ASSUMPTIONS UNDERLYING SWANSON

CARING THEORY
 NURSING
Swanson (1991, 1993) defines nursing as “informed caring for the well-being of

others”.

 She asserts that the nursing discipline is informed by empirical knowledge

from nursing and other related disciplines, as well as “ethical, personal and

aesthetic knowledge derived from the humanities, clinical experience, and

personal and societal values and expectations” (Swanson, 1993, p. 352

 PERSON
Swanson (1993) defines persons as “unique beings who are in the midst of becoming
and whose wholeness is made manifest in thoughts, feelings, and behaviors”

She posits that the life experiences of each individual are influenced by a complex
interplay of “a genetic heritage, spiritual endowment and the capacity to exercise free
will”

Hence, persons both shape and are shaped by the environment in which they live
PERSON
Swanson (1993) views persons as dynamic, growing, self-reflecting, yearning to be connected
with others, and spiritual beings.

She suggests:

the following: “ . . . spiritual endowment connects each being to an eternal and universal source of
goodness, mystery, life, creativity, and serenity. The spiritual endowment may be a soul, higher
power/Holy Spirit, positive energy, or, simply grace. Free will equates with choice and the capacity
to decide how to act when confronted with a range of possibilities”
PERSON
Swanson noted, however, that limitations set by race, class, gender, or access to care might prevent
individuals from exercising free will.

 Hence, acknowledging free will mandates nursing discipline to honor individuality and consider a whole
range of possibilities that are acceptable or desirable to those whom the nurses attend.

The person does not just address the patient but also the family, groups and society.
Thus, with this understanding of personhood, nurses are mandated to take on leadership roles in fighting
for human rights, equal access to health care, and other humanitarian causes.

Lastly, when nurses think about the other to whom they direct their caring, they also need to think of self
and other nurses and their care as that cared-for other.
 HEALTH
According to Swanson (1993), to experience health and well-being is: “To live
the subjective, meaning-filled experience of wholeness”

Wholeness involves a sense of integration and becoming where in all facets of

being are free to be expressed.

 The facets of being include the many selves that make us a human: our
spirituality, thoughts, feelings, intelligence, creativity, relatedness, femininity,
masculinity, and sexuality, to name just a few”.
HEALTH
Thus, Swanson sees reestablishing well-being as a complex process of curing
and healing that includes “

Releasing inner pain,

Establishing new meanings,
 Restoring integration,
Emerging into a sense of renewed wholeness”
 ENVIRONMENT

The environment was described situationally, It is any context that influences or is

influenced by the client. According to Watson, Caring exists in every society. The nurse
is a part of the environment and she should provide a therapeutic environment for the
patient.

Health; According to Swanson, to experience health and well-being is to live the

subjective, meaning-filled experience of wholeness. Health perception is different
among individuals. Nurses must consider health from the patient's perspective which
could include their cultural beliefs and taboos, religious beliefs and how it affects their
health.
 THEORETICAL ASSERTION
Swanson’s Theory of Caring (Swanson, 1991, 1993, 1999b) was empirically
derived through phenomenological inquiry.

It offers a clear explanation of what it means for nurses to practice in a caring
manner and emphasizes that the goal of nursing is promotion of well-being.
Swanson (1991) defines caring as “a nurturing way of relating to a valued other
toward whom one feels a personal sense of commitment and responsibility”
Key words in this definition include: nurturing (growth and health producing);
 way of relating (occurs in relationships);
 to a valued other (the one cared-for matters);
toward whom one feels a personal (individualized and intimate);
sense of commitment (bond, pledge, or passion);
and responsibility (accountability and duty). Whereas this definition applies to all
caring relationships, relationships of central concern for nursing include nurse to
client, nurse to nurse, and nurse to self
THEORETICAL ASSERTION
According to Swanson, a fundamental and universal component of good nursing is
caring for the client’s biopsychosocial and spiritual well-being.

