Swanson’s Theory of Caring

Introduction

Numerous theories have been used in the explanation of the nursing practice. However, for critical analysis of this practice, more emphasis has been put on middle-range theories. The purpose of these theories is to provide a middle reality on generalizing practices in areas in nursing. Also, offering the nurses collective ideas is very useful in their nursing practice. For this paper, the theory of selection is Swanson’s Theory of Caring, which is one of the most outstanding theories used in demonstrating how nurses care for their patients as one of the essential attributes contributing to the well-being of the patients. The theory was put forward by Kristen Swanson, proposed in the year 1991, highlighting the clinical activities (Wolf & France, 2017). Swanson highlights that care for the whole person is the backbone for better care and achieving better health. This paper presents Swanson’s theory of care, its analysis, and its evaluation.

Theory Description

Purpose

Primarily, the role of this theory is to explain caring linking it to nursing practice and care. Swanson’s Theory of care has a central focus on teaching and healing, especially dealing with pregnant mothers. Also, the theory gives insights on both families and healthcare givers o how to address issues on miscarriages and the healing processes (Lillykutty & Samson, 2018). The theory seeks to ensure that the services offered are at their best, providing closure.

Concepts

            The theory makes part of the middle-range theories of caring. More precisely, being structured around five primary concepts, which are maintained belief, knowing, being with, doing for, and lastly enabling (Lillykutty & Samson, 2018). These five components are essential and need adequate time for their development on skills to apply them in nursing practice.

Definitions

            Swanson’s theory of caring is comprised of five components that need to be defined. Maintaining belief is defined as the ability to others in esteem and more critically believing in their ability to achieve their goals. Therefore, the nurses should seek empowerment from the patients to make them gain hope and trust. The aspect of knowledge is trying to understand the meaning of events based on other persons' perceptions. Additionally, knowing is a concept that encompasses seeking to understand events in life while avoiding all possible assumptions. The focus is on persona being cared for, assessing in-depth, seeking cues, and, more importantly, engaging the caregiver and the person being cared for in the process of knowing (Lillykutty & Samson, 2018). Another important concept is being with, which means getting emotionally present for the other person. This provides an opportunity to share feelings; however, it is essential to make sure that the person being cared for is not burdened.  This also means being with the individuals physically to share experiences and ensuring the patient’s situation is well understood.

            The other aspect is “Doing for,” which is an essential component defined by actions to help protect and increase comfort for the person being cared for. This incorporates those activities that are aimed at contributing to health, either achieve recovery or peaceful death. Also, entails adhering to wills, strength, or knowledge. Additionally, focusing on “Enabling,” which focuses on facilitating other persons through life transitions on unfamiliar events (Mårtensson et al., 2020). The role of this concept is empowerment, especially through information, support, generating alternatives, validating feelings, thinking through things, and offering feedback.

Relationships

            Relationships are based on the above concepts, with an assumption that all people reveal some common characteristics. It is assumed that all the people are complex, spiritual, reflective, growing, and thus they appreciate the need of being connected. It is also assumed that nurses understand their role as leaders who fight for human rights, equity in access to health care, and other humanitarian causes (McKelvey, 2018). Besides, the nurses are believed to share experiences and knowledge of caring with others. This concept is genuine, based on the fact that nurses are always willing to share their experiences in various situations and learn from others.

Structure

Figure 1: Structure of caring according to Swanson (Turkel et al., 2018)

Assumptions

All theories are based on various assumptions; this is similar to Swanson’s theory of care, which assumes that caring is effectively demonstrated and its practice is interpersonal. It is also assumed that effective care leads to health and growth. In addition, caring accepts people now as well as in the future (Kalfoss & Owe, 2015). Another assumption is that a caring environment is a basis for development, and thus caring practice is the central focus for nurses and nursing practice.

Theory Analysis

Theory’s Origin

The theory is attributed to Swanson, which is a middle-range theory created over several years. It noted that she developed her theory as she performed phenomenological studies with mothers who have experienced miscarriages, mothers of infants in the intensive care unit, and those at social risks. According to Swanson, caring was the practice of nurturing, through relating to a valued other, especially those one has built with a sense of commitment and responsibility (Lillykutty & Samson, 2018). She closely emphasized caring and the benefits that are borne once the nurses build belief with their patients.

Unique Focus

            The uniqueness of Swanson’s theory of caring is the view on people’s dynamism, growth, self-reflection, and the urge to get connected with others. The view of people being spiritual is not common among many theorists and thus makes this one unique. Also, Swanson believes that the spiritual being is behind the connection of each being to the universe and eternity. This is the source of universal goodness, creativity, mysteries of life, and serenity (Lillykutty & Samson, 2018). Additionally, she presents the spiritual endowment based on soul, positive energy, higher power, or simply grace. She also equates free will to choose, which can decide to act amid various possibilities.  

 

 

 

Content

In addition, to the five principles mentioned earlier, the theory is also built on four meta-paradigm concepts. These concepts include in this paradigm include the person, health, environment, and nursing.

