Guest Contributors:
Midalys Quevedo Navarro, Assistant Professor & PhD Student, Faculty of Medical Sciences of Mayabeque, Cuba
AND
Tetsuya Tanioka, Professor of Nursing, Tokushima University, Japan | Director, Rozzano Locsin Institute

Within nursing and the human sciences, the translation of concepts is not a mere linguistic exercise but a significant task that requires safeguarding the essence of values and practices.

Boykin & Schoenhofer (2001) highlight that the distinction between care and caring is fundamental for understanding the philosophy of nursing and its application in professional practice. Their model, Nursing As Caring, situates caring as the essence of the discipline, transcending technical actions to embrace relational meaning.

In English, “care” generally refers to the concrete actions a professional performs for another person: procedures, tasks, technical attentions. It is the visible “doing” — that which can be measured and described as part of the caregiving labor. Yet, as Morvillers (2015) points out, this term does not necessarily imply a profound human bond; one can provide care without genuine affective or ethical commitment in the relationship.

By contrast, “caring” introduces a relational and existential dimension. It is not only about what is done, but how it is done and the meaning it acquires in the nurse–patient interaction. Watson (2008) emphasizes that caring entails tenderness, respect, and recognition of the other’s dignity. It transcends technique and becomes an expression of shared humanity. Put simply: care is the action, caring is the relationship.

In Spanish, the term “cuidado” often encompasses both senses, which can generate ambiguity. We say cuidado both to refer to practical attention and to express ethical or affective attitude. However, in academic and philosophical contexts, differentiation is necessary. López Corría and Torres Velásquez (2006) suggest that one possible strategy is to use cuidado to translate care and el cuidar or acto de cuidar to translate caring. In this way, the distinction between technical action and relational experience is preserved.

This differentiation maintains coherence with theories such as Nursing as Caring, where Boykin & Schoenhofer (2001) insist that caring is the foundation of nursing as a discipline. In Spanish, speaking of “cuidado sin cuidar” reflects a critique of dehumanized practices: tasks performed without tenderness or personal regard. Conversely, cuidar expresses the ethical commitment to recognize the patient as a person. Recent contributions reinforce this vision: Amezcua (2024) highlights the values that advance nursing as a discipline, while Leyva-Moral et al. (2024) and El-Messoudi et al. (2023) explore cultural adaptation and competence in caring practices. Similarly, Springer et al. (2023) evaluate transcultural nursing curricula that strengthen the relational dimension of care.

Applying this distinction to the Japanese context reveals a similar yet more complex phenomenon. In Japan, the katakana loanword care (ケア) has become deeply rooted, but is used primarily to denote “action,” referring to clinical procedures, physical tasks, or institutional services. By contrast, when attempting to translate cuidar literally into Japanese, it becomes a gerundial expression meaning “the act of caring” (care-suru-koto, ケアすること). Yet this literal translation fails to convey the profound ethical and philosophical nuance of Nursing As Caring—the way of living and being in which one continuously knows and respects the other within an authentic human-to-human relationship.
Consequently, Japanese nurses often ask: “What exactly is caring?” The confusion is so widespread that some Japanese websites even misinterpret caring as “Care-Ring.” For decades, Japanese nursing academia has employed an unnatural/literal translation, Ikirareta Teiken (“生きられた経験” in a passive, rigid form), for the concept of “Lived Experience.” In our view, lived experience should be understood as “the vivid, lived reality the person is experiencing in the present moment.”

This linguistic struggle directly reflects clinical reality. The essence of caring and nursing competence lies in the depth with which we allow ourselves to enter and share this vivid lived reality of the person.

Two clinical narratives illustrate this point.

The first concerns a 90-year-old woman with dementia. One afternoon, she gazed intently out the hospital window. A nurse approached to announce dinner and asked, “What are you looking at?” The patient warmly replied, “My son is coming home.” When asked his age, she smiled: “He is 10 years old and returning from elementary school.” Within a conventional care framework, a nurse might correct her reality or focus solely on escorting her to the dining hall. But within a genuine caring relationship—rooted in aesthetic knowing—the nurse does not dismiss this as mere memory or symptom. Instead, she steps into the patient’s beautiful inner world, fully validating and celebrating this vivid, lived reality of a loving mother and her young son. By cradling the patient’s overflowing emotions with both hands, the nurse honors and praises the aesthetic beauty of the patient’s immediate reality. This is not technical “doing”; it is a profound relational “being.” True caring capacity is demonstrated in the ability to be invited into and share the sacred space of the patient’s lived experience.

The second narrative occurred in a psychiatric ward using standard NANDA-I nursing diagnoses. When nurses asked patients with chronic schizophrenia about their dreams and hopes, one said, “I want to be Prime Minister,” another, “I want to study abroad in the United States.” From the rigid perspective of conventional medical models, these expressions would be instantly categorized as “grandiosity” or “altered thought processes.” Yet, blinded by the system of care (doing/diagnosing), we miss the essence of caring (being/knowing).

