The effectiveness of Watson's Caring Model on the quality of life and blood pressure of patients with hypertension

Critical analysis of the scientific production on Jean Watson's Theory of Human Care

OBJECTIVES

to analyze current scientific production on the use of the theoretical-methodological precepts of Jean Watson's Theory of Human Care/Clinical Caritas Process.

METHODS

quantitative, exploratory, descriptive study using data from 1979 to 2023 in the Scopus database. Analysis was carried out using VOSviewer software.

RESULTS

the 73 studies included establish a network of collaboration among 221 authors from 155 institutions in 18 countries, who discuss the development of ethical behavior in nursing staff, through technical improvement, implementation, and validation of instrumental strategies capable of measuring and evaluating the quality of holistic and empathetic care. The Theory of Human Caring contributes to nursing training and care, and Process Clinical Caritas-Veritas is useful for the different possibilities of practice and education.

CONCLUSIONS

it is important to strengthen with more empirical data a nursing work model centered on individual human care, supporting the evolution of scientific nursing knowledge.

Impact of Watson's human caring-based health promotion program on caregivers of individuals with schizophrenia

BACKGROUND

Caring for people with schizophrenia is accompanied by challenges that impact caregiver health. We conducted this study to explore the effect of a Caring Science-Based health promotion program on the sense of coherence and well-being among caregivers of persons with schizophrenia.

METHODS

This randomized clinical trial with the Solomon four-group design was conducted on 72 caregivers randomly allocated into two intervention and two control groups. A health promotion program based on Watson's theory was performed individually through five face-to-face sessions and a four-week follow-up. Settings were the psychiatric centers of the three educational, specialty, and subspecialty Ibn-e-Sina, Moharary, and Hafez hospitals affiliated with Shiraz University of Medical Sciences (SUMS), south of Iran. The data were collected using a demographic information form, the Sense of Coherence Scale, and the Caregiver Well-Being Scale. One-way ANOVA, chi-square, Kruskal-Wallis, and independent t-test were used to determine the homogeneity at baseline. In the post-test, multiple between-groups and pairwise comparisons were assessed by One-way ANOVA and Tukey's post-hoc. Within-group comparisons were evaluated using paired t-tests. All tests were two-tailed, and the statistical level was considered 0.05.

RESULTS

Data analysis showed that the mean scores of caregiver sense of coherence and well-being from pre-intervention to post-intervention were significantly increased in the intervention groups (p < 0.001). At the same time, there were no significant differences in the control groups.

CONCLUSION

The health promotion program based on Watson's human caring theory facilitated ongoing intrapersonal, and holistic caring and improved the sense of coherence and well-being in caregivers of persons with schizophrenia. Hence, this intervention is recommended for developing healing care programs.

TRIAL REGISTRATION

https://www.irct.ir/trial/55040 : IRCT20111105008011N2 (11/04/2021).

A concept analysis of Watson's nursing Caritas process

AIM

The main objective of this analysis is to give an understanding of Watson's nursing Caritas as a concept.

DESIGN

Watson's nursing Caritas is an abstract concept, and difficult to define and operationalize because of its philosophical nature. Watson's nursing Caritas develops a clear relationship between care, caring factors, and the processes of human life.

METHODS

We used Walker and Avant's method. PubMed, Scopus, Ovid, EBSCO, Science Direct, Web of Science, Google Scholar, and ProQuest were searched. "Caritas process" and "Watson's caring theory" were searched. In the primary search, 883 articles were found, but eventually, 25 articles were included in the study.

RESULTS

We define Watson's nursing Caritas as the process based on caring consciousness, engaging in reliable human caring relationships for healing support, integrity, and development of humanity that alters the concept of caring into a higher ethical commitment inspired by responsibility for others, and different meanings, including kindness, compassion, joyfulness, and peacefulness and leads to the establishment of caring behavior in clinical Watson's nursing Caritas, thus leading to improving performance.

CONCLUSION

Clinical nursing Caritas enables nurses to develop an effective human being relationship between nurse-client-family, and ultimately achieve a common experience and perception of caring.

