A thorough analysis of theory is vital to determine its adequacy for guiding practice or research. For this assignment you are to critique a theory or conceptual model (best to use middle range theories for your assignment and capstone work) that you are interested in using to support your capstone work. Before you begin your assignment, please discuss with your ideas with the instructor to make sure you have chosen a theory that would apply well to your work.
Introduction and Background
In recent days, the number of people choosing nursing as their profession is increasing sharply and there are different reasons for such consideration. Nursing is the profession where human care process requires compassion, humanitarian senses and relates to the personal knowledge and experience of the healthcare experts (Lachman, 2012). The Watson’s Theory of Care discusses about the personal traits and philosophical mindset that a healthcare expert should possess while caring for an ill patient. The theory of Watson is widely used in the nursing practice and is composed of several ethical and philosophical implications. This theory also discussed the holistic approach of caring by creating a transpersonal relationship with the patient. Watson first established the theory in between 1975-1979 further several modifications have been introduced in this theory (Sitzman & Watson, 2013). In the recent nursing professional context, the theory of caring helps the nursing professional to comply with the four ethical considerations of medical profession. It is the congruence between the values on healthcare profession with the concepts present in this theory that helps the nursing professionals, the healthcare organization, and the clinical administration to promote basic humanitarian principles (Alligood, 2017). In this assignment, the Watsons theory of caring will be described by discussing its theoretical definitions and concepts as well as the theory structure and the assumptions. Further, a critique to the theory will be discussed using semantic and structural clarity and consistency. The current aspect of the theory with modern nursing study as well as the discussion about usage of this theory to develop new practice model with improvement plan will be discussed.
Purpose
The Watson’s theory of caring is basically focused to four aspect of healthcare such as promotion of healthcare, preventing the disease or illness, caring for the ill or sick individual and restoring wellbeing or health. Therefore the prime purpose of this theory is to promote healthcare with keeping medical cure at the central of the practice (Ranheim, Kärner & Berterö, 2012). This theory allows each healthcare professional to use the theory according to their facility by promoting growth and improvement of the patient. The theory played several roles in the care process, such as it helped to develop a healthy relationship with the patient, helped to make the care process unconditional and acceptance for everyone (Glaser, 2017). Further, it helped the nursing professionals to use holistic approach with equal focus of patients mind, soul, body and emotions at the same time and promote health through their own knowledge and interventions within the patient so that their health literacy can be improved (Alligood, 2017).
Watson’s Theory of Care and Modern Nursing Practice
Theoretical concepts
The Watson’s theory of caring is composed of four different concepts which are related to human being, their health, the social or environmental and about the nursing profession. Within these, the social concept holds much importance because it the social environment that determines one’s capability or range of thinking and the personal goal they strive for their entire life (Sitzman & Watson, 2013). According to the Watson’s theory caring has its own place in each society and there are always compassioned people who cared for others. However, according to Glaser (2017), compassion and caring attitude is not transferred by genes from one generation to another, but it is the social norms and culture that helps to transfer the positive attitude to generations. The second theory was about the human-being and this theory described humans as the valued person who is seeking healthcare and that person should be respected, valued, assisted, nurtured and integrated in the care process so that psychologically the care help the patient to attain health (Lachman, 2012). The third concept is regarding the concept of health and this theory defines health as the appropriate balance between the mind, body and soul and focuses entirely on their unity and harmony. The combination of physical, mental and social wellbeing helps human being to adapt to a general maintenance level of daily functioning and marks the absence of illness within the body (Swanson, 2012). The final concept is about nursing and this theory defines the nursing practice as the human science that incorporates health and illness experiences and treats them using personal experience, professional concepts, scientific means, esthetic background and ethical considerations. There are several sub concepts present in the Watsons theory of caring such as self, time and phenomenal field that helps to specific the broadened border of this theory into shorter segments (Alligood, 2017).