Swanson (1993) asserts that caring is grounded in maintenance of a basic belief in

human beings, supported by knowing the client’s reality, conveyed by being
emotionally and physically present, and enacted by doing for and enabling the client.
The caring processes overlap and may not exist in separation. Each is an integral
component of the overarching .
ACCEPTANCE BY THE NURSING COMMUNITY
Practice:
The proposition that caring is central to nursing practice had its beginning in
the theorist’s own insights into the importance of caring in professional
nursing practice and in findings from Swanson’s phenomenological
investigations.
Her subsequent investigations demonstrated applicability of the Theory of
Caring in clinical nursing practice, education, and research.

Swanson’s theory has been embraced as a framework for professional

nursing practice in the United States, Canada, and Sweden.
SWANSON MULTISYSTEM.PPTX
 EDUCATION
Thus Swanson’s theory offers nurse educators a simple way of initiating students into the

profession by immersing them in the language of what it means to be caring and cared for in

order to promote, restore, or maintain the optimal wellness of individuals.

 Recent review of computerized databases (MEDLINE, CINHAL, and Digital Dissertations)

indicated that Swanson’s work on caring and miscarriage has been cited or otherwise

utilized in over 160 data-based publications.

 RESEARCH
Examples of applications of Swanson’s Theory of Caring in clinical research
Exploring clinical scholarship in practice (Kish & Holder, 1996); Guidelines
for nurses working with patients diagnosed with multiple sclerosis (Yorkston,
Klasner, & Swanson, 2001).
 Assessing the impact of caring in work with vulnerable populations
(Kavanaugh, Moro, Savage, et al., 2006).
The importance of creating a caring environment for older adults (Sikma,
2006); Wojnar’s (2007).
Research of children who sustained traumatic brain injury (Roscigno &
Swanson, 2011).
FURTHER DEVELOPMENT
Swanson is interested in further development by testing and applying her theory in
clinical practice.

There is much potential for further development by testing Swanson’s Theory of

Caring in various contexts of health and illness.

Also, her processes of caring suggest that the theory is applicable in other helping
disciplines such as teaching, social work, and medicine as well as other life
situations for nursing.
CRITIQUE
ACTIVITY 2
Patient Iman is a 46-year-old married woman with four children. She is in the
hospital recovering from a colostomy procedure due to the removal of a malignant
tumor that was discovered in its early stages,

Iman suffers from severe pain in the place of the operation, but what Iman worries
about is her health and whether she will recover from the tumor, in addition to her
anxiety about her appearance and the way to care for colostomy.

Incorporates Swanson's Theory of Caring into care plan for Iman?

REFERENCE

•Alligood, M. R. (2014). Nursing theorists and their work. (8th edition). St. Louis:
Mosby.

•Andershed, B., & Olsson, K. (2009). Review of research related to Kristen Swanson's
middle-range theory of caring. Scandinavian Journal Of Caring Sciences,23(3), 598-610.
doi: 10.111/j.1471-6712.2008.00647.

•Chin, P.L. & Kramer, M.K. (2008) Integrated theory and knowledge development in nursing
(7th ed.) St. Louis, MO: Mosby.

•Swanson, K.M.(1993)Nursing as informed caring for the well-being of others. Journal of

Nursing Scholarship 25(4) pp 352-357.
REFERENCES

•Stasuk, J.( 2012,02,26) Theory of Caring (Video file) Retrieved from

https://www.youtube.com/watch?v=GtWr3kiMAY8 .

•Virginia Medical Center(2016) Virginia Mason launches new model of nursing

care.Retrievedfromhttps://www.virginiamason.org/body.cfm?
id=158&action=detail&ref=3774.

•Wojnar, D.M., Swanson, K.M., Adolfsson, A. (2011) Confronting the inevitable: A

conceptual model of miscarriage for use in clinical practice and research. Death Studies
35 pp 536-558 doi:10.1080/07481187.2010.536886.