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Government College of Nursing Ahmedabad: SUB:-Advanced Nursing Practice Topic: Jean Watson'S Theory of Nursing

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GOVERNMENT COLLEGE OF
NURSING AHMEDABAD
SUB:- ADVANCED NURSING
PRACTICE
TOPIC: JEAN WATSONS THEORY
OF NURSING
SUBMITTED TO :
MRS. MINAXI D. PATEL
LECTURER SR. SCALE CL-I
GOVT. COLLEGE OF NURSING
AHMEDABAD
SUBMITTED BY:
MUKESHKUMAR P.TANK
F. Y. M.Sc. NURSING
YEAR 20-20!
2
Jean Watson's Philosophy and theory of
Nursing
Introduction
Born: West Virginia
Educated: BSN, University of Colorado, 1964, S, University of Colorado,
1966, !"#, University of Colorado, 19$%
#istinguis"ed !rofessor of Nursing and endo&ed C"air in Caring Science at
t"e University of Colorado 'ealt" Sciences Center(
)ello& of t"e *+erican *cade+y of Nursing(
!reviously, #ean of Nursing at t"e University 'ealt" Sciences Center and
!resident of t"e National ,eague for Nursing
#r( Watson "as earned undergraduate and graduate degrees in nursing and
-syc"iatric.+ental "ealt" nursing and !"# in educational -syc"ology and
counselling(
&idely -u/lis"ed aut"or and reci-ient of several a&ards and "onors,
.international 0ellogg )ello&s"i- in *ustralia, )ul/rig"t 1esearc" *&ard in
S&eden and si2 364 'onorary #octoral #egrees, including % 5nternational
'onorary #octorates 3S&eden, United 0ingdo+, 6ue/ec, Canada4(
'er researc" "as /een in t"e area of "u+an caring and loss(
7"e foundation of 8ean Watson9s t"eory of nursing &as -u/lis"ed in 19$9 in
nursing: :7"e -"iloso-"y and science of caring;
5n 19<<, "er t"eory &as -u/lis"ed in :nursing: "u+an science and "u+an
care;(
Major Concepts
.+ain focus in nursing is on carative factors(
.for nurses to develo- "u+anistic -"iloso-"ies and value syste+, a strong
li/eral arts /ac=ground is necessary(
t"e caring stance t"at nursing "as al&ays "eld is /eing t"reatened /y t"e tas=s
and tec"nology de+ands of t"e curative factors
The seven assumptions
1 Caring can /e effectively de+onstrated and -racticed only inter-ersonally(
3
! Caring consists of carative factors t"at result in t"e satisfaction of certain
"u+an needs(
" Effective caring -ro+otes "ealt" and individual or fa+ily gro&t"(
# Caring res-onses acce-t -erson not only as "e or s"e is no& /ut as &"at "e or
s"e +ay /eco+e(
$ * caring environ+ent is one t"at offers t"e develo-+ent of -otential &"ile
allo&ing t"e -erson to c"oose t"e /est action for "i+self or "erself at a given
-oint in ti+e(
% Caring is +ore :"ealt"ogenic; t"an is curing( * science of caring is
co+-le+entary to t"e science of curing(
& 7"e -ractice of caring is central to nursing(
The ten primary carative factors
1( 7"e for+ation of a "u+anistic. altruistic syste+ of values(
>( 7"e installation of fait"."o-e(
%( 7"e cultivation of sensitivity to one9s self and to ot"ers(
4( 7"e develo-+ent of a "el-ing.trust relations"i-
?( 7"e -ro+otion and acce-tance of t"e e2-ression of -ositive and negative
feelings(
6( 7"e syste+atic use of t"e scientific -ro/le+.solving +et"od for decision
+a=ing
$( 7"e -ro+otion of inter-ersonal teac"ing.learning(
<( 7"e -rovision for a su--ortive, -rotective and @or corrective +ental, -"ysical,
socio.cultural and s-iritual environ+ent(
9( *ssistance &it" t"e gratification of "u+an needs(
1A(7"e allo&ance for e2istential.-"eno+enological forces(

'riginal 1( Carative )actors*
ju+taposed against the emerging
Caritas Processes,
Carative )actors
Caritas Processes
1( 'u+anistic B*ltruistic Values( 1( !racticing ,oving.=indness C EDuani+ity
for self and ot"er(
>( 5nstilling@ena/ling )ait" C 'o-e(
>( Being aut"entically -resent to@ ena/ling
@sustaining@"onouring dee- /elief syste+ and
su/Eective &orld of self@ot"er(
4
%( Cultivation of Sensitivity to one9s self
and ot"er(
%( Cultivating of one9s o&n s-iritual -racticesF
dee-ening self. a&areness, going /eyond :ego
self;(
4( #evelo-+ent of "el-ing.trusting,
"u+an caring relations"i-(
4( #evelo-ing and sustaining a "el-ing.