Bridging Healing and Therapy: A Mixed-Methods Study on Support Group Intervention Based on Watson's Theory of Human Caring

The support group process effect on caregiver burden on family members of dementia patients based on Watson's theory of human caring was that a significant difference was found between caregivers and control groups. Qualitatively, the support group process could reduce caregiver burden and improve coping skills.

A comparative descriptive analysis of perceived quality of caring attitudes and behaviours between haemodialysis patients and their nurses

Aim

Despite its importance in nursing, perceived quality of the nurse-patient relationship has seldom been researched. This study sought to examine and compare the quality of caring attitudes and behaviours as perceived by haemodialysis patients and their nurses.

Design

This comparative descriptive study involved 140 haemodialysis patients and 101 nurses caring for them in ten haemodialysis units in the French-speaking part of Switzerland.

Methods

Participants completed a sociodemographic questionnaire and the Caring Nurse-Patient Interaction Scale (CNPI-70).

Results

Both nurses and patients reported a high frequency of caring attitudes and behaviours. Patients gave higher ratings than nurses did on all the caring dimensions, except spirituality. Implications are discussed.

EDUCATIONAL INTERVENTIONS IN IMPROVING QUALITY OF LIFE FOR HYPERTENSIVE PEOPLE: INTEGRATIVE REVIEW

ABSTRACT Objective: to evaluate the effectiveness of educational interventions in improving the quality of life of people with arterial hypertension. Method: an integrative literature review which included studies that conducted educational interventions aimed at the hypertensive public to improve quality of life. The search was performed in the following databases: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO and CINAHL, without restriction of language, date and sample size. For this, the following descriptors were crossed: “hipertensão” (hypertension), “educação em saúde” (health education) and “qualidade de vida” (quality of life). 619 articles were retrieved and after the selection and analysis process, a total of 10 made up this review. Data extraction and analysis were performed with the help of validated instruments and the result summarized. Results: Most studies were developed on a quasi-experimental basis, using generic instruments to measure quality of life with significant improvement after educational interventions, with group technology being the most used educational strategy. Just one study used a specific instrument to evaluate hypertensive patients. Conclusion: these results may direct the interventions to be implemented by health professionals in managing arterial hypertension. Further investigations are needed to identify and verify the most effective interventions for hypertensive patients, considering heterogeneous profiles and aiming at improving quality of life.

Investigation of Nursing Students' Perception of Caring Behaviors

Introduction: Nursing is a caring profession. Developing nursing student’s perception of the care remains one of the most important goals of the education process.

Methods: A descriptive-correlational study was carried out in order to identify the caring behaviors, perceptions and associated factors of the nursing students. The target group of the study consisted of 530 nursing students. The data were collected by using the "demographic characteristics form" and "Caring Assessment Questionnaire" (Care-Q). T-test and ANOVA were used in the statistical analysis of the data. Multiple Regression Analysis - Hierarchical Model was used for the analysis of determination.

Results: Mean (SD) of total Care-Q points of the students was 5.0 (0.9), the highest average score of the sub-groups was 5.5 (1.1) in the trusting relationship sub-group; and the lowest average points was 4.5 (1.2) points in the Anticipates sub-group. It was concluded that the perceptions of the students about the caring behaviors is at a good level, and the perceptions of the students about the caring behaviors was affected by the attitudes, plans and experiences of the students about the profession.

Conclusion: Developing the confidence of the students during the nursing education, ensuring the opportunities for empathy and developing the course contents on the bases of the concept of care are the applicable results of this study.

The Effect of Watson's Human Caring Model on Meaning of Life and Symptom Management in Cancer Patients Undergoing Chemotherapy

PURPOSE

The purpose of this study was to determine the effect of Watson's Human Caring Model on the meaning of life and symptom management in cancer patients undergoing chemotherapy.

DESIGN

The study was conducted using a real test model featuring a pretest and posttest and a control group.

