2. Jean Watson
The philosophy and science of caring
examine the relatedness of all
includes human science, human
caring, processes, experiences and
phenomena
Rosemarie parse
Human becoming theory focuses
on the quality of life for the
patient. (George, 2011)
3. INTRODUCTION:
In the realms of the present times, improvements in health care
system have intensified nurse's workload and responsibilities
sad but true, nurses in the present times often forget their
caring attitudes when they are faced with stressful and difficult
situations.
Despite of this, we nurses must learn how to deal with the
complexities arising in every patient situation and must find
ways of preserving their caring practice. One nursing theory
has seemed indispensable for this goal-Jean Watson's theory
of human caring.
4. Jean Watson view of caring is the most valuable
attribute nursing has to offer to humanity, yet
caring has received less emphasis than other
aspects of the practice of nursing over time.
In Watson's view disease might be cured but
illness would still remain because without caring,
health is not fully attained.
5. Jean Watson - born in West Virginia, US
1964 - BSN, University of Colorado
1966- MS Psychiatric-Mental Health Nursing, University of Colorado
1973 - PhD, in Educational psychology and Counseling. University of
Colorado
Distinguished Professor of Nursing and Chair in Caring Science at the
University of Colorado Health Sciences Center.
6. • Fellow of the American Academy of Nursing.
• Dean of Nursing at the University Health
Sciences Center and President of the National
League for Nursing
• 6 Honorary Doctoral Degrees.
• Research - human caring and loss.
• 1988- her theory published in "nursing:
human science and human care".
7. "A human science of persons and
human health- illness experiences
that are mediated by professional,
personal, scientific, esthetic, and
ethical human care transactions"
(Watson, 1988.
8. CARATIVE FACTORS,
EVOLVING INTO CARITAS
FACTORS
Caring occasion
/caring moment
Transpersonal caring
relationships
ELEMENTS CARING THEORY
9. CARITAS
• Caritas has a greater spiritual
dimension
• In Greek, caritas means "to cherish
and to give special loving attention"
10. 10 CARATIVE FACTORS CARITAS
PROCESS
• practice of loving kindness and equanimity
within context of caring consciousness.
1.Formation of a Humanistic altruistic System of
Values
11. • being authentically present and enabling and
sustaining the deep belief system and
subjective life world of self and one being cared
for.
2. Instillation of Faith-Hope
12. • cultivation of one's own spiritual
practice and transpersonal self, going
beyond ego self.
3. Cultivation of Sensitivity to Self
and to Others
13. • developing and sustaining helping-
trusting authentic caring relationship.
4. Development of a Helping-Trust
Relationship
14. • being present and supportive of the
expression of positive and negative feelings as
a connection with deeper spirit of self and the
one being cared for.
5. Promotion and Acceptance of the
Expression of Positive and Negative
Feelings
15. • creative use of self and all ways of
knowing a part of the caring process, to
engage in artistry of caring-healing
practices
6.Systematic Use of the Scientific
Problem- Solving Method for Decision
Making
16. • engaging in genuine teaching- learning experience
that attends to the unity of being and meaning,
attempting to stay within others frame of reference
7. Promotion transpersonal Teaching-
Learning
17. • creating healing environment at all
levels, whereby wholeness, beauty,
comfort, dignity and peace are
potentiated
8.Provision for Supportive, Protective, and
Corrective Mental, Physical sociocultural and
Spiritual Environment
18. • nurse recognizes the biophysical, psychophysical,
psychosocial and intrapersonal needs of self and
patient all the while remembering patients must
satisfy lower-order needs before attempting to
attain higher-order needs
9. Assistance with Gratification of Human Needs
while preserving human dignity and wholeness
19. • Phenomenological and spiritual dimensions of
caring and healing that cannot be fully explained
scientifically through modern western medicine-
soul care for self and the one being cared for
10. Allowance for and being open to Existential
20. Transpersonal means to go beyond one's own ego and reach a
deeper spiritual connection while comforting a patient.
The transpersonal relationship depends on:
A commitment from the nurse to enhance and protect human
dignity
An awareness from the nurse that they have the ability to heal.
The nurse must go beyond the objective role
21. • To preserve and protect a person's humanity, and dignity.
• Preserve a patients spirit to ensure the patient does not
become an object.
• This relationship allows the nurse and the patient to
mutually seek out meaning and in turn lead to a
transcendence of suffering (Watson, 2001).
