JEAN WATSON THEORY OF HUMAN CARING

JEAN WATSON’S
THEORY OF
HUMAN CARING
By: ROMMEL LUIS C. ISRAEL III
By: ROMMEL LUIS C. ISRAEL III 1

The Philosophy
and Science of
Caring
Jean Watson,
PhD, RN, AHN-
BC, FAAN
Using "caring as a
theme", Jean
Watson developed
the "carative
factors" to help
develop the ever
evolving nursing
philosophies and
theories. (Chitty,
308-9) By: ROMMEL LUIS C. ISRAEL III 2

Jean Watson:
Background and
Education
• Born in West Virginia
• Diploma nursing from Lewis-Gale
School of Nursing in 1961
• BSN from University of Colorado in
1964
• MS from University of Colorado in 1966
• PhD from University of Colorado in
1973
• The Philosophy and Science of Caring
first published book in 1979
• Founder, Center for Human Caring,
University of Colorado Health Sciences
Center in 1986

Jean Watson:
Background and
Education
• States “my early work emerged from my own values,
beliefs, and perceptions about personhood, life,
health, and healing”(Tomey & Alligood, 2006, p. 94)
• Influenced by the nursing theorist/philosophers that
came before her like Nightingale, Henderson, and her
own personal beliefs.
• Knowledge development is important value as seen
by her numerous writings and teaching positions.
• Values about nursing are "developing; maintaining
and exemplifying relationship-centered care
practices" (Watson Caring Science Institute, n.d.)

Jean Watson: Concept
“Jean Watson's Philosophy and
Science of Caring addresses how
nurses express care to their patients.
Caring is central to nursing practice,
and promotes health better than a
simple medical cure. She believes
that a holistic approach to health
care is central to the practice of
caring in nursing” (Nursing Theory,
2011).

Global
Concepts
Human Being (Patient and Nurse)
• Is subjective and unique
• Has distinct human needs, which are
biophysical, psychophysical,
psychosocial and interpersonal
• Needs to be valued, respected,
nurtured, understood and assisted
• Is directly influenced by the external
environment
Environment
• Is critical to the holistic healing
(mental, physical, social, emotional,
spiritual, developmental, protective,
supportive environments), which is
conducive to a patient’s health and
wellbeing

Global
Concepts
Health
• Viewed holistically, as the unity between body,
mind, and soul, with all parts working together in
harmony and functioning to their full capacity
• Absence of illness, or the presence of efforts that
leads its absence
Nursing
• Providing caring, professional and thoughtful
interactions to restore and promote holistic health
and to prevent illness
• Based on human values
• Dedicated to the wellbeing of others
• Concerned with the health promotion, health
restoration, and illness prevention (Chitty & Black,
2011, p. 309)

GLOBAL
CONCEPTS

Jean Watson: Theory and
Nursing Process
Watson’s nursing process
parallels the scientific research
process. Both provide a
framework for decision making.
Both involve solving a problem.

Jean
Watson’s
Theory
and
Nursing
Process
1) Assessment
• Involves observation and identification of a
problem
• Includes the formulation of hypothesis
2) Care Plan
• It helps to determine how variables will be
examined and measured
• It helps to determine what data will be
collected and how it will be collected
3) Intervention
• It is the implementation of the care plan
• It includes the collection of the data
4) Evaluation
• Analysis of the data
• Effects of the interventions based on the data
• Includes the interpretation of the results
• It may also generate additional hypothesis

Interpretation & Inference
•Caring can be effectively demonstrated and
practiced only interpersonally.
•Caring consists of carative factors that result
in the satisfaction of certain human needs.
•Effective caring promotes health and
individual or family growth.
•Caring responses accept person not only as
he or she is now but as what he or she may
become.

Interpretation & Inference
• 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.
• Caring is more “healthogenic” than is curing. A science of caring is
complementary to the science of curing.
• The practice of caring is central to nursing.
(Nursing Theories: A Companion to Nursing Theories and Models,
2012).
• Jean Watson’s theory was founded on the humanistic aspects of
nursing in combination with scientific knowledge. Her concept
shows a caring, nurturing relationship between the nurse and
patient.

Implications &
Consequences
•A more holilstic care
approach.
•Better nurse patient
relationship.
•Patient feeling more
empowered in the
decision making
process.

Evaluation
of The
Philosophy
and
Science of
Caring
Jean Watson’s The Philosophy of
science and caring Provides a
model unique to nursing with
concepts that can be applied
within many facets of our world.
Influenced by her desire to return
the human to human interaction
to nursing, Watson related her
philosophy to the four global
concepts. This philosophy can be
applied within any discipline of
nursing by promoting healing not
through focus on the curative
factors but instead the mind,
body and soul of the patient.

