JEAN WATSON

THEORY OF HUMAN CARING

Human Being/Person

• She adopts a view of the human being as: “….. 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”.

Health

• Watson believes that there are other factors that are needed to be included in the WHO
definition of health. She adds the following three elements:
o A high level of overall physical, mental and social functioning
o A general adaptive-maintenance level of daily functioning
o The absence of illness (or the presence of efforts that leads its absence)

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.

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.
• “A human science of persons and human health-illness experiences that are mediated by
professional, personal, scientific, esthetic and ethical human transactions”.

CARING AS THE ESSENCE OF NURSING (JEAN WATSON, 1979)

Watson viewed caring as the essence of nursing. Caring connotes responsiveness

between the nurse and the person. The nurse co-participates with the person. The purpose of
caring is to assist the person in gaining control and becoming knowledgeable, and in the process
promote health changes. If we have thought of the concept of empowerment while reading this,
yes, we can say that it is similar to that. By allowing the client to be knowledgeable, the nurse
provides an environment for better decision-making, better self-control and, better self-respect.
The concept is common to Filipino culture: “kakayahan" or "patibayin ang kakayahan," meaning
assisting the person in gaining control.

While it is true that caring as an attribute in nursing has been described and clarified by
many others, there is uniqueness in Watson's science of caring. Basic assumptions for the
science of caring are supported by ten carative factors that provide structure to the concept of
caring. According to Watson, the first three carative factors provide the philosophical foundation
for the science of caring. The remaining seven carative factors spring from the foundation laid by
these first three.

Watson’s theory has 3 Major Conceptual Elements:

1. Carative Factors (evolving toward the “Clinical Caritas Processes”)
2. Transpersonal Caring Moment
3. Caring Moment/Caring Occasion

10 Carative Factors

1. FORMATION OF A HUMANISTIC-ALTRUISTIC VALUE SYSTEM. The value of altruism

(regard for others as a personal action) is learned at an early age. It is a value shared with
parents. One's own life experiences are learning opportunities to gain insights about dealing with
others. Caring based on humanistic values and altruistic behavior "can be developed through
examination of one's own views, beliefs, interactions with various cultures and personal growth
experiences." This development is perceived necessary for the nurse's own maturation.

2. INSTALLATION OF FAITH-HOPE. This factor is deemed essential to both carative and

curative processes. To nurses, this provides a basis for looking into the healing power of belief,
or the spiritual dimension, when curing is not possible. The use of Faith-Hope as a nursing
intervention allows nurses to explore alternative methods of healing, like meditation. It seems
that the goal for this activity is the provision of a sense of wellbeing through belief systems that
are meaningful to the client.

3: CULTIVATION OF SENSITIVITY TO SELF AND OTHERS. Nurses promote "health and

higher level functioning only when they perform person-to-person relationships as opposed to
manipulative relationships." There is a need for the nurse to develop and examine one's own
feelings. Through this process, increased sensitivity to others is developed. The nurse becomes
honest and promotes self-growth and self-actualization. Watson's premise further states "that at
the highest level of nursing, the nurse's human care responses, human care transactions, and
presence in the relationship transcend the physical material world." The explanation makes it
clear that interactions between the nurse and the client deal with the person's emotional and
subjective world as a means to learn the inner self

4: DEVELOPMENT OF A HELPING-TRUST RELATIONSHIP. Communication, both verbal and

non-verbal, is a mode of accomplishing a helping-trust relationship to establish rapport and
caring. Characteristics common to this carative factor are congruence, empathy, warmth and
honesty. Positive acceptance of another is most often expressed by body language, touch and
tone of voice. I'm sure that given your clinical experiences, you can think of many situations to
relate to this fourth carative factor.

5: PROMOTION AND ACCEPTANCE OF THE EXPRESSION OF POSITIVE AND NEGATIVE

FEELINGS. According to Watson, it is important to facilitate awareness of both negative and
positive feelings to improve on one's level of awareness. Feelings need to be considered in a
caring environment. Being aware of both positive and negative feelings leads to better
understanding of behavior.

6: SYSTEMATIC USE OF THE SCIENTIFIC PROBLEM-SOLVING METHOD FOR DECISION

MAKING. This factor gives notice to the limitations nurses have in assessing the issue of
developing a scientific base because most of our time is dedicated to the performance of nursing
tasks such as procedures and treatments. Thus, recognition is given to the use of the systematic
problem-solving method in building nursing knowledge. In the same way, the argument extends
to other methods of knowing like utilizing research-based findings in order to improve nursing
practice and provide holistic care.

7: PROMOTION OF INTERPERSONAL TEACHING-LEARNING. Through this factor, persons

(clients) gain control over their own health because it provides them with both information and
alternatives. Learning offers opportunities to individualize information dissemination. The caring
nurse focuses on the learning and teaching process, as well as in understanding the client's
perception of the situation. This provides for a cognitive plan workable within the client's frame of
reference.

8: PROVISIONS FOR A SUPPORTIVE, PROTECTIVE AND (OR) CORRECTIVE MENTAL,

PHYSICAL, SOCIOCULTURAL AND SPIRITUAL ENVIRONMENT. There are two divisions or
categorizations relative to this factor: external variables which include physical, safety and
environmental factors; and internal variables which refer to mental, spiritual or cultural activities
which the nurse may manipulate for the person's well-being. An interdependence exists between
internal and external factors since the person perceives the situation in the environment as
either threatening or non-threatening. There are events in a person's life that can arouse a
sense of threat. The person appraises the situation and copes to the best of his ability. The
nurse's assessment capabilities can be valuable in helping the person appraise the situation and
cope with it. The nurse's intervention is aimed at helping, the person develop a more accurate
perception to help strengthen coping capabilities.

Provision of comfort, safety and privacy are major aspects of this carative factor. A clean and
esthetic environment is considered a basic element. Esthetics is deemed essential in the
promotion of increased self-worth and dignity.

9: ASSISTANCE WITH THE GRATIFICATION OF HUMAN NEEDS. The hierarchy of human

needs is the essence of this carative factor. It is grounded in a hierarchy of need similar to that of
the Maslow’s. Watsons has created a hierarchy which she believes is relevant to the science of
caring in nursing. According to her, 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.
10:ALLOWANCE FOR EXISTENTIAL-PHENOMENOLOGICAL-SPIRITUAL 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.

Transpersonal Caring Relationship

• a special kind of human relationship that depends on :
o Nurse’s commitment on protecting and enhancing human dignity and a
deeper/higher self
o Nurse’s caring consciousness to preserve and honor the embodied spirit, thereby
not reducing the patient to a moral status of an object
• The nurse’s caring and connection have potential to heal since experience, intention, and
perception are taking place.
• Nursing goes beyond an objective assessment and shows concern for the patient’s own
healthcare
• Goal of transpersonal caring relationship protects, enhances, and preserves human
dignity, humanity, wholeness, and inner harmony
Caring Occasion/Moment
Caring occasion is the moment when the nurse and another person come
together in such a way that an occasion for human caring is created. Both persons
come together in a human-human transaction. The one caring for and the one being
cared for are influenced by the choices and actions decided within the relationship