Swanson Kristen - Theory of caring

THEORY OF CARING - KRISTEN SWANSON 

About Kristen Swanson

Kristen Swanson received her nursing degree from the University of Rhode Island in 1975 and her master's degree in nursing in 1978 from the University of Pennsylvania. She went on to get a doctorate degree from the University of Colorado with an emphasis in Psychosocial Nursing. Her books, periodical and journal articles and lectures have been ongoing since the early 1980s. 

Kristen Swanson was an affiliate professor and chair of the Family and Child Nursing program at the University of Washington Medical Center. Swanson also is a professor of Nursing Leadership and is a Robert Wood Johnson Nurse Executive Fellow. In August 2009 Swanson became the sixth dean of the University of North Carolina at Chapel Hill School of Nursing.

She was influenced by women who experienced miscarriage, caregivers of infants in the NICU, interview socially at risk mothers

About theory

The human caring theory is a grand theory that was developed by Watson in the 1970’s, then in 1991, Swanson proposed her caring theory which is a middle range theory consisting of five caring processes (Chen & Chou, 2010). Swanson’s five caring processes include knowing, which is striving to understand an event. Being with, which is being emotionally present. Doing for, this is where you do for the patient as they would do for themselves if they were able. Enabling, facilitating the patient through life transitions which are unfamiliar to them. Lastly, maintaining belief, sustaining faith helps patients get through the process (Polit & Beck, 2004).

Swanson's Theory of Caring asserts that nursing care is a set of interrelated processes that evolve from the nurse's own convictions and knowledge& his/her interactions with the patient. 

Model of the theory

Swanson's Theory is based on the research and practice of Dr. Kristen Swanson. Her focus primarily has been on pregnancy issues. Nurses are best known for being natural caregivers and Swanson’s Theory of Caring focuses on teaching and healing during pregnancy. Her theory gives insight on how patients, families and healthcare providers deal with miscarriages and the healing process that is necessary to provide closure. Her practices have been incorporated into obstetric education models and physician practices around the country, according to biographers at the University of Washington Medical Center.

Swanson's Theory takes the necessary steps to deal with miscarriages on all levels. Her studies have encompassed caring-based counseling techniques that serve the mothers and fathers and the dynamics between the two following a miscarriage. She incorporates techniques to deal with the sociocultural effects of the loss of a baby. Swanson's Theory goes beyond the physical aspects that health care practitioners consider to promote emotional healing from the effects of miscarriage and spontaneous abortion.

The Swanson Theory of Caring has five basic principles, according to the guide followed by nurses at Winter Haven Hospital in Florida. The five principles are knowing, being with, doing for, enabling/empowering and maintaining belief. According to Swanson, caregivers should do their best to know and understand what the famly is going through and be present to listen and not burden them with more than they can handle. They should do for the family what needs to be done and help facilitate their passage through the event. Finally, nurses who follow Swanson's theory of caring maintain the belief that the family can get through the crisis.

FIVE CARING PROCESSES

Objective of Swanson's Model : deliver care that promotes dignity, respect & empowerment

5 components of caring:

• Knowing

• Being with 

• Doing for 

• enabling 

• Maintaining belief

STRUCTURE OF CARING

  

KNOWNING:

• Avoiding assumptions
• Cantering on the one cared for
• Assessing thoroughly
• seeking cues
• engaging the self of both

BEING WITH:

• being there
• Conveying availability
• enduring with
• sharing feelings
• Not burdening

DOING FOR:

• Comforting
• anticipating needs
• performing competently/ skilfully
• Protecting
• Preserving dignity

ENABLING/ INFORMING

• Informing/ explaining
• Supporting/advocating 
• generating alternatives
• giving feedback
• Validating feelings

MAINTAINING BELIEF

• believing in
• maintaining a hope-filled attitude
• helping to find meaning
• offering realistic optimism
• "Going the distance"

Metaparadigm of the theory

Persons;  Swanson described person as unique beings who are in the midst of becoming and whose wholeness is made manifest in thoughts,feelings, and behaviors. (Swanson 1993). The person enjoy free will. Nurses should avoid letting the race,class, religion, skin color or gender of the person set limitation on the quality of health care that will be provided. The person does not just address the patient but also the family, groups and society. 

Environment; The environment was described situationally, It is any context that influences or is influenced by the client. According to Watson, Caring exists in every society. The nurse is a part of the environment and she should provide a therapeutic environment for the patient. 

Health; According to Swanson, to experience health and well-being is to live the subjective, meaning-filled experience of wholeness. Health perception is different among individuals. Nurses must consider health from the patient's perspective which could include their cultural beliefs and taboos, religious beliefs and how it affects their health. 

Nursing; Nursing is the informed care for the well-being of others. Swanson's defintin of the concept of nursing is very simple and direct. She states that nursing is being well informed and knowledgeable about how a person is to be cared for, in other to help them improve their health. The nursing discipline makes use of knowledge from nursing and other related discipline like ethics, humanities, clinical experiences, person and society expectation of values.

Applications to Nursing practice

In clinical practices,nurses need to incorporate all five of Swanson’s caring processes. When a patient has just gone through a miscarriage; provide empathy and try to understand her grief, give the family space and time, and listen when they want to talk. Let the patient know that you are emotionally connected by touching her on her arm or hand and letting her know how deeply sorry you are for her loss and that you can not imagine what she is going through at this point in time.

 Assist patients to do what they would normally do for themselves, by providing privacy, peri-care, nutrition, and comfort. Help patient through this unfamiliar event by placing a leaflet on her door so other healthcare workers know that a fetal demise has occurred. Create a keepsake box that includes a book that the family can write their feelings in. Provide patients with literature on the healing process, funeral homes for the infant, and support groups that they can attend or websites that they can refer to. Most importantly, provide closure by encouraging them to hold the baby. If these patients are able to get closure they will have hope and be able to face a future with meaning.

By: 

Jideofor Racheal

Ikegwuonu Chigozie Blessing

Adewoyin Imisioluwa E.

References

Chen, S., & Chou, F. (2010). A comparison of the caring theories of Watson and Swanson [Chinese]. Journal Of Nursing, 57(3), 86-92.

Polit, D. and Beck, C.T. (2004). Nursing research: Principles and methods. Lippincott Williams & Wilkins.

Swanson, K. (1993). Nursing as informed caring for the well-being of others. IMAGE: Journal of Nursing Scholarship, 25(4), 352-357. Retrieved from http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291547-5069

https://swansoncaringtheory.weebly.com/assumptions-and-definitions.html

https://www.nursingald.com/articles/12244-swanson-s-theory-of-caring

https://www.livestrong.com/article/31652-swansons-theory/

https://ww2.mc.vanderbilt.edu/evidencebasedpractice/40293