Watson’s Philosophy

& Theory
of Transpersonal
Caring

Adopted by
Ibrahim Ayasreh

Supervised by
Prof. Lubna Abu-Shaikha
 Objectives

 By the end of this presentation , participants will be able to :

- Identify the theorist credentials and theoretical sources.

- Analyze the major concepts and definitions for the Watson’s theory.
- Discuss the major assumptions of Watson’s theory.
- Discuss the theoretical assertions of the theory.
- Discuss how Watson’s theory can be applied to practice, education
and research.
- Critique the theory of unitary of human being
 Outline

 Credentials and Background of the Theorist.

 Theoretical resources.
 Major concepts of the Watson philosophy.
 Major assumptions of Watson philosophy.
 Theoretical assertion regarding metaparadigms.
 Application by the Nursing Community.
 Critique.
Credentials and Background of the Theorist

 Margaret Jean Harman Watson, PhD, RN, AHN-BC, FAAN.

 Grew up in West Virginia.

 1961 : married to Douglas, Moved to Colorado.

 She has two grown daughters, Jennifer and Julie, and five grandchildren.
Credentials and Background of the Theorist
(Degrees Earned)

 1969-73 : Ph.D. Educational Psychology and Counseling

University of Colorado, Boulder, CO

 1969-70 : Graduate study: Social and Clinical psychology

University of Colorado, Boulder, CO Graduate School

 1964-66 : M.S. psychiatric mental-health nursing; Minor: psychology

University of Colorado Medical Center, Denver, CO

 1962-64 : B.S. nursing University of Colorado, Boulder, CO

 1958-61 : R.N. Diploma in nursing Lewis-Gale School of Nursing, Roanoke, VA

Credentials and Background of the Theorist
(Employment Record)

 1973-75 : Assistant Professor, University of Colorado, School of Nursing, Denver, CO

 1974-90: Associate Professor, University of Colorado, School of Education, Boulder, CO

 1979-81 : Professor and Director of Doctoral Program, University of Colorado, School of

 Nursing, Denver, CO

 1984-90 : Dean and Professor, University of Colorado, School of Nursing, Denver, CO

 1986-97 : Founder and Director, Center for Human Caring, University of Colorado Health
Sciences Center, Denver, CO

 1992-present : Distinguished Professor, Nursing, University of Colorado

Credentials and Background of the Theorist

 Recipient of 15 Honorary Doctorates – 12 International.

 Jean Watson has authored 11 books, shared in authorship of six books, and has
written countless articles in nursing journals.
 Credentials and Background of the Theorist

2010 – Current: Founder/Director Watson caring Science Institute

 WCSI is an international non-profit organization created to advance the philosophies, theories and practices
of Human Caring, originated by Jean Watson.

 WSCI is dedicated to help the current health care system retain its most precious resource – competent,
caring professional nurses – while preparing a new generation of health professionals in a broader model of
Caring Science.

 WSCI will help to ensure caring and healing for the public, reduce nurse turnover, and decrease costs to the
system.
Watson’s Work
 Theoretical Sources

 Watson (1988) defines theory as “an imaginative grouping of

knowledge, ideas, and experience that are represented symbolically
and seek to illuminate a given phenomenon”.

 Watson acknowledges a phenomenological, existential, and spiritual

orientation from the sciences and humanities as well as assumptions of
feminist theory, metaphysics, phenomenology, quantum physics,
wisdom traditions, perennial philosophy, and Buddhism.
 Theoretical Sources

Nightingale Concept of environment

Carl Roger Nurses understand not manipulate others

Levinas & Løgstrup ’Ethics of face

 Main Concepts

 Transpersonal healing and transpersonal caring relationship.

 Caring moment/ caring occasion.

 Caring consciousness.

 The 10 carative factors.

 Describes how the
Transpersonal Transpersonal nurse goes beyond
caring seeks to the objective
Caring Relationship
connect with and assessment to show
embrace the spirit of concern toward
the other through the subjective/deeper
processes of caring meaning
 Caring Moment / Occasion

 It is a heart-centered encounters between two people, each with their

own “phenomenal field”/background come together in a human-to-
human transaction.

Moral
Intentional Honoring Authentic
commitment

Self- Awareness & Self-Discovery

 Carative Factors and Caritas Processes

 Watson offered a translation of the original carative factors into

clinical caritas processes that suggested open ways in which they
could be considered.

 The carative factors differ from the caritas process in their spiritual
dimension and evocation of love and caring (Watson, 2015).
 Caritas in contemporary nursing literature

 Introduced to recent nursing literature in 1989 by Katie Eriksson.