METHODS

The sample consisted of 158 adult cancer patients (79 in both the experimental and control groups). The sample size was determined and the participants were allocated to groups using power analysis and a random sampling method. For the pretest, both groups completed an introductory questionnaire, the Life Attitude Profile, and the General Symptom Inventory. Then, the experimenter visited the experimental group patients' homes three times, at 2-week intervals, to provide nursing care based on Watson's model. Finally, after 8 weeks, a posttest was conducted by having both groups complete the Life Attitude Profile and General Symptom Inventory once again.

RESULTS

In the experimental group, the mean total posttest score for the Life Attitude Profile was determined to be 164.21 ± 36.5, and the mean total General Symptom Inventory score was 55.06 ± 13.19; however, in the control group, the mean total Life Attitude Profile score was 127.31 ± 10.61 and the mean total General Symptom Inventory score was 136.91 ± 16.20. The mean differences between the groups were statistically significant (p < .001).

IMPLICATIONS FOR PRACTICE

Care based on Watson's model increases the sense of meaning in life and decreases symptom levels for patients undergoing chemotherapy.

Effects on nurses' quality of working life and on patients' quality of life of an educational intervention to strengthen humanistic practice among hemodialysis nurses in Switzerland: a protocol for a mixed-methods cluster randomized controlled trial

BACKGROUND

Humanistic nursing practice constitutes the cornerstone of the nursing profession. However, according to some authors, such practice tends to fade over time in favour of non-humanistic behaviours. To contrast this tendency, an educational intervention (EI) based on Watson's Theory of Human Caring was developed and tested in two pilot studies involving, respectively, rehabilitation nurses in Quebec (Canada) and haemodialysis (HD) nurses in Switzerland. In light of the positive results obtained in these, another study is being undertaken to examine more in depth the EI's effects on both HD nurses and patients in French Switzerland. The EI is expected to have positive effects on quality of nurse-patient relationship (NPR), team cohesion, nurse quality of working life (QoWL), and patient quality of life (QoL).

METHODS/DESIGN

The study described in this protocol will use a mixed-method cluster randomised controlled trial design. For the quantitative component, nurse and patient data will be collected through questionnaires. The accessible population of 135 nurses and 430 patients will be clustered into 10 HD units. These units will be randomised into an experimental group (EG) and a waiting-list control group (WLCG). Measurements will be taken at baseline (pre-intervention) and repeatedly over time (post-intervention): immediately at EI completion and six and 12 months thereafter. For the qualitative portion of the study, 18 semi-structured interviews will be conducted with EG nurses picked at random two months after EI completion to explore perceived changes in nurse humanistic practice. Qualitative data will be analysed through the relational caring inquiry method, a phenomenological approach. Descriptive and inferential statistics will be computed from the quantitative data.

DISCUSSION

The study described in this protocol will determine if and how the proposed EI promotes humanistic nursing practice and how this practice affects quality of NPR, nurse QoWL, and patient QoL. Moreover, it will lay the groundwork for offering the EI to nurses in other healthcare sectors.

TRIAL REGISTRATION

This clinical study was registered with ClinicalTrials.gov [NCT03283891, 14/09/2017].

A Proposed Middle-Range Theory of Nursing in Hypertension Care

Nursing in hypertension care comprises counselling about lifestyle changes, blood pressure measurement, and being a translator for the physician. For the patient, changing lifestyle means performing self-care. As not much in the form of research and guidelines for nurses is available, a middle-range theory of nursing in hypertension care was developed to guide nurses in their practice, in order to improve the nursing of patients and design studies for investigating nursing in hypertension care. Concepts are presented related to the patient (attitude and beliefs regarding health and sickness, autonomy, personality and traits, level of perceived vulnerability, hardiness, sense of coherence, locus of control, self-efficacy, and access to social support and network) and the nursing (applying theories and models for behavioural change in the consultation and using counselling skills, patient advocacy, empowerment, professional knowledge and health education, and supporting the patient). Then the concepts related to the consultation (communication, shared decision-making, concordance, coping, adherence, and self-care) are integrated with Orem's theory of nursing. Clinical and research implications of the theory are discussed.

