Jean Watson: Theory of Human Caring

Alcular, Alesna, Algabre

History and Background

Margaret Jean Watson was born on June 10, 1940 and grew up in Welch, West
Virginia. She is an American nurse theorist and nursing professor who is best
known for her theory of human caring. She developed “Philosophy and Theory
of Transpersonal Caring” or “Caring Science” and is also the founder of Watson
Caring Science Institute.
Jean Watson ardently and quickly progressed through her nursing education,
earning her bachelor’s degree in nursing in 1964, a master of science in
psychiatric and mental health nursing in 1966, and a Ph.D. in educational
psychology and counseling in 1973, all from the University of Colorado.
After Jean Watson concluded her doctoral degree, she has served in both
faculty and administrative positions in the School of Nursing faculty, University of Colorado Health Sciences
Center in Denver. She is the founder of the original Center for Human Caring in Colorado and is a Fellow of the
American Academy of Nursing. She previously served as Dean of Nursing at the University Health Sciences
Center and is a Past President of the National League for Nursing.
The foundation of Jean Watson’s theory of nursing was published in 1979: “Nursing: The Philosophy and Science
of Caring. While in 1988, her theory was published in “Nursing: Human Science and Human Care”. Her study on
caring has been integrated into education and patient care to various nursing schools and healthcare facilities
worldwide.
Watson believes that the main focus in nursing is on carative factors. Believing that for nurses to develop
humanistic philosophies and value system, a strong liberal arts background is necessary.

Philosophy and Theory of Transpersonal Caring

Watson’s Philosophy and Science of Caring is concerned with how nurses express care to their patients. Her
theory stresses the humanistic aspects of nursing as they intertwine with scientific knowledge and nursing
practice.
The nursing model states that “nursing is concerned with promoting health, preventing illness, caring for the sick,
and restoring health.” It focuses on health promotion, as well as the treatment of diseases. According to Watson,
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.
According to her theory, caring can be demonstrated and practiced by nurses. Caring for patients promotes
growth; a caring environment accepts a person as they are and looks to what they may become.
Watson also defined three of the four metaparadigm concepts in nursing, including the person or human being,
health, and nursing. She referred to the human beings as a valued person in and of themselves to be cared for,
respected, nurtured, understood, and assisted; in general, a person’s philosophical view as a fully functional
integrated self. A human is viewed as greater than and different from the sum of his or her parts. Meanwhile,
health is defined as a high level of overall physical, mental, and social functioning, a general adaptive-
maintenance level of daily functioning, the absence of illness, or the presence of efforts leading to the absence
of illness. And nursing is a science of persons and health-illness experience mediated by professional, personal,
scientific, and ethical care interactions.

She does not define the fourth metaparadigm concept of the environment but instead devised 10 caring needs
specific carative factors critical to the caring human experience that need to be addressed by nurses with their
patients when in a caring role.
Theory of Human Caring Metaparadigm

The Philosophy and Science of Caring have four major concepts: human being, health, environment or society,
and nursing.

Human being
Human being is a valued person to be cared for, respected, nurtured, understood, and assisted; in general, a
philosophical view of a person as a fully functional integrated self. A human is viewed as greater than and
different from the sum of his or her parts.

Health
Health is the unity and harmony within the mind, body, and soul; health is associated with the degree of
congruence between the self and the self as experienced. It is defined as a high level of overall physical, mental,
and social functioning; a general adaptive-maintenance level of daily functioning; and the absence of illness, or
the presence of efforts leading to the absence of illness

Nursing
Nursing is a human science of persons and human health-illness experiences mediated by professional,
personal, scientific, esthetic, and ethical human care transactions.

Environment
The society provides the values that determine how one should behave and what goals one should strive toward.
Watson states:

“Caring (and nursing) has existed in every society. Every society has had some people who have cared for
others. A caring attitude is not transmitted from generation to generation by genes. The culture of the profession
transmits it as a unique way of coping with its environment.”

10 Carative Factors
Watson’s 10 carative factors are:
1) forming humanistic-altruistic value systems,
2) instilling faith-hope,
3) cultivating a sensitivity to self and others,
4) developing a helping-trust relationship,
5) promoting an expression of feelings,
6) using problem-solving for decision-making,
7) promoting teaching-learning,
8) promoting a supportive environment,
9) assisting with the gratification of human needs, and
10) allowing for existential-phenomenological forces. The first three factors form the “philosophical
foundation” for the science of caring, and the remaining seven come from that foundation.
10 Carative Factors
Watson devised 10 caring needs specific carative factors critical to the caring human experience that need to be
addressed by nurses with their patients when in a caring role. As carative factors evolved within an expanding
perspective, and as her ideas and values evolved, Watson offered a translation of the original carative factors
into clinical caritas processes that suggested open ways in which they could be considered.

The first three carative factors are the “philosophical foundation” for the science of caring, while the remaining
seven derive from that foundation. The ten primary carative factors with their corresponding translation into
clinical caritas processes are listed below.

