Watson Human Caring Theory

Abstract

According to Watson (1997), the core of the Theory of Caring is that "humans cannot be treated as objects and that humans cannot be separated from self, other, nature, and the larger workforce." Her theory encompasses the whole world of nursing; with the emphasis placed on the interpersonal process between the care giver and care recipient. The theory is focused on "the centrality of human caring and on the caring-to-caring transpersonal relationship and its healing potential for both the one who is caring and the one who is being cared for" (Watson, 1996). Watson's hierarchy of needs begins with lower-order biophysical needs, which include the need for food and fluid, elimination, and ventilation. Next are the lower-order psychophysical needs, which include the need for activity, inactivity, and sexuality. Finally, are the higher order needs, which are psychosocial. These include the need for achievement, affiliation, and self-actualization.

Full text

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Review Article
Watson Human Caring Theory
Mrs.Usha rani K ∗
Abstract
According to Watson (1997), the core of the Theory of Caring is that “humans cannot be treated as objects and that humans
cannot be separated from self, other, nature, and the larger workforce.” Her theory encompasses the whole world of nursing;
with the emphasis placed on the interpersonal process between the care giver and care recipient. The theory is focused on “the
centrality of human caring and on the caring-to-caring transpersonal relationship and its healing potential for both the one who
is caring and the one who is being cared for” (Watson, 1996). Watson’s hierarchy of needs begins with lower-order biophysical
needs, which include the need for food and fluid, elimination, and ventilation. Next are the lower-order psychophysical needs,
which include the need for activity, inactivity, and sexuality. Finally, are the higher order needs, which are psychosocial. These
include the need for achievement, affiliation, and self-actualization.
1 Introduction
Nursing is defined by caring. At Redlands Community Hos-
pital, nursing has embraced the theory of Jean Watson’s
Caring Science. Caring Science helps us to embrace the
positive energy that flows from an integrated mind, body
and spirit and is mutually rewarding to both the patient and
the nurse. Forged by the vision of Florence Nightingale who
asserted that the “role of a nurse is to put her patient in the
best position to be able to self-heal”, nurses are optimally
positioned to be the heart of healing. By actively engaging
in caring through authentic presence and intentionality, the
nurse is able to optimize her patient’s ability to heal from
within.[1]
2 Background of Jean Watson
Jean Watson is an American nurse theorist and nursing pro-
fessor who is best known for her Theory of human caring.
She is the author of numerous texts, including Nursing: The
Philosophy and Science of Caring. Watson’s research on car-
ing has been incorporated into education and patient care at
hundreds of nursing schools and healthcare facilities across
the world.[2]
∗Assistant professor, Rama college of Nursing, Mandhana, Kanpur, In-
dia. E-mail:Neha2010dec@gmail.com
2.1 Early Life
Watson was born on June 10, 1940 in Williamson, West
Virginia. Education Jean Watson graduated from the Lewis
Gale School of Nursing in Roanoke, Virginia, in 1961. She
continued her nursing studies at the University of Colorado
at Boulder, earning a B.S. in 1964, an M.S. in psychiatric and
mental health nursing in 1966, and a Ph.D. in educational
psychology and counseling in 1973. She has been awarded
nine honorary doctoral degrees in six countries.
Figure 1: Jean Watson
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2.2 Academic Appointments
Watson is a Distinguished Professor of Nursing at the Uni-
versity of Colorado, where she formerly served as Dean of
Nursing.
2.3 Leadership Achievements
She is a past president of the National League for Nursing.
2.4 Honors and Awards
1999: Norman Cousins Award, Fetzer Institute.[3]
3 Caring Theory
Watson developed the Theory of Human Caring. She
founded the non-profit Watson Caring Science Institute in
2008. The ten primary carative factors are :
1. The formation of a humanistic- altruistic system of
values.
2. The installation of faith-hope
3. The cultivation of sensitivity to one’s self and to others
4. The development of a helping-trust relationship
5. The promotion and acceptance of the expression of
positive and negative feelings.
6. The systematic use of the scientific problem-solving
method for decision making
7. The promotion of interpersonal teaching-learning
8. The provision for a supportive, protective and /or cor-
rective mental, physical, socio-cultural and spiritual envi-
ronment.
9. Assistance with the gratification of human needs.
10. The allowance for existential-phenomenological
forces.[4]
The first three carative factors form the “philosophical
foundation” for the science of caring.
The remaining seven carative factors spring from the foun-
dation laid by these first three.
1. The formation of a humanistic- altruistic system of
values
•Begins developmentally at an early age with values
shared with the parents.
•Mediated through ones own life experiences, the learning
one gains and exposure to the humanities.
’•Is perceived as necessary to the nurse’s own maturation
which then promotes altruistic behavior towards others.
2. Faith-hope
•Is essential to both the carative and the curative processes.
•When modern science has nothing further to offer the
person, the nurse can continue to use faith-hope to provide a
sense of well-being through beliefs which are meaningful to
the individual.
3. Cultivation of sensitivity to one’s self and to others
•Explores the need of the nurse to begin to feel an emotion
as it presents itself
•Development of one’s own feeling is needed to interact
genuinely and sensitively with others.
•Striving to become sensitive, makes the nurse more au-
thentic, which encourages self-growth and self-actualization,
in both the nurse and those with whom the nurse interacts.
•The nurses promote health and higher level functioning
only when they form person to person relationship.
4. Establishing a helping-trust relationship
•Strongest tool is the mode of communication, which
establishes rapport and caring.
Characteristics needed the Helping-Trust Relationship
are:
•Congruence
•Empathy
•Warmth
•Communication includes verbal, nonverbal and listening
in a manner which connotes empathetic understanding.[5]
5. The expression of feelings, both positive and negative
•“Feelings alter thoughts and behavior, and they need to
be considered and allowed for in a caring relationship”.
•Awareness of the feelings helps to understand the behav-
ior it engenders.
6.The systematic use of the scientific problem-solving
method for decision making
•The scientific problem- solving method is the only
method that allows for control and prediction, and that per-
mits self-correction.
•The science of caring should not be always neutral and
objective.
7.Promotion of interpersonal teaching-learning
•The caring nurse must focus on the learning process as
much as the teaching process.
•Understanding the person’s perception of the situation
assist the nurse to prepare a cognitive plan.[6]
8. Provision for a supportive, protective and /or correc-
tive mental, physical, socio-cultural and spiritual environ-
ment
•Watson divides these into eternal and internal variables,
which the nurse manipulates in order to provide support and
protection for the person’s mental and physical well-being.
•The external and internal environments are interdepen-
dent.
•Nurse must provide comfort, privacy and safety as a part
of this carative factor.
9. Assistance with the gratification of human needs
•It is based on a hierarchy of need similar to that of the
Maslow’s.
•Each need is equally important for quality nursing care
and the promotion of optimal health.
•All the needs deserve to be attended to and valued.[7]
Watson’s Ordering of Needs
Lower order needs (biophysical needs)

