Analysis

ANALYSIS ON THE THEORY OF CARING

I.              SCOPE OF THE THEORY

The central idea of the Theory of Human Caring is that "humans cannot be treated as objects, and that humans cannot be separated from self, other, nature, and the larger universe" (Watson, 1997, p. 50).

• Watson (1989b) claimed that her theory encompasses the whole of nursing; the emphasis, however, is placed on the interpersonal process between the caregiver and the care recipient.
•  The theory focuses on "the centrality of human caring and on the caring-to-caring transpersonal relationship and its healing potential for both the one who is caring and the one who is being cared for" (Watson, 1996, p. 141).
• The Theory of Human Caring more specifically focuses on the relation between use of the clinical caritas processes and the development of a transpersonal caring relationship within the context of the caring occasion/caring moment and caring (healing) consciousness.

 It is, therefore, appropriately categorized as a middle-range explanatory theory.

II.            CONTEXT OF THE THEORY    

Watson’s theory is unique in the concept of its basic assumptions for the science of caring in nursing and the ten carative factors that form the structure. These assumptions are premises and prepositional statements that conceptualize the foundation of the caring-healing paradigm.

Watson (1989b) regards her theory as metaphysical. She explained that "it goes beyond the rapidly emerging existential-phenomenological approaches in nursing, to perhaps a higher level of abstraction and sense of personhood, incorporating the concept of the soul and transcendence."

Watson (1985) viewed caring as the most valuable attribute nursing has to offer to humanity. She contended that caring can assist the person to gain control, become knowledgeable and promote health changes ( George, 2001).

The theory generally asks questions rather than state hypotheses

III.           SIGNIFICANCE/ STRENGTHS

• It is when we include caring and love in our work and our life that we discover and affirm that nursing ,like teaching, is more than just a job, but a life-giving and life-receiving career for a lifetime of growth and learning
• To engage in a unitary caring science, the nurse clinician, nurse educator and nurse scientist embraces a philosophy and a way of life that is not limited to one’s professional role
• This theory places the client as the focus of practice rather than technology; it places the client in the context of the family, the community and the culture
• The Theory of Human Caring gives attention to the spiritual aspects of human existence and the soul. Watson's recent writings place even greater emphasis on spirituality (Watson, 1999, 2001; Watson & Smith, 2002).
• Another significant feature of the theory is the potential for personal growth by nurses as they engage in transpersonal caring relationships. Furthermore, through establishment of intersubjectivity, the caregiver can become the care receiver.
• The Theory of Human Caring meets the criterion of testability for middle-range theories in part. Watson (1985) noted that "qualitative-naturalistic-phenomenological field methods of inquiry or a combined qualitative-quantitative inquiry" are in keeping with the Theory of Human Caring . More specifically, she maintained that the "optimal method for studying the theory is through field study that is qualitative in design ... a phenom-enological-existential methodology"
• Empirical indicators designed to measure the concepts of the Theory of Human Caring have begun to be developed. The instruments are:

Ø  Caring Assessment Report Evaluation Q-sort (CARE-Q)

Ø  Caring Satisfaction (CARE/SAT)

Ø  Caring Behaviors Inventory

Ø  Caring Behaviors Assessment Tool

Ø  Caring Behaviors of Nurses Scale

Ø  Professional Caring Behaviors

Ø  Nyberg Caring Assessment (Attributes) Scale

Ø  Caring Ability Inventory

Ø  Caring Behavior Checklist

Ø  Client Perception of Caring

Ø  Caring Assessment Tool

Ø  Caring Assessment Tool-Admin

Ø  Caring Assessment Tool-Edu

Ø  Peer Group Caring Interaction Scale

Ø  Organizational Climate for Caring Questionnaire

Ø  Caring Efficacy Scale

Ø  Holistic Caring Inventory

Ø  Caring Dimensions Inventory

Ø  Caring Attributes, Professional Self-Concept Technological Influences Scale

Ø  Caring Professional Scale

Ø  Methodist Health Care System Nurse Caring Instrument

IV.           LIMITATIONS

• While Watson acknowledgesthe need for biophysical bas eto nursing, this area receives little attention in her writings
• The ten carative factors primarily delineate the psychological needs of the person
• While the carative factors have a sound foundation based on other disciplines, they need further research in nursing to demonstrate their application in nursing, especially in this time where best evidence practice should be demonstrated.

• Although Watson claimed allegiance to the human science perspective, her distinction between the person's experience of the world and the world as it actually is, as well as her suggestion of incongruities between the person and nature, are inconsistent with the human science view that humans cannot be separated from their experienced worlds (Mitchell & Cody, 1992

References:

Watson, J. (1985). Nursing: Human science and human care: A theory of nursing. Norwalk, CT

Watson, J. (1989b). Watson's philosophy and theory of human caring in nursing. In J.P. Riehl-Sisca (Ed.), Conceptual models for nursing practice (3rd ed., pp. 219-236). Norwalk, CT: Appleton  Lange.  

Watson, M.J. (1996). Watson's theory of transpersonal caring. In P. Hinton Walker  B. Neuman (Eds.), Blueprint for use of nursing models (pp. 141-184). New York: NLN Press.

Watson, J. (1997). The theory of human caring: Retrospective and prospective. Nursing Science Quarterly, 10, 49-52.

Watson, J. (1999). Postmodern nursing and beyond. New York: Churchill Livingstone.

Watson, J.,  Smith, M.C. (2002). Caring science and the science of unitary human beings: A trans-theoretical discourse for nursing knowledge development. Journal of Advanced Nursing, 37, 452-461.