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“JEAN WATSON” “THEORY OF HUMAN CARING” In partial fulfillment of the requirements for Nursing Care Management 100 Theoretical Foundations of Nursing Members Atong, Jan Karoi G. Cadag, Naomi Katherine G. Cadiente, Mark Angelo C. Calza...

“JEAN WATSON” “THEORY OF HUMAN CARING” In partial fulfillment of the requirements for Nursing Care Management 100 Theoretical Foundations of Nursing Members Atong, Jan Karoi G. Cadag, Naomi Katherine G. Cadiente, Mark Angelo C. Calzado, Nicole P. Chua, Ma. Loissa Jellaine M. Collado, Jianna D. Dapito, Jella Clarise G. Submitted to Asst. Prof. Allan A. Valenzuela, RN, MAN Lecturer AUGUST 2024  Theoretical Framework I. DEFINITION OF THEORY In everyday use, the "theory" commonly refers to an unverified speculation or an educated guess without supporting evidence. However, it refers to a scientific explanation supported by laws and facts that makes testable predictions and is subjected to change or rejection if new evidence contradicts it, as highlighted by the American Museum of Natural History. Jean Watson believes theory helps us collect thoughts and experiences in a way that makes us understand things better. The Latin word for "to see" means it helps us see things more clearly. Watson's view includes ideas from many areas, like philosophy, intellectual guidance from feminist theories, and metaphysics, to gain deeper insight. Jean Watson is known for her theory of "Philosophy and Theory of Transpersonal Care," or "Human Caring," which is about providing support and compassion that acknowledges their importance and potential growth as her theory have been widely offered to healthcare facilities and nursing schools around the world to promote the theory more. II. MAJOR CONCEPTS OF HUMAN CARING THEORY A. 10 CARATIVE FACTORS/10 CARITAS PROCESSES The 10 Carative Factors serve as the core foundation of Jean Watson’s Theory of Human Caring. These factors are essential aspects of the discipline and profession of nursing since they are considered central to the field of nursing and present a moral ideal for nursing practice. However, as Watson’s ideas evolved, she expanded the 10 Carative Factors to 10 Caritas Processes, which translated the original carative factors into clinical caritas processes. These Caritas Processes provide a roadmap for nurses who aim to deliver compassionate and patient-centered care. The Caritas Processes serve as an extension of the original 10 Carative Factors to provide a deeper understanding and representation of the theory of human caring. Carative Factors Caritas Process Interpretation/Description Examples of Its Application to Nursing “The formation of a Sustaining It embraces the maintaining A nurse provides gentle humanistic-altruistic Humanistic-Altruistic values and practicing of values like care to a terminally ill system of value” by Practicing kindness, empathy, equanimity, patient, promoting Loving-Kindness, and love towards oneself and comfort to alleviate the Compassion, and Equanimity others. Applying these values patient's distress. The With Self/Other (Embrace) in practice can help nurses nurse attentively listens to offer compassionate care and the concerns of the build meaningful connections patient and provides with patients. Also, such values support, which highlights contribute to the emergence of the essence of humanistic and altruistic compassion. Throughout, principles in a nurse, which the nurse maintains a further promote great patient calm and gentle care. composure, allowing the patient to face the challenging situation properly and with solace, thereby upholding humanistic-altruistic values. “The instillation of Being Authentically Present; It highlights the importance of A nurse actively listens to faith-hope” Enabling Faith, Hope, and the ability to be authentically the patient and shows Belief System; Honoring present for another person, or genuine interest in their Subjective Inner, Life-World patient, which can help the concerns and feelings, of Self/Others (Inspire) person maintain faith and hope respecting the patient's about their outcome. It also personal beliefs and life  promotes the importance of experiences. building a supportive and authentic bond between the nurse and the patient. “The cultivation of Being Sensitive to Self and Recognizing and accepting A nurse reflects on the sensitivity to one’s self Others by Cultivating Own one’s own feelings helps not frustration and empathy and to other” Spiritual Practices, Beyond only the nurses but also the he or she feels while Ego-Self to Transpersonal patients. It highlights the working with a Presence (Trust) importance of being sensitive challenging patient. By to oneself so that a person, or a acknowledging these nurse, can learn to be sensitive emotions in herself or to others. himself, the nurse gains a deeper understanding of the patient. This self-awareness helps the nurse become more authentic, patient, and mindful in his or