Introduction
Dr. Watson`s human caring model transformed from a concept of grand theory to a structured and contextualized middle-range nursing theory through revisions, expansion, time and interpretations (Chinn & Kramer, 2008). By analyzing this theory, logical connections are made for the proposition statement that spirituality develops wellbeing. “Synthesized Method for Theory Evaluation” (McEwen & Wills, 2014, p.108) is utilized to conduct the analysis. The description of the theory will enhance the readers understanding of operational definition for major concepts and statements, models and diagrams associated with the concept, outcomes and consequences.
Theoretical or Operational Definitions for Major Concepts
The concept of transpersonal caring is delicately intertwined into Dr. Watson`s theoretic framework of human caring. Developed from the studies of psychological science, the concept of “transpersonal” relates to profound affiliation, connectedness, and the sharing amongst individual beyond egoistic needs into the realms of the spirituality: it is the sharing of one`s deeper self with others and exceeding the physical as the emphasis of attention (Watson, 2002). McEwen & Willis (2014) described transpersonal as, “an intersubjective human-to-human relationship” (p. 176). The operational meaning to this context is related to application of the theory to the nurse- patient relationship, the patient is affected by and affects the nurse and vice versa. Through the experience of caring, both the entities share the journey towards recovery in the moment leading to a shared phenomenal field and improvise the caring science. Nevertheless, the nursing professional are expected to employ more deliberate effort in making the association and formulating the transpersonal caring relationship as beyond the reluctance, the societal norms expect the nurse to be more sympathetic and genuinely caring of their patients. In addition, the more successful the transpersonal relationship concept is in well-being of a patient, the higher the expectations from nurses are generated. This may end up leading society to be dependent on the nurse more often than the medical technology.
Another concept in Jean Watson`s theory is related to carative factors that serves as the standards for nursing practice in contrast to the curative factors of medicine. The ten carative factors are deliberate caring processes that helps an individual to attain or maintain health, or anticipate a peaceful death in comparison to the curative factors that aim at curing the patient’s disease process. In recent studies, Watson has offered the concept of clinical caritas process over the innovative carative factors. It has delicately woven the concept of spirituality and love into the framework. This perspective is consistent with Florence Nightingales model of nursing and a turning point within the caring-healing model. Poignantly, the concept has engaged the nurses within an advanced conceptual framework as the caritas process require another level of ontological human experience or competency, beyond medical technological efficiency.
Theoretically and Operationally Defined Statements
In her theory, Jean Watson has made many theoretical assertions demonstrating her unique perspective towards humanity. According to Watson’s theory, “Nursing is concerned with promoting health, preventing illness, caring for the sick, and restoring health.” Caring is the central concept of her theory and health is “unity and harmony within the mind, body and soul” (Tomey & Alligood, 2006. pp.99). It is a state of comprehensive physical, spiritual, mental and social welfare and functioning (Hagopian, 2007). Also, the theory states that caring can promote a patient’s health above than the curative measures. The caring model recognizes the patient needs thus creating the needed balance of the patient physical and mental comfort.
Furthermore, the interpersonal-spiritual nature of Watson`s theory maintains the human incorporation with self, others, nature and the universe (Sourial, 1999). According to Watson (1999), the human experience relates to the understanding of one`s existence in the world, which involves the personal “frame of references” that are specific to that person only. The self is defined by Watson, as the insight of association of the “I” or “ME” to other and different aspects of life. And, time defined in past, present and future are denoted as “merge and fuse”; present being the subjective reality and the past is being the objective reality. However, the context related to self as perceived vs. self as experienced is defined in reference to well-being, the context of illness or factors leading to absence of illness are missing. The major concepts of the theory are abstract but the linkages between the statements and concepts are difficult to follow. Studies have been conducted to investigate the spiritual dimension but no study has been linked to find the relationship between positive health outcomes with human care transactions.
Theory Model and Diagram
The Jean Watson`s theory of human caring has three major concepts: the carative factors, transpersonal caring relationship and caring moments. A diagram including these three factors has been demonstrated in the Journal of Advanced Nursing in 1996. The model is broken down with the first component being the human care process, second are the human transactions resulting from the first component and latterly the outcomes of the model (Sourial, 1996). The first, human care process, incorporates the ten carative factors, and intersubjective ideal and moral conviction in which the patient`s individual importance is recognized (Sourial, 1996). The ten-caritas process/ carative factors presume a knowledge base and clinical competence, moral ideal presupposes the nurses as the protector, enhancer and preserver of the human dignity and intersubjective ideal nurse subjects the significance of patients in the caring moment (Sourial, 1996). The crucial moment lies in between the nurse and the patient making caring as an intersubjective human process in the diagram (Sourial, 1996). As a consequence of the human care process, the human care transactions transpire incorporating actual, intersubjective and transpersonal caring moments. The actual caring occasion anticipates a moment in which the nurse and the patient come together to create the occasion for human caring (Sourial, 1996). After the creation, the intersubjective caring occasion is projected in which a relationship is established between the subjective worlds of the nurse and the patient with impending achievement for greater spiritual self. Lastly, transpersonal caring moments are established in which the one`s mind-body-soul engages to another`s in a presenting moment or spiritual coalition is experienced (Sourial, 1996). The theory of Watson has been beautifully simplified through this diagram predicting the possible outcomes including harmony, healing and transcendence.
Outcomes and Consequences
The development of this theory is ever-evolving work in progress, hence it has surpassed and amended to our precipitously changing society and nursing practice. It responds well to the dynamics of human caring phenome and focuses on nurse self-care. For its diverse knowledge, the theory has been utilized in education and research at national and international level. Numerous clinical practice model’s initiation and application at different practices, formulation of administrative directives and presentation at and for all age groups are some of the major outcomes observed for this theory. The outcomes of applying the Jean Watson theory of caring and the transpersonal care concept can guide nursing interventions for nurse- patient relationship, via ethical and moral liability support best nursing practice, and augment transcendent self-care of the nurse along with the patient. Nevertheless, it can be witnessed that the theory presents strong elements but also has its own limitation. There`s a lack of definition for the intersubjective ideas and detracts the nurses from their professional skills and training. Additionally, nurses looking for concrete standards may feel comfortable implementing this theory alone making the theory look meaningless (McCanes, 1999). The application of the caritas factor can also be time-consuming if not intervened in a proper manner. Thus, the carative factor may have strong bases in other discipline, it may need further research in nursing to demonstrate their application to practice.
Conclusion
Watson`s Theory of Human Caring aids the nurses to improve caring behavior, recapping the act of caring is a vital part of the healing process. A celestial experience can be witnessed between the nurse and the patient`s relationship modelling this theory. Understanding the spiritual concept can lead the help understand the concept of human caring. However, more research needs to be conducted to define its application in nursing practice. The empiricism of this well-developed theory might be lost due to its lack of practicality in nursing settings.
Reference:
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