Evaluation of “The Philosophy and
Science of Caring”: Origins
• Is The Philosophy and Science of Caring unique to Nursing?
• My focus has been on nursing in relation to its covenant to offer
compassionate human service to sustain and preserve human dignity
and humanity; to sustain caring in instances where it is threatened,
biologically or otherwise; a concern with deep caring-healing
relationships with humans who are experiencing suffering, loss, grief,
death, change/ transition with life threats and challenges, and
seeking meaning to be in right-relation, harmony with self and other,
and that which is greater than human. Thus, my focus on caring, and
caring- healing relationships, emerges from within the discipline of
nursing and the practice of professional nursing; but paradoxically
transcends nursing. (Clarke, 2009).

Evaluation of “The Philosophy and Science
of Caring”: Origins
• What Influenced The Philosophy and Science of Caring?
• Jean Watson, “found herself frustrated by the almost complete lack of
conceptual, intellectual or philosophical focus on the human aspect of
patient care.” (Petrovski, 2012).
• Watson's education in the early 1960s stressed what she refers to as
"curing” techniques and procedures related to a specific disease and its
treatment within medical science framework. (Petrovski, 2012).
• “Called for a return to the earlier values of nursing and emphasized the
caring aspects of nursing.” (Chitty, 2010).
• "No one was giving voice to the human experience," says Dr. Watson. "I
was longing for intellectual theories or values or a conceptual
framework of what was happening with patient care and the human-to-
human relationships." (Petrovski, 2012).

Evaluation
of The
Philosophy
and Science
of Caring:
Global
Concepts
The Philosophy and
Science of Caring
addresses the Person
• Both the patient and the Nurse
(Chitty, 2010).
• “Dr. Watson has labored to
transform nursing into a holistic
caring-healing professional practice,
grounded in the philosophy, ethic
and science of caring, that addresses
not just the body but the unity of
mind-body-spirit.”(Petrovski, 2012).
• Watson also focused on this
reciprocity of the relationship, which
she indicated addresses the
importance of the nurse’s own
caretaking. (Lachman, 2012).

Evaluation of
The
Philosophy
and Science
of Caring:
Global
Concepts
The Philosophy and
Science of Caring
addresses the
Environment
• One that supports human
caring (Chitty, 2010).
• The nurse guided by
Watson’s work has
responsibility for creating and
maintaining an environment
supporting human caring.
(Chitty, 2010).

Evaluation
of The
Philosophy
and Science
of Caring:
Global
Concepts
The Philosophy and
Science of Caring
addresses Health
• In terms of health promotion and
illness prevention. (Chitty, 2010).
• Illness and disease was equated
with lack of harmony within the
mind, body and soul experienced
in internal and external
environments. (Chitty, 2010).
• Nursing is concerned with health
promotion, health restoration, and
illness prevention. (Chitty, 2010).
• Watson defines the person’s
health as a subjective experience.

Evaluation
of The
Philosophy
and
Science of
Caring:
Global
Concepts
The Philosophy and
Science of Caring
addresses Nursing
• What nurses contributed to the encounter
with the patient. (Chitty, 2010).
• Watson views nursing as both a science and
an art. according to Watson, being an artist
is part of our role and certainly part of
caring for patients and their families. (Cara,
n.d.).
• Caritas honors the dignity of self and other
and wholeness of being, which empowers
nurses-and thereby their patients-through
the quality of their caring-healing
relationships and interactions. (Petrovski,
2012).
• Emphasized how the nurse and the patient
change together through transpersonal
caring. (Chitty, 2010).

Other theories
generated from
The Philosophy
and Science of
Caring
• Jean Watson has researched and
published the utilization of her theory
multiple times
• Following publication of her 1979
work, Watson’s caring theory
evolved from basic thinking to one of
greater awareness of divine and
holistic interpersonal relationships
• In 1985, she proposed eleven
assumptions to explain the
relationship between nursing,
human values, and caring for others
• In 1999, Postmodern Nursing and
Beyond, Watson describes an
ontological shift in human
consciousness by suggesting practice
paths for practitioners
• Jean Watson’s Theory of Caring,
among others has been used in
research towards an empirical
development of a middle range theory
of caring.
(Swanson, 1991).

