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Slide 1: Philosophy and Science of Caring Erminia Gabello, RN, BSN
Slide 2:  Graduated in 1961 from the Lewis Gale School of Nursing in Roanoke, Virginia  Baccalaureate degree in Nursing from University of Colorado, Boulder Campus in 1964  Master’s degree in psychiatric-mental health nursing in 1966 at the Health Sciences Campus  Doctorate in educational psychology and counseling in 1973 at the Graduate School, Boulder campus (Tomey, 2006)
Slide 3:  Distinguished Professor of Nursing and holds the Murchinson-Scoville Endowed Chair in Caring Science at the University of Colorado School of Nursing  Founder of the original Center for Human Caring in Colorado  Fellow of the American Academy of Nursing  Served as Dean of the University of Colorado School of Nursing  Past president of the National League for Nursing (NLN)  Founder of the Watson Caring Science Institute in 2008 (Tomey, 2006)
Slide 4:  International Kellogg Fellowship in Australia  Fulbright Research Award in Sweden  Holds 8 Honorary Doctoral Degrees  5 International Honorary Doctorates in Sweden, UK, Spain, British Columbia, and Quebec, Canada  1993 recipient of the NLN Martha E. Rogers Award  Fetzer Institute Norman Cousins Award (Tomey, 2006)
Slide 5:  2005 – Caring Science as Sacred Science  2002 – Assessing and Measuring Caring in Nursing and Health Sciences  1999 – Postmodern Nursing and Beyond  1985 – Nursing: Human Science and Human Care  1979 – Nursing: The Philosophy and Science of Caring
Slide 6:  Nursing theorists: Florence Nightingale, Madeleine Leininger, Virginia Henderson, Hildegard Peplau  Other philosophical traditions: Hegel, Marcel, Kierkegaard, Heidegger, Whitehead, and Eastern philosophy  Dr. Sally Godow  Phenomenological psychology and philosophy: Carl Rogers, Irving Yalom (Watson, 2007)
Slide 7:  Carative Factors (evolving toward the Clinical Caritas Processes)  The Transpersonal Caring Relationship  The Caring Occasion/Caring Moment
Slide 8:  Humanistic-altruistic system of values  Faith-hope  Sensitivity to oneself and others  Helping-trusting relationship  Expressing positive and negative feelings  Creative problem-solving caring process  Transpersonal teachinglearning  Supportive, protective, and/or corrective mental, physical, societal, and spiritual environment  Human needs assistance  Existentialphenomenologicalspiritual forces (Watson, 2008)
Slide 9:  Core: those aspects of nursing that actually potentiate therapeutic healing processes and relationships  Trim: practice setting, procedures, functional tasks, and specialized clinical focus of disease, technology, and techniques surrounding the diverse preoccupations of nursing (Watson, 1997)
Slide 10:  Practicing loving kindness and equanimity for self and others  Being authentically present; enabling/sustaining/honoring deep belief system and subjective world of self/other  Cultivating one’s own spiritual practices; deepening self-awareness, going beyond “ego-self”
Slide 11:  Developing and sustaining a helping-trusting authentic caring relationship  Being present to and supportive of the expression of positive and negative feelings as a connection with deeper spirit of self and the one being cared for  Creative use of self and all ways of knowing/being/doing as part of the caring process
Slide 12:  Engaging in genuine teaching-learning experience that attends to the unity of being; attempt to stay within others’ frames of reference (“coaching” role vs. imparting of information)  Creating healing environment at all levels (physical, non-physical, and subtle environment of energy and consciousness) whereby wholeness, beauty, comfort, dignity, and peace are potentiated
Slide 13:  Assisting with basic needs; holding an intentional caring consciousness of touching and working with the embodied spirit of another, honoring the unity of being; allowing for spirit-filled connection  Opening and attending to spiritual, mysterious, unknown existential dimensions of life-death-suffering (Watson, 2008)
Slide 14:  A special kind of human care relationship  A union with another person  High regard for the whole person and their being-in-the-world (Watson, 2007)
Slide 15:  Both persons, with their unique phenomenal fields, have the possibility to come together in a human-to-human transaction  Focal point in space and time when nurse and other come together in such a way that an occasion for human caring is created (Watson, 2007)
Slide 16:  Caring science is the essence of nursing and the foundational disciplinary core of the profession  Caring can only be effectively demonstrated and practiced interpersonally  The intersubjective human-to-human processes and connections keep alive a common sense of humanity  Caring consists of Carative Factors/Caritas Processes that facilitate healing, honor wholeness, and contribute to the evolution of humanity
