Critical Appraisal of Jean Watson's Theory of Human Caring 1chibaby
An Appraisal of a Study Done Predicated on Watson's Human Caring Theory
August 1, 2020
Description of the study
This study was titled "Effects of Nursing Care Based on Watson's theory of Human Caring on Anxiety, Distress, and Coping When Infertility Treatment Fails: A Randomized Controlled Trial" (Durgun & Okumus, 2017). It concentrated on establishing the impact of incorporating Jean Watson's theory on caring in nursing routines during infertility treatment. The study was carried out at an infertility clinic in Turkey between April and November in 2012, on 86 women going through infertility treatment at the clinic.
Watson's theory emphasizes the importance of caring as part of health restoration in human beings (Gonzalo, 2019). It highlights that caring is essential in nursing practice. Her theory is based on ten carative factors, with three main ones being the philosophical bedrock of the healing science. They include creating a humanistic-compassionate value system, instilling hope and faith in people, and building a self and others (Watson, 2012). It is no secret that infertility treatment failure leads to a lot of anxiety and distress, and the families require professional support in coping with the stress and failed expectations.
Of the 86 women in the study, 45 were put in the intervention set of participants, and 41 were placed in the control set. After the treatment was complete, 32 treatments of the intervention set participants failed, while 35 of those in the control set failed. The intervention set was treated to a follow-up nursing and nurturing care plan based on Watson's Theory, while the control set was treated to a standard nursing care plan. The data collection methods used in the study included Anxiety scales, Distress Scales, and Coping Methods Inventories, and analysis of the data was done through the statistics software SPSS. The analysis revealed that nursing plans predicated on Watson's Theory are indeed effective in reducing the anxiety and distress that infertility patients deal with, and in improving the coping mechanisms of the patients.
Type, Design, and Quality of the study
The type of study was randomized controlled, and all its phases were designed using the Consolidated Standards of Reporting Trials method. All the women who took part in the study did so voluntarily. However, they were not aware of their assignment in either the control or intervention group. The women's assignment in either group was done by someone removed from the study and was done using the block randomization method. In this way, the designation was random and hidden from the person performing it. The staff working at the clinic were also blinded to the groups to which the women were assigned. Furthermore, the women's appointments in the two groups were set at separate times to prevent them from talking about their treatments. None of the participants dropped out of the study.
The two nursing care programs were implemented from the very start of the treatments. This system fostered trust between the participants and the researcher and made it easier to follow up with the ladies whose treatment was unsuccessful. The results were all evaluated in the group to which the participants were designated. Additionally, the follow-up assessment, which involved six sessions during the treatment process, one session before and after the pregnancy test, and two sessions after the treatment's failure, was spread out over a period long enough to effectively determine the effects of the two nursing care plans correctly. The participants' socio-demographic data also showed that the base clinical variables of both the intervention set and control set were similar and that the groups were homogenous.
Furthermore, the tools used to measure and analyze the data were credible and supportable. They included the use of the Spiel Berger's State-Trait Anxiety scale in determining the participants' levels of anxiety throughout the process, the Infertility Distress Scale to aid in portraying the participants' emotions towards the treatment, and a Coping Methods Inventory to aid in outlining the coping mechanisms used by the women at different stages of the treatment. The inventory measured how the women used five coping approaches, which included self-confidence, optimism, self-doubt, submission, and seeking social support. Finally, the statistical analysis software SPSS (version 13) was used to analyze the data collected.
Results of the study
In general, the results of the study established that nursing practices predicated on Watson's Theory are undoubtedly useful in reducing the anxiety and distress that infertility patients experience during the treatment process. The intervention set's mean anxiety score lessened by 13 points, and the distress levels lessened by 14 points by the end of the treatment and follow-up processes. The intervention set's favorable coping methods score increased. In contrast, a negative rise was revealed in the control set's scores for anxiety, distress, and harmful coping methods.
Specifically, for all three measurements, the analysis revealed that there was no difference between the scores for the control and intervention sets at the start of the treatment. However, this state changed as the treatments progressed, and the two nursing care plans were implemented during follow-ups. For the anxiety scores, the change from start to end of the treatment for the intervention set was a variance of 78.09, while for the control set, it was 2.69. For the distress sale, the intervention set's change was 52.31, while for the control set was 6.80.
The same trend was observed for all coping methods, with a significant change being perceived in the intervention set's favorable coping methods and little change perceived in the control set's methods. The care group utilized the positive coping mechanisms more like the self-confidence and optimism approaches. The nursing plan based on Watson's Theory was also precise based on how it was structured and implemented in the intervention group.
Feasibility and rationale for the study
However, not all the clinically relevant outcomes of the nursing care plan were measured. The study focused on the women alone, whereas the treatment is usually done for the couple. Nonetheless, the benefits of the care plan were numerous. The care plan based on Watson's Theory ensured that the women were encouraged to express their emotions more and were thus able to use more positive coping methods during and after the treatments. Reduced anxiety and distress levels also had a positive effect on the success of the treatment. The psychological support aided those whose treatment failed in dealing with depression. The care plan also provided much-needed guidance to the nurses in supporting the patients.
In conclusion, the nursing care plan was proved to be undeniably feasible in terms of application in nursing care. Its implications for practice were positive since no circumstances emerged from the study that would prevent its application in all nursing care types, not just infertility nursing care. Moreover, the benefits of its application are numerous, as seen above. The study also definitely fostered the Human Caring Theory's advancement, but further research would be welcome.
Durgun, O. Y., Okumuş, H. (2017). Effects of nursing care based on Watson's theory of human caring on anxiety, distress, and coping, when infertility treatment fails: a randomized controlled trial. Journal of Caring Sciences, 6 (2), 95-109.
Fineout-Overholt, E., Melnyk, B., Stillwell, S., Williamson, K. (2010). Critical Appraisal appraisal of the Evidenceevidence: Part II. American Journal of Nursing, 110(9), 41-48.
Watson, J. (2012). Human Caring Science: A Theory of Nursing. 2nd ed. U.S: Jones & Bartlett Learning, Sudbury, MA