trusting, aut"entic caring relations"i-(
?( !ro+otion and acce-tance of
e2-ression of -ositive and negative
feelings(
?( Being -resent to, and su--ortive of, t"e
e2-ression of -ositive and negative feelings as
a connection &it" dee-er s-irit of self and t"e
one./eing.cared.for(
6( Syste+atic use of scientific 3creative4
-ro/le+.solving caring -rocess(
6( Creatively using -resence of self and all
&ays of =no&ing@+ulti-le &ays of Being
@doing as -art of t"e caring -rocessF
engaging in artistry of caring."ealing
-ractices(
$( !ro+otion of trans-ersonal
teac"ing.learning(
$( Engaging in genuine teac"ing.learning
e2-eriences t"at attend to &"ole -erson, t"eir
+eaningF atte+-ting to stay &it"in ot"er9s
fra+e of reference(
<( !rovision for a su--ortive,
-rotective, and@or corrective +ental,
social, s-iritual environ+ent(
<( Creating "ealing environ+ent at all levels
3-"ysical, non. -"ysical, su/tle environ+ent
of energy and consciousness &"ere/y
&"oleness, /eauty, co+fort, dignity and -eace
are -otentiated(
9( *ssistance &it" gratification of
"u+an needs(
9( *ssisting &it" /asic needs, &it" an
intentional, caring consciousness of touc"ing
and &or=ing &it" e+/odied s-irit of
individual, "onouring unity of BeingF allo&ing
for s-iritual e+ergence(
1A( *llo&ance for e2istential.
-"eno+enological s-iritual
di+ensions(
1A( G-ening and attending to s-iritual.
+ysterious, un=no&n
e2istential di+ensions of life.deat"F attending
to soul care for
self and one. /eing. cared. for(
7"e first t"ree carative factors for+ t"e :-"iloso-"ical foundation; for t"e science of
caring( 7"e re+aining seven carative factors s-ring fro+ t"e foundation laid /y t"ese
first t"ree(
1 The formation of a humanistic- altruistic system of values
Begins develo-+entally at an early age &it" values s"ared &it" t"e -arents(
ediated t"roug" one9s o&n life e2-eriences, t"e learning one gains and
e2-osure to t"e "u+anities(
5s -erceived as necessary to t"e nurse9s o&n +aturation &"ic" t"en -ro+otes
altruistic /e"aviour to&ards ot"ers
! )aith-hope
5
5s essential to /ot" t"e carative and t"e curative -rocesses(
W"en +odern science "as not"ing furt"er to offer t"e -erson, t"e nurse can
continue to use fait"."o-e to -rovide a sense of &ell./eing t"roug" /eliefs
&"ic" are +eaningful to t"e individual(
" Cultivation of sensitivity to one.s self and to others
E2-lores t"e need of t"e nurse to /egin to feel an e+otion as it -resents itself(
#evelo-+ent of one9s o&n feeling is needed to interact genuinely and
sensitively &it" ot"ers(
Striving to /eco+e sensitive, +a=es t"e nurse +ore aut"entic, &"ic"
encourages self.gro&t" and self.actualiHation, in /ot" t"e nurse and t"ose &it"
&"o+ t"e nurse interacts(
7"e nurses -ro+ote "ealt" and "ig"er level functioning only &"en t"ey for+
-erson to -erson relations"i-(
# /sta0lishing a helping-trust relationship
Strongest tool is t"e +ode of co++unication, &"ic" esta/lis"es ra--ort and
caring(
S"e "as defined t"e c"aracteristics needed to in t"e "el-ing.trust relations"i-(
7"ese are:
o Congruence 3si+ilarity4
o Empathy
o Warmth
Co++unication includes ver/al, nonver/al and listening in a +anner &"ic"
connotes e+-at"etic understanding(
$ The e+pression of feelings* 0oth positive and negative
:)eelings alter t"oug"ts and /e"avior, and t"ey need to /e considered and
allo&ed for in a caring relations"i-;(
*&areness of t"e feelings "el-s to understand t"e /e"avior it engenders(
% The systematic use of the scientific pro0lem-solving method for decision
ma1ing
*ccording to Watson, t"e scientific -ro/le+. solving +et"od is t"e only
+et"od t"at allo&s for control and -rediction, and t"at -er+its self.correction(
S"e also values t"e relative nature of nursing and su--orts t"e need to e2a+ine
and develo- t"e ot"er +et"ods of =no&ing to -rovide an "olistic -ers-ective(
7"e science of caring s"ould not /e al&ays neutral and o/Eective(