Theoretical definitions
The Watson’s theory of caring involved several concepts and sub concepts that defined three main aspects of human caring process. The first concept is of survival needs of humans that can be defined as the need of food, water, shelter and healthcare needs. The second concept defines the functional needs of humans and according to that activity or inactivity and sexuality falls under it (Lusk & Fater, 2013). The third definition is about the integrative needs and involves achievements and affiliation of humans whereas the final definition is of growth-determining needs and includes self-actualization. All these needs define the Watson’s theory of caring and establishes the nursing profession as the large part of the model of caring including the patients care, overall wellbeing and promotes the patients harmony (Butts & Rich, 2013).
Concepts in Watson’s Theory of Care
The prime four variables of Watson’s theory of care are society, human being, health and nursing. The connection between these variables are effective as it helps to determine the patient safety. While applying these variables in the practice it helps to evoke kindness and love towards the patient and helps to inspire faith honor and hope within others. Further these variables are linked through trust and beliefs that the patients and healthcare professions share for the betterment and improvement of health (Butts & Rich, 2013).
The theory structure of Watson theory of care is associated with care, love compassion and peace. A pictorial description of the model is posted below.
According to the theory, the caring process is similar to the universe and from here the care process for soul and spirit starts. During this process of caring and healing, the theory helps the healthcare professionals to maintain the dignity and harmony of the system. The green square at the background determines calmness whereas the blue circle determines the complete universe (Lukose, 2011).
According to Labrague (2012), the Watson’s theory of caring is made up of seven different assumptions.
- The first assumption determines that caring process can only be practices interpersonally and through this effective demonstration of this process is possible.
- The process of caring is composed of carative factors and the result of these should comply with the human needs (Watson, 2012).
- Effective caring process helps to promote the growth and improvement of individual as well as family.
- Caring process helps to heal the patient irrespective of what he/she is.
- The environment of caring process helps the patient to make decision regarding his own health and take part in the healthcare process.
- The science of caring is complementary to the science of curing
- The nursing practice should be at the center of science of curing (Labrague, 2012)
While the critical discussion of the Watson’s theory of caring mentioning the basis of criticism is mandatory as deepening on these the argument about the negative aspects pf the caring theory is presented. The criticism discussion will be focused on clarity of the theory, its simplicity, generalizability, accessibility and importance.
In the theory of Watson, she described the theory of caring, carative factors, love, compassion and caritas in very artful and non-technical manner due to which, in recent era, maximum of the healthcare expert feels the irrelevancy of this concept in the healthcare system. According to Wiklund Gustin & Wagner (2013), it takes time to understand the core meaning of her theory and it is impossible to understand the theory at once. For example, in her theoretical description, she talks about transcendence and maximum of the healthcare experts are unable to understand the meaning without searching it over internet. Maximum portion of the Watson theory is consisting of self-reflection about her own practice, experience and art or poetry so that her philosophical concepts can be understood easily. The critique related to clarity can be divided into two sections, semantic clarity and consistency and the structural clarity and consistency (Masters, 2014).
As discussed in the previous section, the theory is difficult to understand due to its lingual choices and further the presence of arts and poetic explanations to philosophical concepts makes the theory difficult to understand. The core concept of the theory is regarding the nursing practice and concept of care. However, while making the point of clinical caritas and emerging care the difficult words and poetry related explanation makes it little difficult to understand. However, the theory was able to consistently focus on the concept of care (Adams, 2014).
Critique of Watson’s Theory of Care
The Watson’s theory of care was able to make the theory relevant and consistent by involving theories such as theory of human being caring, the caring theory, and transpersonal caring. However, structural inconsistent made these theory confusing and difficult to understand (Ray, 2012). Further there are several interchangeable terms such as moment of care and occasion of care within the theory that made the structure of theory confusing and Irrelevant. However, the intention of using these words were clear and she was able to establish the point of holism care process through her theory of caring (Adams, 2014).
