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CHAPTER 35 Kristen M. Swanson 695

traditional legacy of nursing as a caring-healing who have experienced unexpected pregnancy loss.
discipline and the concepts in Swanson’s theory Recent review of computerized databases (MEDLINE,
as applicable in practice. Since 1998, the Nursing CINHAL, and Digital Dissertations) indicated that
Practice Council at IWK used Swanson’s Theory of Swanson’s work on caring and miscarriage has been
Caring as their framework for professional nursing cited or otherwise utilized in over 160 data-based pub-
practice. lications. Examples of applications of Swanson’s The-
Nurse caring is manifested in different ways and ory of Caring in clinical research include exploring
practice contexts. For example, in a postpartum con- clinical scholarship in practice (Kish & Holder, 1996);
text, demonstration of a baby bath to new parents guidelines for nurses working with patients diagnosed
incorporates all five caring processes. The act involves with multiple sclerosis (Yorkston, Klasner, & Swanson,
being with by demonstrating bathing the newborn to 2001); assessing the impact of caring in work with
the parents. The unrushed timing of the bath so the vulnerable populations (Kavanaugh, Moro, Savage,
infant is awake and parents are present conveys will- et al., 2006); the importance of creating a caring envi-
ingness (doing for or enabling); and the observing, ronment for older adults (Sikma, 2006); Wojnar’s (2007)
querying, and involving parents in the task engages study of lesbian couples who miscarried; and Roscigno’s
them in their own infant’s care (intended outcome) research of children who sustained traumatic brain
while acknowledging that they are perfectly capable injury (Roscigno & Swanson, 2011; Roscigno, Swanson,
of caring for their new child and that their preferences Solchany, et al., 2011).
matter (knowing and maintaining belief). In carrying
out this seemingly simple act, the nurse creates an
optimal environment for learning that enables new Further Development
parents to make decisions about infant care, while Swanson is interested in further development by test-
leveraging the task as an opportunity to engage in a ing and applying her theory in clinical practice. There
meaningful social encounter and developing a trust- is much potential for further development by testing
ing relationship. Swanson’s Theory of Caring in various contexts of
health and illness. Also, her processes of caring suggest
Education that the theory is applicable in other helping disciplines
Humane and altruistic caring occurs when the theory such as teaching, social work, and medicine as well as
is used in various practice areas such as feeding or other life situations for nursing.
grooming an incapacitated older adult, monitoring
and managing the recovery of a patient who suffered Critique
a stroke, or enhancing infant care skills of new par-
ents. Nurse caring, as demonstrated by Swanson in Clarity
research with women who miscarried, caregivers in The concept of caring and caring processes (knowing,
the NICU, and socially at-risk mothers, recognizes being with, doing for, enabling, and maintaining belief)
the importance for nurses to attend to the wholeness that are central to the theory are clearly defined and
of humans in their everyday lives. Thus Swanson’s arranged in a logical sequence that describes the pro-
theory offers nurse educators a simple way of initiat- cesses of caring delivery. Swanson’s theory offers clear
ing students into the profession by immersing them definitions and contextual linkages with the concepts
in the language of what it means to be caring and of the nursing discipline (person, nurse, environment,
cared for in order to promote, restore, or maintain the and health) in nurse-client interactions, thus further
optimal wellness of individuals. explicating the definitions.

Research Simplicity
Swanson has persisted in the development of her the- A simple theory has a minimal number of concepts.
ory, describing and defining the concept of caring and Swanson’s Theory of Caring is simple yet elegant. It
basic caring processes, instrument development, and brings the importance of caring to the forefront and
testing in intervention research with women and men exemplifies the discipline’s values. The main purpose