Kristen Swanson: Theory of Caring WEEK# 8

NCM 100 | Theoretical Foundations of Nursing Date (11/17/2022) | Ma’am Palicpic

● She joined the faculty at the University of

OUTLINE: Washington School of Nursing and
I. Credentials & Background continued her scholarly work as professor
II. Theoretical Sources and chairperson of the Department of
● Dr. Jacqueline Fawcett Family Child Nursing until the summer of
● Dr. Jean Watson 2009.
● Dr. Kathryn E. Barnard ● She conducted research funded by the
III. Use of Empirical Evidence National Institutes of Nursing Research.
IV. Major Concepts & Definitions ● From 2004 to 2009, she was Dean and
● Caring Alumni Distinguished Professor at the
● Maintaining Belief University of North Carolina (UNC)
● Knowing School of Nursing at Chapel Hill and
● Being With Associate Chief Nursing Officer for
● Doing for Academic Affairs at UNC hospitals for 5
● Enabling years.
V. Major Assumptions ● Swanson was inducted as a fellow in the
● Nursing American Academy of Nursing in 1991
● Person and received a Distinguished Alumnus
● Health Award from the University of Rhode
● Environment Island in 2002.
VI. Acceptance by the Nursing Community ● She was also selected as a fellow for the
● Practice Robert Wood Johnson Foundation
● Education (RWJF) Nurse Executive Fellows
● Research Program in 2004.
VII. Further Development
THEORETICAL SOURCES

● Three people inspired her to come up

Legend: Black for book Red for audio lecture
with her theory:
Note: PowerPoint presentation was unavailable
o Dr. Jacqueline Fawcett,
o Dr. Jean Watson, and
CREDENTIALS & BACKGROUND o Dr. Kathryn E. Barnard.
● Kristen M. Swanson was born in Providence, 1. She acknowledges Dr. Jacqueline
Rhode Island. Fawcett’s course on the conceptual
● She earned her baccalaureate degree (magna basis of nursing practice, which led her
cum laude) from the University of Rhode to understand the difference between the
Island, College of Nursing, in 1975. goals of nursing and other health
● She began her career as a registered nurse disciplines.
at the University of Massachusetts Medical ● And realize that caring for others as they
Center in Worcester. go through life transitions of health,
● She pursued graduate studies in Adult Health illness, healing, and dying was congruent
and Illness Nursing at the University of with personal values.
Pennsylvania in Philadelphia. ● The approach of nursing is different from
● After receiving a master’s degree in nursing other medical approaches. Although
in 1978, she worked briefly as a clinical most of our theories and fundamentals
instructor of medical-surgical nursing at the are the same, the way we manage
University of Pennsylvania School of Nursing certain diseases and illnesses is different
and subsequently enrolled in the doctoral from other medical fields.
nursing program at the University of Colorado ● In nursing, we use more of a holistic
in Denver. approach where even the spiritual well-
● She decided to learn more about the human being is catered to while the medical
experience and responses to miscarrying. puts more emphasis on the curative
● This theory of caring is focused on several aspect of the illness.
areas but the first area she placed emphasis ● Nursing covers areas such as life
on was mothers who experienced transitions of health, illness, healing, and
miscarriages. dying which other health disciplines tend
● Caring and miscarriage became the focus to overlook.
of her doctoral dissertation and subsequently 2. Swanson chose Dr. Jean Watson as her
her program of research. mentor during her doctoral studies.
● She received an individually awarded ● She attributes the emphasis on exploring
National Research Service postdoctoral the concept of caring in her doctoral
fellowship from the National Center for dissertations to Dr. Watson’s influence.
Nursing Research, which she completed ● However, despite the close working
under the direction of Dr. Kathryn E. Bernard relationship and emphasis on caring in
at the University of Washington in Seattle. Swanson’s dissertation, Swanson’s
program of research on caring and

