1. Watson’s Theory of Transpersonal Caring
Ellenor Chance BSN, RN

2. Introduction
The changes in the health care delivery systems around the world have intensified nurses’ responsibilities and workloads. Nurses must now deal with patients’ increased acuity and complexity in regard to their health care situation. Despite such hardships, nurses must find ways to preserve their caring practice. Jean Watson’s Transpersonal Caring Theory can be used to foster and preserve these caring behaviors.

3. Explanation of theory
The major elements of her theory are (a) the carative factors, (b) the transpersonal caring relationship, and (c) the caring occasion/caring moment.
Carative Factors
*Viewed as a guide for the core of nursing
*She uses the term carative to contrast with conventional medicine’s curative factors.
*Her carative factors attempt to “honor the human dimensions of nursing’s work and the inner life world and subjective experiences of the people we serve”.

4. Explanation of Theory *The factors include the following ten elements:
-Humanistic-altruistic system of value.
-Faith-Hope.
-Sensitivity to self and others.
-Helping-trusting, human care relationship.
-Expressing positive and negative feelings.
-Creative problem-solving caring process.
-Transpersonal teaching-learning.
-Supportive, protective, and/or corrective mental, physical, societal, and spiritual environment.
-Human needs assistance.
-Existential-phenomenological-spiritual forces.

5. Explanation of Theory
In 2001, Watson introduced the concept of Clinical “Caritas” process which has since replaced the carative factors.
The word “caritas” originates from the Greek vocabulary, meaning to cherish and to give special loving attention.
The Clinical Caritas process emphasizes a greater spiritual dimension and is outlined as followed:
-(CCP1)Practice of loving kindness and equanimity within context of caring consciousness.
-(CCP2)Being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and the one-being-cared-for.
-(CCP3) Cultivation of one’s own spiritual practices and transpersonal self, going beyond ego self, opening to others with sensitivity and compassion.
-(CCP4) Developing and sustaining a helping-trusting, authentic caring relationship.
-(CCP5) Being present to, and supportive of, the expression of positive and negative feelings as a connection with deeper spirit of self and the one-being- cared-for.

6. Explanation of Theory
-(CCP6) Creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices.
-(CCP7) Engaging in genuine teaching-learning experience that attends to unity of being and meaning, attempting to stay within others’ frames of reference.
-(CCP8) Creating healing environment at all levels (physical as well as non-physical), subtle environment of energy and consciousness, whereby wholeness, beauty, comfort, dignity, and peace are potentiated.
-(CCP9) Assisting with basic needs, with an intentional caring consciousness, administering “human care essentials,” which potentiate alignment of mind, body, spirit, wholeness, and unity of being in all aspects of care; tending to both the embodied spirit and evolving spiritual emergence.
-(CCP10) Opening and attending to spiritual-mysterious and existential dimensions of one’s own life-death; soul care for self and the one-being-cared-for.

7. Transpersonal Caring relationship
-For Watson (1999), the transpersonal caring relationship characterizes a special kind of human care relationship that depends on:
-The nurse’s moral commitment in protecting and enhancing human dignity as well as the deeper/higher self.
-The nurse’s caring consciousness communicated to preserve and honor the embodied spirit, therefore, not reducing the person to the moral status of an object.
-This relationship describes how the nurse goes beyond an objective assessment, showing concerns toward the person’s subjective and deeper meaning regarding their own health care situation.
-The goal of a transpersonal caring relationship corresponds to protecting, enhancing, and preserving the person’s dignity, humanity, wholeness, and inner harmony.

8. Caring Occasion
The moment (focal point in space and time) when the nurse and another person come together in such a way that an occasion for human caring is created.
-Both persons, with their unique phenomenal fields, have the possibility to come together in a human-to-human transaction.
-The nurse needs to be aware of her own consciousness and authentic presence of being in a caring moment with her patient.
-Both the one cared-for and the one caring can be influenced by the caring moment through the choices and actions decided within the relationship, thereby, influencing and becoming part of their own life history.
-The caring occasion becomes “transpersonal” when “it allows for the presence of the spirit of both—then the event of the moment expands the limits of openness and has the ability to expand human capabilities

9. Origin
Watson’s theory originated from her notes on personhood, life, health, and healing that she wrote while as a faculty member at the University of Colorado. These notes later became the bases for her first book entitled, The Philosophy and Science of Caring.
Watson’s theory of transpersonal caring is based in the sciences and humanities, with philosophers such as Carl Rogers, Maslow, Nightengale, Henderson, and Peplau all having influence on her work

10. Transpersonal Caring in Practice
The use of transpersonal caring in practice is to develop caring as an ethical framework for the profession and discipline of nursing and to clarify its existence with other health sciences.
Caring/Caritas model is consistently one of the nursing caring theories used as a guide in Magnet Hospitals.
Caring Rounds at bedside with patients

11. Transpersonal Caring in Research
Transpersonal caring is used in research to aid in the development of nursing as human science and through qualitative methods (Alligood & Tomey, 2010, p. 101)
Transpersonal Caring theory can be used in research to assess nurses perceptions on caring for different patient populations.
Meyer (2011) conducted a study to explore the experience of pediatric nurses caring for dying children.-

12. Research Cont
Transpersonal caring is also be used in research to assess the patient’s perceptions of the nurses use of caring behaviors.
Wilberg and Bundas (2010) study looked at patient’s perceptions on intercultural caring in maternity care.

13. Transpersonal Caring in Education
Watson’s theory is used in educating graduate nursing students providing ontological, ethical, and epistemological bases for their practice.
Watsons framework is used in numerous baccalaureate and graduate nursing programs across the country.

14. Transpersonal Caring to guide nursing research.
Meyer (2011) conducted a study to explore the experience of pediatric nurses caring for dying children. The study was conducted using phenomenological methods. The interviews were audio taped, transcribed, and analyzed to identify themes and essences of the experiences. The essences of the nurses' experiences were identified: (a) alleviate, (b) tribute, (c) amid, (d) blessed, (e) silence, (f) sympathy, (g) craft, and (h) impact .The themes and essences were then compared to Watson's Theory of Human Caring and her Caritas Processes.

15. Transpersonal Caring in Practice
Watson (2009) published a article that highlights the use of transpersonal caring in clinical practices. She states that those facilities aspiring to achieve deeper level of patient caring are most apt to use the theory of transpersonal caring. She identifies Magnate status hospitals as on industries that widely use the Caritas Care model. Watson states that transpersonal caring model can impact health care and the health care system with improved patient care and creation of a holistic care environment.

16. References
Alligood, R, M., & Tomey, A, M. (2020). Jean watson, In (Eds.). Alexopoudoulous, Y and
Bays, H. Nurisng theories.(pp ). 5th ed. Maryland Heights:Missouri
Meyer, L, R. (2011). The experience of pediatric intensive care nurses caring for dying children. Azusa Pacific University Retrieved from: &FMT=7&DID= &RQT=309&attempt=1&cfc=1
Watson, J. ( 2009). Caring science and human caring theory: Transforming personal and professional practices of nursing and health care. JHHSA Retrieved from: /ictp-handouts/TransformingPersonalAndProfessionalPractices.pdf
Wikiberg, A., & Bondas, T. (2010). A patient perspective in research on intercultural caring in maternity care: A meta-ethnography. Int J Qual Stud Health. 5(1) Retrieved from: