The main objective is to provide the viewer with the knowledge to understand the link between the four main concepts of the Nursing Metaparadigm and Jean Watson’s Theory of Human Caring. To this end, the formative ideas of Watson’s theory will be discussed in detail and a working statement of the four concepts of nursing will be presented. The natural bridge between the two will be presented as a means to relate to patients and provide a higher level of patient care resulting in positive patient outcomes.
Jean Watson (born June 10, 1940) began her nursing education by graduating from Gale School of Nursing in 1961. She earned a Baccalaureate of Science degree in 1964, and a Master of Science in psychiatric and mental health nursing in 1966, followed by a Ph. D. in educational psychology and counseling in 1973, all from the University of Colorado at Boulder. She also served as president of the National League of Nursing (NLN) from 1995 to 1996. During her career she established the Theory of Human Caring. This theory, which places a heavy reliance upon the building of rapport and the promotion of health by an emphasis on psychosocial wellness and support, is based on seven assumptions as to the efficacy of the nature of human caring as an efficacious curative agent and ten carative factors that spring from these seven assumptions.
Watson developed seven assumptions upon which to base the tenets of her theory. These ideas center around the observable effects interpersonal relationships have on the physical, psycho-social, emotional, and spiritual health of individuals, families, and communities. The belief that individualism has a place in society but does not most effectively serve to facilitate an environment able to sustain a high level of health is central to the theory. An emphasis on the acceptance of one’s current state of wellness is presented as paramount to reaching towards an ideal state of wellness. One on one interactions play an important role in pursuing this wellness, but the necessity of a consistently caring environment, or community, is given as ideal. It is also understood in Watson’s assumptions that caring, while not clinical curative, provides the avenue for healing and curative interventions. Relating this to nursing is the observation that caring is central to the science and art of nursing by providing the fertile ground on which nurses practice.
The ten carative factors begin by pointing to the idea that an idea that an attitude of extrinsic focus, that is thinking of others rather than ourselves is preferable for the application of the theory in real-life scenarios. The installation of faith-hope flows from this outward-minded worldview, and is coupled with the development of an empathetic understanding of other people. This, in turn, promotes the development of rapport with other people. From this freely flows an environment of acceptance and a relationship of trust where any thought or emotion can be shared. Watson’s theory does not exclude the scientific process. Instead it relies on the scientific process, and the understanding acquired through one’s education to realize what is and is not healthy though or emotion is, and provides the means to redirect these emotions and thoughts toward a more “healthful” context. Nor does the theory deny the existence or importance of human needs. In fact, hierarchy of needs similar to Maslow’s is primary to the implementation of the Theory of Human Caring.
The Nursing Metaparadigm focuses on four major concepts. Those concepts are the human being, health, the environment and society, and nursing. Each of these concepts provide and interactive field for the other three. With the human being as the center. In the form of patient, caregiver, family and community the human being concept flows naturally into interrelational aspect of the environment/society concept. It is this environment in which the practice of nursing is found, and the implementation of Watson’s theory can take place.
Watson’s theory presents the human being in general, and the interrelation of human beings in particular, as the core of her nursing theory. From this perspective, the physical human body is the conduit of the nature of humanity. By acknowledging that belief in the seven assumptions and ten factors of the Theory of Human Caring, Watson makes the case that by caring first for the intrinsic humanity of an individual, that is by nurturing and aiding the humanist desires and forces, an avenue for treating the physical health of a person is created.
Health is the continuum of physical, emotional and psychological well-being of an individual. As previously stated, the Theory of Human Caring is an avenue to caring for the needs of an individual. While not a direct approach of physical interventions, it places an emphasis on the psycho-social and spiritual aspect of a person in an effort to create a dynamic trusting relationship where nursing interventions may be performed in expectations of more successful positive patient outcomes. These positive outcomes are based both on the trust created between the nurse and patient, and the psycho-social / spiritual restorative nature within the patient by the implementation of the theory itself.