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•The need for food and fluid
•The need for elimination
•The need for ventilation
Lower order needs (psychophysical needs)
•The need for activity-inactivity
•The need for sexuality
Higher order needs (psychosocial needs)
•The need for achievement
•The need for affiliation
•Higher order need (intrapersonal-interpersonal need)
•The need for self-actualization.[8]
10. Allowance for existential-phenomenological forces
•Phenomenology is a way of understanding people from
the way things appear to them, from their frame of reference.
•Existential psychology is the study of human existence
using phenomenological analysis.
•This factor helps the nurse to reconcile and mediate the
incongruity of viewing the person holistically while at the
same time attending to the hierarchical ordering of needs.
•Thus the nurse assists the person to find the strength or
courage to confront life or death[9]
4 Watson’s Theory and the four Ma-
jor Concepts
1. Human being
Human being refers to “ 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. He, human is viewed as greater
than and different from, the sum of his or her parts”.[10]
2. Health
Watson adds the following three elements to WHO defi-
nition of health:
•A high level of overall physical, mental and social func-
tioning
•A general adaptive-maintenance level of daily function-
ing
•The absence of illness (or the presence of efforts that
leads its absence)
3. Environment/society
According to Watson, caring (and nursing) has existed in
every society.
•A caring attitude is not transmitted from generation to
generation.
•It is transmitted by the culture of the profession as a
unique way of coping with its environment.[11]
4. Nursing
•“Nursing is concerned with promoting health, preventing
illness, caring for the sick and restoring health”.
•It focuses on health promotion and treatment of disease.
She believes that holistic health care is central to the practice
of caring in nursing.[13]
She defines nursing as
•“A human science of persons and human health-illness
experiences that are mediated by professional, personal, sci-
entific, esthetic and ethical human transactions”.
5 Watson’s Theory and Nursing Pro-
cess
Nursing process contains the same steps as the scientific
research process. They both try to solve a problem. Both
provide a framework for decision making.
1. Assessment
Involves observation, identification and review of the
problem; use of applicable knowledge in literature.
Also includes conceptual knowledge for the formulation
and conceptualization of framework.
Includes the formulation of hypothesis; defining variables
that will be examined in solving the problem.
2. Plan
It helps to determine how variables would be examined
or measured; includes a conceptual approach or design for
problem solving. It determines what data would be collected
and how on whom.
3. Intervention
It is the direct action and implementation of the plan.
It includes the collection of the data.
4. Evaluation
•Analysis of the data as well as the examination of the
effects of interventions based on the data.
•Includes the interpretation of the results, the degree to
which positive outcome has occurred and whether the result
can be generalized.
•It may also generate additional hypothesis or may even
lead to the generation of a nursing theory.
6 Watson’s Theory and the Charac-
teristic of a theory
•Logical in nature
•Relatively simple
•Generalizable
•Based on phenomenological studies that generally ask
questions rather than state hypotheses.
•Can be used to guide and improve practice.
•Supported by the theoretical work of numerous human-
ists, philosophers, developmentalists and psychologists.
Strengths
•This theory places client in the context of the family, the
community and the culture.
•It places the client as the focus of practice rather than the
technology.
Limitations