6
& Promotion of interpersonal teaching-learning
7"e caring nurse +ust focus on t"e learning -rocess as +uc" as t"e teac"ing
-rocess(
Understanding t"e -erson9s -erce-tion of t"e situation assist t"e nurse to
-re-are a cognitive -lan
2 Provision for a supportive* protective and ,or corrective mental* physical*
socio-cultural and spiritual environment
Watson divides t"ese into eternal and internal varia/les, &"ic" t"e nurse
+ani-ulates in order to -rovide su--ort and -rotection for t"e -erson9s +ental
and -"ysical &ell./eing(
7"e e2ternal and internal environ+ents are interde-endent(
Watson suggests t"at t"e nurse also +ust -rovide co+fort, -rivacy and safety
as a -art of t"is carative factor(
3 4ssistance 5ith the gratification of human needs
5t is grounded in a "ierarc"y of need si+ilar to t"at of t"e aslo&9s(
S"e "as created a "ierarc"y &"ic" s"e /elieves is relevant to t"e science of
caring in nursing(
*ccording to "er eac" need is eDually i+-ortant for Duality nursing care and
t"e -ro+otion of o-ti+al "ealt"(
*ll t"e needs deserve to /e attended to and valued
Watson.s ordering of needs
,o&er order needs 3/io-"ysical needs4
o The need for food and fluid
o The need for elimination
o The need for ventilation
,o&er order needs 3-syc"o-"ysical needs4
o The need for activity-inactivity
o The need for sexuality
Watson9s ordering of needs
7
o Higher order needs (psychosocial needs)
o The need for achievement
o The need for affiliation
o Higher order need (intrapersonal-interpersonal need)
o The need for self-actualization
1esearc" findings "ave esta/lis"ed a correlation /et&een e+otional distress
and illness( *ccording to Watson, t"e current t"in=ing of "olistic care
e+-"asiHes t"at:
o Factors of the etiological component interact and produce change
through complex neuro-physiological and neuro-chemical pathays
o Each psychological function has a physiological correlate
o Each physiological component has a psychological correlate
1( 4llo5ance for e+istential-phenomenological forces
!"eno+enology is a &ay of understanding -eo-le fro+ t"e &ay t"ings a--ear
to t"e+, fro+ t"eir fra+e of reference(
E2istential -syc"ology is t"e study of "u+an e2istence using
-"eno+enological analysis(
7"is factor "el-s t"e nurse to reconcile and +ediate t"e incongruity of vie&ing
t"e -erson "olistically &"ile at t"e sa+e ti+e attending to t"e "ierarc"ical
ordering of needs(
7"us t"e nurse assists t"e -erson to find t"e strengt" or courage to confront life
or deat"(
Watson.s theory and the four major concepts
1 6uman 0eing
S"e ado-ts a vie& of t"e "u+an /eing as: :I(( a valued -erson in and of "i+
or "erself to /e cared for, res-ected, nurtured, understood and assistedF in
general a -"iloso-"ical vie& of a -erson as a fully functional integrated self(
'e, "u+an is vie&ed as greater t"an and different fro+, t"e su+ of "is or "er
-arts;(
! 6ealth
8
Watson /elieves t"at t"ere are ot"er factors t"at are needed to /e included in
t"e W'G definition of "ealt"( S"e adds t"e follo&ing t"ree ele+ents:
* "ig" level of overall -"ysical, +ental and social functioning
* general ada-tive.+aintenance level of daily functioning
7"e a/sence of illness 3or t"e -resence of efforts t"at leads its a/sence7
" /nvironment,society
*ccording to Watson caring 3and nursing4 "as e2isted in every society( *
caring attitude is not trans+itted fro+ generation to generation( 5t is
trans+itted /y t"e culture of t"e -rofession as a uniDue &ay of co-ing &it" its
environ+ent
# Nursing
*ccording to Watson 8nursing is concerned &it" -ro+oting "ealt", -reventing
illness, caring for t"e sic= and restoring "ealt";(
5t focuses on "ealt" -ro+otion and treat+ent of disease( S"e /elieves t"at
"olistic "ealt" care is central to t"e -ractice of caring in nursing(
S"e defines nursing asI((8* "u+an science of -ersons and "u+an "ealt".