Slide 17:  Effective caring promotes healing, health, and individual or family growth and a sense of wholeness, forgiveness, evolved consciousness, and inner peace  Caring responses accept a person not only as he or she is now, but as what he or she may become
Slide 18:  A caring relationship invites the emergence of human spirit, opening to authentic potential, being authentically present, and allowing the person to explore options  Caring is more “healthogenic” than curing  Caring science is complementary to Curing Science  The practice of Caring is central to nursing (Watson, 2008)
Slide 20:  Adequacy: theory is organized around the 10 Carative Factors/Caritas Processes  Provides a clear conceptual structure and order for nursing phenomena under consideration  Theory is still evolving and further refinement is in progress – “Ontological Competencies” and “Caring Literacy”
Slide 21:  Clarity: non-technical language that is easy to understand  Use of metaphor, personal stories, artwork and poetry to clarify complex concepts  At times, lengthy hyphenated phrases are difficult to grasp immediately
Slide 22:  Consistency: definitions and concepts used consistently throughout the development and evolution of the theory  Sometimes uses words interchangeably in referring to the same phenomenon (i.e. caring transaction, occasion, and moment)
Slide 23:  Logical development: theory has followed logical line of thought Carative Factors Caritas Processes Ontological Caring Competencies and Caritas Literacy
Slide 24:  Level of theory development: Middle-range? Metatheory? Philosophy?
Slide 25:  Complexity: may be viewed as complex when considering the existential-phenomenological nature of the theory  Watson draws upon a number of disciplines in the formulation of her theory
Slide 26:  Discrimination: Watson’s concepts are unique and lead to research results that could not have been arrived at using another theory  Reality convergence: concept of caring is central to the practice of nursing. The basic assumptions of Watson’s theory reflect the realities of everyday nursing practice and even the realities of our human condition
Slide 27:  Pragmatic: Watson’s theory has been used as framework in a large volume of research over the past 30 years  Scope: theory is unique in that is abstract and broad in scope, but this has not prevented links with research and practice
Slide 28:  Significance: theory has resulted in the improvement of health outcomes in a wide range of national and international research and practice settings  Utility: abstract nature of the theory has not prevented its utilization in a wide variety of research in nursing
Slide 29:  The Caring Behavior Inventory (Wolf et al., 1994)  The Caring Behavior Assessment Tool (Cronin & Harrison, 1988)  The Nyberg Caring Attribute Scale (Nyberg, 1990)  The Caring Assessment Tool (Duffy, 1992)  The Caring Efficacy Scale (Coates, 1997) (Smith, 2004)
Slide 30:  Practice problem: end-of-life care in elderly hemodialysis patients with ESRD
Slide 31: Brown E.A. (2007). Epidemiology of renal palliative care. Journal of Palliative Medicine, 10(6), 1248-1252.
Slide 32: Davidson, S.N. (2006). Facilitating advanced care planning for patients with end-stage renal disease: The patient perspective. Clinical Journal of the American Society of Nephrology, 1, 1023-1028.
Slide 33: Strickland, D. (1996). Applying Watson’s theory for caring among elders. Journal of Gerontological Nursing, 22(7), 6-11.
Slide 34: Brown E.A. (2007). Epidemiology of renal palliative care. Journal of Palliative Medicine, 10(6), 12481252. Davidson, S.N. (2006). Facilitating advanced care planning for patients with end-stage renal disease: The patient perspective. Clinical Journal of the American Society of Nephrology, 1, 10231028. Smith, M. (2004). Review of research related to Watson’s theory of caring. Nursing Science Quarterly, 17(1), 13-25.
Slide 35: Sourial, S. (1996). An analysis of Watson’s theory of human care. Journal of Advanced Nursing, 24, 400-404. Strickland, D. (1996). Applying Watson’s theory for caring among elders. Journal of Gerontological Nursing, 22(7), 6-11. Tomey, A.M. & Alligood, M.R. (2006). Nursing theorists and their work. St. Louis: Mosby Elsevier.
Slide 36: Watson, J. (1997). The theory of human caring: Retrospective and prospective. Nursing Science Quarterly, 10(1), 49-52. Watson, J. (2007). Nursing: Human science and human care. A theory of nursing. Sudbury: Jones and Bartlett. Watson, J. (2008). Nursing: The philosophy and science of caring (revised ed.). Boulder: University Press of Colorado.