursing would be like without this theory.

References

Adams, L. Y. (2016). The conundrum of caring in nursing. International Journal of Caring Sciences, 9(1), 1-8.

Barry, C. D., Gordon, S. C., & King, B. M. (2015). Nursing case studies in caring: Across the practice spectrum. New York: Springer Publishing Company.

Chokwe, M.E., & Wright, S. C.D. (2013). Caring during clinical practice: Midwives’ perspective. Curationis, 36(1), 1-7.

Dos, S. M. R., Baliza, M. F., Misko, M. D., Silva, L., Bousso, R. S., & Vendramim, P. (2014). The practice of nurses caring for families of pediatric inpatients in light of Jean Watson. Revista Da Escola De Enfermagem, 48, 80-86.

Durgun, O. Y., & Okumuş, H. (2017). Effects of Nursing Care Based on Watson’s Theory of Human Caring on Anxiety, Distress, And Coping, When Infertility Treatment Fails: A Randomized Controlled Trial. Journal of Caring Sciences, 6(2), 95-109.

Favero, L., Mazza, V. D. A., & Lacerda, M. R. (2012). Experience of a nurse in transpersonal caring for families of neonates discharged from the intensive care unit. Acta Paulista De Enfermagem, 25(4), 490-496.

Lukose, A. (2011). Developing a Practice Model for Watson’s Theory of Caring. Nursing Science Quarterly, 24(1), 27-30.

Nelson, J., & Watson, J. (2012). Measuring caring: International research on caritas as healing. New York: Springer.

Oza, Y. D., Okumus, H., Lash, A. A. (2015). Implementation of Watson’s Theory of Human Caring: A Case Study. International Journal of Caring Sciences, 8(1), 25-35.

Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, 1-16.

Smith, M. C., & Parker, M. E. (2015). Nursing theories & nursing practice. P hiladelphia, PA : F.A. Davis Company.

Watson, J. (2007). Watson’s theory of human caring and subjective living experiences: carative factors/caritas processes as a disciplinary guide to the professional nursing practice. ScieELO, 16(1), 129-135.