The article reaction is preoperative anxiety can be reduced with holistic nursing. Rosenberg, S. (2006). Utilizing the Language of Jean Watson's Caring Theory Within a Computerized Clinical Documentation System. CIN: Computers, Informatics, Nursing.

This article describes and critiques a healthcare facility that was part of an eight-hospital organization that adopted Watson's theory of caring as part of their nursing philosophy. It provides an overview of the caring theory and its many meanings. Rosenberg critiques the caring theory, stating that during the implementation of the theory within the setting described, it was noted that there was no mechanism in the current documentation system for clinical nursing staff to document the patient experience using any language specific to the theory. As a result, the nurses at the healthcare facility decided to develop a new context in charting that consisted of an extensive clinical documentation system upgrade. The article concluded with a discussion of the steps taken that supported the newly adopted caring philosophy at the facility. The application and reaction is that such a system could be implemented at other facilities as well.

Saewyc, E. (2000). Nursing Theories of caring. Journal of Holistic Nursing. (18)(2):114-128.

This article discusses the manner in which caring has emerged as a central paradigm in nursing over the past four decades. Saewyc suggests that caring as a central focus in nursing care of adolescents is developmentally appropriate and has been documented as the primary mechanism of effective health promotion for working with teens throughout the world. The article concludes that other disciplines in adolescent health are beginning to realize the importance of caring therapeutics in practice, but nursing remains in the forefront of theory development and research in this area and is well positioned to provide leadership in further articulating caring theory within adolescent health care. In applying the theory of caring to nursing, it is suggested that nurses must include advocacy for the legitimacy and the importance of caring modalities in promoting the health of adolescents. The reaction to this article is positive, in that youths are more susceptible to caring than other patients would be.

Stroud, S. (2004). To Touch on Caring.

Whitireia Nursing Journal.

Stroud discusses the aspect of "caring" and its' meaning, involvement, appearance and difference in nursing. Stroud explains that although many nurse theorists agree that caring is the heart of nursing, there are a variety of theories about what actually constitutes caring in the nursing context. Watson's theory of caring is discussed in relation many other caring theories. The article concludes that there is tension between the increasingly technological and medicalized influences on nursing practice, and the reaction against this toward a more humanistic view of nursing. As applied to nursing, practitioners are able to learn about various caring theories, find ways to deal with tension and internal disagreements in their practice, and apply these ideas when dealing with difficult patients. The article's reaction to nursing is that the quality of care, or whether nurses actually give care at all, will depend on the attitude that the nurse brings to their actions.

Research Articles

Baldursdottir, G. & Jonsdottir, H. (2002). The importance of nurse caring behaviors as perceived by patients receiving care at an emergency department. Heart & lung. (31)(1):67-75.

The study researched the affect of heavy nurse workloads on patient care. The purpose of the study was to identify which nurse caring behaviors are perceived by patients in an emergency department as important indicators of caring. The nurse caring behaviors were categorized in terms of relative importance with respect to demographic variables and perceived illness. The study method consisted of a 61-item questionnaire mailed to 300 emergency department patients that reflected the 10 factors of Watson's theory. The study results indicated that subjects scored the items involving clinical competence (such as giving shots, etc.) as the most important nurse caring behaviors. The study concluded that the study mirrored previous research, that subjects considered clinical competence to be the most important nurse caring behavior. The application and reaction of this study is that clinical competence further emphasizes the notion of caring as a moral stance integral to all interactions with patients.

Brown, C., Holcomb, L., Maloney, J., Naranjo, J., Gibson, C. & Russell, P. (2007). Caring in Action: The Patient Care Facilitator Role Caring in Action: The Patient Care Facilitator Role. Retrieved October 23, 2007, at http://www.uscsh.edu.

The research studied plans for a new patient care facilitator (PCF) role, and identified research strategies to evaluate the effectiveness of the caring model. The study method consisted...

