A teoria do cuidado humano de Watson e as experiências subjetivas de vida: fatores caritativos/caritas processes como um guia disciplinar para a prática profissional de enfermagem

Este artigo fornece uma visao geral da teoria de Cuidado Humano de Watson, a nocao de Caritas e o fenomeno humano. Uma enfase especial e dada sobre os 10 Fatores Caritativos/Caritas Processes, os processos de viver humano e as experiencias subjetivas de vida que fazem parte da estrutura da teoria. Estes aspectos centrais dos conceitos da teoria e processos de viver sao desenvolvidos na fundamentacao filosofica e etica do corpo da Teoria de Cuidado. Juntos, eles servem como um guia para a pratica profissional, bem como, um esquema disciplinar para a Ciencia do Cuidado.


INTRODUCTION
The origin of the original theory of human caring was my first book -Nursing: the philosophy and scie work was published before there was formal attention to nursing theory as the disciplinary foundation education, and practice.
:49 It also ser ethical-philosophical foundation for the deeply human dimensions of nursing.
The theoretical concepts were derived and emerged from, my personal/professional experiences; they empirically grounded and combined with my philosophical, intellectual, and experiential background.emerged from my own values, beliefs, perceptions and experiences about rhetorical and ineffable ques mean to be human?What does it mean to care?What does it mean to heal?What does it mean to develo practices about life phenomena and subjective human experiences?What is a living philosophical con and life meaning in health and illness?Questions and views of personhood, life, death, change, health, healing, caring, wholeness, pain, suffer guiding my quest to identify a framework for nursing as a distinct entity, profession, discipline and scie separate from, but complementary to medicine. 1 My views were heightened by my commitment to the mission of nursing; its ethical covenant with society as sustaining human caring; in honoring the lived other; in seeking to preserve humanity, even when threatened; attending to and helping to sustain hum oneness of being, to hold the other in their wholeness, even when they could not feel whole themselve which transcend illness, diagnosis, condition, setting, and so on, and are enduring and timeless across changes in society and science.
Since then, the original work has expanded and evolved through a generation of other theory-based bo followed: -"Nursing: human science and human care, a theory of nursing".Connecticut (USA): Appleton/Century Reprinted/republished, New York (NY/USA): National League for Nursing; 1988.Reprinted/republishe Jones & Bartlett; 1999. 3-"Postmodern sursing and seyond".Edinburgh (Scotland): Churchill-Livingstone.Reprinted/republish Brace/Elsevier; 1999. 4Caring science as sacred science".Philadelphia (USA): FA Davis; 2005.5 The first book "Nursing: the philosophy and science of caring" 1 provided the original core and structur Human Caring: 10 Carative Factors.These factors were identified as the essential aspects of caring in nu perhaps nurses were not practicing professional nursing, but were functioning as technicians or skilled dominant framework of medical techno-cure science. Tsecond book "Nursing: human science and h nursing" 3 expanded upon the philosophical, transpersonal aspects of a caring moment as the core fram the ideas more explicitly within a broader context of ethics, art and even metaphysics-spiritual, as deep within which nursing dwells, but often does not name, nor articulate, nor act on.
As it has been pointed out in postmodern discourse today; "if a profession does not have its own langu thus it is important to name, claim, articulate and act upon the phenomena of nursing and caring and th living experiences of self and other; this focus for nursing and caring science is essential if nursing is to raison d être for existing in science and society.This work makes more explicit that if nursing is to survi then it has to sustain and make explicit its covenant with the public which includes knowledge, values, practices of caring, healing, health, and living phenomena of human experiences.
The third book "Postmodern nursing and beyond" 4 brought a focus to the professional paradigm whic ontology of relations and an ethical-ontological foundation before the conventional epistemology of s The need to clarify the ontological foundation of Being-in-Relation within a Caring paradigm; the unity was the focus of this work, going beyond the outdated separatist ontology of modern, Era I medical ind It is here in this book that the spiritual and evolved energetic aspects of caring consciousness and inten presence and personal evolution of the practitioner became more developed.This evolution was place post -modern cosmology of healing, wholeness, oneness which is an honoring of the unity of all, and t and life phenomena in which nursing dwells.
My most recent theoretical book "Caring science as sacred science"5 was selected as an AJN Book of th the category of research; it expands further upon the original work on caring, now placing Caring Scien moral-philosophical -evolved scientific context, guided by the works of Emmanual Levinas (French) 6 (Danish). 7This latest work seeks a science model that reintegrates metaphysics with the physical doma of -Belonging, (to infinite field of Universal Cosmic Love) as before and underneath Being-by-Itself alo and separate from, the broader universal field of infinity, to which we all belong and return to from ear brings a decidedly sacred dimension to the work of caring, making more explicit that living human exp phenomena with spiritual and philosophical-ethical-moral dimensions; reminding us that we dwell in mystery because we are working with the living processes, the life force, life energy, the soul if you will This focus makes more explicit that relational, existential-spiritual human caring dimensions and the d deeper meaning of life are part of the inner healing journey we make with self and others on this earth happens when we are practicing within a caring-healing model.When we are conscious of an expanded expanded deeper moral-ethical foundation as the nature of caring and human living processes, we hav understanding and humility.We are asked to acknowledge a need for wisdom, even to surrender, to th Self, and the outer world controls, that often we think we have.
With that background of my major books on Caring theory, Philosophy, and Caring Science the rest of several of the conceptual aspects of the work; the core of the original work in context of its evolution; ou Factors (CF).