 Eriksson (1990) argues that caritas "caring which is based on human

love“.

 In 2006, Jean Watson adopted caritas in her theory of human caring as

she developed caritas processes which involves charity, compassion and
generosity of spirit.
 Carative Factors and Caritas Processes

1) Formation of a Humanistic Altruistic System of Values:

Definition Satisfaction through giving and extension of the sense of

self.

Caritas processes Practice of loving-kindness and equanimity within the

context’of’caring’consciousness”
Carative Factors and Caritas Processes

1) Formation of a Humanistic Altruistic System of Values:

- How to practice:
* Validates uniqueness of self and others.
* Recognizes vulnerabilities in self and others.
* Treats self and others with loving kindness.
* Accepts self and others as they are.
* Respect and pays attention to others.
 Carative Factors and Caritas Processes

2) The instillation of faith-hope:

Definition It’describes’the’nurse’s’role’in’developing’effective’
nurse-patient interrelationships and in promoting
wellness by helping the patient adopt health-seeking
behaviors

Caritas processes “Being’authentically’present’and’enabling’and’sustaining’

the deep belief system and subjective life-world of self
and’one’being’cared’for”
 Carative Factors and Caritas Processes

2) The instillation of faith-hope:

- How to practice:
* Creates opportunity for silence/reflection/pause
* Views life as a mystery to be explored rather than a problem to be solved.
* Helps others to believe in themselves.
* Supports others’’sense of hope.
* Encourages others in their ability to go on with life.
 Carative Factors and Caritas Processes

3) The cultivation of sensitivity to one’s self and to others:

Definition The recognition of feelings leads to self actualization

through self-acceptance for both the nurse and patient

Caritas processes “Cultivation’of’one’s’own’spiritual’practices’and’

transpersonal’self’going’beyond’the’ego’self”
 Carative Factors and Caritas Processes

3) The cultivation of sensitivity to one’s self and to others:

- How to practice:
* Transforms “tasks”’into healing interactions.
* Practices discernment in evaluating circumstances and situations vs. being
judgmental.
* Accepts self and others on a basic spiritual level as unique and worthy of
our respect and caring.
 Carative Factors and Caritas Processes

4) Development of a helping-trusting, human caring relation:

Definition Trusting relationship promotes and accepts the expression

of both positive and negative feelings. It involves
congruence, empathy, and effective communication.
Caritas processes “Developing’and’sustaining’a’helping’trusting’authentic’
caring’relationship”
 Carative Factors and Caritas Processes

4) Development of a helping-trusting, human caring relation:

- How to practice:
* Brings full honest, genuine self to relationship.
* Demonstrates awareness of own and other’s style of communications.
* Practices non-judgmental attitudes.
* Do not engage in rumors, Does not engage in gossips.
 Carative Factors and Caritas Processes

5) The promotion and acceptance of the expression of positive and

negative feelings:
Definition The sharing of feelings is a risk-taking experience for
both nurse and patient. The nurse must be prepared for
either positive or negative feelings
Caritas processes Being present to, and supportive of, the expression of
positive and negative feelings as a connection with deeper
spirit and self and the one-being-cared for
 Carative Factors and Caritas Processes

5) The promotion and acceptance of the expression of positive and

negative feelings:
- How to practice:
* Allows for uncertainty and the unknown.
* Encourages narrative/storytelling as a way to express understanding.
* Actively listens and lets the energy flow through one’s self without being
consumed by other’s feelings.
 Carative Factors and Caritas Processes

6) systematic use of a creative problem solving caring process:

Definition Use of the nursing process brings a scientific problem-

solving approach to nursing care.

Caritas processes “Creative’use’of’self’and’all’ways’of’knowing’as’part’of’

the caring process; to engage in the artistry of caring-
healing’practices”
 Carative Factors and Caritas Processes

6) systematic use of a creative problem solving caring process:

- How to practice:
* Integrates aesthetics, ethical, empirical, personal ways of knowing with
creative, imaginative, and critical thinking for full expression of caring.
* Helps others explore alternative ways, to find new meaning in their
situations.
 Carative Factors and Caritas Processes

7) The promotion of transpersonal teaching-learning:

Definition It separates caring from curing. It allows the patient to be

informed and shifts the responsibility for wellness and
health to the patient.
Caritas processes “Engaging’in’genuine’teaching-learning experience that
attends to unity of being and meaning, attempting to stay
within’others’’frame’of’reference”
 Carative Factors and Caritas Processes

7) The promotion of transpersonal teaching-learning:

- How to practice:
* Seeks first to learn from others, understand their worldview; then shares,
coaches, and provides information, tools, and options to meet others’’needs.
* Helps others formulate and give voice to questions and concerns to ask
health care professionals.
 Carative Factors and Caritas Processes

8) The provision of supportive, protective, and (or) corrective mental,

physical, societal, and spiritual environment:
Definition Nurses must recognize the influence that internal and
external environments have on the health and illness of
individuals.
Caritas processes “Creating’healing’environment’at’all’levels’(physical’as’
well as nonphysical, subtle environment of energy and
consciousness, whereby wholeness, beauty, comfort,
dignity,’and’peace’are’potentiated)”
 Carative Factors and Caritas Processes

8) The provision of supportive, protective, and (or) corrective mental,

physical, societal, and spiritual environment:
- How to practice:
* Creates a healing environment.
* Creates space for human connections to naturally occur.
* Pays attention to others’’routines and rituals.
 Carative Factors and Caritas Processes

9) The assistance with gratification of human needs:

Definition The nurse recognizes the biophysical, psychophysical,

psychosocial, and intrapersonal needs of self and patient.

Caritas processes “Assisting’with’basic’needs,’with’an’intentional’caring’

consciousness,’administering’‘human’care’essentials,’’
which potentiate alignment of mind body spirit,
wholeness, and unity of being in all aspects of care
 Carative Factors and Caritas Processes

9) The assistance with gratification of human needs:

- How to practice:
* Respects others’’unique individual needs.
* Makes others as comfortable as possible.
* Respects others’’need for privacy.
* Involves family/significant others.
 Carative Factors and Caritas Processes

10) Allowance for existential-phenomenological-spiritual forces:

Definition It is included to provide a thought-provoking experience,

leading to a better understanding of the self and others.

Caritas processes “Opening’and’attending’to’spiritual-mysterious and

existential’dimensions’of’one’s’own’life-death; soul care
for self and the one-being-cared’for”
 Carative Factors and Caritas Processes

10) Allowance for existential-phenomenological- spiritual forces:

- How to practice:
* Allows for the unknown to unfold.
* Surrenders control and anticipates miracles.
* Acknowledges one’s own and others’’inner feelings.
* Shows respect for those things that have meaning to others.
* Accepts that some life happenings are inexplicable.
 Major Assumptions

 Moral commitment, intentionality, and caritas consciousness by the

nurse protect, enhance, and potentiate human dignity, wholeness, and
healing.

 The conscious will of the nurse affirms the subjective and spiritual
significance of the patient while seeking to sustain caring in the midst
of threat and despair.
 Major Assumptions

 The nurse seeks to recognize, accurately detect, and connect with

the inner condition of spirit of another through genuine presence
and by being centered in the caring moment; actions, words.

 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 scientific, technical, aesthetic, and human
means of communication
 Major Assumptions

 The caring-healing modalities within the context of

transpersonal caring/caritas consciousness potentiate harmony
by releasing some of the disharmony, that is, the blocked
energy that interferes with natural healing processes.

 Ongoing personal and professional development and spiritual

growth, as well as personal spiritual practice, assist the nurse
in entering into this deeper level of professional healing
practice.
 Major Assumptions

 The nurse’s own life history, previous experiences, having

lived through or experienced various human conditions, and
having imagined others’’feelings in various circumstances are
valuable teachers for this work.

 Continuous growth for developing and maturing within a

transpersonal caring model is ongoing.
 Theoretical Assertions

 Nursing:

- To’Watson’(1988),’nursing’consists’of’“knowledge,’thought,’values,’
philosophy,’commitment,’and’action,’with’some’degree’of’passion”

- Watson (2012) sees nursing as a science, art, and moral ideal.

- Nurses are interested in understanding health, illness, and the human

experience; promoting and restoring health; and preventing illness.
 Theoretical Assertions

 Personhood (Human Being):

- Watson uses interchangeably the terms human being, person, life,

personhood, and self.

- She views the person as “a unity of mind/body/spirit/nature”

 Theoretical Assertions

 Health:

- She’defined’health’as’“unity’and’harmony’within’the’mind,’body,’and’soul”.

- Three elements must be included: (1) a high level of overall physical,

mental, and social functioning; (2) a general adaptive-maintenance level of
daily functioning; (3) the absence of illness.

- Illness is not necessarily disease; [instead it is a] subjective turmoil or

disharmony’within’a’person’s’inner’self’or’soul’at’some’level’of’disharmony’
within the spheres of the person.
 Theoretical Assertions

 Environment:

 Watson did not explicitly define environment, but it was specifically used in
the 10 carative factors
 Emphasized on supportive, protective, and or corrective mental, physical,
societal, and spiritual environments.