Fit for Practice: Analysis and Evaluation of Watson’s Theory of Human Caring

The aim of the authors of this paper is to analyze Watson’s theory of human caring for its usefulness and worth in education, practice, and research. The reason for undertaking this analysis is to evaluate if Watson’s theory would be useful for nursing in those countries where such theories were not an established part of the nursing curriculum. Furthermore, in some European countries, their political past or cultural influences led to an unquestioned adoption of the biomedical model. As their political culture changes, many social structures have had to be revisited, and for nursing, this has meant the introduction of theoretical reasoning, teaching, and practice.

Review of Research Related to Watson's Theory of Caring

Forty retrievable studies are reviewed, covering the period of 1988 to 2003, that were based on Watson’s theory of caring. The author provides an overview of the studies, identifies measurement instruments developed, critiques the body of work, and offers suggestions for future research.

Relationship between diabetes mellitus, hypertension and obesity, and health-related quality of life in Gaziantep, a central south-eastern city in Turkey

AIMS AND OBJECTIVES

The main goal of nursing care should be to increase health-related quality of life as well as improve the medical status of patients with chronic disease. For this reason, this study aims to evaluate and compare the health-related quality of life of patients with diabetes mellitus, hypertension and obesity in Gaziantep, a south-eastern city in Turkey.

BACKGROUND

Diabetes mellitus, hypertension and obesity are the most decisive factors in terms of adversely affecting health-related quality of life.

DESIGN

A cross-sectional, descriptive design was used.

METHOD

In this study, the research population included a total of 1601 diabetes mellitus, hypertension and obesity patients. To evaluate health-related quality of life of patients, Short Form-36 (SF-36) was used. Student's t-test, one-way anova and chi-square analyses were used for comparisons between groups.

RESULTS

In total, 18·1% of patients had combined obesity, hypertension and diabetes mellitus; 16·1% had hypertension and diabetes mellitus. Approximately 16·1% had only hypertension; 15·4% had obesity and hypertension; 13·3% had diabetes mellitus; 12·7% had obesity and diabetes mellitus; and 8·4% had obesity. The health-related quality of life physical component mean scores of patients with combined obesity and hypertension were lower than that of the other groups (p < 0·05). Health-related quality of life physical component mean scores were determined as 34·5 (SD 0·4), and mental component mean scores were determined as 43·9 (SD 4·4). Health-related quality of life physical component mean scores of moderately active patients were higher, while older age and lower educational and income levels had a negative effect on health-related quality of life (p < 0·05).

CONCLUSION

Diabetes, hypertension and obesity decrease patient health-related quality of life while physical activity increases it. The coexistence of obesity and hypertension, in particular, has a more negative effect on health-related quality of life.

RELEVANCE TO CLINICAL PRACTICE

Patients with hypertension, obesity and diabetes mellitus need professional support from nurse. Frequent health-related quality of life evaluation and support is required for chronic patients, especially for those who are older, have lower educational and income levels and those with more than one chronic disease.

The effects of a walking program on older Chinese American immigrants with hypertension: a pretest and posttest quasi-experimental design

OBJECTIVE

Hypertension is known to have high rates among Chinese Americans. Identifying culturally specific interventions to reduce sedentary behavior may be effective in reducing hypertension. This study examines the effects of an 8-week walking program with and without cultural modification.

DESIGN

The study used a 2-group, pretest and posttest, quasi-experimental design.

SAMPLE

A total sample of 128 Chinese American immigrants with hypertension were assigned to walking groups.

RESULTS

The results showed that the walking program had no significant effects upon participant blood pressure or walking endurance. The results also revealed that individuals in the maintenance stage walked longer than those in the preparation stage. A comparison of demographic data showed that subjects with a lower level of education walked more minutes per week, which contributed to lower systolic blood pressures among this group as compared with those with a higher level of education.

CONCLUSIONS

These results suggest that this walking protocol, when translated into Chinese and when accompanied by a weekly telephone reminder and other interactions with a Chinese-speaking nurse, is appropriate to use without additional cultural modification. Future research should examine other components of Chinese culture or should apply this protocol for a longer period of time.