DEVELOPMENT
The Caritas Processes (CP) are juxtaposed against the original Carative Factors.The Caritas Processes are other which have evolved; CP are intended to offer a more fluid language for understanding a deeper l the deeper dimensions of living processes of human experiences.The original terms and concepts of th needed to evolve as they seemed too set in the language of the earlier era, although still relevant.
Nevertheless, in this article, I am using the two forms almost interchangeable.However, Caritas makes connection between Caring and Love and human living processes.These aspects are more prominent science. 5me exemplars of how the work in used as a guide to transforming practices within the context of livin included in Box 1.
These 10 original Carative Factors remain as the timeless structural core of the Theory, while allowing emergence into more fluid aspects of the model captured by the 10 Caritas Processes.
In introducing the original concepts of Carative Factors as core for a nursing philosophy and science, I theoretical counterpoint to notion of Curative so dominant in medical science.Thus, the Carative Facto framework to hold the discipline and profession of nursing; they were informed by a deeper vision and the human dimensions /living processes of caring in nursing; the art and human science context.I was aspects of professional nursing that transcended medical diagnosis, disease, setting, limited and chang technology of specialized foci.What remains as core? 10 Carative Factors (embellished by philosophic Caritas consciousness).
In moving from the concept of Carative, to Caritas I was making an overt evocation of love and caring t paradigm to connect with the existential-spiritual dimensions and living processes of human experienc ironically places nursing in its most mature paradigm, while reconnecting with heritage and foundation the spiritual living processes of our humanity.
With Caritas incorporated more explicitly into my work, it locates the theory within an ethical and onto point for considering not only its science, but its societal human caring mission.This direction makes a connection between caring and healing and the evolved human consciousness of living subjective exp phenomena.The background for this work is published on my website.See www.uchsc.edu/nursing/cinformation. 8

CONTEXT FOR CARATIVE/CARITAS PROCESSES
The Carative Factors/Caritas Processes are not complete without acknowledging the worldview and ph which holds the concepts.For example: a cosmology of oneness of Being; phenomenal field which hon intersubjective inner life world, transpersonal caring relationship, caring occasion and caring moment.dimensions serve to remind that any nurse -patient encounter can be considered a caring occasion wh moment" can be created and experienced, depending upon the consciousness, intentionality, and phil orientation which is guiding the nurse. 2 A caring moment transcends time and space and continues as pattern of life of both nurse and patient.

Humanistic: altruistic system of values
Caring is grounded on a set of universal humanistic altruistic values.Humanistic values include kindne and love for self and others.They derive from childhood experiences and are enhanced by beliefs, cult values arise from commitments to and satisfaction from receiving through giving.They bring meaning one s belief and relationships with other people.Humanistic-altruistic feelings and acts provide the ba promote the best professional care, and as such, constitute the first and most basic factor for science an

Enabling and sustaining faith and hope
The history of medicine is replete with documentation of the importance of a person s belief in faith an Hippocrates thought that an ill person s mind and soul should be inspired before one s illness was trea examples, medicine itself was secondary to magic, incantations, spells, and prayers.In this Carative Fa encouraged, honored and respected as significant influences in promoting and maintaining health.Reg scientific regimen is required for medical care of a person, the nurse should nurture faith and hope and of the one-being-cared for.Even when there is nothing left to do medically, the nurse nurtures a patien something or someone beyond his or her self.

Sensitivity to self and other
To be human is to feel.All too often people allow themselves to think their thoughts, but not feel their f develop sensitivity to one s self and to others is to recognize and feel one s feelings.
The development of self and the nurturing of judgment, taste, values, and sensitivity in human relation emotional states.The development of feeling is encouraged by the humanities and compassionate life Sensitivity to self is the recognition and acknowledgement of feelings -painful as well as happy ones.I into oneself and a willingness to explore one s own feelings.People who are not sensitive to and repre be unable to allow others to express and explore their feelings.Sensitivity to self not only leads to selfpsychological growth, but to sensitivity and acceptance of others.
Nurses who are sensitive to others are better able to learn about another s view of the world which, sub concern for others comfort, recovery, and wellness.Nurses who recognize and use their sensitivity pro and self-actualization, and are able to encourage the same growth in others.Without this factor nursing

Developing helping: trusting, caring relationship
The human caring relationship is transpersonal. in that it connotes a special kind of relationship: a con person, a high regard for the whole person and their Being-in-the-world.In the transpersonal human c nurse enters into the experience of another person, and another can enter into the nurse s experiences.intersubjectivity in which both persons are involved.It is an art in which the nurse forms a union with t with the spirit-filled person, behind the patient, that transcends the physical.This connection honors th human dignity and preservation of humanity.

