Human Care and Watson’s Theory
Theory of Human Caring,Health and Illness,Assumptions of Theory,11 Caring Paradigm Assumptions,Seven Premises,10 Hierarchical Curative Factors,Implementation or Research
Theory of Human Caring
conceptual model, a frame work, or a middle-range theory, which seeks to
provide a moral and philosophical basis for nursing.
The Theory of Human Caring
(Watson, 2001) was developed between 1975 and 1979 as an “attempt to bring
meaning and focus to nursing as an emerging discipline and distinct health
profession with its own unique values, knowledge, and practices, with its own
ethic and mission to society” (p. 344).
Many varied, philosophical views held
by Nightingale, Henderson, Krueter , Hall, Leininger, Gadow , Peplau, Maslow,
Heidegger, Erickson, Lazarus, deChardin and Sarte influenced the development of
the Theory of Human Caring.
Perennial philosophy, wisdom traditions, quantum
physics, and feminist theory also guided the philosophical and intellectual
development of the theory (Fawcett, 2000b). These humanities and sciences
provided a phenomenological, existential, and spiritual orientation upon which
Watson developed the framework for her theory.
Watson (1996) states that, both
retrospectively and prospectively, her work “can be read as philosophy, ethic,
or even paradigm or worldview” (p. 142).
The concepts Watson defined in the
Theory of Human Caring was “derived from clinically in ducted, empirical
experiences (and combined with] philosophical, intellectual and experiential
(past experiences, with her early work emerging from her own) values, beliefs,
and perceptions about personhood, life, health and healing” (Watson, 1996, p.
143).
Health and Illness
The traditional health illness phenomena defined within nursing and
medicine is replaced with the deeply human experiences of life itself.
Watson’s theory focuses on “the centrality of human caring and on the
caring-to-caring trans personal relationship and its healing potential for both
the one who is caring and the one who is being cared for” (Wat son, 1996, p.
141) .
Assumptions of Theory
Watson’s Theory of Human Caring includes the following major
assumptions as stated in her first book Nursing: The Philosophy and Science of
Caring (1979):
1. Caring can only be effectively demonstrated and practiced inter personally.
2. Caring consists of curative factors that result in the
satisfaction of certain human needs.
3. Effective caring promotes health and individual or family
growth.
4. Caring responses accept a person not only as he/she is now but
as what he/she may become.
5. A caring environment offers the development of potential by
allowing the person to choose the best action for himself/herself at a given
time.
6. Caring is more “health genic” than is curing. The practice of
caring integrates biophysical knowledge with the knowledge of human behavior to
generate or promote health and to provide ministrations to those who are ill. A
science of caring is therefore complimentary to the science of curing.
7. The practice of caring is central to nursing.
11 Caring Paradigm Assumptions
As Watson
(1979/1985a, 1985b) continued in the development of the philosophy and science
of her model, she proposed 11 caring paradigm assumptions which further defined
nursing’s social and ethical responsibilities based upon human values and
altruism which are paraphrased below:
1. Care and love are primal, universal forces.
2. Nourishment of care and love, cornerstones of humanity, fulfills
humanity.
3. Sustaining the caring ideology of nursing will affect
civilization’s development and nursing’s contribution to society.
4. You must care for yourself before you can care for others.
5. Nursing has always valued caring in regard to people’s health.
6. Caring is the essence of nursing.
7. In the health care delivery system, caring has been increasingly
deemphasized.
8. Modern technological advances have sublimated nursing’s caring
frame.
9. Preservation and advancement of human care are significant
concerns for nursing now and in the future.
10. Only through interpersonal relationships can human care be
effectively demonstrated.
11. Nursing’s social, moral, and scientific contributions to
mankind and society lie in its commitments to human care ideals in theory,
practice, and research (Watson, 1996, pp. 149-151).
Seven Premises
The following seven premises based upon the interpersonal
transpersonal spiritual aspects of Watson’s (1985) work provide the foundation
for further development of her theory:
1. A person’s mind and emotions are windows to the soul.
2. A person’s mind and soul are not confined to the physical
universe but transcend time and space.
3. Inseparable spheres of the human being, the mind, body, or soul
can be accessed by the nurse.
4. The soul or a person exists in and for itself.
5. People need the love and care of each other in order to nourish
humanity, advance civilization, and love together.
6. Finding meanings in the context of the human predicament
provides solutions.
7. The totality of human experience at any given moment constitutes
a phenomenal field.
10 Hierarchical Curative Factors
Key components of the theory of human caring include human care and
transpersonal relationships. Reverence and sacredness of life are fundamental.
Art and science are converted into a redefined concept of humanistic care in which
both the nurse and the individual receiving the care are affected, resulting in
a more humanistic, holistic self transcendence (Watson, 1997).
The 10
hierarchical curative factors are aspects of nursing that “actually potentiate
therapeutic healing processes for both the one caring and the one being cared
for” (Watson, 1996, pp. 154-155) and include:
1. Formation of a humanistic-altruistic system of values
2. Enabling and sustaining faith-hope
3. Cultivation of sensitivity to self and to others
4. Development of a helping-trusting caring relationship.
5 . Promotion and acceptance of the expression of positive and
negative feelings and emotions
6. Engaging in creative, individualized problem-solving caring
processes
7. Promotion of transpersonal interpersonal teaching learning
8. Provision for a supportive, protective, and corrective mental,
physical, sociocultural, and spiritual environment
9. Assistance with gratification of human needs while preserving
human dignity and wholeness
10. Allowance for existential phenomenological spiritual dimensions
of caring and healing that cannot be fully explained scientifically through
modern Western medicine.
According to Watson (2002) the processes of caring and healing
occur when transpersonal caring seeks to embrace the soul of the other.
This
transpersonal caring creates a caring moment in which the nurse has the ability
to center consciousness and intentionality on caring, healing, and wholeness
rather than on the pathological processes.
This framework provides holistic and
complete caring in a caring moment. The spiritual nature of human beings,
striving for inner harmony, is the key to understanding the fundamental key of
transpersonal caring of humans.
Implementation or Research
Watson’s Theory of Human Caring is used in many published research
studies, articles, and book chapters, and has served as a guide for master’s
and doctoral student research. This theory also serves as the foundation for
doctoral educational programs, hospital units, and outpatient services.
Human
science nursing “allows for the questioning of ultimate meanings and ethical
values of human’s health and nursing” (Watson, 1985/1999a, p. 16). Watson’s
theory incorporates the sacredness of the relationship between humans,
impacting the caring, healing environment through the art and science of
nursing.
This theory of transpersonal caring has made and will continue to make
a significant and lasting impact on nursing science.