her actions towards patients. “Development of a Development and Sustaining Having a trusting and caring A nurse states the risks of helping-trust Loving, Trusting-Caring relationship between a nurse treatment options relationship” became Relationships (Nurture) and a patient is an essential presented to a patient “development of a factor in human caring. It with all honesty while help-trusting human highlights the authentic being empathetic, caring process” connection between the nurse genuine, and caring and the patient, which involves towards the patient. congruence, empathy, non-possessive warmth, and effective communication. “The promotion and Allowing for Expression of It is important to possess the A nurse listens attentively acceptance of the Positive and Negative ability to be attentive and to patients who share both expression of positive Feelings—Listening supportive regarding the their fears about their and negative feelings” Authentically to Another feelings of a person or patient, illness and their hopes Person’s Story (Forgive) may it be a positive feeling or a and faith for recovery. negative feeling. In this way, The nurse acknowledges the nurse can help the patient and validates the patients' feel heard. By acknowledging sentiments and ensures the feelings and emotions of a that patients feel heard patient, the relationship and understood. between the nurse and the patient can lead to a more authentic, trusting, and deeper connection. “The systemic use of Creative This approach highlights the A patient refuses to go the scientific problem Problem-Solving—“Solution- use of creative problem-solving into surgery because the solving method for Seeking” Through Caring skills to enhance patient care patient feels anxious decision making”, Process, Full Use of Self and beyond conventional methods. about the surgery. To became “systemic use of Artistry of Caring-Healing It involves various ways of address the situation, a creative problem Practices via Use of All Ways knowing, such as intuition, aside from providing solving caring process” of ethics, and personal insight, medical facts about the Knowing/Being/Doing/Becomi and is not simply bounded by positive impact of the ng (Deepen) scientific knowledge. surgery, the nurse also Significantly, this process relies on their insight and highlights the collaboration of intuition to offer creative thinking and techniques that promote systematic scientific logic. relaxation and provides comforting words to serve as an assurance for the patient. “The promotion of Engage in Transpersonal Working with the person's A nurse must explain or transpersonal Teaching and Learning subjective meaning. Work from instruct ways that the teaching-learning” Within the Context of Caring their frame of reference not patient can easily Relationship, Staying Within your frame of reference. So understand. Other’s Frame of Reference. that you can engage them in the (Balance) understanding of what they need to know at that point in time. “The provision of Creating a Healing The ability to have compassion, A nurse should provide a supportive, protective, Environment at All Level’s, a loving kindness, presence, healing environment and and (or) corrective Subtle Environment for consciousness, intentionality. accept their patient as a mental, physical, Energetic, Authentic Caring This allows them to be seen, to person and not see them societal, and spiritual Practice (Co-Create) know they matter that becomes as a case. environment” part of understanding that we become the healing environment. “The assistance Reverentially Assisting With Basic needs have to be A nurse should provide gratification of human Basic Needs as Sacred Acts, responded to with fullness of patients with their basic needs” Sustaining Human Dignity dignity, humility, and with needs like food, water, (Minister) compassionate service. This air, activity, sufficient becomes a sacred act that we rest, and elimination. serve for that person. “The allowance for Opening and Attending to the Allows us to be open to A nurse should be open to existential-phenomenol Spiritual, Mystery, mysteries and miracles and stay other people's beliefs. ogical-spiritual Unknowns–Allowing for within the other person’s forces”(in the 2004 Miracles (Open) experience so that miracles can Watson Website) indeed happen.  