Quality of Life in Contemporary Nursing Theory

A critical appraisal of the concept, quality of life, as used in nursing theories, is presented in a historically situated context. This approach to concept analysis was selected to illuminate the subjective, contextual, and fluid nature of the concept. Based on this review, quality of life is defined as an intangible, subjective perception of one's lived experience. From a review of Peplau's, Rogers', Leininger's, King's, and Parse's conceptualizations of quality of life, it is concluded that it may be viable to replace health with quality of life as a metaparadigm concept for nursing.

A critical review of appropriate conceptual models for use by coronary care nurses

BACKGROUND

There is little evidence of the extent of conceptual model use within cardiovascular nursing. Concern exists within nursing that nursing theory and conceptual model use within practice is less than optimal. It is further suggested that there is little evidence of nursing theory occupying its true position as the central tenet of nursing practice and cardiovascular nurses have been challenged to reconsider this aspect of practice.

AIM

The aim of this review is to explore the effectiveness of conceptual models used within cardiovascular nursing to further explore their potential benefit.

METHODS

Using key terms, a search was conducted using electronic databases CINAHL and PUBMED; yielding seven papers that fulfilled selection criteria.

FINDINGS

Few papers related to research studies in the area. However, of those identified significant examination and testing of concepts emerged within the studies. Rather than merely using concepts as an organizing framework or a component of the study, theories alluded to were scrutinized and consistently applied. Although studies identified mostly referred to specific testing and examination of aspects of conceptual models, the notion of self-care and support for clients emerges as a strong theme within the review. The relationship between nurse and client seemed to be pivotal in any noted improvements.

CONCLUSIONS

The findings have limited application to practice. In the absence of large-scale longitudinal studies, only selected aspects of conceptual models or theory were scrutinized. Further research is required in this area to identify conceptual models of nursing that are most appropriate for cardiovascular nursing care.

Optimizing Nursing Care by Integrating Theory-Driven Evidence-Based Practice

An emerging challenge for nursing leadership is how to convey the importance of both evidence-based practice (EBP) and theory-driven care in ensuring patient safety and optimizing outcomes. This article describes a specific example of a leadership strategy based on Rosswurm and Larrabee's model for change to EBP, which was effective in aligning the processes of EBP and theory-driven care.

Conceptual models used by nurses working in coronary care units--a discussion paper

In the UK, Europe and the USA conceptual models of nursing are features of many undergraduate nursing curricula [Alligood MR. The nature of knowledge needed for nursing practice. In Alligood MR, Marriner-Tomey A, editors. Nursing theory utilisation and application. London: Mosby, 2002, Tierney AJ. Nursing models extant or extinct? J Adv Nurs 1998;8(1):77-85] and commonly used in practice. However, UK nurses in practice continue to be dissatisfied with conceptual model use [Griffiths P. An investigation into the description of patients' problems by nurses using two different needs-based nursing models. J Adv Nurs 1998;28(5):969-977, Mason C. Guide to practice or 'load of rubbish'? The influence of care plans on nursing practice in five clinical areas in Northern Ireland. J Adv Nurs 1999;29(2):380-387, Murphy K, Cooney A, Casey D, Connor M, O'Connor J., Dineen B. The Roper, Logan and Tierney Model: perceptions and operationalization of the model in psychiatric nursing within one health board in Ireland. J Adv Nurs 2000;31(6):1333-1341]. An association with increased paperwork and documentation together with a belief that these abstract concepts do not quite fit with the practice setting has resulted in a generalised apathy towards their use in some areas [Timmins F. Critical care nursing in the 21st Century. Intensive Crit Care Nurs 2002;18:118-127]. In an era of concerns about both cost and quality, together with an increased impetus towards multi-professional working patterns and role expansion, alternative models of care, such as critical pathways and care pathways are gaining increased favour in the clinical setting [Johnson S, editor. Pathways of care. Oxford; Blackwell Science 1997]. The aim of this paper is to consider whether or not the traditional conceptual models of nursing are apt for today's practicing coronary care nurse. Specific questions to be addressed are: what is the research evidence that informs conceptual model use in coronary care and what are the conceptual models that commonly inform contemporary practice in coronary care nursing? Suggested ways forward for conceptual model use within nursing are also proposed.