This section falls under the external criticism of the theory and talks about the external factors such as the structure, the concepts that has been used to deliver the core idea of the theory. According to Ranheim, Kärner & Berterö (2012), the theory is not clear and simple but the reader has to read it multiple times to understand the underneath meaning of the concepts. The theory of human caring contains concepts and words that require high intellectual level to understand the meaning and therefore the interpretation can be different as per the background and experience of the interpreter.
The theory is consisting of different concepts of healthcare, healing and need of compassion to treat the patient for achievement of overall wellbeing. The relevancy of those concept and utilization of the concepts in modern healthcare makes the theory general and usable in each aspect of healthcare. Further as the theory has been modified several times since its creation, the generalize concepts has increased its adequacy (Ray, 2012).
The accessibility of this theory is much higher than the contemporary concepts of healing and caring as the theory is much closer to reality convergence. According to this theory, nurses should focus on higher accessibility and should provide care to patients who are unable to care for themselves (Ranheim, Kärner & Berterö, 2012). Further Watson herself followed the theory to create a healthcare institute to meet her goals of healthcare. Therefore, using the theory of transpersonal caring and theory of human care, the theory makes the healthcare facility accessible for the people seeking quality care.
While discussing the significance of the theory, the scope, utility and significance of the theory should be discussed. The theory is very much comprehensive and determines the overall concept of care used in nursing prospect. However, due to its complex meanings and less accessible due to semantic aspect, the scope decreases, as the nursing professionals who want to access to a concrete and strong formula for the development of their own theory of caring will not be able to utilize the concepts present in the theory (Ranheim, Kärner & Berterö, 2012). Despite of the fact, the significance of this theory holds very much importance in the nursing practice. According to recent researcher (), healthcare experts of new generation are keen to apply the concept present in the Watson theory on their own practice to comply with the concept of care (Ray, 2012).
Structural Clarity and Consistency of Watson’s Theory of Care
According to Vandenhouten et al., (2012), the theory including humanitarian concepts, theory of caring is much more relevant in recent times as increasing amount of healthcare concerns has detached the compassion and emotion from the caring process. The theory of Watson is applicable in each situation and context of caring due to the presence of humanitarian base. There are example of number of universities that has already included the theory of care in their philosophical concepts of caring. There are a number of questions present in the current healthcare system that the theory clarifies with simple concepts and assumptions (Morrall & Goodman, 2013). For example, if any healthcare expert faces any dilemmatic situation and is unable to decide between survival need and growth related needs of the patient, the theory provides answer by prioritizing survival need as it consists of fundamental needs of human being such as food, water and quality healthcare. Further, the theory helps to improve the healthcare process by determining the fact that the capability of nursing professional determines the success of this theory. Critical thinking and critical reasoning about the healthcare process is also involved in this section that helps to decide the best possible care for the patient using the care theory (Vandenhouten et al., 2012).
It is quite difficult to apply theoretical concepts in the practical nursing practice as they are quite complex and it is difficult to control the situation. The financial causes, the everyday schedule and increased use of technological instruments in the healthcare practice increases the amount of negative aspect in care process. Therefore, usage of care process can help to foster positive aspects of negative aspect in the process.
The capstone project of interest is to apply the theory of caring in the screening protocol for the stroke affected patients in their acute phase, and are eligible for the screening of depression prior to hospital discharge. I am a consultation liaison in the psychiatry of the hospital and according to the data of hospital only 8 patients out of 395 who has faced acute stroke had registered themselves for the mental healthcare. It determines that maximum of the patients were not receiving holistic approach of care and hence, the theory of care should be applied in the process so that the healthcare experts focus on each of the aspect of healthcare which is spiritual, mental and physical (White, 2014). For the implementation of the theory of care, all the healthcare experts, nursing staff and mental healthcare experts involved in the process will be provided with a session about the theory of care developed by Watson and will be provided with opportunity to apply the concepts in their practice prior to the actual screening program. Application of this theory will help the healthcare experts to understand the effectiveness of concepts and assumptions of care in the overall wellbeing of the patient. Further, the staff will be aware of using the holistic approach of care in care process so that four main ethical consideration of medical profession can be complied (Butts & Rich, 2013). Further, it will help the nursing staff to perform monotonous work and application of the concepts in their daily work provides them with opportunity to connect with each patient that provides them a better way to implement the interventions. Furthermore, as the Watson’s theory is constructive and easily adaptable, the nursing staff will take less time to acquire the concepts if educated properly and as the theory also includes self-reflection and examples hence, by relating to the theory, the nursing professional will be able to learn, review and reflect their experience regarding new care practice (White, 2014). In this context, it should be mentioned that the theory will be able to develop the process only if the senior and advanced nursing professionals are able to spread their learnings to others so that each professional in the healthcare setting can contribute in the developmental process (Morrall & Goodman, 2013).