The respondents included nurses, physicians, and ancillary professional and nonprofessional staff.
The study results indicated that patients perceived that everyone knew their care when they had a PCF than with no PCF. The study results concluded that a PCF increased the continuity of patient care. In applying the study results to nursing, patients who had a PCF for their care felt ready to go home at a significantly higher rate than did those who did not have a PCF. The reaction to this study is that love, caregiving, and emotional connection are strong themes surrounding the role of the PCF, and the PCF assists patients, families, doctors and nurses.

Childs, a. (2006). The Complex Gastrointestinal Patient and Jean Watson's Theory of Caring in Nutrition Support. Gastroenterology Nursing. (29)(4):283-288.

Childs studied a 34-year-old man diagnosed with bowel cancer that underwent surgery for the removal of 90% of the stomach, spleen and left kidney that the tumor was attached to. The patient underwent chemotherapy for three months to shrink the tumor, but suffered side effects that reduced his eating, resulting in weight loss of over 20 kg in two months. Under Watson's theory of care, he was able to gain two to three pounds a week for the next eight weeks and continue chemotherapy. His care was managed and maintained in his home with the support of his family and community nursing. The results of the study indicated that nutrition support did not remove the cancer, but sustained him enough to continue chemotherapy. The nurse was able to care for him holistically by providing the therapy required. The reaction to the study is that the theory of caring was not enough to cure the cancer.

Ciechanowski, P., Walker, E., Katon, W., Russo, J. (2002). Attachment Theory: A Model for Health Care Utilization and Somatization. Psychosomatic Medicine (64):660-667.

This research examined Watson's theory of caring in relation to attachment theory, which proposes that cognitive schemas based on earlier repeated experiences with caregivers influence how individuals perceive and act within interpersonal relationships. The researchers hypothesized that medical patients with preoccupied and fearful attachment would have higher physical symptom reporting and that preoccupied attachment would be associated with higher and fearful attachment with lower primary care utilization and costs. The study method consisted of a large sample of adult female primary care health maintenance organization patients. The study results indicated that patients with preoccupied attachment had the highest primary care costs and utilization, whereas patients with fearful attachment had the lowest. Applied to nursing, this suggests that attachment style is an important factor in assessing symptom perception and health care utilization. The reaction is that despite being on opposite ends of the utilization spectrum, patients with preoccupied and fearful attachment have the highest symptom reporting.

Erci, B., Sayan, a., Tortumluoglu, G., Kilia, D., Sahin, O. & Gungormus, Z. (2003). The effectiveness of Watson's Caring Model on the quality of life and blood pressure of patients with hypertension. J Adv Nurs. (41)(2):130-139.

The study applied Watson's caring model to determine the effectiveness of a nurse's caring relationship on the blood pressure and the quality of life of patients with hypertension. The study methods consisted of a one-group pretest and post-test; patients diagnosed with hypertension were given questionnaires consisting of demographic characteristics; their blood pressure was measured, and a quality of life scale was administered. Nurses trained in Watson's theory used the caring process when visiting the patients and their families once a week for blood pressure measurement over a 3-month period. The study found significant differences between mean scores of general well-being, physical symptoms and activity, medical interaction. For the nursing field, the study indicated that hypertension patients receiving care under Watson's theory had an increased quality of life and decreased blood pressure. The reaction to the research is positive; Watson's caring model is recommended as a guide to patients with hypertension.

Erikkson, K., Rudolfsson, G. & Post, I. (2007). The Development of Caring in the Perioperative Culture: Nurse Leaders' Perspective on the Struggle to Retain Sight of the Patient. Nurs Adm Q. (31)(4):312-324.

This study focused on Swedish nurse leaders and what constitutes caring in the perioperative culture and knowledge and responsibility for the development of caring. The study method consisted of open-ended question interviews with 10 nurse leaders, in which they described their experiences of developing perioperative caring. The study results indicated that developing a perioperative caring culture is a process that includes…