illness e2-eriences t"at are +ediated /y -rofessional, -ersonal, scientific,
est"etic and et"ical "u+an transactions;(
9
Watson.s theory and nursing process
Watson -oints out t"at nursing -rocess contains t"e sa+e ste-s as t"e scientific
researc" -rocess( 7"ey /ot" try to solve a -ro/le+( Bot" -rovide a fra+e&or=
for decision +a=ing( Watson ela/orates t"e t&o -rocesses as:
1 4ssessment
5nvolves o/servation, identification and revie& of t"e -ro/le+F use of
a--lica/le =no&ledge in literature(
*lso includes conce-tual =no&ledge for t"e for+ulation and conce-tualiHation
of fra+e&or=(
5ncludes t"e for+ulation of "y-ot"esisF defining varia/les t"at &ill /e
e2a+ined in solving t"e -ro/le+(
! Plan
10
5t "el-s to deter+ine "o& varia/les &ould /e e2a+ined or +easuredF includes
a conce-tual a--roac" or design for -ro/le+ solving( 5t deter+ines &"at data
&ould /e collected and "o& on &"o+(
" Intervention
5t is t"e direct action and i+-le+entation of t"e -lan(
5t includes t"e collection of t"e data(
# /valuation
*nalysis of t"e data as &ell as t"e e2a+ination of t"e effects of interventions
/ased on t"e data(
5ncludes t"e inter-retation of t"e results, t"e degree to &"ic" -ositive outco+e
"as occurred and &"et"er t"e result can /e generaliHed(
5t +ay also generate additional "y-ot"esis or +ay even lead to t"e generation
of a nursing t"eory(
Watson.s 5or1 and the characteristic of a theory
*ccording to Watson* 8a t"eory is an i+aginative grou-ing of =no&ledge,
ideas and e2-eriences t"at are re-resented sy+/olically and see= to illu+inate
a given -"eno+enon;
S"e vie&s nursing as,:I(/ot" a "u+an science and an art and as suc" it cannot
/e considered Dualitatively continuous &it" traditional, reductionist, scientific
+et"odology;(
S"e suggests t"at nursing +ig"t &ant to develo- its o&n science t"at &ould not
/e related to t"e traditional sciences /ut rat"er &ould develo- its o&n conce-ts,
relations"i-s and +et"odology(
7"eories can interrelate conce-ts in suc" a &ay as to create a different &ay of
loo=ing at a -articular -"eno+enon
7"e /asic assu+-tions for t"e science of caring in nursing and t"e ten carative
factors t"at for+ t"e structure for t"at conce-t is uniDue in Watson9s t"eory(
S"e descri/es caring in /ot" -"iloso-"ical and scientific ter+s(
Watson also indicates t"at needs are interrelated(
7"e science of caring suggests t"at t"e nurse recogniHe and assist &it" eac" of
t"e interrelated needs in order to reac" t"e "ig"est order need of self.