ALVEZ, ANACTA, AGRESAN, CASTIL, COPINO

 Kristen Swanson: Theory of Caring WEEK# 8
NCM 100 | Theoretical Foundations of Nursing Date (11/17/2022) | Ma’am Palicpic

miscarriage is not an application of ● Hence, she retained the wording that

Watson’s theory of human caring. described the acts of caring and
● Rather, Swanson, and Watson each proposed that all-inclusive care in a
assert that the compatibility of their complex environment embraces
findings on caring in their individual balance among caring, attaching,
programs of research adds credibility to managing responsibilities, and
their theoretical assertions. avoiding bad outcomes.
● Watson’s Theory of Human Caring and ● Swanson recalls after this study, she
Swanson’s Theory of Caring is somehow was finally able to define caring and
the same but they differ in some areas. refine her understanding of caring
For example, where they derive their processes.
nursing theory. ● Collectively, phenomenological
● Swanson’s theory is considered to be inquiries with women who miscarried,
middle-range, meaning her approach is caregivers in the NICU, and socially
specific and not general. Her theory at-risk mothers formed a basis for
focuses first on women who experienced the expansion of the caring model
miscarriages (a very specific population). into the middle-range theory of
While Watson’s was generic and broad. caring.
● Although they differ in some areas, their ● Researchers concluded that applying
similarities stem from the actions of their the theory of caring in clinical
nursing care plan they are still the same. practices is an effective strategy to
You care for the person physically, promote healing after unexpected
spiritually, and emotionally. pregnancy loss for women and men
3. Swanson acknowledges Dr. Kathryn E. as individuals and as couples.
Barnard for encouraging her transition
MAJOR CONCEPNS & DEFINITIONS
from the interpretive to a contemporary
empirical paradigm and for transferring ● Caring is a nurturing way of relating to
caring knowledge from her a valued other to whom one feels a
phenomenological investigations to personal sense of commitment and
intervention research and clinical responsibility.
practice with women who have ● The caring model proposed five basic
miscarried. processes (knowing, being with, doing
● Basically, focused on the application of for, enabling, and maintaining belief).
the theory to the clinical area. Once she
conceptualized her theory, she applied
Barnard’s “contemporary approach”
meaning to date approach.

USE OF EMPIRICAL EVIDENCE

● Swanson formulated her theory of

caring inductively, as a result of
several investigations.
● For her doctoral dissertations, using
descriptive phenomenology, she ● Maintaining belief is sustaining faith
analyzed data from in-depth in another’s capacity to get through an
interviews with 20 women who had event or transition and face a future
recently miscarried. with meaning, believing in another’s
● As a result of this phenomenological capacity and holding him or her in high
investigation, Swanson proposed two esteem, maintaining a hope-filled
models: (1) The Caring Model, and attitude, offering realistic optimism, and
(2) The Human Experience of standing by the one cared for no matter
Miscarriage Model. what situation.
● The caring model proposed five o You are to support a person or
basic processes (knowing, being with, the sustaining faith of your
doing for, enabling, and maintaining patient in order to go through
belief) that give meaning to acts the disease process and to go
labeled as caring. back to the prior lifestyle before
● Swanson (1990) discovered that the he/she got sick.
caring process she identified with o Philosophical attitudes towards a
women who miscarried was also person (in general) and the
applicable to mothers, fathers, designated client (in specific).
physicians, and nurses who were o You become the support
responsible for the care of infants in system/person of your client in
the NICU. order for them to feel that you
are there to help.

ALVEZ, ANACTA, AGRESAN, CASTIL, COPINO

 Kristen Swanson: Theory of Caring WEEK# 8
NCM 100 | Theoretical Foundations of Nursing Date (11/17/2022) | Ma’am Palicpic