Promoting and accepting the expression of positive and negative feelings and emotions
Because feelings after thoughts, behavior, and experiences, they need to need to be acknowledged and human caring process.A focus on feelings and the "non-rational" emotional aspects of an event is nece engaged in the human caring process.The caring relationship can move to a deeper, more honest and nurse allows for this CF.Further, in listening to and honoring another person s feelings we honor their meaning and importance for them and their healing.By listening to another person s story, it may be th can offer.It may be the nurse who is the only one who listens to and honors another s story and all the that accompany it.

Engaging in creative, individualized, problem-solving caring process
Professional nursing employs the nursing process, which is a creative, problem-solving method to assi in all nursing situations.A creative approach acknowledges that nurses use all ways of know/being/do clinical caring.Nursing problems solving in not a linear one to one process, but often the nurse walks i grasps the "gestalt -reading the field, in the instant.This process involves full use of self and all of one instincts, intuition, aesthetics, technology, skills, empirics, ethics, personal and even spiritual knowing.model for practice, all knowledge is valuable and accessed for clinical caring.The process invites creati as systematic scientific logic and technology.

Transpersonal Teaching-Learning
Nurses have a long history about the educational-teaching role; however there has been more emphas information rather than a conscious intentionality to engage in authentic processes and relationships o reciprocity, in that the nurse seeks to work from the patient s frame of reference, grasping the meaning information for the person, as well as the readiness and timeliness for the person to receive the inform explicit that learning is more than just receiving information and data.It involves a caring relationship teaching learning.This CF evolves toward more of a coaching role in which the person becomes their o contrast to a conventional imparting-of-information role.

Provision of supportive, protective, and/or corrective mental, physical, societal, and spiritual environment
The purpose of providing such an environment is quality care and also healing/wholeness.The areas t are: comfort; privacy; safety; clean; aesthetic surroundings.
Nurses often have a great deal of control of the environment, but without a consciousness of their oblig systematical responsibility for the environment to protect, support and/or correct the patient.
More recently this factor has taken on entirely new meaning.In addition to acknowledging the environ physical place to attend to in conventional way, one now is invited to consider the nurse as influencing example, using theory as guide to environment one can think of the nurse as repatterning the environm harmony, and use of caring-healing modalities to assist in patterning a more healing environment; e.g.relaxation, music-sound, intentional touch, art and so forth. 9,5An even more expanded view of environ Quinn 9 and expanded by Watson 5 suggests and invites us to consider the nurse as the environment.In we are invited to consider the practitioner and his/her evolved caring consciousness, presence, intentio the critical ingredient in the environment. 5 this view, then we have to turn toward the practitioner and the Nurse Self as an energetic, vibrationa patient and outer environment.:94 -If I am the environment, how can I Be a more caring-healing environment?-How can I Become a safe space, a sacred vessel for this patient and his/her inner healing journey?
-In what ways can I look at, into this person (how am I to face this other) to draw out healing/wholene -How can I use my consciousness, my Being, my presence, my voice, my touch, my face, my hands, my Environment now takes on entirely different meaning with this evolved view, moving beyond physical having to pay attention to the nurse and his/her caring consciousness affecting the entire field.
Assisting with gratification of Basic Human Needs, while preserving human dignity and wholeness Assistance with another s basic needs gives nurses access to the physical body in a very intimate way.A and great gift to society to take care of others when in need of care.In a Caring Science model it is ackn however is not just touching one physical body or meeting physical needs, but noting that when touch touching just the body, but embodied spirit.It is also made explicit in this work that all needs are unifie all needs are equally important and must be valued and responded to for caring-healing.

Allowing for, being open to, existential-phenomenological and spiritual dimensions of caring and healing
This last CF brings up the phenomenon of the unknowns, which cannot be explained scientifically, thro of modern medicine.This CF allows for mystery and philosophical, metaphysical aspects of human ex phenomena which do not conform to conventional views of science and rational thinking.Nevertheles real to those affected.This CF allows for spiritual filled meanings and unknowns to emerge open to inf miracles.This CF honors spirit-filled meanings, cultural beliefs, myths, and metaphors and inner subj and patients and families, allowing cures and miraculous cures and healings.

CONCLUSION
Finally this framework for Caring Science and practices proposes that nursing, individually and collect preservation of humanity and seeks to sustain caring in instances where it is threatened.The Carative F serve as structure and order for a theoretical -philosophical foundation for the discipline and professi ideals and caring factors and processes proposed foster the evolution and deepening of humankind an humanity.