actualiHation(
Theories must 0e logical in nature
11
Watson9s &or= is logical in t"at t"e factors are /ased on /road assu+-tions
&"ic" -rovide a su--ortive fra+e&or=(
Wit" t"ese carative factors s"e delineates nursing fro+ ot"er -rofessions
7"ese carative factors are logically derived fro+ t"e assu+-tions and related to
"is "ierarc"y of needs(
Theories should 0e relatively simple yet generali9a0le
7"e t"eory is relatively si+-le as it does not use t"eories fro+ ot"er disci-lines
t"at are fa+iliar to nursing(
7"e t"eory is si+-le relatively /ut t"e fact t"at it de.e+-"asiHes t"e
-at"o-"ysiological for t"e -syc"osocial di+inis"es its a/ility to /e
generaliHa/le(
S"e discusses t"is in t"e -reface of "er /oo= &"en s"e s-ea=s of t"e :tri+; and
t"e :core; of nursing(
S"e defines tri+ as t"e clinical focus, t"e -rocedure and t"e tec"niDues(
7"e core of t"e nursing is t"at &"ic" is intrinsic to t"e nurse.client interaction
t"at -roduces a t"era-eutic result( Core +ec"anis+s are t"e carative factors(
Theories can 0e the 0asis for hypotheses that can 0e tested
Watson9s t"eory is /ased on -"eno+enological studies t"at generally as=
Duestions rat"er t"an state "y-ot"eses( 5ts -ur-ose is to descri/e t"e
-"eno+ena, to analyHe and to gain an understanding(
7"eories contri/ute to and assist in increasing t"e general /ody &it"in t"e
disci-line t"roug" researc" i+-le+ented to validate t"e+
*ccording to Watson t"e /est +et"od to test t"is t"eory is t"roug" field study(
*n e2a+-le is "er &or= in t"e area of loss and caring t"at too= -lace in
Cundeelee, Western *ustralia and involved a tri/e of a/origines(
Theories can 0e utili9ed 0y practitioners to guide and improve their practice
Watson9s &or= can /e used to guide and i+-rove -ractice(
5t can -rovide t"e nurse &it" t"e +ost satisfying as-ects of -ractice and can
-rovide t"e client &it" t"e "olistic care so necessary for "u+an gro&t" and
develo-+ent(
7"eories +ust /e consistent &it" ot"er validated t"eories, la&s and -rinci-les
/ut &ill leave o-en unans&ered Duestions t"at need to /e investigated
Watson9s &or= is su--orted /y t"e t"eoretical &or= of nu+erous "u+anists,
-"iloso-"ers, develo-+entalists and -syc"ologists(
12
S"e clearly designates t"e t"eories of stress, develo-+ent, co++unication,
teac"ing.learning, "u+anistic -syc"ology and e2istential -"eno+enology
&"ic" -rovide t"e foundation for t"e science of caring(
:trengths
Besides assisting in -roviding t"e Duality of care t"at client oug"t to receive, it
also -rovides t"e soul satisfying care for &"ic" +any nurses enter t"e
-rofession(
*s t"e science of caring ranges fro+ t"e /io-"ysical t"roug" t"e intra-ersonal,
eac" nurse /eco+es an active co-artici-ant in t"e client9s struggle to&ards
self.actualiHation(
7"e client is -laced in t"e conte2t of t"e fa+ily, t"e co++unity and t"e
culture(
5t -laces t"e client as t"e focus of -ractice rat"er t"an t"e tec"nology(
;imitations
Jiven t"e acuity of illness t"at leads to "os-italiHation, t"e s"ort lengt" stay,
and t"e increasing co+-le2 tec"nology, suc" Duality of care +ay /e dee+ed
i+-ossi/le to give in t"e "os-ital(
W"ile Watson ac=no&ledges t"e need for /io-"ysical /ase to nursing, t"is area
receives little attention in "er &ritings(
7"e ten caratiive factors -ri+arily delineate t"e -syc"osocial needs of t"e
-erson(
W"ile t"e carative factors "ave a sound foundation /ased on ot"er disci-lines,
t"ey need furt"er researc" in nursing to de+onstrate t"eir a--lication to