Person	Based on Swanson's theory, a bidirectional relationship exists between people and the environment; this is a molding relationship.
Health	She also states that the definition of health should be based on society and its evolution; it builds on changes and trends in societal norms, values, and beliefs.
Environment	This is the setting that alters or can be altered by the client.
Nursing	Nursing refers to specialized people in caregiving.

 

Theory Evaluation

Significance

             Theory importance is its applicability in practice. The significance of this theory is its ease of applicability in the nursing profession. The theory helps in understanding clients, building a good rapport among them to ensure better care services. However, despite the consequences, there is a need to ensure that the nurses play their role as supporters and mentors to our patients.

Comprehensiveness

            This theory has high utility in nursing. The theory is applicable in many nursing fields; despite the original setup for pregnant mother care, it can be used in other sectors. For instance, it can be applied to in-home care and ending in oncology treatment services. The availability of comprehensive information presented by the theorists makes various nurses choose the theory over others (Kalfoss & Owe, 2015). Through this theory, nurses learn how to apply various techniques in various parts revolving around their practice.

Logical Congruence

Not many theorists take full utilization and realization of logic, which makes theories unique. However, Swanson’s middle-range theory deploys a logic structure in the presentation of ideas. The logic is seen in the categorization of empirical aspects of care actions, which employs systematic literature and the conceptualization process. Additionally, the author presents an understanding of facts and goes beyond empirical data. Besides, Swanson uses theoretical prospects and reflection on other theories, referencing Jean Watson’s Theory (Hubert, 2018). Watson had earlier built a theory named Transpersonal Caring, which would be similar to Swanson’s Theory of Caring; both theories are in most stances cited together, as they portray a high level of credibility.

Credibility

            Swanson’s theory is highly credible. For instance, the Carolina Care Model was based on this theory to develop practices aimed at promoting patient care. This was practiced at the University of North Carolina hospitals. Additionally, Wang and Hsu highlight a full description based on their experiences, using Swanson’s care theory. The two utilize this theory in offering care on terminal lung care patients, with a patient suffering from spiritual distress (Kalfoss & Owe, 2015). Swanson’s models have been highly used in hospitals and also used by various physicians in their practice. By using this theory, the nurses have been in position to provide care to the patients and take care of themselves.

 

 

Contribution to Nursing

            From the discussion above, we understand how this theory has been helpful in the nursing practice. Nurses can effectively apply the theory of care into the caring processes as they go about their daily practices. More importantly, the nurses are in a position to avoid taking the theoretical underpinnings for granted. Based on various scholars, the major challenge faced by the nurses in their profession is on how to measure the care, especially in a complex and evolving healthcare environment (Ortega Barco & Muñoz de Rodríguez, 2018). Therefore, the ability to transform theory into practice will act as a scale that can measure the quality of care offered. Through investigation on empirical attributes of care can help transform care and fully implement theory into practice. This will help offer quality services for both patients and nurses to ensure overall well-being.

Conclusion

In general, quality care is an essential component of nursing that has been around us for centuries. Throughout this time, the nursing department has been in the race towards improving patient and nurse comfort. Essentially, there have been unmentioned efforts daily that focus on growing the profession and health organization to achieve the best. There is a need, therefore, to advance in nursing education, especially on caring. This would also incorporate current technologies and practices, appreciating the changes and evolution in practice. The use of both education and technology will help in promoting best practices in nursing activities.

 

References

Hubert, P. M. (2018). Application of Jean Watson's theory of transpersonal caring in nurses practicing in a pain center (Doctoral dissertation, Seton Hall University).

Kalfoss, M., & Owe, J. (2015). Empirical verification of Swanson’s caring processes found in nursing actions: Systematic review. Open Journal of Nursing, 5(11), 976.

Lillykutty, M. J., & Samson, R. (2018). Insights from Kristen M Swanson's Theory of Caring. Asian Journal of Nursing Education and Research, 8(1), 173-177.

Mårtensson, S., Hodges, E. A., Knutsson, S., Hjelm, C., Broström, A., Swanson, K. M., & Björk, M. (2020). Caring Behavior Coding Scheme based on Swanson’s Theory of Caring–development and testing among undergraduate nursing students. Scandinavian Journal of Caring Sciences.

McKelvey, M. M. (2018). Finding meaning through Kristen Swanson’s caring behaviors: a cornerstone of healing for nursing education.

Mertens, D. M., & Wilson, A. T. (2018). Program evaluation theory and practice. Guilford Publications.

Ortega Barco, M. A., & Muñoz de Rodríguez, L. (2018). Evaluation of the Nursing Care Offered during the Parturition Process. Controlled Clinical Trial of an Intervention based on Swanson’s Theory of Caring versus Conventional Care. Investigación y Educación en Enfermería, 36(1).

Turkel, M. C., Watson, J., & Giovannoni, J. (2018). Caring science or science of caring. Nursing Science Quarterly, 31(1), 66-71.

Wolf, Z. R., & France, N. E. (2017). Caring in nursing theory. International Journal of Human Caring, 21(2), 95-108.