o If they are reluctant in your skills ● Once all five steps are performed
then nursing care will not be successfully, we are able to achieve
efficient. Client well-being/wellness.
● This paradigm was first applied to
● After establishing a good rapport with women who experienced
the patient, you get to know the miscarriages.
patient.
MAJOR ASSUMPTIONS
● Knowing is defined as striving to
understand the meaning of an event in ● Her major assumptions focus on:
the life of the other, avoiding nursing, person-client, health, and
assumptions, focusing on the person environment.
cared for, seeking cues, assessing
meticulously, and engaging both the Nursing
one caring and the one cared for in the
● Informed caring for the well-being of
process of knowing.
others.
o Informed understanding of the
● She asserts that nursing is informed
clinical condition (in general) and
by empirical knowledge from nursing
the situation and client (in
and related disciplines.
specific)
● There is ethical, personal, and
o Assessing, probing questions and
aesthetic knowledge derived from the
getting information/data to know
humanities, clinical experience, and
more about your client.
personal and societal values and
● Being with means being emotionally
expectations.
present to the other. It includes being
there in person, conveying Person
availability, and sharing feelings
without burdening the one cared for.
● She defined persons as “unique
o As a nurse, we always
beings who are in the midst of
exercise therapeutic
becoming and whose wholeness is
communication with the
made manifest in thoughts, feelings,
clients.
and behaviors”.
o Message conveyed to the
● She posits that the life experiences
client.
individuals are influenced by are a
o For example, if your client is
complex interplay of “genetic
complaining about the service
heritage, spiritual endowment, and
offered to them you have to
the capacity to exercise free will”.
apply therapeutic
● Swanson views persons as dynamic,
communication. Acknowledge
growing, self-reflecting, yearning to
them and put yourself in their
be connected with others, and
shoes.
spiritual beings.
● Doing for means doing for others
● The life experience of an individual
what one would do for self if at all
influenced by their genetic heritage is
possible, including anticipating needs,
what makes the person dynamic
comforting, performing skillfully and
growing, self-reflecting, yearning to
competently, and protecting the one
be connected with others, and
cared for while preserving his or her
spiritual beings.
dignity.
● It is in our nature to be dynamic and
o Therapeutic actions
complex from others. Our coping
● Enabling is facilitating the other’s
mechanism is different from others,
passage through life transitions and
etc.
unfamiliar events by focusing on the
● She suggests the following: “spiritual
event, informing, explaining,
endowment connects each being to
supporting, validating feelings,
an external and universal source of
generating alternatives, thinking
goodness, mystery, life, creativity,
through, and giving feedback.
and serenity…”
o Therapeutic actions
● This means that someone is more
● After exercising the first three steps,
supreme and of higher power than
you finally do the care and act as an
the person.
enabler or passageway for care.
● The spiritual endowment may be a
Meaning, if the patient cannot
soul, higher power/ Holy Spirit,
perform an action you can provide
positive energy, or, simply grace.
help but if they can, you let them
Free will equates with choice and the
practice autonomy or
capacity to decide how to act when
self-independence.
confronted with a range of
possibilities.

ALVEZ, ANACTA, AGRESAN, CASTIL, COPINO

 Kristen Swanson: Theory of Caring WEEK# 8
NCM 100 | Theoretical Foundations of Nursing Date (11/17/2022) | Ma’am Palicpic

Health Education

● Experience health and well-being. ● The theory offers nurse educators a

● According to Swanson, to experience simple way of initiating students into
health and well-being is to: the profession by immersing them in
“to live the subjective, meaning-filled the language of what it means to be
experience of wholeness. Wholeness caring and cared for to promote,
involves a sense of integration and restore, or maintain the optimal
becoming wherein all facets of being wellness of individuals.
free to be expressed. The facets of
Research
being include the many selves that
make us a human: our spirituality,
thoughts, feelings, intelligence, ● One theory of research will always
creativity, relatedness, femininity, bring another theory after.
masculinity, and sexuality, to name ● Swanson has continued the
just a few.” development of her theory,
● Thus, Swanson reestablishes well- describing and defining the concept
being as a complex process of curing of caring and basic caring process,
and healing that includes “releasing instrument development, and
inner pain, establishing new testing in intervention research with
meanings, restoring integration, and women and men who have
emerging into a sense of renewed experienced unexpected pregnancy
wholeness.” loss.
Environment FURTHER DEVELOPMENT

● This means there are more theories

● Swanson defines environment as to come.
situational. ● Her process of caring suggest that
● She maintains that for nursing it is the theory is applicable in other
“any context that influences or is helping disciplines such as
influenced by the designated client”. education. Social work, and
● Swanson states that there are many medicine as well as additional life
influences on the environment, such situations for nursing.
as the cultural, social, biophysical,
political, and economic realms, to
name only a few. END OF TRANSCRIPTION
● The environment and person-client in
nursing may be viewed
interchangeably. REFERENCES
● Anything outside of the person is
considered to be part of the ● Nursing Theorists and Their Work
environment. 10th Edition
ACCEPTANCE BY THE NURSING
COMMUNITY

● In terms of acceptance, all are

perceived as positive.

Practice

● They demonstrated the applicability

of the theory of caring in clinical
nursing practice, education, and
research.
● The proposition that caring is central
to nursing practice had its beginning
in the theorist’s own insights into
the importance of caring in
professional nursing practice and in
findings from Swanson’s
phenomenological investigations.

ALVEZ, ANACTA, AGRESAN, CASTIL, COPINO