-ractice(
<esearch related to Watson.s theory
Saint 8ose-" 'os-ital in Grange, California "as selected 8ean Watson9s t"eory
of "u+an caring as t"e fra+e&or= /ase for nursing -ractice(
7"e effectiveness of WatsonKs Caring odel on t"e Duality of life and /lood
-ressure of -atients &it" "y-ertension( 8 *dv Nurs( >AA% 8anF413>4:1%A.9(
7"is study de+onstrated a relations"i- /et&een care given according to
WatsonKs Caring +odel and increased Duality of life of t"e -atients &it"
"y-ertension( )urt"er, in t"ose -atients for &"o+ t"e caring +odel &as
-ractised, t"ere &as a relations"i- /et&een t"e Caring +odel and a decrease in
-atientKs /lood -ressure( 7"e Watson Caring odel is reco++ended as a guide
to nursing -atients &it" "y-ertension, as one +eans of decreasing /lood
-ressure and increase in Duality of life(
13
artin, ,( S( 319914( Using Watson9s t"eory to e2-lore t"e di+ensions of adult
-olycystic =idney disease( *NN* 8ournal, 1<, !- 4A%.4A6 (
ullaney, 8( *( B( 3>AAA4( 7"e lived e2-erience of using Watson9s actual
caring occasions to treat de-ressed &o+en( 8ournal of 'olistic Nursing, 1<3>4,
!-1>9.14>
artin, ,( S( 319914( Using Watson9s t"eory to e2-lore t"e di+ensions of adult
-olycystic =idney disease( *NN* 8ournal, 1<, !- 4A%.4A6
Conclusion
Watson -rovides +any useful conce-ts for t"e -ractice of nursing(
S"e ties toget"er +any t"eories co++only used in nursing education and does
so in a +anner "el-ful to -ractioners of t"e art and science of nursing(
7"e detailed descri-tions of t"e carative factors can give guidance to t"ose &"o
&is" to e+-loy t"e+ in -ractice or researc"(
Using "er t"eory can add a di+ension to -ractice t"at is /ot" satisfying and
c"allenging(
'vervie5 of Jean Watson.s Theory
8ean Watson9s 7"eory of 7rans-ersonal Caring also called 7"eory of 'u+an Caring
or 7"e Caring odel &as develo-ed in 19$9(
7"is t"eory "as evolved over t"e years /ut t"e /asic -re+ise re+ains t"e sa+e(
5t e+-"asiHes t"e "u+anistic as-ects of nursing in co+/ination &it" scientific
=no&ledge
Watson designed t"is t"eory to /ring +eaning and focus to nursing as a distinct
"ealt" -rofession(
Watson 0elieves that:
:Caring; is an endorse+ent of -rofessional nurses identity
edicines identity is t"at of :caring;
)lorence Nig"tingale a--eared to agree in "er state+ent: :5t is t"e surgeon &"o saves a
-erson9s life II(it is t"e nurse &"o "el-s t"is -erson live;
4ccording to Watson* the nurse.s role is to=
Esta/lis" a caring relations"i- &it" -atients
7reat -atients as "olistic /eings 3/ody, +ind and s-irit4
#is-lay unconditional acce-tance
7reat -atients &it" a -ositive regard
#is-lay unconditional acce-tance
7reat -atients &it" a -ositive regard
!ro+ote "ealt" t"roug" =no&ledge and intervention
S-end uninterru-ted ti+e &it" -atients: :caring +o+ents;
14
Watson defines interactions or 8caring moments> as follo5s=
7"e nurse and -atient +a=e contact(
:7"e nurse enters t"e -atient9s roo+,; a feeling of e2-ectation is created(;
Watson 0elieves that through the nurse.s attitude and competence,
a -atient9s &orld can /eco+e:
. ,arger or s+aller
. Brig"ter or dra/
. 1ic" or dull
. 7"reatening or secure
Watson also /elieves t"ese +o+ents transfor+ /ot" t"e -atient and nurse and t"at t"ey are
lin=ed toget"er(
<eferences
1( 7i+/er B0( )unda+ental s=ills and conce-ts in !atient Care, $t" edition,
,WW, N
>( Jeorge B( 8ulia , Nursing 7"eories. 7"e /ase for -rofessional Nursing !ractice
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