A Critical Appraisal of Watson’s Theory

A Critical Appraisal of Watson’s Theory

Critical appraisal of evidence is the third step of evidence-based practice. Critically appraising evidence helps determine the collected evidence’s validity, reliability, and applicability to the clinical question (Melnyk & Fineout-Overholt, 2018). Jean Watson’s theory of human caring is a mid-range nursing theory. This focuses on the interpersonal relationship between the caregiver and care recipient (Pajnkihar et al., 2017). It shifts the focus of nursing care to entail holistic aspects of human health. According to this theory, nurses should have education skills to help them strive to ensure patient satisfaction. It’s the moral role of nurses to take care of their patients.

The study entitled “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” was published in the Journal of Caring Sciences by Durgun Ozan & Okumuş (2017). This study uses Jean Watson’s theory of human caring as its theoretical framework. This paper describes the effect of nursing care on anxiety and distress when treatments of infertility fail.

Type of Study

This study is an experimental study. Experimental studies are commonly used to demonstrate the effectiveness of healthcare interventions. This study is an experimental study since it has two sets of study participants: the control and test groups. Both of these groups were randomly selected for this study. The study group had forty-five female participants, while the control had forty-one female participants. The study group received the intervention, while the control group received the placebo.

Study Design

The study is critically appraised as an experimental single-blinded randomized controlled trial. This study aims to evaluate the effectiveness of nursing care based on Watson’s theory to manage distress relating to infertility. The women who participated in this study were blinded either into the study group or the control group. The study was conducted in  Diyarbakır Veni-Vidi IVF Center between April 2012 and November 2012. Block randomization was used to hide information concerning the randomization (Durgun Ozan & Okumuş, 2017). The study featured all the 10 Watson’s carative factors.

Quality of the Study

The hierarchy of evidence gives this randomized clinical trial a grade of recommendation of level II. Watson’s theory was selected since it has been proven to have positive healthcare outcomes on both patients and nurses. According to Durgun Ozan & Okumuş (2017), the inclusion criteria at the beginning required that the study participants had primary infertility, were aged over 18 years, have the ability to speak, read, and write Turkish, application of assisted reproduction strategies such as IVF and at the end participants who tested negative for pregnancy were included in the study. The exclusion criteria were participants were those diagnosed with chronic conditions.

The NCSS-PASS software was used to calculate the sample size with a margin of error of 0.005% in the reliability range of between 80 % and 95% (Durgun Ozan & Okumuş, 2017). These scores were guided by the anxiety mean scores of women undergoing infertility treatment. The sample was conducted at the end of the study and was found to be a strong 0.8.  The study participants did not know the group in which they were being placed. A block randomization method was used by an individual who was not part of the study.

The data collected in this study included sociodemographic forms, pre-treatment assessment data, assessment results after the first embryo transfer, and follow-up assessments in the eighth week (Durgun Ozan & Okumuş, 2017). The researchers collected this data through face-to-face interviews. The participant also completed data in the data collection tools in around fifteen minutes.

The data collection was systematic in this study. All participants were asked similar questions about selected themes at selected intervals. They were given ten to fifteen minutes, which was enough to elaborate on their feelings. All participants were informed of the aim of the study and the possibility of refusing to be part of this study. The interviews for this study were based on the themes related to the improvement process. All the 10 Caritas of the Watson theory were included in this study (Durgun Ozan & Okumuş, 2017). Ethical approval was sought from the University’s ethical review board. Data analysis was done using the SPSS software, while the sample power and size analysis was done using the NCSS-PASS software.

Results

The study results revealed high anxiety levels in participants whose infertility treatment failed and negative pregnancy test results. This was determined to be a natural reason. There was a significant difference between the control group and the study group to comprehend the difference that resulted from the nursing care based on Watson’s theory. Nursing caring, based on Watson’s theory, caused a difference in anxiety levels. This shows that the intervention was not based on medicine but rather on love and humanity. Infertility nurses can use this theory to offer patient-centered, sensitive, and honest care to help reduce anxiety.

Implications for Practice

The study has revealed that nurses should apply Watson’s theory of caring to improve the coping strategies of patients with infertility due to failed infertility treatments. Nurses can help these patients express their emotions and teach them effective problem-solving skills to help them hand the anxiety levels. Nurses should implement prevention strategies based on relaxation exercises and provide relevant information to infertile women to improve their psychosocial responses (Durgun Ozan & Okumuş, 2017). The study has revealed that during infertility treatment, the psychosocial needs of the women also increase. Nurses must thus apply Watson’s theory to guide them in implementing psychosocial support interventions.