B. TRANSPERSONAL CARING RELATIONSHIP Jean Watson developed the Theory of Human Caring that highlights Transpersonal Caring and connection between nurse and patient. This goes beyond physical health that determines their spiritual, emotional, mental needs. Experience of a shared respect for humanity are the key factors of Transpersonal Caring. Ultimately, it reinforces that the essence of healing lies in partnering with patients as people rather than their condition. C. CARING OCCASION/CARING MOMENT The interaction between a nurse and a patient holds a transformative quality that surpasses mere routine care to establish a unique connection that uplifts the healing essence for both individuals involved in the exchange of caregiving and receiving it manifests the importance of offering healthcare with mindfulness and presence while embracing an approach to holistic wellness that improves patient contentment and overall results additionally promoting development, for nurses in their careers and personal journeys. III. RELATION TO NURSING PRACTICE, EDUCATION, AND RESEARCH Practice The Attending Nursing Caring Model (ANCM) represents the application of Watson Caring Science to practice, which was first defined by Watson and Foster (2003) as a theory-based application. The ANCM was a one-of-a-kind pilot project in a Denver children’s hospital, based on the “attending” physician paradigm. The ANCM is focused on the nursing care model. It is constructed as a Nursing-Caring-Science, theory-guided, evidence-based, collaborative practice model for applying it to the conduct and oversight of pain management in a 37-bed postsurgical unit (Watson & Foster, 2003, p.363). The ANCM’s purpose is to maintain continual caring contact with children in pain and their families. The ANCM is evident throughout the hospital, providing a caring and healing presence. Watson’s approach remains influential and revolutionary in hospital systems applying for first and continued Magnet status. Watson’s theory is being used both nationally and internationally to inform nursing’s professional practice. The hospitals currently affiliated with National Caring Science include Stanford Health, Brigham and Women’s, Hefner VA Medical Center, Colorado Children’s Hospital, Ascension of St. John Hospital, Baptist Medical Center, and others (Watson, personal communication, June 1, 2020). The ANCM emphasizes maintaining an ongoing compassionate connection with children in pain and their families, reflecting Watson’s Ten Caritas Processes and Carative Factors. The ANCM shows essential care provided by nurses by fostering a caring, inspiring, nurturing, healing environment and incorporating practices including love, kindness, trust, empathy, and others. Because of ANCM, nurses continue to provide not just physical but also emotional and spiritual needs of the patient, embodying Watson’s transpersonal caring theory. The ANCM’s influence extends to hospitals aiming for Magnet status, showcasing how Watson’s caring science continues to influence nursing practice and improve patient care. Education Watson’s works focus on educating nursing students and providing them with ontological, ethical, and epistemological bases for their practices, along with research directions (Hills & Watson, 2011). Watson’s caring theory is taught in numerous nursing curricula such as Bellarmine College, Indiana State University, Oklahoma City University, University of Minnesota, and University of Arizona. There are various excellent creative caring science nursing programs in the United States including Viterbo University, Nevada State College, and Florida Atlantic University. Moreover, the concepts of this theory are used in international nursing programs in Australia, Japan, Brazil, Finland, etc. One of the aims of Watson’s Caring Science Institute (WCSI) is to educate, and offers numerous trainings, education materials including online videos and books. It also offers an interdisciplinary dissertation in caring science research in addition to postdoctoral training in caring science. The massive open online course (MOOC) entitled “Caring Science, Mindful Practice” teaches participants both about Watson’s theory and introduces principles of mindful practice. Remote learning gives an opportunity to reach worldwide audiences and expand awareness of Watson's theory, but it also presents unique challenges; Watson's Caring in the Digital World (Sitzman & Watson, 2017) is a handbook for teaching caring in a digital setting. WCSI also provides online films that describe the ten caritas processes and show instances of each in action (Watson, personal communication, June 1, 2020). The WCSI plays a vital role in furthering this idea by providing various educational tools and training activities. This enables Watson's work available globally, and allows healthcare professionals to embrace these principles into their practice regardless of location. Furthermore, the institution addresses the issues of modern education with tools such as "Caring in the Digital World," which assists educators in applying Watson's caring ideas to digital learning settings. By providing multidisciplinary research opportunities and postdoctoral training, WCSI promotes continued professional development and advanced research in caring science. In addition, Watson’s theory will help produce more student nurses that address the patient holistically and have a strong ethical and philosophical foundation for their practice. Research Qualitative, naturalistic, and phenomenological methods have been identified as particularly relevant to the study of caring and to the development