Deidre Bringold, Jennifer Edgell, Tammy Garcia, Jessica Hull,
Jody Montgomery, Carol Young
Slide 2
Nursing Model The evidenced based research presented in this
journal is Jean Watsons theory of caring. The theory focuses on
caring for the patient as a whole, mind, body and soul rather than
as an illness. This theory dwells on the importance of building
meaningful relationships between nurses and patients instead of
making patients feel as if they are nothing more than a burden that
the nurse has to care for.
Slide 3
Rationale The rationale for using this theory as a frame work
for practice is to explore alternative ways to help our patients.
Nursing is far more than curing a patient. Nursing is about
healing, not only body, but mind and soul as well. Watson, discuss
paradigms that can help nurture a strong healing relationship
between the patient and nurse that embraces the patient as a whole.
Nurses can build relationships with their patients. These
relationships will improve the patients quality of care because the
patient will trust the nurse more and open up to the nurse about
different things that might be beneficial for the patients medical
care.
Slide 4
Research Studies Selected Complimentary therapies and healing
practices: faculty/student beliefs, attitudes and implications for
nursing education. Reviewed by Jessica Hull Rediscovering the Art
of Healing Connection by creating the Tree of Life Poster; A Pilot
Program for Hospitalized Older Adults. Reviewed by Deidre Bringold
The Effectiveness of Watsons Caring Model on the Quality of Life
and Blood Pressure of Patients with Hypertension. Reviewed by Carol
Young
Slide 5
Research Studies Selected Creating a Profile of a Nurse
Effective in Caring. Reviewed by Tammy Garcia Taking the eagle's
view: using Watson's Conceptual Model to investigate the
extraordinary and transformative experiences of nurse healers.
Reviewed by Jennifer Edgell The lived experience of using Watson's
actual caring occasion to treat depressed women. Reviewed by Jody
Montgomery
Slide 6
Research Review #1 This journal encompassed Watsons theory by
providing alternatives to the normal medical treatment generally
seen in practice. Each alternative was based on the healing
processes of mind, body and soul. The article stepped out of the
journal medical treatment and discussed the power of healing
relationships and caring in general.
Slide 7
Research Review #1 The article stated that alternative
treatments and healing practices when paired with basic treatment
plans can be proven to be as successful and in some cases more
successful than the average treatment alone. Some of the
alternative treatments and healing practices discussed that seem to
be beneficial were: massage, music, healing touch, prayer,
spiritual healing, and effective listening.
Slide 8
Research Review #1 The article touched base not only on the
benefits to the patients but also the benefits to the nurse-patient
relationship. The reasoning behind this study was to determine if
patients healing, benefited from alternative forms of therapies and
what the attitudes of nursing students and faculty was towards the
therapies. The study was held at a university-based nursing
program.
Slide 9
Research Review #1 There were definitely some limitations with
this study. Evidence in general was lacking. Most of the
information if not all was based on personal experience from the
nurse. No patient opinions of studies were obtained or conducted.
Also those who participated were with students with little floor
experience or faculty members with lack of floor experience. Only
134 individuals participated all of who were a part of the same
university and curriculum.
Slide 10
Research Review #1 This study was very informative and most
definitely related to Watsons theory of caring. I think that this
information could be used to help build curriculum in nursing
programs based on the art of healing rather curing. Far too often
we focus on the disease and medications and studies that we forget
about the caring aspect of nursing. This information could be used
to help build programs based on the positive effects for patients
and overall nursing relationships.
Slide 11
Research Review #1 Reference Halcon, L, Chlan, L, Kreitzer, M,
& Leonard, B. (2003). Complimentary therapies and healing
practices: faculty/student beliefs, attitudes and implications for
nursing education. Journal of Professional Nursing, 19(6),
Retrieved from http://www.professionalnursing.org/article/S8755-
7223(03)00133-9/pdf doi: 10.1016/S8755- 7223(03)00133-9
Slide 12
Research Review #2 Watsons idea of building relationships was
conveyed in this study by having the patient share information
about himself/herself to the caregiver by using the Tree of Life
posters. These posters allowed the patients to talk to the nurse
about certain subjects they were comfortable talking about. The
facility was able to come up with this idea using Watsons theory of
human caring as their foundation.
Slide 13
Research Review #2 Research Findings The facilities saw that
they needed to improve their relationship between nurses and
patients. The hospital piloted this program called the Tree of
Life, in which, the facility had the patients pick topics of
importance to them and write them on a tree poster. When a nurse
goes in to a patients room they are to pick a topic from the tree
that the patient put on the tree, and discuss that topic with the
patient so that they can build more meaningful relationships.
Slide 14
Research Review #2 This program was proposed in hopes that it
would make patients feel like they are really being cared for, and
arent just another duty to perform on the nurses busy list of
things to do. This study was done in rehabilitation sub-acute
units, with diagnoses such as stroke, hip or knee replacements.
During this study the researchers noticed, based on surveys the
participants took before and after the study, that there was an
improvement in the quality of care given to the patients by the
nurses.