22. CARING OCCASION/CARING MOMENT
Watson (1998, 1999) stated that when human caring is created the
nurse and patient come together to create a moment, this is
known as the caring occasion/caring moment.
Watson (1999) feels as though the nurse and the patient must be
aware of the caring moment so as to make appropriate choices
and actions, thereby the nurse without knowing becomes a part of
the patients "life history"
23. ASSUMPTIONS
Moral commitment, intentionality and caritas
consciousness by the nurse protect, enhance and
potentiate human dignity, wholeness and healing.
The nurse seeks to recognize, accurately detect
and connect with the inner condition of spirit of
another person through genuine presence and
being centered in the caring moment
24. The nurse's ability to connect with another at this
transpersonal spirit to spirit level is translated via
movements, gestures, facial expressions, procedures,
information, touch, sound, verbal expressions and other
means to caring healing modalities.
Ongoing personal and professional development and
spiritual growth assists the nurse in entering into this
deeper level of professional healing practice.
25. P
R
O
P
O
S
I
T
I
O
N
S
Nursing care can be and is physical,
procedural, objective and factual.
A person's body is confined to time and
space, but the mind and soul are not
confined to the physical universe.
Persons need one another in a caring,
loving way. Love and caring are two
universal givens.
26. 1. PERSON/PATIENT
A unity of mind-body-spirit-nature; embodied spirit.
Is subjective and unique, not objective, predictable and
calculating
Has distinct human needs, which are biophysical,
psychophysical, psychosocial and interpersonal
Is to be valued, cared for, respected, nurtured.
Understood and assisted.
JEAN WATSON THEORY AND NURSING` s METAPARADIGM
27. 2. ENVIRONMENT:
• Is crucial to the holistic healing (mental,
physical, social, emotional, spiritual
.developmental, protective, supportive
environments), which is conducive to a
patients health and wellbeing, non physical
energetic.
• Recently- A environment; a vibrational field
integral with the person where the nurse is
not only in the environment but "the nurse
is environment"
28. 3. HEALTH
• Unity and harmony within the body, mind and soul
• A harmony between the self and others and between
the self and nature; and openness to increased
possibility.
• Illness is not necessarily disease, but rather a
subjective disharmony within the spheres of person.
Disease in turn creates more disharmony.
29. 4. NURSING
• Reciprocal transpersonal relationship
in caring moments guided by carative
factors and caritas processes.
30. Logical in nature
Relatively simple
Generalizable
Based on phenomenological studies that generally ask
questions rather than state hypotheses.
Can be used to guide and improve practice.
Supported by the theoretical work of numerous
humanists, philosophers , developmentalists and
psychologists.
31. Strengths and Limitation of Theory
Strength
• Places client in the context of the family, the
community and the culture.
• Places the client as the focus of practice rather
than the technology.
32. L
I
M
I
T
A
T
I
O
N
S
Biophysical needs of the individual
are given less important.
The ten carative factors primarily
delineate the psychosocial needs of
the person.
Needs further research to apply in
practice.
33. WATSON’s THEORY AND
NURSING PROCESS
ASSESSMENT
Mutual engagement of nurse and the patient as well as
observation, identification and review of the problem whether
physical or psychosocial in nature.
Analysis and nursing diagnosis follows gathering of
assessment data
34. 2. PLAN
Includes discussion and
establishment of goals
Goals of Watson's theory
relate to growth of
oneself and others.
35. 3. INTERVENTION
It is the direct action and
implementation of the plan.
List of caritas presented by Watson
are a series of interventions
designed to achieve goals
appropriate to her philosophy and
theory of transpersonal caring.
36. 4. EVALAUTION
Effective interventions are related to
achieving the goals of intervention.
Evaluation process is achieved by mutual
reflection.
37. APPLICATIONS OF WAT SON S THEORY
Nursing Education
A two year curriculum of serial seminars designed to support new heirs in their clinical.
Educational and professional growth now include a unit on self-care to promote healing
and self- growth.
Caring modalities are used in pain management unit.
Watson's theory is being taught in numerous baccalaureate nursing curricula including
Bellarmine College in Worcester Massachusetts: Indiana State University in Terre Haute.
Indian and Florida Atlantic University in Boca Raton Florida.
Watson emphasizes that both the core and trim of nursing are necessary in curricula of
nursing. Core Of nursing includes those aspects of nurse-patient relationship resulting
in a therapeutic outcome. Trim Of nursing includes the procedures, tasks and
techniques used by various practice settings.