Nurses should use approaches such as teaching-learning, human-needs assistance, expression of emotions, problem-solving and belief-hope development in the human caring theory (Durgun Ozan & Okumuş, 2017). Nurses working in infertility clinics should thus focus on strategies that will reduce anxiety levels related to infertility and enhance positive coping strategies. Approaches based on Watson’s theory are influential, and hence, nurses should use them to manage negative feelings, stress, and anxiety.

Further Research/Evaluation

This study had several limitations. This study did not include the husbands of the women in the study. Evidence shows that couples applying for infertility treatment should be assessed together (Durgun Ozan & Okumuş, 2017). However, males were not included in this study since they do not regularly continue with infertility treatment. The second limitation is that there was a small sample size in both the study and control group. This may hinder the study researchers from comprehending the effects of the nursing interventions in the study and control group. The final limitation is the nature of this study. The women who started infertility treatment one month later should have been part of the study, and their follow-ups should have also been done a month later to avoid any losses.  These women started the study later on, and hence, their follow-ups should have also been done later. However, the follow-ups were done at the same time.

This study connected Watson’s Theory of Human Caring with nursing interventions to reduce anxiety levels and improve coping strategies in women whose infertility treatment had failed. Further studies should be done to evaluate the effects of other external factors that cause anxiety in these women. This study did not consider other variables, such as socioeconomic status or family problems. More research should also be done to determine the impact of educating nurses on Watson’s Caring theory and how this would impact the nursing interventions they implement in holistic care.

Conclusion

The primary role of nurses is to care for patients. Watson’s theory further reinforces this role on the importance of an interpersonal relationship between the caregiver and care recipient. Durgun Ozan & Okumuş (2017) aimed to determine the effectiveness of using Watson’s theory in reducing anxiety in women whose infertility treatment has failed. The study was conducted in Turkey. The participants in the control group were forty-one women, while those in the experimental group were forty-five. The study was a single-blinded, randomized controlled trial. The study results revealed that using Watson’s theory effectively reduces anxiety stress and improves positive coping strategies after the failure of infertility treatments in women. This study further revealed that the incorporation of nursing theoretical frameworks into practice could improve patient and nurse satisfaction and improve their interprofessional relationship. It is thus critical to apply this theory since it has positive impacts on nursing care. The study has confirmed that Watson’s theory can positively impact patients and healthcare providers.

References

Durgun Ozan, 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. https://doi.org/10.15171/jcs.2017.010

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice. LWW.

Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, e2940. https://doi.org/10.7717/peerj.2940

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Assignment #2 you are to critically appraise a nursing research study that uses Jean Watson’s Human Caring theory. The critical appraisal that you will be doing will require that you do the following to determine the legitimacy and value of the articles you are choosing to review:

A Critical Appraisal of Watson’s Theory

Title of the article and the journal
Author and Date of publication – has to be within the past 5 years to be used as evidence.
Type of article published: systematic review, meta-analysis, random clinical trials, cohort studies, etc
EBP pyramid level of evidence (Ranks are levels I – VII)
(go to the EBP rating system for the hierarchy of evidence in Melnyck’s book (pg 10): Use these levels for all papers due at the beginning of the semester
Level I: Systematic review, meta-analysis studies of clinical trials, or evidence-based clinical practice guidelines based on systematic reviews (the title of the article usually indicates the article is one of these categories)
Level II: randomized clinical trial
Level III: Non-randomized clinical trial
Level IV: Well-designed case-controlled or cohort study
Level V: Systematic review of descriptive or qualitative studies
Level VI: Evidence from a single descriptive or qualitative study
Level VII: Opinion of authorities or expert opinions
Was the study appropriate and valuable to improve health
Who were the participants, how many, was a power analysis done to determine if statistical analysis should be performed
Was randomization or volunteer, or specific sample selection used
If a systematic review or meta-analysis, how did the authors determine what articles to choose to review?
What was the intervention?
Were the instruments used to analyze the data valid and reliable
What were the results? This includes the statistics findings
What were the strengths and weaknesses of the published article?
This includes the EBP pyramid, the instrument’s reliability/validity, sample size, type of analysis done, results, limitations, etc
Did the strengths or weaknesses predominate, and should the article be used to support your project and practice change?

See reference sample paper attached.