of nursing as a human science (Nelson & Watson, 2011; Watson, 2012). Watson proposes that combining qualitative and quantitative research, sometimes known as mixed-methods design, may be effective for extending idea discovery and testing (Watson, 2008). A rising body of national and international research tests, expands, and assesses the hypothesis (DiNapoli et al., 2010; Nelson and Watson, 2011). As Watson's theory gains traction in the literature, researchers are providing statistical validation for its impact through randomized controlled trials that demonstrate the efficacy of nursing care guided by Watson's theory in reducing distress experienced by infertile women (Arslan-Ozkan et al, 2014). Wei & colleagues' 2019 systematic review of interventional research applies Watson's theory, demonstrating further advancement of the idea. Nelson and Watson (2011) conducted studies in seven countries on caring surveys and research tools for caring science. They found that there are differences in international perceptions of caring, nurse-patient relationships, and guidelines for hospitals seeking Magnet status. Numerous tools have been validated to measure nurses' caring behaviors and patient satisfaction (Sitzman & Watson, 2019). The Watson Caritas Patient Score is a significant tool for quantifying the outcomes of caring science (Brewer & Watson, 2015). Watson and the WCSl are partnering with Press Ganey on national caritas research using five caritas items in the Press Ganey survey to link patient experiences of caring with outcomes (Watson, personal communication, June 1, 2020). Since 2016, 53 PhD dissertations and DNP projects in nursing have been conducted using Watson Caring Science, focusing on nursing education, clinical interventions, and workforce concerns. Watson's caring theory contributes significantly to nursing research by focusing on understanding persons' lived experiences. Nelson and Watson's international research, as well as numerous PhD dissertations and DNP projects, demonstrate Watson's theory's global and multidisciplinary application in nursing practice, addressing aspects such as compassion fatigue, leadership, and holistic care interventions. Furthermore, Watson's theory can be used to promote nursing science by focusing on care as a major idea, which can motivate the development of new nursing theories. Case Analysis A 62-year-old inmate is admitted to this hospital from prison with a complaint of chest pain. The patient is being worked up for possible myocardial infarction and admitted to the cardiac unit. Because the patient is an inmate, while he is in the hospital a prison guard will be posted outside of the patient's room and the patient will be handcuffed to the bed rail. During the initial assessment, the admission nurse finds the patient to be withdrawn. The nurse discovers the patient has a past medical history significant for abuse of multiple substances. The patient describes how the addictive behaviors led to his incarceration and estrangement from his family. The patient expresses to the nurse interest in meeting with a chaplain while in the hospital. Describe examples of the how the nurse can provide care to this patient as guided by each of the 10 Cantas processes 1. Embrace (Loving-Kindness) The nurse can demonstrate compassion and understanding by treating the inmate with dignity, regardless of his criminal history. By acknowledging the patient's past struggles with substance abuse without judgment, the nurse can foster a supportive and nonjudgmental environment. 2. Inspire (Faith-Hope) The nurse can encourage the patient by affirming that he has the potential for healing and growth, even in difficult circumstances. By facilitating a meeting with the chaplain, the nurse honors the patient's request for spiritual support, thereby nurturing his faith and hope. 3. Trust (Transpersonal) The nurse should be sensitive to the inmate's emotional and spiritual needs, recognizing the importance of his request for chaplaincy services. Respecting his spiritual beliefs and practices can help the patient feel more at ease and supported during his hospital stay. The nurse should make the patient feel comfortable in order for them to build an open and deep intercommunication. 4. Nurture (Relationship) Establishing a trusting relationship is crucial. The nurse can take time to listen to the patient’s concerns, showing genuine interest in his well-being. By doing so, the patient may feel more comfortable sharing his feelings, leading to better care and support. 5. Forgive (Holding Space) The nurse can acknowledge the patient's feelings of withdrawal and isolation without trying to immediately change or dismiss them. Instead, the nurse can offer a safe space for the patient to express his emotions and explore his feelings of estrangement and regret. 