Clock hours are designed to respond to immediate needs and to encompass a diverse
range of topics from conflict resolution. professional development. to health treatment
plans, physiology of medical diagnosis and in service on new technologies and
pharmacological interventions.
38. Nursing Practice
• Holistic approach is being instituted in various institutions.
• Watson's theory is clinically validated in various populations
and settings.
• Clinical settings include critical care units, neonatal intensive
care units, pediatric and gerontological care units.
• Population include women who have had newborns in
intensive care units and women identified as socially at risk
• post-myocardial patients, oncology patients, persons with
AIDS and elderly.
39. Nursing Research
• Watson caring is used in conceptual and theoretical development.
• Jean Watson hopes that nursing research will incorporate and
explore esthetic, metaphysical, empirical and contextual
methodologies.
• Abstractness of the concept of caring and the clinical reality (e.g. brief
interactions with patients afforded by outpatient or Office visits) has
limited the development of knowledge basein Watson's caring theory.
• Research and practice must focus on both the subjective and
objective patient outcomes in determining whether caring is essence
of nursing.
40. CRITIQUE OF WATSON THEORY
Clarity
Watson's theory uses nontechnical, yet
sophisticated language.
Her increasing inclusion of metaphor, personal
reflection, artwork and poetry make her complex
concepts more tangible and esthetically appealing.
41. Watson draws a number of discipline to
formulate her theory.
It is viewed as complex when considering
existential- phenomenological nature of her
work
Simplicity
42. The generality is limited by emphasis placed on
psychosocial aspect than the physiological aspect of
caring.
Watson's theory must be internalized to practice and
the nurses who want clear guidelines may not feel
secure when try rely on this theory.
Generality
43. Watson theory is descriptive and evolving as nature and
welcomes inputs by others.
The methodology relevant to studying trans-personal
caring and developing nursing as a human science and art
can classified as qualitative, naturalistic or
phenomenological.
Watson acknowledges that a combination of qualitative
and quantitative inquiry may also be useful.
Empirical Precision
44. • Watson's theory provides a useful and important
metaphysical orientation for delivery of nursing
care.
• It helps nurses and patient find meaning and
harmony in period of increasing complexity.
Derivable Consequences
45. Implication of Jean Watson theory in Nursing
• Ms. M., a patient in her 50s with a history of type 1 diabetes and acute
myocardial infarction, has been in the cardiac intensive care unit overnight and
is worried about her young daughter. She also has questions about her own
treatment and prognosis. Her evening nurse notices her sad expression, takes
hold of her hands, looks into her eyes, and answers her questions and
concerns, including explaining angiography and watching a video describing
the process with her. The nurse then arranges for Ms. M. to have an immediate
video call with her daughter.
• In this model, the nurse practices many of the core tenets of Watson’s theory
by being present and picking up on nonverbal cues, practicing empathy, and
clearly communicating with the patient, all of which help instill a sense of
psychological well-being.
46. Research Article
Effects of Nursing Care Based on Watson’s Theory of Human
Caring on Anxiety, Distress, And Coping, When Infertility Treatment
Fails: A Randomized Controlled Trial
Abstract
Introduction:
The failure of infertility treatment leads to individual, familial, and
social problems. The objective of this study was to evaluate the
effectiveness of the nursing care program based on Watson’s
"Theory of Human Caring" on anxiety and distress caused by
coping when the treatment fails.
47. Methods:
• This study randomized controlled trial study was conducted from April to November 2012, with 86
Turkish women with infertility (intervention group: 45, control group: 41). Follow-up of 32 infertile
women, who failed infertility treatment from intervention group, and 35 infertile women, who
failed infertility treatment from control group, continued for another four weeks. Data were
collected through Spiel Berger’s State/Trait Anxiety Inventory, Distress Scale, and Ways of
Coping Questionnaire
Results:
• The intervention and control groups significantly differed in terms of anxiety, distress, and coping
levels. The intervention group’s mean anxiety score decreased by thirteen points and distress by
fourteen points (in a positive direction). The intervention group’s mean positive coping style score
increased. Whereas a negative increase was observed in the control group’s values depending on
the failure of the treatment.
Conclusion:
• Watson’s theory of human caring is recommended as a guide to nursing patients with infertility
treatment to decrease levels of anxiety and distress, and to increase the positive coping style
among infertile women.