Slide 15
Research Review #2 Limitations This study was a little biased
as they only used patients that volunteered. There was not a
control group. The facility used a limited amount of patients, and
these patients volunteered to be in the study. With the busyness of
the hospital the facility was not the ideal location to perform
this research.
Slide 16
Research Review #2 Implications This Tree of Life program is a
simple way to address the need for nurses to build relationships
with their patients. This program could be generalized to hospitals
in most places in the United State to improve the quality of care.
If nurses continue to build these relationships nurses can gain
more information about their patients, which will help improve how
nurses care for patients.
Slide 17
Research Review #2 Reference Pipe, T.B., Mishark, K., Hansen,
P., Hentz, J.G., Hartsell, Z.(2010). Rediscovering the Art of
Healing Connection by creating the Tree of Life Poster; A Pilot
Program for Hospitalized Older Adults. Journal of Gerontological
Nursing, 36(6), 47-56.
Slide 18
Research Review #3 Hypertension affects many people. As nurses,
we can have a positive effect on our patients with the care we give
to treat hypertension. By using Watsons Caring Model as a guide a
study was done comparing care given by nurse researchers to
patients with hypertension. The goal of the study was to determine
the effectiveness of a nurses caring relationship according to
Watsons Caring Model on the blood pressure and the quality of life
of patients with hypertension. (Erci et al., 2003)
Slide 19
Research Review #3 The study took place in Turkey in 2000 with
52 hypertensive patients from four healthcare units. Pre and post
tests were given. Nurse researchers were trained to utilize Watsons
Caring Model. The patients were visited for three months on a
weekly basis.
Slide 20
Research Review #3 Research Questions How does the Watson
Caring Model affect quality of life and blood pressure? Is there a
correlation between quality of life and blood pressure? (Erci et
al., 2003) Aim To determine the relationship between the quality of
life and hypertension, and the effect of Watsons Caring Model on
the quality of life and the blood pressure of a group of patients
with hypertension in Erzurum, Turkey. (Erci et al., 2003)
Slide 21
Research Review #3 Nurse researchers used Watsons Caring Model
and the 10 carative factors. Mind-body-spirit is the basis of
Watsons care plus understanding how to comfort the patient, educate
and offer compassion. The goal was to establish a trusting and
caring relationship which would lead to compliance. Previous
teaching regarding hypertension was that it would go away.
Slide 22
Research Review #3 Patients hypertension began to improve as
the caring relationship and the understanding of the disease, diet
was understood and followed and researchers created a healing
environment at all levels (physical as well as nonphysical) (Erci
et al., 2003). Patients were educated on diet, exercise, medication
compliance, coping with stress and measuring blood pressure
regularly. Some researchers noted a relationship between education
and nursing care given to the patient with an increase in quality
of life.
Slide 23
Research Review #3 Researchers believe the results of the study
concluded Watsons Caring Model increased quality of life and
decreased blood pressure. The researchers believe that this is
because the model considers persons holistically together with
their physical, psychological and social environment, and increases
problem solve capacity. (Erci et al., 2003) According to this
study, Watsons Caring Model can be recommended in the future for
nurses to use for their hypertensive patients to lower their blood
pressure and improve the quality of life.
Slide 24
Research Review #3 Reference Erci, B., Sayan, A., Tortumluoglu,
G., Kilic, D., Sahin, O., & Gungormus, Z. (2003) The
effectiveness of watsons caring model on the quality of life and
blood pressure of patients with hypertension. Journal of Advanced
Nursing, 41(2), 130-139.
Slide 25
Research Review #4 Two surveys: 1) Caring Factory survey
(CFS)-the patients perspective 20 items to assess the patients
perspective of care from the nurse Scoring on a 7 point Likert
Scale Score of 7 indicates the highest agreement to the statement
Score of 4 indicates neutral agreement to the statement Score of 1
indicates the least agreement to the statement
Slide 26
Research Review #4 2) Health Care Environment Survey (HES)-the
nurses perspective on her working environment 86 items to assess
the staff perception of the work environment including
Relationships with managers, coworkers, physicians Scoring on a 7
point Likert Scale Score of 7 indicates the highest agreement to
the statement Score of 4 indicates neutral agreement to the
statement Score of 1 indicates the least agreement to the
statement
Slide 27
Research Review #4 85 pairs of nurse/patient Data Analysis from
both evaluations Data was correlated to profile the nurses
identified as the most caring The findings: The most caring nurses
work scheduled hours, not more Age of nurse didnt matter. The most
caring nurses in the study did have the most professional
experience regardless of age. The most caring nurses were most
affected by stress in relationships with patients They enjoyed
coworker relationships They most often provided the continuity of
care from admission to discharge
Slide 28
Research Review #4 Limitations of the study New area of study
Research for theoretical studies are not fully developed Liberal
statistical parameters Small sample size Implications for Practice
The ability to have a profile of a caring nurse Help educators
develop a curriculum that helps prepare caritas nurses Better
patient outcomes if the patient feels a connective relationship
with the nurse
Slide 29
Research Review #4 Critical Reflection Further studies needed
Restore core values and caring back into healthcare Better patient
outcomes? Caring nurses=Better patient outcomes? Caring nurses=cost
effectiveness? Personality tests prior to employment-caring test
prior to employment?
