Ms. Nidhi Shukla
M .Sc. Nursing 1st year
“Too often we underestimate
the power of a touch, a smile, a
kind word, a
listening ear, an honest
compliment, or the smallest act
of caring, all
of which have the potential to
turn a life around.”
• Born in West Virginia,
currently living in Colorado.
• She earned a B.Sc. in 1964,
MS in Psychiatric Nursing in
1966 and PhD in Educational
Psychology and Counseling
• Founder of the Center for
Human Caring in Colorado.
Watson's philosophy of caring attempts to define
outcome of nursing activity in regard to the
humanistic aspects of life. Her theory and philosophy
of caring is based on the values of kindness, concern,
love of self and others and respect for the spiritual
dimensions of the person.
The foundation of Jean Watsons’s theory of nursing
was published in 1979 in nursing- The philosophy
and science of caring.
Watson’s defined nursing as a human science of persons
and human health- illness experiences that are mediated
by professional, personal, scientific, esthetic and ethical
human care transactions.
Watson’s defined human caring in nursing as
“an act and a science in which caring is a
human to human process demonstrated
through a therapeutic interpersonal
MAJOR ELEMENTS OF WATSON’S THEORY OF HUMAN
The structure for the science of caring is built upon
the ten carative factors, these are-
1. Formation of a humanistic- altruistic system of
2. The installation of faith-hope.
3. The cultivation of sensitivity to one’s self and to
4. The development of helping- trust relationship.
5. The promotion and acceptance of the expression of
positive and negative feelings.
6.The systematic use of the scientific problem- solution
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
9. Assistance with the gratification of human need.
10. The allowance for existential- phenomenological
1.The formation of a humanistic-altruistic system
Begins developmentally at an early age with values
shared with the parents.
Mediated through ones own life experiences, the
learning one gains and exposure to the humanities.
Is perceived as necessary to the nurses own maturation
which then promotes altruistic behavior towards
Is essential to both the carative and the curative
When modern science has nothing further to offer the
person, the nurse can continue to use faith- hope to
provide a sense of well- being through beliefs which
are meaningful to the individual.
3.Cultivation of sensitivity to one’s self
and to others-
Development of one’s own feeling is needed to interact
genuinely and sensitivity with others.
Striving to become sensitive, makes the nurse more
authentic, which encourages self-growth and self
actualization, in both the nurse and those with whom
the nurse interacts.
The nurse promote health and higher level
functioning only when they form person to person
4.Establishing a helping- trust
Strongest tool is the mode of communication, which
establishes rapport and caring.
She has defined the characteristics needed to develop
the helping- trust relationship. They are congruence,
empathy and warmth.
Communication includes verbal, nonverbal and
listening in a manner which express empathy,
5.The expression of feelings, both
positive and negative-
According to Watson, “feelings alter thoughts and
behavior, and they need to be considered and allowed
for in a caring relationship.”
According to her such expression improves one’s level
Awareness of the feelings helps to understand the
behavior its engenders.
6.The systematic use of the scientific problem-
solving method for decision making-
According to Watson, the scientific problem solving
method is the only method that allows for control and
prediction, and that permits self correction.
She also values the relative nature of nursing and
supports the need to examine and develop the other
methods of knowing to provide a holistic perspective.
The science of caring should not be always neutral and
7.Promotion of interpersonal teaching-
The caring nurse must focus on the learning process as
much as the teaching process.
Understanding the person’s perception of the situation
assist the nurse to prepare a cognitive plan.
8. Provision for a supportive, protective and /or
corrective mental, physical, socio-cultural and
Watson divides these into external and internal variables,
which the nurse manipulates in order to provide support
and protection for the persons mental and physical well
The external and internal environments are
Watson suggests that the nurse also must provide comfort,
privacy and safety as a part of this carative factors.
9.Assistance with the gratification of
It is grounded in a hierarchy of need similar to that of
She has created a hierarchy which she believes is
relevant to the science of caring in nursing.
According to her, each need is equally important for
optimal health. All the needs deserve to be attended to
Watson’s ordering of needs-
Lower order needs (biophysical needs, psychological need)-
The need for food and fluid.
The need for elimination
The need for ventilation
The need for sexuality
Watson’s ordering of needs-
Higher order needs ( psychosocial needs).
The need for achievement.
The need for affiliation.
The need for self- actualization.
10. Allowance for existential- phenomenological
Phenomenology is a way of understanding people
from the way things appear to them, from their frame
Existential psychology is the study of human existence
using phenomenological analysis.
This factor helps the nurse to reconcile and mediate
the incongruity of viewing the person holistically
while at the same time attending to the hierarchical
ordering of needs.
Thus the nurse assists the person to find the strength
of courage to confront life or death.
TRANSPERSONAL CARING RELATIONSHIP
Transpersonal describes an
intersubjective, human to human
relationship that encompasses two
individuals, both the nurse and the
patient in a given moment.
Describes how the nurse goes
beyond the objective assessment to
show concern toward the person’s
subjective/deeper meaning of their
Involves mutuality between the two
Is protects, enhances and
preserve human dignity,
humanity, wholeness and
Goal of transpersonal caring
Transpersonal caring relationship is a special kind of human
relationship that depends on-
Nurse’s commitment on
protecting and enhancing
human dignity .
