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86 UNIT II Nursing Philosophies

Watson states, “I make the point to use mind, body, p. 305). She says that “healing spaces can be used to
soul or unity within an evolving emergent world help others transcend illness, pain, and suffering,”
view-connectedness of all, sometimes referred to emphasizing the environment and person connec-
as Unitary Transformative Paradigm-Holographic tion: “when the nurse enters the patient’s room, a
thinking. It is often considered dualistic because I use magnetic field of expectation is created” (Watson,
the three words ‘mind, body, soul.’ I do it intentionally 2003, p. 305).
to connote and make explicit spirit/metaphysical—
which is silent in other models” (Watson, personal
communication, April 12, 1994). Logical Form
The framework is presented in a logical form. It con-
Health tains broad ideas that address health-illness phenom-
Originally, Watson’s (1979) definition of health was ena. Watson’s definition of caring as opposed to curing
derived from the World Health Organization as, “The is to delineate nursing from medicine and classify the
positive state of physical, mental, and social well-being body of nursing knowledge as a separate science.
with the inclusion of three elements: (1) a high level of Since 1979, the development of the theory has
overall physical, mental, and social functioning; (2) a been toward clarifying the person of the nurse and
general adaptive-maintenance level of daily function- the person of the patient. Another emphasis has
ing; (3) the absence of illness (or the presence of efforts been on existential-phenomenological and spiri-
that lead to its absence)” (p. 220). Later, she defined tual factors. Her works (2005) remind us of the
health as “unity and harmony within the mind, body, “spirit-filled dimensions of caring work and caring
and soul”; associated with the “degree of congruence knowledge” (p. x).
between the self as perceived and the self as experi- Watson’s theory has foundational support from
enced” (Watson, 1988, p. 48). Watson (1988) stated theorists in other disciplines, such as Rogers, Erikson,
further, “illness is not necessarily disease; [instead it is and Maslow. She is adamant that nursing education
a] subjective turmoil or disharmony within a person’s incorporate holistic knowledge from many disciplines
inner self or soul at some level of disharmony within integrating the humanities, arts, and sciences and that
the spheres of the person, for example, in the mind, the increasingly complex health care systems and
body, and soul, either consciously or unconsciously” patient needs require nurses to have a broad, liberal
(p. 47). “While illness can lead to disease, illness and education (Sakalys & Watson, 1986).
health are [a] phenomenon that is not necessarily Watson incorporated dimensions of a postmodern
viewed on a continuum. Disease processes can also paradigm shift throughout her theory of transper-
result from genetic, constitutional vulnerabilities and sonal caring. Her theoretical underpinnings have
manifest themselves when disharmony is present. Dis- been associated with concepts such as steady-state
ease in turn creates more disharmony” (Watson, 1985, maintenance, adaptation, linear interaction, and
1988, p. 48). problem-based nursing practice. The postmodern
approach moves beyond this point; the redefining of
Environment such a nursing paradigm leads to a more holistic,
In the original ten carative factors, Watson speaks to humanistic, open system, wherein harmony, interpre-
the nurse’s role in the environment as “attending to tation, and self-transcendence emerge reflecting a
supportive, protective, and or corrective mental, epistemological shift.
physical, societal, and spiritual environments” (Watson,
1979, p. 10). In later work, she has a much broader Application by the Nursing Community
view of environment: “the caring science is not only
for sustaining humanity, but also for sustaining the Practice
planet . . . Belonging is to an infinite universal spirit Watson’s theory has been validated in outpatient,
world of nature and all living things; it is the primor- inpatient, and community health clinical settings
dial link of humanity and life itself, across time and and with various populations, including recent ap-
space, boundaries and nationalities” (Watson, 2003, plications with attention to patient care essentials