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CHAPTER 7 Jean Watson 83

MAJOR CONCEPTS & DEFINITIONS
Original 10 Carative Factors effective communication. Congruence involves
Watson bases her theory for nursing practice on the being real, honest, genuine, and authentic. Empa-
following 10 carative factors. Each has a dynamic thy is the ability to experience and thereby under-
phenomenological component that is relative to the stand the other person’s perceptions and feelings
individuals involved in the relationship as encom- and to communicate those understandings. Non-
passed by nursing. The first three interdependent possessive warmth is demonstrated by: a moder-
factors serve as the “philosophical foundation for ate speaking volume, a relaxed open posture, and
the science of caring” (Watson, 1979, pp. 9-10). As facial expressions that are congruent with other
Watson’s ideas and values have evolved, she has communications. Effective communication has
translated the 10 carative factors into caritas pro- cognitive, affective, and behavior response com-
cesses. Caritas processes included a decidedly spiri- ponents (Watson, 1979).
tual dimension and overt evocation of love and
caring. (See Table 7-1 for the original carative fac- 5. Promotion and Acceptance of the Expression
tors and for caritas process interpretation.) of Positive and Negative Feelings
The sharing of feelings is a risk-taking experience
1. Formation of a Humanistic Altruistic System for both nurse and patient. The nurse must be
of Values prepared for either positive or negative feelings.
Humanistic and altruistic values are learned early The nurse must recognize that intellectual and
in life but can be influenced greatly by nurse edu- emotional understandings of a situation differ
cators. This factor can be defined as satisfaction (Watson, 1979).
through giving and extension of the sense of self
(Watson, 1979). 6. Systematic Use of the Scientific Problem-Solving
Method for Decision Making
2. Instillation of Faith-Hope Use of the nursing process brings a scientific
This factor, incorporating humanistic and altruistic problem-solving approach to nursing care, dispel-
values, facilitates the promotion of holistic nursing ling the traditional image of a nurse as the doctor’s
care and positive health within the patient popula- handmaiden. The nursing process is similar to the
tion. It also describes the nurse’s role in developing research process in that it is systematic and orga-
effective nurse-patient interrelationships and in nized (Watson, 1979).
promoting wellness by helping the patient adopt
health-seeking behaviors (Watson, 1979). 7. Promotion of Interpersonal Teaching-Learning
This factor is an important concept for nursing in
3. Cultivation of Sensitivity to Self and Others that it separates caring from curing. It allows the
The recognition of feelings leads to self- patient to be informed and shifts the responsibility
actualization through self-acceptance for both the for wellness and health to the patient. The nurse
nurse and patient. As nurses acknowledge their facilitates this process with teaching-learning
sensitivity and feelings, they become more genuine, techniques that are designed to enable patients to
authentic, and sensitive to others (Watson, 1979). provide self-care, determine personal needs, and
provide opportunities for their personal growth
4. Development of a Helping-Trust Relationship (Watson, 1979).
The development of a helping-trust relationship
between the nurse and patient is crucial for 8. Provision for a Supportive, Protective, and
transpersonal caring. A trusting relationship Corrective Mental, Physical, Sociocultural,
promotes and accepts the expression of both and Spiritual Environment
positive and negative feelings. It involves con- Nurses must recognize the influence that internal
gruence, empathy, nonpossessive warmth, and and external environments have on the health

Continued