• Keywords: Infertility, Anxiety, Nursing care
48. HUMAN BECOMING THEORY
Rosemarie Rizzo Parse
INTRODUCTION
• The Parse theory of human becoming guides nurses In their practice to focus on quality of
life as it is described and lived (Karen & Melnechenko, 1995).
• The human becoming theory of nursing presents an alternative to both the conventional
bio-medical approach and the bio-psycho-social-spiritual (but still normative) approach of
most other theories of nursing.
• The human becoming theory posits quality of life from each person's own perspective as the
goal of nursing practice.
• Rosemarie Rizzo Parse first published the theory in 1981 as the "Man-living-health" theory
• The name was officially changed to "the human becoming theory" in 1992 to remove the
term "man," after the change in the dictionary definition of the word from its former
meaning of "humankind."
49. ABOUT THE THEORIST
Educated at Duquesne University, Pittsburgh
MSN and Ph.D. from University of Pittsburgh
Published her theory of nursing, Man-Living-Health in 1981
Name changed to Theory of Human Becoming in 1992
Editor and Founder, Nursing Science Quarterly Has published eight
books and hundreds of articles about Human Becoming Theory
Professor and Niehoff Chair at Loyola University, Chicago
50. The human becoming theory was developed as a human science nursing
theory in the tradition of Dilthey, Heidegger, Sartre, Merleau-Ponty, and
Gadamer and Science of Unitary Human Beings by Martha Rogers.
The assumptions underpinning the theory were synthesized from works
by the European philosophers, Heidegger, Sartre, and Merleau-Ponty,
along with works by the pioneer American nurse theorist, Martha
Rogers.
The theory is structured around three abiding themes: meaning,
rhythmicity, and transcendence.
THEORY DEVELOPMENT
51. ASSUMPTIONS
ABOUT MAN
The human is coexisting while conconstituting
rhythmical patterns with the universe.
The human is open, freely choosing meaning in
situation, bearing responsibility for decisions.
The human is unitary, continuously co constituting
patterns of relating.
The human is transcending multi dimensionally with
the possibles
52. ABOUT BECOMING
Becoming is unitary human-living-health.
Becoming is a rhythmically co-constituting human-
universe process.
Becoming is the humans patterns of relating value
priorities.
Becoming is an inter-subjective process of
transcending with the possibles.
Becoming is unitary humans emerging
53. THREE MAJOR ASSUMPTIONS OF HUMAN
BECOMING
MEANING:
• Human Becoming is freely choosing personal meaning in situations in the inter-
subjective process of living value priorities.
• Man’s reality is given meaning through lived experiences
• Man and environment co-create
RHYTHMICITY
Human Becoming is co-creating rhythmical patterns of relating in mutual process with
the universe.
Man and environment co-create ( imaging, valuing, language) in rhythmical patterns
TRANSCENDENCE
Human Becoming is co-transcending multi-dimensionally with emerging possible.
Refers to reaching out and beyond the limits that a person sets
One constantly transforms
54. SUMMARY OF THE THEORY
• Human Becoming Theory includes Totality Paradigm
• Man is a combination of biological, psychological, sociological
and spiritual factors
• Simultaneity Paradigm
• Man is a unitary being in continuous, mutual interaction with
environment
• Originally Man-Living-Health Theory
55. PERSON
Open being who is more than and different from the sum of the parts
ENVIRONMENT
Everything in the person and his experiences Inseparable, complimentary
to and evolving with
HEALTH
Open process of being and becoming. Involves synthesis of values
NURSING
A human science and art that uses an abstract body of knowledge to serve
people
56. SYMBOL OF HUMAN
BECOMING THEORY
Black and white = opposite paradox significant to
ontology of human becoming and green is hope
Center joined =co created mutual human universe
process at the ontological level & nurse-person process
Green and black swirls intertwining = human-universe co
creation as an ongoing process of becoming
57. STRENGTH AND WEAKNESS
STRENGTHS
Differentiates nursing from other disciplines
Practice - Provides guidelines of care and useful administration
Useful in Education
Provides research methodologies
Provides framework to guide inquiry of other theories (grief, hope, laughter, etc.)
WEAKNESS
Research considered to be in a “closed circle”
Rarely quantifiable results - Difficult to compare to other research studies, no control
group, standardized questions, etc.
