Analysis and Evaluation of Jean Watson's Theory of Caring

Analysis and Evaluation of Jean Watson's Theory of Caring

Since its establishment as a profession more than a century ago, Nursing has been a source for numerous debates related to its course, methods and development of nursing knowledge. Many nursing definitions and theories have evolved over time. Furthermore it is in a constant process of been redefined.

The purpose of this paper is an overview of Jean Watson's Theory of Caring. This theory can be taken into account as one of the most philosophicaly complicated of existent nursing theories. The Theory of Human Caring, which also has been referred

to as the Theory of Transpersonal Caring, is middle Ð'- range explanatory theory. (Fawccett, 2000) The central point of which is on the human component of caring and actual encounter between the client and the caregiver. Jean Watson has stated that her work was motivated by her search of a new meaning to the world of nursing and patient care. " I felt a dissonnance between nursing's (meta) paradigm of caring-healing and health, and medicines's (meta) paradigm of diagnosis and treatment, and concentration on disease and pathology". (Watson, 1997,p.49)

Jean Watson's theory was first published in 1979. Later Watson explained that this work was an attempt to solve some conceptual and empirical problems, with no intention to create a theory. This theory was expanded and formalized in her next book in 1985. Since than Watson continued to refine her ideas through various publications. At his time, the major conceptual elements of the theory are ten Clinical Caritas Processes (originally Carative factors), Transpersonal Caring Relationship, Caring Moment/Occasion and Caring Consciousness. According to Watson's theory, the human care process is performed through a Transpersonal Caring Relationship guided by the Carative factors, which are based on humanistic Ð'- altruistic value system.

The Theory of Human Caring was initialy based on data about variety of aspects of caring, collected through open Ð'- ended quistionnaire. The purpose of this research was to evaluate different points of view, expressed by both the clients and registered nurses. In addition to this data, Watson's theory uses broadly recognized work from other disciplines. Specific philosophers cited by Watson, as sources are Rogers, Whitehead, Gadow, Yalom etc. Furthermore, she also recognises the contribution of the eastern philosophy in her work.

According toWatson (1985), her philosophical orientation is existential Ð'- phemenological, spiritual and methaphysical. She is the first nursing theorist to support the idea of soul and to accentuate the spiritual dimension of human existence. Watson describes nursing as an art and a human science with the major focus being the process of a human care for individuals, families and groups. According to her beliefs, body, mind and soul are distinquished from each other. Nevertheless, Watson also states that harmony is required among the three to be the highest form of health and that it is the nursing goal to help people to reach this equanimity. This goal can be accomplished through transpersonal relationship.

Within the Theory of Human Caring, during transpersonal caring moment, the nurse and the patient gain entry into the lived knowledge of each other. In order for transpersonal contact to occur both the caregiver and the one being cared for should experience a process of being and becoming, both are influenced by the nature of transaction. (Watson, 1985) Watson defines human caring as a moral ideal, that the nurse should carry during every transaction. According to her theory, that ideal will assure a certain needed behaviour at the time of the caring occasion.

Another concepts in Watson's theory are person, health, illness and environment. Watson defines person not only as a spiritual being, but also as a material physical being that is also a part of nature and the physical world. "A person is experiencing and perceiving physiological individual that is able to find meaning and harmony in existence" (Watson, 1979, p.55). Watson beliefs that that the person is not limited by time and space and able to control his physical world. Consequently she refers to environment as " the universal or cosmic level of existence" and perceives person and environment as " a field of connectedness". (Watson, 1985)

Furthermore, Watson (1985) defined a connection between health and illness. As it was stated previously, health, according to the Theory of Human Caring is unity and harmony within the mind, body and soul. Moreover, health is also associated with the degree of congruence between the experienced and perceived self. Consequently illness is a disharmony within a person's mind, body and soul, which can lead to disease. Thus, nursing as a discipline has a role of helping a person to find meaning in illness and existence in general. According to Jean Watson, everything in the universe is connected. Humans cannot be separated from self, other, nature and the larger univers and should be treated as a whole.

Watson (1997) is concerned that caring values of nursing and nurses have been submerged within contemporary medical systems, which are dominated by economics. She beliefs that nurses must continuosly question and be open to new possibilities, as well as form and reconsider ancient and new knowledge. There is a well - known gap between theory and practice in nursing. Encorporating Watson's theory into practice requires an exclusive moral and spiritual pledge from a nurse towards herself and the patient.

This writing process brings me to a question. Is every nurse capable to reach this level of commitment? Watson has stated in her publications that her theory framework is difficult to study concretely. However, a practice methology for the application of the theory in practise, has been extracted from Watson's publications. Since than, the number of published reports of the theory has grown.

One of the concepts that received a wide coverage as a research issue in the several past years is caregiver. In 1995 Sandra Weeks made an attempt to investigate future family caregivers points of view regarding their needs. Watson's theory of Human Caring was used as a theoretical framework for this research, while Matthi Questionnaire was used as an assessable tool. The Questionnaire has provided a list of 45 tasks, divided

to a several categories, with the major focus on assisting disabled adult and maintaining caregiver and family well Ð'- being. This article concentrates on two major ideas of Watson's theory Ð'- caring as an obstract concept and caring moment as a measurable one. As a hypothesis to this study,