References
Adams, L. Y. (2016). The conundrum of caring in nursing. International Journal of Caring Sciences, 9(1), 1.
Alligood, M. R. (2017). Nursing Theorists and Their Work-E-Book, 9th edn, pp. 23-87. Elsevier Health Sciences.
Butts, J. B., & Rich, K. L. (2013). Philosophies and theories for advanced nursing practice6th edn, pp. 32-78, Jones & Bartlett Publishers.
Glaser, B. (2017). Discovery of grounded theory: Strategies for qualitative research, 2nd edn, pp. 23-98, Routledge.
Labrague, L. J. (2012). Caring competencies of baccalaureate nursing students of Samar State University. Journal of Nursing Education and Practice, 2(4), 105.
Lachman, V. D. (2012). Applying the ethics of care to your nursing practice. Medsurg Nursing, 21(2), 112.
Lukose, A. (2011). Developing a practice model for Watson’s theory of caring. Nursing Science Quarterly, 24(1), 27-30.
Lusk, J. M., & Fater, K. (2013, April). A Concept Analysis of Patient?Centered Care. In Nursing Forum (Vol. 48, No. 2, pp. 89-98).
Masters, K. (2014). Nursing theories: A framework for professional practice,1st edn, pp 123-176, Jones & Bartlett Publishers.
Morrall, P., & Goodman, B. (2013). Critical thinking, nurse education and universities: some thoughts on current issues and implications for nursing practice. Nurse Education Today, 33(9), 935-937.
Ranheim, A., Kärner, A., & Berterö, C. (2012, April). Caring theory and practice—Entering a simultaneous concept analysis. In Nursing Forum (Vol. 47, No. 2, pp. 78-90). Blackwell Publishing Inc.
Ranheim, A., Kärner, A., & Berterö, C. (2012, April). Caring theory and practice—Entering a simultaneous concept analysis. In Nursing Forum (Vol. 47, No. 2, pp. 78-90). Blackwell Publishing Inc.
Ray, M. A. (2012). The theory of bureaucratic caring for nursing practice in the organizational culture. Caring in Nursing Classics: An Essential Resource, p.309.
Sitzman, K., & Watson, J. (2013). Caring science, mindful practice: Implementing Watson's human caring theory, 1st edn, pp. 123-156, Springer Publishing Company.
Swanson, K. M. (2012). Empirical development of a middle range theory of caring. Caring in Nursing Classics: An Essential Resource, 211.
Vandenhouten, C., Kubsch, S., Peterson, M., Murdock, J., & Lehrer, L. (2012). Watson's theory of transpersonal caring: Factors impacting nurses professional caring. Holistic nursing practice, 26(6), 326-334.
Watson, J. (2012). Nursing: The philosophy and science of caring (revised edition). In Caring in nursing classics: An essential resource (pp. 243-264). Springer Publishing Co Inc., New York.
White, L. (2014). Mindfulness in nursing: An evolutionary concept analysis. Journal of advanced nursing, 70(2), 282-294.
Wiklund Gustin, L., & Wagner, L. (2013). The butterfly effect of caring–clinical nursing teachers’ understanding of self?compassion as a source to compassionate care. Scandinavian Journal of Caring Sciences, 27(1), 175-183.