JNPE, March 2019, Vol.5, Issue 1, ISSN No.2395-1974 31
•Biophysical needs of the individual are given less im-
portant.
•The ten caratiive factors primarily delineate the psy-
chosocial needs of the person.
•Needs further research to apply in practice.[13]
7 Conclusions
Watson provides many useful concepts for the practice of
nursing. She ties together many theories commonly used in
nursing education. The detailed descriptions of the carative
factors can give guidance to those who wish to employ them
in practice or research.
References
[1]. "Global Caring Connections". CU College of Nursing.
Retrieved June 22, 2012.
[2]. "W Jean , PhD, RN, AHN-BC, FAAN". Watson Caring
Science Institute. Retrieved June 22, 2012.
[3]. 14th International IONS Conference". Institute of
Noetic Sciences. Archived from the original on May 12,
2012. Retrieved June 22, 2012.
[4]. BK Timber . Fundamental skills and concepts in Patient
Care, 7th edition, LWW, New Yok.
[5]. B J George , Nursing Theories- The base for professional
Nursing Practice , 3rd ed. Norwalk, Appleton Lange.
[6]. M E Wills , M McEwen (2002). Theoretical Basis for
Nursing Philadelphia. Lippincott Williams wilkins.
[7]. I A Meleis, (1997) , Theoretical Nursing : Development
Progress 3rd ed. Philadelphia, Lippincott.
[8]. C C Taylor, (2001)The Art Science Of Nursing Care
4th ed. Philadelphia, Lippincott.
[9]. P A Patricia, ,G A Perry, (1992) Fundamentals Of
Nursing –Concepts Process Practice 3rd ed. London
Mosby Year Book.
[10]. L M Vandemark . Awareness of self expanding
consciousness: using Nursing theories to prepare nurse
–therapists Ment Health Nurs. 2006 Jul; 27(6) : 605-15
[11]. P G Reed , The force of nursing theory guided- practice.
Nurs Sci Q. 2006 Jul;19(3):225
[12]. M Y Cheng . Using King’s Goal Attainment Theory
to facilitate drug compliance in a psychiatric patient. Hu
Li Za Zhi. 2006 Jun;53(3):90-7.
[13] S C Delaune ,. PK Ladner , Fundamental of nursing,
standard and practice, 2nd edition, Thomson, NY, 2002.