Carative Factors Caritas Process

1. “The formation of a humanistic-altruistic system of “Practice of loving-kindness and equanimity within the
values.” context of caring consciousness.”
“Being authentically present and enabling and
2. “The instillation of faith-hope.” sustaining the deep belief system and subjective life-
world of self and one being cared for.”
3. “The cultivation of sensitivity to one’s self and “Cultivation of one’s own spiritual practices and
others.” transpersonal self-going beyond the ego-self.”
4. “Development of a helping-trust relationship”
“Developing and sustaining a helping trusting,
became “development of a helping-trusting, human
authentic caring relationship.”
caring relation” (in 2004 Watson website)
“Being present to, and supportive of, the expression
5. “The promotion and acceptance of the expression
of positive and negative feelings as a connection with
of positive and negative feelings.”
deeper spirit and self and the one-being-cared for.”
6. “The systematic use of the scientific problem-
“Creative use of self and all ways of knowing as part
solving method for decision making” became
of the caring process; to engage in the artistry of
“systematic use of a creative problem-solving caring
caring-healing practices.”
process” (in 2004 Watson website)
“Engaging in genuine teaching-learning experience
7. “The promotion of transpersonal teaching-
that attends to the unity of being and meaning,
learning.”
attempting to stay within others’ frame of reference.”
“Creating healing environment at all levels (physical
8. “The provision of the supportive, protective, and (or)
as well as the nonphysical, subtle environment of
corrective mental, physical, societal, and spiritual
energy and consciousness, whereby wholeness,
environment.”
beauty, comfort, dignity, and peace are potentiated)”
“Assisting with basic needs, with an intentional caring
consciousness, administering ‘human care
9. “The assistance with the gratification of human
essentials,’ which potentiate alignment of mind-body-
needs.”
spirit, wholeness, and unity of being in all aspects of
care.”
10. “The allowance for existential-phenomenological
“Opening and attending to spiritual-mysterious and
forces” became “allowance for existential-
existential dimensions of one’s own life-death; soul
phenomenological spiritual forces” (in 2004 Watson
care for self and the one-being-cared for”
website)
Transparent Caring Relationships

❑ Moral commitment to protect and enhance human dignity.

❑ Caring consciousness of self as person/nurse and others.
❑ Caring based on practicing and honoring wholeness and mind, body and spirit in self and each
other.
❑ Inner harmony and authentic presence to truly be connected.

Caring Moments

❑ Authentic – Intentional connection

❑ Sharing meaningful human experiences
❑ Honoring the patient
❑ Human spirit leading to new discoveries
❑ Keeping all interactions heart-centered

Theory of Human Caring of Jean Watson

Nowadays, a lot of people choose nursing as a profession. There are many reasons to consider becoming a
professional nurse, but compassion is often a trait required of nurses. This is for the reason that taking care of
the patients’ needs is its primary purpose. Jean Watson’s “Philosophy and Theory of Transpersonal
Caring” mainly concerns how nurses care for their patients and how that caring progresses into better plans to
promote health and wellness, prevent illness and restore health.

In today’s world, nursing seems to be responding to the various demands of the machinery with less
consideration of the needs of the person attached to the machine. In Watson’s view, the disease might be cured,
but illness would remain because, without caring, health is not attained. Caring is the essence of nursing and
connotes responsiveness between the nurse and the person; the nurse co-participates with the person. Watson
contends that caring can help the person gain control, become knowledgeable, and promote healthy changes.

Watson’s Hierarchy of Needs

With the gratification of human needs, Watson’s hierarchy of needs begins with lower-order biophysical needs
or survival needs, the lower-order psychophysical needs or functional needs, the higher-order psychosocial
needs or integrative needs, and finally, the higher-order intrapersonal-interpersonal need or growth-seeking
need. Watson’s Hierarchy of Needs

Lower Order Biophysical Needs or Survival Needs

Watson’s hierarchy of needs begins with lower-order biophysical needs or survival needs. These include the
need for food and fluid, elimination, and ventilation.

Lower Order Psychophysical Needs or Functional Needs

Next in line are the lower-order psychophysical needs or functional needs. These include the need for activity,
inactivity, and sexuality.

Higher-Order Psychosocial Needs or Integrative Needs

The higher-order psychosocial needs or integrative needs include the need for achievement and affiliation.

Higher-Order Intrapersonal-Interpersonal Need or Growth-seeking Need

The higher-order intrapersonal-interpersonal need or growth-seeking need is the need for self-actualization.
Watson’s Theory and The Nursing Process

The 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.

The Goal of Watson’s Theory of Human Caring

The theory of caring moves past scientific practice of nursing to create an authentic relationship
framework. By providing caring science with scientific care, human spirit and inner healing occur. In
addition, implementing this model of human caring principles, nurses discover a more meaningful
practice to make a more rewarding career and profession.

✓ To present the idea that compassion is part of the soul, and positive actions will stem from
humanistic-altruistic values.
✓ Nurses should be authentically present in care for others.
✓ Developing a helping-trusting relationship promotes support to embark on healing processes
within mind-body-spirit wholeness.

References:

Alligood, M. R. (2018). Nursing Theorists and their works (pp. 66–79). Elsevier.

https://arakmu.ac.ir/file/download/news/1581932519-nursing-theorists-and-their-work-e-

book.pdf?fbclid=IwAR02bVNc-Blsp2NhhN1JbkSHJa3kf3uVjqdbkICR7TOzy8wkQ5rc6vLQKfM

Watson, J. (1979). Nursing: The philosophy and science of caring. Boston: Little, Brown.

Watson, J. (1996). Watson’s theory of transpersonal caring. In P. J. Walker & B. Neuman (Eds.),

Blueprint for use of nursing models: Education, research, practice and administration (pp. 141–

184). New York: National League for Nursing Press