Watson‟s Carative Factors

and“Caritas”

Revised by Dr. Ann Waterman

2011

Curative Factors vs Carative Factors

Curative factors aim at curing the patient of

disease, Carative factors aim at the caring process

that helps the person attain (or maintain) health or

die a peaceful death” (Watson, 1985, p.7).

Caritas

Latin:

“To cherish, to appreciate, to give

special, if not loving, attention to.”

Caritas Process involves

charity, compassion and

generosity of spirit

Outcomes of this process

include healing and health

Carative Factor #1

The Formation of A Humanistic-Altruistic

Value System

Caritas: Cultivating the practice of loving-kindness and

equanimity toward self and other as foundational to

Caritas consciousness

One receives through having an inner state of “balance”

Appreciate the unique individual

Capacity to tolerate and “see” through another‟s „eyes”

Non-interference with what is

Carative Factor #2

The Instillation of Faith-Hope

Caritas: Being authentically present: enabling,

sustaining, and honoring the faith, hope, and

deep belief system and the subjective life world

of self/others

Discover what is important to another

Respect the patient‟s beliefs and encourage them as

significant influences in promoting and maintaining

health

Consider one‟s potential

Nurture faith and hope in self and others

Carative Factor #3

Cultivation of Sensitivity to One‟s Self and

Others

Caritas: Cultivation of one‟s own spiritual practices

and transpersonal self, going beyond ego-self

Recognize and acknowledge feelings

Be introspective, honest and authentic

Accept yourself which will lead to acceptance of others

Sensitivity to patient feelings enhances the connection with

the patient

Carative Factor # 4

Development of Helping-Trust Relationship

Caritas: Developing and sustaining a helping-

trusting caring relationship

Try to enter into the experience of another, empathy

Use effective communication skills

Center self and be truly present

Use of appropriate touch as a form of

communication

Use acceptance and positive regard with the other

Be intensely attentive when communicating

Carative Factor # 5 Promotion and Acceptance

of

Positive & Negative Feelings

Caritas: Being present to, and supportive of, the

expression of positive and negative feelings

Consider and observe for the intellectual response

as well as the emotional response

Allow others to express negative and positive

feelings without feeling defensive

Use supportive behaviors and understanding

Carative Factor # 6 The systematic use of the scientific problem-

solving method for decision making.

Caritas: Creative use of self and all ways of knowing as

part of the caring process; engage in the artistry of Caritas nursing

Imagination

Creativity

Nursing process

Nursing research

Critical Thinking

Carative Factor # 7

The Promotion of Interpersonal

Teaching-Learning

Caritas: Engage in genuine teaching-learning

experience that attends to unity of being

and subjective meaning-attempting to stay

within the other‟s frame of reference

Health teaching is one of our main functions

Assess the person‟s current knowledge, need to

know, and what they want to know

Effective teaching/learning will help decrease stress

– don‟t forget evaluation

Carative Factor # 8

Provision for a Supportive, Protective and/or

Corrective Mental, Physical, or Spiritual Environment

Caritas: Creating a healing environment at

all levels

Holistic based care is needed

Some areas to consider are: safety, comfort, privacy,

dignity, protection, internal and external factors in the

environment, and cleanliness

Carative Factor # 9

Assistance with Gratification of Human

Needs

Caritas: Administering sacred nursing acts

of caring-healing by tending to basic

human needs

Survival needs such as ventilation, elimination, food,

and fluids

Functional needs such as activity and rest

Integrative needs such as belonging and achievement

Growth-seeking needs such as interpersonal needs and

spiritual needs.

Carative Factor # 10

Allowance for Existential and Phenomenological

Factors

Caritas: Opening and attending to

spiritual/mysterious and existential

unknowns of life-death-suffering (allowing for a

miracle)

Openness to the unknown

Understand the person from their frame of reference since

persons must find their own meaning and solutions to

problems

When persons feel understood they feel safe, relief,

satisfied, accepted, and less lonely

Phenomenology

Things as they appear in our experience, or the ways we

experience things.

This approach values the total person as more important

than the pathogen, bacteria or illness alone

Even though the nurse can never fully know what the

person is experiencing, the nurse seeks to understand the

individual and his/her experiences

Existentialism

The Existentialist View (We create our own nature.): We

are thrown into existence first without a predetermined

nature and only later do we construct our nature or

essence through our actions.

Carative Factors/Caritas

Processes

A caring relationship is one of potential and authentic

presence

A caring relationship allows the person to explore

options, choosing the best action for self

Caring is more “healthogenic” than curing

Caring Science is complimentary to Curing Science

Patient Expectations of

nurses:

Caring,

Compassionate,

Able to teach,

Trusting,

Respectful,

Confident, and

Competent

Using Caring Theory

Better care given

Positive health outcomes

Patient Satisfaction

Nurse Satisfaction

How you are as a nurse

Depending on your caring, attitude, and competence the patient‟s world can become:

Larger or smaller

Brighter or drab

Rich or dull

Threatening or secure

Nurses have the ability to make a huge difference in the healthcare experiences of their patients.

Caring questions to consider

Is caring for family and friends different than caring for patients and their families?

How does a nurse nurture faith and hope in a client?

Watson believes that the science of caring must achieve a balance between scientific knowledge and humanistic practice. How do you interpret this statement?

What behaviors do you feel are important to establish a trusting-caring relationship?

What carative factors have you used when working with patients and families?

Case Study in Caring

Your client Ms. Ford, is a newly diagnosed diabetic. While she was hospitalized you explained her care, offered her choices when possible, and established a good rapport with her. Prior to discharge you plan to discuss her disease, her current medications and the new ones the physician has ordered. You plan to teach her and her significant other how to inject her insulin and monitor her blood sugar. You will implement some health promotion in terms of skin care and nutrition information also. You have consulted with the dietician and have been instrumental in coordinating her discharge planning as well as developing her ongoing nursing care.

What carative factors/caritas processes will you use to accomplish this?

What caring behaviors will you use?