Nursing Care Theory
Nature Of Theory
The theory Nursing as Caring (Boykin & Schoen Hofer, 1993, 2001) provides a conceptual framework for the nature of nursing as a caring discipline and profession.
Embodying the aesthetic and personal realms of knowing in nursing (Carper, 1978; Chinn & Kramer, 2004; Boykin, Parker, & Schoen Hofer, 1994), the theory incorporates the artistic and empathic aspects of nursing situations as personal caring connections between the nurse and the nursed as they occur in the moment.
The theory of Nursing as Caring is essential to the core essence of
nursing, providing a structure for practice, administration, education, and
research.
Major assumptions/fundamental beliefs underlying the transformational model of the theory of Nursing as Caring include:
- Persons are caring by virtue of their hu-
- Manness persons are caring, moment to moment
- Persons are whole and complete in the moment
- Personhood is a process of living grounded in caring
- Personhood is enhanced through participating in nurturing relationships with caring others
- Nursing is both a discipline and a profession (Boykin & Schoen Hofer, 2001a, p. 11).
The focus of Nursing as Caring is that nursing, both as a discipline and as a profession, "involves the nurturing of persons living and growing in caring" (Boykin & Schoen Hofer, 2001a, p. 12).
Central concepts include caring, characterized by altruistic actions and the recognition of value and connectedness between the nurse and the nurse, the nursing situation, "a shared lived experience in which the caring between nurse and nurse enhances personhood" (Boykin & Schoen Hofer, p . 13), and the caring between, a personal connection encounter between the nurse and the nursed "within which personhood is nurtured" (Boykin & Schoen Hofer, p. 14).
An integral component of Nursing as Caring, the Dance of Caring Persons, represents the circular nature of caring grounded in the valuing of one another (the nurse and the nursed) as unique caring individuals (Boykin & Schoen Hofer, 2001a; Boykin, Schoen Hofer, Smith, St Jean, & Aleman, 2003).
This
element of the theory acknowledges the need for a paradigm shift from the
traditional top-down hierarchical structures present in health care
organizations to circular structures of mutuality and respect found within
nurse-client collaborative partnerships.
Research approaches developed within the context of the theory of Nursing as Caring include focusing on the discovery of the meaning of lived caring, and the understanding of value experienced in nursing situations (Boykin & Schoen Hofer, 2001a). A qualitative group phenomenology approach was utilized to provide insight into the meaning of lived caring.
Research participants generated data in focus group settings and also developed the synthesis of meaning (Schoen Hofer, Bingham, & Hutchins, 1998). Qualitative research methodologies grounded in dialogue and description and interpreted as themes characterize research into the value experienced in nursing situations (Boykin &Schoen Hofer, 2001b, Boykin et al., 2003).
Nursing as Caring guides research by providing a broad conceptual framework for the development of middle-range theories that address more specific phenomena of nursing as caring in areas of nursing practice, administration, and education.
Examples of developments of such mid-range theoretical models based on the theory of Nursing as Caring include the theory of technological competence as caring in critical care nursing (Locsin, 1998); Dunphy's (1998) "circle of caring" model for advanced practice nursing which focuses on caring processes; and the caring-based nursing model that grounded an acute care unit in the perspective of nursing as caring (Boykin et al., 2003).
Future directions include the
development of new methods of nursing inquiry appropriate to the study of
Nursing as Caring allowing for research of the meaning of nursing within the
lived experience of the nursing situation (Boykin & Schoen Hofer, 2001a).
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