According to Watson, caring (and nursing) has existed in every society, but is not transmitted generationally. That is, caring (like nursing) is a learned skill, no inherited, and manifests as a way to provide a means of coping in a communally-based environment. Nurses play a unique role in this concept with regard to the Theory of Human caring, in that, they often are placed specifically in the midst of personal turmoil when caring for a patient and, by extension, the patient’s family. Since the belief that caring is not inherited, it becomes the nurses role to extend the same support and relational avenues of providing health to the other members of the patient’s family who are suffering. This avenue is provided not so much for the restoration physical health, but the restoration emotional, spiritual, and psycho-social balance so that an ideal environment for healing and recovery, or palliative care be provided for the patient.
Watson defines nursing as, “ a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions.” Again, it is the avenue of provision for healthcare, not the direct physical intervention, that Watson focuses upon. Within the Theory of Human Caring, the physical interventions of nursing are viewed more as a skilled tradesman might view his craft; they are a collection of experience and training that are honed through practice and study, but have less degree of variance in their implementation than does effectively developing the ability to provide higher-level caring for an individual. While the role of counselor is one that a nurse may be called to fulfill, it is truly not at the core of Watson’s theory as applied in nursing. Instead, using some of the same tools as a counselor might, Watson expects the nurse to “care” for a patient in such a way that their spiritual, emotional and psycho-social problems may not be “cured,” but that they are acknowledged in such a way that the avenue to facilitate curative efforts is established.
In summary the Theory of Human caring cannot stand without the four concepts of the nursing metaparadigm. The four concepts provide the base for the theory to be built upon, and the mechanics by which it is implemented. In turn, Watson’s theory provides an avenue to apply skills, theories, and interventions of nursing care. The Theory of Human Caring is not one that can be dropped as a nurse walks out of the place of employment, at least it should not be. Instead, adoption as a worldview, a lens through which each personal exchange occurs would serve the nurse well towards, not only patient care, but effecting a sincerity in their practice that is conducive to patient trust and positive patient outcomes.
Theory of Human Caring
An Exploration of
“Theory of Human
as it Relates to the
Provide a brief description of Jean Watson’s
Theory of Human Caring.
List the ten “curative factors” of Watson’s theory.
Provide an introduction to the “Nursing
Discuss the specific mechanics of Watson’s
theory as it relates to the four major concepts of
the “Nursing Metapardigm.”
Jean Watson a Brief History:
Born June 10, 1940
Graduated Gale School of Nursing, 1961
Undergraduate through Ph. D education at
University of Colorado, Boulder, 1973
Served as President of National League of Nursing,
Developed the Theory of Human Caring
The Seven Assumptions of the
Theory of Human Caring
1. Caring can be effectively demonstrated and practiced
2. Caring consists of curative factors that result in the
satisfaction of certain human needs.
3. Effective caring promotes health and individual or family
4. Caring responses accept person not only as he or she is now
but as what he or she may become.
5. A caring environment is one that offers the development of
potential while allowing the person to choose the best
action for himself or herself at a given point in time.
6. Caring is more “ healthogenic” than is curing. A science of
caring is complementary to the science of curing.
7. The practice of caring is central to nursing.
The Ten Carative Factors of
the Theory of Human Caring
1. The formation of a humanistic- altruistic system of values.
2. The installation of faith-hope.
3. The cultivation of sensitivity to one’s self and to others.
4. The development of a helping-trust relationship
5. The promotion and acceptance of the expression of
positive and negative feelings.
6. The systematic use of the scientific problem-solving
method for decision making
7. The promotion of interpersonal teaching-learning.
8. The provision for a supportive, protective and /or
corrective mental, physical, socio-cultural and spiritual
9. Assistance with the gratification of human needs.
10. The allowance for existential-phenomenological forces.
The Nursing Metaparadigm
The four concepts:
1. The Human Being
3. The Environment / Society
The Human Being
A physical body
A conduit / avenue for treatment
Basic to the Theory of Caring
“Maybe this one moment, with this one person, is the very reason we’re
here on Earth at this time.”
- Jean Watson, The Caring Moment
A physical body
A conduit / avenue for treatment
Basic to the Theory of Caring
The Environment / Society
Setting for nursing care
Means of learning caring
Includes immediate and extended family
A body of knowledge
Interdependent theory and concepts
Skill-set for building rapport