Evaluation of
“The
Philosophy
and Science
of Caring”:
Practice
Situations
• Kaiser Permanente Northern California is
systematically integrating caring science
and theory-based practices in all of the 21
Northern California Kaiser facilities. Others,
such as Baptist Health in Jacksonville and
Miami, Fla., Children's Hospital Colorado,
the Michael F. DeBakey Veterans Hospital in
Houston, and Atlanta Veteran's Hospital, are
engaged in new forms of evidence-based
caring science knowledge. In these systems,
nurses are becoming scholar clinicians,
implementing new professional Caring
Science models system wide, as well as
exploring new empirical connections
between human caring and patient
outcomes. (Petrovski, 2012).
• The frequency and number of Magnet
hospital’s use of caring theory as one core
Magnet criterion, is evidence and testimony
of caring theory and its impact on nursing
over time. (Clarke, 2012).

Evaluation of “The Philosophy and Science of Caring”: Practice Situations

Evaluation of
“The
Philosophy
and Science
of Caring”:
Practice
Situations
Questions to use in practice that can help assess
the person
• Tell me about your spiritual and cultural beliefs?
• Tell me about your goals and expectations?
Questions to help the nurse reflect upon his/her
caring practice
• How do I express my caring consciousness and
commitment to the persons and their families?
To working colleagues? To other health care
professionals? To my superiors? To the
institution?
• How do I define the person, environment,
health/healing, and nursing?
Questions to use in practice that can help assess
the patient’s perspective about health
• Tell me how you perceive yourself in this
situation?
• What meaning are you giving to this situation?
• Tell me about your health priorities?
(Cara, n.d.)

Ten
Caritas
Processes
(Watson Caring
Science Institute,
2013).
1. Embrace altruistic values and Practice
loving kindness with self and others.
2. Instill faith and hope and honor others.
3. Be sensitive to self and others by nurturing
individual beliefs and practices.
4. Develop helping – trusting- caring
relationships.
5. Promote and accept positive and negative
feelings as you authentically listen to
another’s story.
6. Use creative scientific problem-solving
methods for caring decision making.
7. Share teaching and learning that addresses
the individual needs and comprehension
styles.
8. Create a healing environment for the
physical and spiritual self which respects
human dignity.
9. Assist with basic physical, emotional, and
spiritual human needs.
10. Open to mystery and Allow miracles to
enter.
By using Watson’s 10 Carative
Factors, the nurse is enabled to
“share their genuine selves with
patients” (Chitty, 2011, p. 309).
Beyond the tasks of nursing care,
the patient necessitates a holistic
model to reach wellness or even a
peaceful passing.

Watson’s Theory and The Nursing Process
he nursing process in Watson’s theory includes the same steps as the scientific
research process: assessment, plan, intervention, and evaluation.
The assessment includes observation, identification, and review of the problem
and the formation of a hypothesis.
Creating a care plan helps the nurse determine how variables would be
examined or measured and what data would be collected.
Intervention is the implementation of the care plan and data collection.
Finally, the evaluation analyzes the data, interprets the results, and may lead to
an additional hypothesis.

Strengths
Although some consider Watson’s theory complex, many find it easy to understand. The model can guide
and improve practice as it can equip healthcare providers with the most satisfying aspects of practice and
provide the client with holistic care.
Watson considered using nontechnical, sophisticated, fluid, and evolutionary language to artfully describe
her concepts, such as caring-love, carative factors, and Caritas. Paradoxically, abstract and simple concepts
such as caring-love are difficult to practice, yet practicing and experiencing them leads to greater
understanding.
Also, the theory is logical in that the carative factors are based on broad assumptions that provide a
supportive framework. The carative factors are logically derived from the assumptions and related to the
hierarchy of needs.
Watson’s theory is best understood as a moral and philosophical basis for nursing. The scope of the
framework encompasses broad aspects of health-illness phenomena. Also, the theory addresses aspects of
health promotion, preventing illness, and experiencing peaceful death, thereby increasing its generality. The
carative factors provide guidelines for nurse-patient interactions, an important aspect of patient care.

Weakness
By:
ROMMEL
LUIS
C.
ISRAEL
III
• The theory does not furnish explicit direction
about what to do to achieve authentic caring-
healing relationships.
• Nurses who want concrete guidelines may not
feel secure when trying to use this theory alone.
• Some have suggested that it takes too much
time to incorporate the Caritas into practice,
and some note that Watson’s personal growth
emphasis is a quality “that while appealing to
some may not appeal to others.”
31

Conclusion
Jean Watson
“emphasized the caring
aspects of nursing”
(Chitty, 2011, p. 308).
Watson’s philosophy
focused on the “human-
to-human relationship”
(Chitty, 2011, p. 308).