Slide 30
Research Review #4 Reference Bent, K., Nelson, J., Persky,
G.J., Watson, J., (2008). Creating a Profile of a Nurse Effective
in Caring. Nursing Administration Quarterly. Caring Competencies
for a Complex Health Care Environment: Part 1. 32(1): 15-20,
January/March 2008.
Slide 31
Research Review #5 Watsons conceptual model of caring/healing
was used study of the extraordinary and transformational
experiences of nurse healers 11 participants selected purposively
from those having a lengthy and committed experience as
practitioners of healing Question: Please describe your emotional
and spiritual experiences associated with your coming to be a nurse
healer? The conversations were analyzed thematically using van
Manens eclectic approach to hermeneutic phenomenology (Hemsley et
al., 2006)
Slide 32
Research Review #5 Research findings Analysis revealed one
unifying theme Walking Two Worlds Connection between the inner
world of nurse healer and indigenous healer or shaman Symbolized by
the eagle moving back and forth between/within different realities
Played significant roles in their inner journeys
Slide 33
Research Review #5 5 essential themes 1) Belonging and
connecting A journey in their lives around feeling that they belong
in the world of people Most had a sense of isolation early in life
which they moved from in their own healing journeys Within the
isolation was a sense of connection with spiritual reality 2)
Opening to spirit Central to the sacred journeys of the
participants was the spiritual opening aligned with the life path
of a healer
Slide 34
Research Review #5 3) Summoning The transition to the path of a
healer was tumultuous for some of the participants, and made
against their will The participants were summoned to the role which
is a significant concept in the study (Hemsley et al., 2006) 4)
Wounding and Healing Journey It was necessary for the participants
to come to terms with their own woundedness in order to become of
valuable service to others (Hemsley et al., 2006) There is value of
suffering in their spiritual journeys
Slide 35
Research Review #5 5) Living as a healer Meeting the unique
challenges that living in 2 worlds requires Finding balance in
living in more than one reality
Slide 36
Research Review #5 Limitations Very small study, only 11
participants This study was biased as they only used selected
participants There was not a control group Results based only on
the participants input, patients were not consulted Credibility van
Manens eclectic approach to hermeneutic phenomenology provides
methodological congruence
Slide 37
Research Review #5 Implications Revealed information regarding
the deeper, transformative experiences of nurses as healers Shared
consciousness of transpersonal fields Watsons Conceptual model
needs to incorporate the understanding that holistic consciousness
can encompass the experience of multiple realities
Slide 38
Research Review #5 Reference Hemsley, M., Glass, N., &
Watson, J. (2006). Taking the eagle's view: using Watson's
Conceptual Model to investigate the extraordinary and
transformative experiences of nurse healers. Holistic Nursing
Practice, 20(2), 85-94. Retrieved from CINAHL Plus with Full Text
database.
Slide 39
Research Review #5 Reflection Healing and caring concept by
Watson is more than an ideal; she states transcendent with the
coevolving human in the universe (Hemsley et al., 2006) Important
to the advancement of nursing as a healing profession Sharing the
healers stories would benefit the profession Opportunity to
recognize how nurses can learn from each other about the innate
healer in all of us
Slide 40
Research Review #6 Depression affects many women. By using
Watsons Caring Occasions to treat depressed women, we can assist
female patients through this difficult time in their lives. The
purpose of this study was to describe the essential structure of
the lived experience of depressed women who enter therapy and
experience Watsons actual caring occasion (ACO) within the
transpersonal caring relationship (TCR) (Mullaney, 2000).
Slide 41
Research Review #6 The rationale for using this model of care
was to decrease patients depressive episodes and reduce clinician
time The study took a sample of 11 depressed women as they related
their subjective experiences in therapy over 6 months All
participants stated that Watsons ACO caused them to persist in
treatment and adopt health seeking behaviors (Mullaney, 2000).
Slide 42
Research Review #6 Limitations small study select group of
participants patients, as well as care givers were consulted after
the study studied 6 months
Slide 43
Research Review #6 Research Findings 100 % of participants
stated that experiencing Watson's actual caring occasion caused
them to continue treatment and adopt health-seeking behaviors.
findings support the expense of appropriate clinician time for
holistic healing in the transpersonal caring relationship
Slide 44
Research Review #6 Reflection Watson's holistic approach and
caring model proves that as nurses, we can impact the patient's
outcome and teach healthier lifestyles. By using the ACO, all of
the patient's experienced a change and sought out healthy
behaviors.
Slide 45
Research Review #6 Reference Mullaney, JA. (2000). The lived
experience of using Watson's actual caring occasion to treat
depressed women. Journal of Holistic Nursing, 2000
Jun;18(2):129-42.
Slide 46
Jean Watsons Theory of Caring Overall impressions Jean Watsons
Theory of Caring touches many facets of nursing practice and has
shown to be beneficial in improving patient quality of care and
outcomes. The affects of the nurse taking on the role of healer are
not limited to the patient, but also can profoundly change the
nurse. The End