Page 709 - alligood 8th edition_Neat

690 UNIT V Middle Range Nursing Theories

MAJOR CONCEPTS & DEFINITIONS
Caring comforting, performing skillfully and competently,
Caring is a nurturing way of relating to a valued and protecting the one cared for while preserving his
other toward whom one feels a personal sense of or her dignity (Swanson, 1991).
commitment and responsibility (Swanson, 1991).
Enabling
Knowing Enablingis facilitating the other’s passage through
Knowing is striving to understand the meaning of an life transitions and unfamiliar events by focusing
event in the life of the other, avoiding assumptions, on the event, informing, explaining, supporting,
focusing on the person cared for, seeking cues, as- validating feelings, generating alternatives, think-
sessing meticulously, and engaging both the one ing things through, and giving feedback (Swanson,
caring and the one cared for in the process of know- 1991).
ing (Swanson, 1991).
Maintaining Belief
Being With Maintaining belief is sustaining faith in the other’s
Being with means being emotionally present to the capacity to get through an event or transition and
other. It includes being there in person, conveying face a future with meaning, believing in other’s ca-
availability, and sharing feelings without burdening pacity and holding him or her in high esteem,
the one cared for (Swanson, 1991). maintaining a hope-filled attitude, offering realistic
optimism, helping to find meaning, and standing
Doing For by the one cared for no matter what the situation
Doing for means to do for others what one would do (Swanson, 1991).
for self if at all possible, including anticipating needs,

Use of Empirical Evidence mothers, fathers, physicians, and nurses who were
Swanson formulated her Theory of Caring induc- responsible for care of infants in the NICU. Hence,
tively, as a result of several investigations. For her she retained the wording that described the acts of
doctoral dissertation, using descriptive phenomenol- caring and proposed that all-inclusive care in a com-
ogy, she analyzed data from in-depth interviews with plex environment embraces balance among caring
20 women who had recently miscarried. As a result of (for the self and the one cared for), attaching (to oth-
this phenomenological investigation, Swanson pro- ers and roles), managing responsibilities (assigned by
posed two models: (1) The Caring Model, and (2) The self, others, and society), and avoiding bad outcomes
Human Experience of Miscarriage Model. The Caring (Swanson, 1990).
Model proposed five basic processes (knowing, being In a subsequent phenomenological investigation
with, doing for, enabling, and maintaining belief) that conducted with socially at-risk mothers, Swanson
give meaning to acts labeled as caring (Swanson- (1991) explored what it had been like for these
Kauffman, 1985, 1986, 1988a, 1988b). This was foun- mothers to receive an intense, long-term nursing
dational for Swanson’s (1991) middle-range Theory of intervention. Swanson recalls that after this study
Caring. she was finally able to define caring and refine the
While a postdoctoral fellow, Swanson conducted understanding of caring processes. Collectively,
a phenomenological study, exploring what it was like phenomenological inquiries with women who mis-
to be a provider of care to vulnerable infants in the carried, caregivers in the NICU, and socially at-risk
neonatal intensive care unit (NICU). Swanson (1990) mothers formed a basis for expansion of the Caring
discovered that the caring processes she identified Model into the middle-range Theory of Caring
with women who miscarried were also applicable to (Swanson, 1991, 1993).