6. Deepen (Creative Self) The nurse can use a holistic approach to care, considering both the physical and emotional aspects of the patient’s condition. For example, if the patient’s anxiety is contributing to his chest pain, the nurse might collaborate with other healthcare professionals to address both his physical symptoms and underlying stress. 7. Balance (Learning) The nurse can educate the patient about his condition, using language and methods that he understands. Additionally, providing information about available resources, such as substance abuse counseling or spiritual care, can empower the patient to take steps toward recovery. 8. Create a Healing Environment The nurse can help create a healing environment by ensuring that the patient’s physical needs are met while also addressing his spiritual needs. This includes advocating for the patient’s comfort, ensuring privacy when he meets with the chaplain, and minimizing unnecessary stressors. 9. Minister (Humanity) In addition to monitoring the patient’s physical health, the nurse can facilitate emotional and spiritual support by arranging visits from the chaplain and providing opportunities for the patient to engage in activities that bring him peace or comfort. 10. Open (Infinity) The nurse can maintain an open attitude toward the possibility of change and healing, even in the most challenging circumstances. By supporting the patient’s desire for spiritual connection and showing empathy, the nurse helps create an environment where healing, both physical and emotional, can occur. 1. Compare the values and beliefs in your own philosophy of person, environment, health, and nursing with Watson's 10 caritas processes - The importance of treating every person with dignity, respect, and compassion as every person has a different perspective and experiences, and that should be respected in our profession. Also the responsibility of nurses to provide care that takes into account the social and cultural contexts of the individual, as well as the broader social and environmental factors that impact health. - Therefore, my intention is to treat each person with respect and dignity, also acknowledging their individuality and personal preferences as maintaining an open and honest communication in order to establish a good partnership with the other individuals, which may help for me to build trust and provide them a better understanding of their needs. My goal is to provide personalized and effective care that honors the dignity and worth of each person I interact with. 2. Create a list of caring behaviors in your own nursing practice. Review Assessing and Measuring Caring in Nursing and Health Sciences (Sitzman & Watson, 2019), and compare your list with the caring behaviors in instruments designed to measure caring. -Being present and attentive to patients. -Demonstrating empathy and understanding. -Providing emotional support. -Treating patients with dignity and respect. -Actively listening to and validating patients' feelings and experiences. -Showing compassion and kindness. - Being responsive to patients' needs and requests. Comparing these with the caring behaviors in instruments designed to measure caring, there is significant overlap. 3. Plan a time and place to meditate for 10 minutes each week, closing your eyes and listening to quiet music. Reflect on ways to feel compassionate, intentional, calm, and peaceful. Consider ways to incorporate ideas from your reflection into your style of nursing practice. - Practicing mindfulness throughout the day to stay present and grounded. - Taking a moment between interactions with patients to center yourself and approach each encounter with a calm and focused mind. - Actively listening to patients without judgment, and offering emotional support and reassurance where appropriate. - Approaching patients with empathy and a compassionate attitude, recognizing each person's unique experiences and needs. - Finding opportunities to express gratitude and recognize the hard work and dedication of my colleagues.  REFERENCES American Museum of Natural History. (2019). What is a Theory? American Museum of Natural History. https://www.amnh.org/exhibitions/darwin/evolution-today/what-is-a-theory Bsn, A. G. (2024, April 29). Jean Watson: Theory of Human Caring. Nurseslabs. Retrieved from: https://nurseslabs.com/jean-watsons-philosophy-theory-transpersonal-caring/ Galeano, M. D., Alfonso, L. E. I., Carvajal, B. V., & De Villalobos, M. M. D. (2023). Transpersonal Caritas Relationship: A new concept from the unitary caring science framework of Jean Watson. Investigación Y Educación En Enfermería, 41(3). https://doi.org/10.17533/udea.iee.v41n3e02 Watson, J. (2007). Watson’s theory of human caring and subjective living experiences: carative factors/caritas processes as a disciplinary guide to the professional nursing practice. Texto & Contexto Enfermagem, 16(1), 129–135. https://doi.org/10.1590/s0104-07072007000100016 YadavFollow, N. (n.d.). Watson’s theory of human caring. SlideShare. Retrieved August 28, 2024, from https://www.slideshare.net/slideshow/watsons-theory-of-human-caring-247215121/247215121