 She emphasized on that “healing spaces can be used to help others

transcend illness, pain, and suffering,”.
 Application by the Nursing Community
(Practice)

 Watson’s’theory’can’be’applied’to’various’populations’and’to’different’clinical’
settings. (Pajnkihar, et al, 2017)

 See Articles:
Bayuo, J. (2017). Case Study in Caring Application of Watson’s Theory of Human
Caring to End of Life Care in the Burns Intensive Care Unit: A Case Report.
International Journal of Human Caring, 21(3), 142-144. doi:10.20467/1091-
5710.21.3.142
Transpersonal caring– healing modalities
Arslan-Özkan, I., Okumuş, H., & Buldukoğlu, K. (2013). A randomized controlled
trial of the effects of nursing care based on Watsons Theory of Human Caring on
distress, self-efficacy and adjustment in infertile women. Journal of Advanced
Nursing, 70(8), 1801-1812. doi:10.1111/jan.12338
Application by the Nursing Community
(Administration/Leadership)

 See Articles:

Watson, J. (2006). Caring Theory as an Ethical Guide to Administrative

and Clinical Practices. Nursing Administration Quarterly, 30(1), 48-55.
doi:10.1097/00006216-200601000-00008
 Application by the Nursing Community
(Education)

 Watson’s’writings’provide’nursing’students’with’ontological,’ethical,’
and epistemological bases for their practice, along with research
directions.

 Watson’s’caring’framework’has’been’taught’in’numerous’baccalaureate’
nursing curricula.
Application by the Nursing Community
(Research)
 Application by the Nursing Community
(Research)

 Watson’s theory has been used as a research framework in many different

studies.

 See Article:

Arslan-Özkan, I., Okumuş, H., & Buldukoğlu, K. (2013). A randomized controlled

trial of the effects of nursing care based on Watsons Theory of Human Caring on
distress, self-efficacy and adjustment in infertile women. Journal of Advanced
Nursing, 70(8), 1801-1812. doi:10.1111/jan.12338
 Critique

 Clarity:
- Watson uses nontechnical, sophisticated, fluid, and evolutionary language to artfully describe her
concepts.

- The concepts in Watson’s theory are abstract and do not achieve full clarity and consistency
(Pajnkihar, et al, 2017)

- Assumptions are clearly listed, but they also remain abstract. (Pajnkihar, et al, 2017)

- Watson’s inclusion of metaphors, personal reflections, artwork, and poetry make her concepts
more tangible and more aesthetically appealing.

- Criticisms on her focus on the psychosocial rather than the pathophysiological aspects of nursing.
 Critique

 Simplicity:

- This theory is viewed as complex when the existential-phenomenological

nature of her work is considered.

- To understand the theory as it is presented, the reader does best by being

familiar with the broad subject matter.
 Critique

 Generality:

- The scope of the framework encompasses broad aspects of health-illness

phenomena.

- The theory addresses aspects of health promotion, preventing illness and

experiencing peaceful death.
 Critique

 Empirical Precision:

- It is not so amenable to traditional scientific research.

- Qualitative nursing approaches are appropriate.

 Critique

 Derivable Consequences:

- Watson’s theoretical concepts, such as use of self, patient-identified needs,

the caring process, and the spiritual sense of being human, may help nurses
and their patients to reach the harmony in complex health issues.

- Professionals in other disciplines share and recognize her work.

Students’ Activity
 References

 Alligood, M. R. (2014). Nursing theorists and their work. (8th edition). St. Louis: Mosby.
 Arslan-Özkan, I., Okumuş, H., & Buldukoğlu, K. (2013). A randomized controlled trial of the
effects of nursing care based on Watsons Theory of Human Caring on distress, self-efficacy and
adjustment in infertile women. Journal of Advanced Nursing, 70(8), 1801-1812.
doi:10.1111/jan.12338
 Bayuo, J. (2017). Case Study in Caring Application of Watson’s Theory of Human Caring to End of
Life Care in the Burns Intensive Care Unit: A Case Report. International Journal of Human Caring,
21(3), 142-144. doi:10.20467/1091-5710.21.3.142
 Ozan, et al (2015). Implementation of Watson’s Theory of Human Caring: A Case Study.
International Journal of Caring Sciences. 8(1) : 25-34.
 Pajnkihar, et al. (2017). Fit for Practice: Analysis and Evaluation of Watson’s Theory of Human
Caring. Nursing Science Quarterly. 30(3) 243–252