Does not utilized the nursing process/diagnoses
Negates the idea that each person engages in a unique lived experience
Not accessible to the novice nurse
Not applicable to acute, emergent care
58. APPLICATION OF THE THEORY
NURSING PRACTICE
A trans-formative approach to all levels of nursing
Differs from the traditional nursing process, particularly in that it does not seek
to “fix” problems
Ability to see patients perspective allows nurse to “be with” patient and guide
them toward desired health outcomes
Nurse-person relationship co-creates changing health patterns
RESEARCH
Enhances understanding of human lived experience, health, quality of life and
quality of nursing practice
Expands the theory of human becoming
Builds new nursing knowledge about universal lived experiences which may
ultimately contribute to health and quality of life
59. CRITIQUE
• Congruence with personal values
• Nurse must subscribe to this world view to truly use it
• Congruence with other professional values
• Complements and competes with other health care professionals’ values
• Exoteric foundations
• Esoteric utility
• Congruence with social values
• Fulfills society’s expectations of nursing role
• Social Significance
• Makes a substantial difference in the lives of clients and nurses
60. Research article
The Meaning of Living with AIDs: A Study Using Parse's
Theory of Man-Living-Health
Abstract
This paper explores the meaning of living with Acquired Immune Deficiency Syndrome
(AIDS) using Parse's theory of man-living-health as the conceptual framework. The
design of the study is based on the qualitative descriptive method. Analysis of the data
gathered from interviews with fourteen subjects reveals the emergence of three
themes related to the meaning of living with AIDS: (a) an abrupt shift in patterns of
being give rise to changing priorities, (b) fluctuating possibilities arise in the
uncertainty of being with and away from close others, and (c) changing hopes and
dreams surface from the insights of suffering. Practice propositions were identified
from the findings of the study.
61. Based on these theory that we have gathered for this presentation,
each theory is useful in the nursing practice because they both involve
the aspect of caring in nursing. Caring has been proven to be the art in
nursing that will help us apply our knowledge as nurses or the nursing
science in practice. The Human Becoming theory is pretty complex
because it discusses the continuous change in man with mutual
interaction with the environment. It is somehow difficulty to apply in
practice because it does not utilize the nursing process. We found it
very broad as well. On the other hand, Watson's The Philosophy and
Science of Caring is more simple because of its utilization of the
nursing process and it can be applicable in acute situations.
62. Depression is becoming apparent in our community in congruence with the current
weather conditions. I have encountered a depressed client who found it difficult to
cope with her divorce during this time of the year.
• Using both theories to address her needs, the Human Becoming Theory is useful when
it comes to her long-term goals and the changes that could happen while she is in the
process of moving on and adapting to her environment. We could explore her
emotions like grief, hope and happiness by the nurse's guidance and holistic
approach. This could be difficult for new nurses because the approach is broad and
they may lack the experience, practice wise, to relate to the patient's situation.
• Jean Watson's The Philosophy and Science of Caring can be applied in this situation in
a more structured manner because we can assess, plan, intervene and evaluate the
patient's situation to achieve both short-term and long-term goals. The problem
would still be addressed holistically with a caring environment that could help the
patient decide on what is the best for her.
63. Conclusions
Parse’s theory of human becoming offers a wonderful
perspective on the concept of patient-centered care. It
is a promising approach to delivering quality nursing
care, based on the holistic vision of the patient’s
personality. Its consequences usually include improved
quality of care and increased patient satisfaction.
Certainly, the concept needs more clarity, especially in
the context of human becoming which is the problem
future researchers will need to solve.
Watson provides many useful
concepts for the practice of
nursing. She ties together many
theories commonly used in
nursing education. The detailed
descriptions of the carative
factors can give guidance to
those who wish to employ them
in practice or research.
64. BIBLOGRAOHY
Tomey ann marriner, nursing theorists and their work
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Parker Marilyn E.nursing theories and nursing
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Brar nk, Text book of advanced nursing practice:1st
edition.punjab India: Jaypee brother (p) LTD;2015
https://en.m.wikipedia.org/wiki/John_B._Watson#:~:
text=In
65. Potter & perry ,fundamentals of nursing .fifth edition . Noida
: Saurabh printers;2004
Karen L. Melnechenko. Parse's Theory of Human Becoming:
An Alternative Guide to Nursing Practice for Pediatric
Oncology Nurses. Journal of Pediatric Oncology Nursing, Vol.
12, No. 3, 122-127 (1995)
Kim hesook suzie,nursing theories conceptual &
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ICPS-International Consortium of Parse Scholars website