The nurses caring and
connection have potential to
heal since experience, intension
and perception are taking place.
Nursing goals beyond an
objective assessment and shows
concern for the patients own
CARING OCCASION / MOMENT
A caring occasion is the
moment when the nurse and
another person come together
in such a way that an occasion
for human caring is created.
Both persons come together
in a human-human
The one caring for and the
one being cared for are
influenced by the choices and
actions decided within the
WATSON’S THEORY AND THE FOUR MAJOR CONCEPTS
She adopts a view of the human being as a valued
person in and of him or herself to be cared for
respected, nurtured, understood and assisted. In
general a philosophical view of a person as a fully
functional integrated self.
Health- Watson believes that there are other factors
that are needed to be included in the WHO definition
of health. She adds the following three elements-
A high level of overall physical, mental and social
A general adaptative - maintenance level of daily
The absence of illness (or the presence of efforts that
leads its absence).
Environment / society- according to Watson caring
(and nursing) has existed in every society. A caring
attitudes is not transmitted from generation to
generation. It is transmitted by the culture of the
profession as a unique way of coping with its
according to Watson “nursing is concerned with
promoting health, preventing illness, caring for the
sick and restoring health.”
It focuses on health promotion and treatment of
disease. She believes that holistic health care is central
to the practice of caring in nursing.
She defines nursing as- a human science of persons
and human health- illness experiences that are
mediated by professional, personal, scientific, esthetic
and ethical human transaction.
WATSON’S THEORY AND NURSING PROCESS
Watson’s points out that nursing process contains the same steps as the
scientific research process. They both try to solve a problem, both
provide a framework for decision making.
Involves observation, identification and review of the problem, use of
applicable knowledge in literature.
Also includes conceptual knowledge for the formulation and
conceptualization of framework.
Includes the formulation of hypothesis, defining variables that will be
examined in solving the problem.
It helps to determine how variables would be
examined or measured, includes a conceptual
approach or design for problem solving. It determines
what data would be collected and how on whom.
it is the direct action and implementation of the plan. It
involves the collection of data.
Analysis of the data as well as the examination of the
effects of interventions based on the data.
Includes the interpretation of the results, the degree
to which positive outcome has occurred and whether
the result can be generalized.
It may also generate additional hypothesis or may ever
lead to the generation of a nursing theory.
WATSON’S WORK AND THE CHARACTERISTICS OF A
According to Watson’s “a theory is an imaginative
grouping of knowledge, ideas and experiences that are
represented symbolically and seek to illuminate a
The basic assumptions for the science of caring in
nursing and the ten carative factors that form the
structure for that concepts in unique in Watson’s
Watson’s also indicates that needs are interrelated.
The science of caring suggests that the nurse recognize
and assist with each of the interrelated needs in order
to reach the highest order need of self- actualization.
Theories must be logical in nature-
Watson’s work is logical in that the factors are based
on broad assumptions which provide a supportive
With these carative factors she delineates nursing
from other professions.
These carative factors are logically derived from the
assumptions and related to the hierarchy of needs.
Theories should be relatively simple yet
The theory is relatively simple as it does not use
theories from other disciplines that are familiar to
She discusses on the “trim” and the “core” of nursing.
She defines trim as the clinical focus, the procedure
and the techniques.
The core of the nursing is that which is intrinsic to the
nurse-client interaction that produces a therapeutic
result. Core mechanism are the carative factors.
Theories can be the basis for hypothesis
that can be tested-
Watsons theory is based on phenomenological studies
that generally ask questions rather than state
hypothesis. Its purpose is to describe the phenomena
to analyse and to gain an understanding.
According to Watson the best method to test this
theory is through field study.
Theories can be utilized by practitioners to guide
and improve their practice-
Watson’s work can be used to guide and improve
It can provide the nurse with the most satisfying
aspects of practice and can provide the client with the
holistic care so necessary for human growth and
Theories must be consistent with other validated
theories, laws and principles but will leave upon
unanswered questions that need to be investigated.
Besides assisting in providing the quality of care that
client ought to receive, it also provides the soul
satisfying care for which many nurses enter the
As the science of caring ranges from the biophysical
through the intrapersonal, each nurse becomes an
active co-participant in the clients struggle towards
The client is placed in the context of the family, the
community and the culture.
It places the client as the focus of practice rather than
Given the acuity of illness that leads to hospitalization,
the short length stay, such quality of care may be
deemed impossible to give in the hospital.
While Watson acknowledge the need for biophysical
basis to nursing, the area receives little attention in her
The ten carative factors primarily delineate the
psychosocial 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 to practice.
HOW TO INTEGRATE JEAN WATSON’S THEORY OF
CARING INTO NURSING PRACTICE
Establishing a caring relationship with patients.
Treat patients as holistic beings.
Display unconditional acceptance.
Treat patients with positive regard.
Promote health through knowledge and intervention.
Spend uninterrupted time with patient.