Conclusion:
continued
•The caring model encompasses
nursing’s metaparadigm:
environment, person, health, &
nursing.
•Allowing the self to be open to
giving and receiving care on a
level beyond just meeting
physical needs opens the nurse:
patient relationship to greater
healing, understanding and
overall care.
•RNs that follow this philosophy
create and maintain a
supportive environment that
embraces human caring while
continuing to meet the patients’
primary human requirements.
(Chitty, 2011, p. 309)

Case Study
Dean Smith is a 48 year old male with ALS (Amyotrophic lateral sclerosis)
which has left him unable to care for himself. Dean was a teacher prior to leaving
for medical disability. He is a widower with two adult children who do not live in
the area and are not close with their Dad. His support network is a former
student, John, who assists him with household chores and a neighbor, Beth, who
manages his medications and takes him to appointments. He presented to the
Emergency Department with increased respiratory effort, fever, and new onset
inability to maintain oral secretions. Beth states that he is also having a hard time
responding to her and she and her husband are concerned to leave him alone.
Admission is arranged for probable pneumonia and likely placement in a
skilled nursing facility. Report is given from the ED to the Medical Surgical team
and Dean is admitted. During admission, Sally, the RN doing his intake notices that
Dean is trying to answer her questions but cannot. He is tearful, making fists and
groaning. Sally asks the CNA assisting them to please give them a minute and
closes the computer. She pulls a chair next to his bed, sits and holds his hand. She
asks if he would like her to tell him a little about herself. He squeezes her hand
and attempts to nod. Sally proceeds to tell Dean about her family, her dog, her
career path and their church. Dean eventually relaxes and falls asleep.

Case
Study:
continued
1. Do Sally’s actions follow the
Watson’s Carative Factors?
2. Looking at Factor 5: “the
promotion and acceptance of
the expression of positive and
negative feelings”, does Sally
sharing with Dean allow him
to do this?
3. What are two ways that Sally
followed Watson’s
philosophy?
4. Would you have done this
differently? How so?

References
Cara, C. (n.d.). A Pragmatic View of Jean Watson’s Caring Theory. Université de Montréal Faculty of Nursing. Retrieved from
http://www.humancaring.org/conted/Pragmatic%20View.pdf
Clarke, P.N., Watson, J., Brewer, B.B. (2009). From theory to practice : caring science according to Watson and Brewer. Nursing Science Quarterly. 22(4). 339-345.
doi: 10.1177/0894318409344769
Chitty, K. K., & Black, B. P. (2011). Professional nursing: Concepts and challenges (6th ed.) Maryland Heights, MO: Saunders Elsevier
Jean Watson’s Theory of Caring. (n.d.). Metaparadigm. Retrieved from
http://upoun207grouph.blogspot.ca/p/metaparadigm-of-concepts.html
Lachman, V.D. 2012Applying the Ethics of Care to Your Nursing Practice. MedSurg Nursing. 21(2). 112-116 Retrieved from
http://nursingworld.org/MainMenuCategories/EthicsStandards/ Resources/Applying-the-Ethics-of-Care-to-Your-Nursing-Practice.pdf
Nursing Theories: A Companion to Nursing Theories and Models. (2012). Jean Watson’s philosophy of nursing. Retrieved from
http://www.currentnursing.com/nursing_theory/Watson.html
Nursing Theory. (2011). Jean Watson's contribution to nursing theory: Philosophy and science of caring. Retrieved from http://nursing-
theory.org/nursing-theorists/Jean-Watson.php

References
Petrovski, L. (2012). All you need is love (and human caring): transforming health care on nurse, hospital at a time.
Colorado Nurse. May/June/July, 15. Retrieved from CINHL database.
Swanson, K.M. (1991). Empirical development of a middle range theory of caring. Nursing Research, 40(3), 161-166. Retrieved
from CINHL database.
Tomey, A. M., & Alligood, M. R. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby Elsevier.
Watson Caring Science Institute. (n.d.). Retrieved from http://watsoncaringscience.org/
Watson Caring Science Institute. (2013). Million Nurse Project. Retrieved from
http://watsoncaringscience.org/education-programs/million-nurse-project/.
Watson Caring Science Institute. (2013). Ten Caritas Processes. Retrieved from http://watsoncaringscience.org/about-
us/caring-science-definitions-processes-theory/.
Gonzalo, A. (2023, January 12). Jean Watson’s Theory of Human Caring . Nurseslabs. https://nurseslabs.com/jean-watsons-
philosophy-theory-transpersonal-caring/

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