To truly know the patient as a whole person means going beyond passive listening or standard management; it demands that we actively embrace, admire, and celebrate their grandest hopes and dreams. When we honor a patient’s dream of becoming Prime Minister rather than pathologizing it, we are recognizing and celebrating the supreme dignity of their human potential. Empathy is not a technical skill to be acquired, but an essential human characteristic, congruent with Nursing As Caring (Boykin & Schoenhofer, 2001), which posits that people are compassionate by virtue of their humanity and that personhood is strengthened through enriching relationships. These patients, in expressing their grand dreams, were not merely exhibiting symptoms; they were manifesting their authentic humanity and potential for growth.

When nursing is reduced to mere tasks or diagnostic labels, the human being is lost from view. Through this theory, we learn that caring is an aesthetic and infinite process of continuously knowing the person (Locsin & Schoenhofer, 2025). It means resisting the temptation to “correct” or mechanically categorize, and instead choosing to embrace the unique personhood of our patients—honoring their human dignity, knowing their grandest hopes and dreams, and compassionately supporting their health and well-being.

The use of care and caring demands linguistic and conceptual sensitivity. While English marks the distinction with two separate terms, in Spanish and Japanese we must employ constructions that clarify meaning. In doing so, we preserve the richness of theory and avoid reductions that impoverish professional practice. Each language contributes unique nuances that enrich the understanding of caring while posing challenges of translation and conceptualization. It is therefore essential to continue this exercise in other languages, with the aim of building a common and accessible language that strengthens nursing as a global discipline. Exploring these variations opens the door to intercultural dialogue that preserves the essence of caring and renders it comprehensible in any context.

References

Amezcua, M. (2024). La enfermería, una profesión y disciplina que avanza por sus valores. Temperamentvm, 20, e14856. https://doi.org/10.58807/temperamentvm20246590

Boykin, A., & Schoenhofer, S. (2001). Nursing as caring: A model for transforming practice. New York: Springer.

El-Messoudi, Y., Lillo-Crespo, M., & Leyva-Moral, J. (2023). Exploring the education in cultural competence and transcultural care in Spanish for nurses and future nurses: A scoping review and gap analysis. BMC Nursing, 22, 320. https://doi.org/10.1186/s12912-023-01483-7

Leyva-Moral, J. M., Watson, C., Granel, N., Raij-Johansen, C., & Ayala, R. A. (2024). Cultural adaptation and validation of the Caring Behaviors Assessment tool into Spanish. BMC Nursing, 23, 240. https://doi.org/10.1186/s12912-024-01892-2

Locsin, R. C., & Schoenhofer, S. O. (2025). Technology as lens for knowing person as caring. Belitung Nursing Journal, 11(3), 261–263. https://doi.org/10.33546/bnj.3830

López Corría, I., & Torres Velásquez, I. R. (2006). Glosario de enfermería en inglés y español de los términos más utilizados por enfermeros. Acimed, 14(5). Disponible en: http://bvs.sld.cu/revistas/aci/vol14_5_06/aci04506.htm

Morvillers, J.-M. (2015). El care, el caring, el cure y el cuidador. Recherche en soins infirmiers, 122(3), 77–81. https://doi.org/10.3917/rsi.122.0077

Springer, S., & colleagues. (2023). Evaluating the effectiveness of a new curriculum for transcultural nursing competence. Journal of Transcultural Nursing, 34(2), 145–157. https://doi.org/10.1177/10436596221148234

Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). Boulder, CO: University Press of Colorado.

About Midalys Quevedo and Tetsuya Tanioka

My name is Midalys Quevedo Navarro. I have been a registered nurse since 1998 and obtained my MSN in 2007. In the first years after graduation, I worked as a clinical nurse and provided services in the Republic of Botswana for three years.

I am a full member of the Cuban Society of Nursing, the Cuban Society of Family Medicine, and the Cuban Society of Public Health. Since 2005, I have served as a university professor at the Faculty of Medical Sciences of Mayabeque, Cuba, where I currently hold the positions of Assistant Professor and Assistant Researcher.
At present, I am enrolled in the doctoral training program of the Cuban Ministry of Public Health. My line of research focuses on population aging, given that Cuba is one of the most aged countries in Latin America and the Caribbean. I base my work on the Nursing As Caring theory, which serves as the guiding theoretical framework for my studies and publications.

Prof. Dr. Tetsuya Tanioka, RN, PhD, FAAN is an internationally recognized researcher and pioneer who specializes in integrating expertise across the distinct fields of Nursing and Engineering. Dr. Tanioka possesses a unique academic background, holding dual doctoral degrees: a Ph.D. in Engineering from Kochi University of Technology, Japan (2002), and a Ph.D. in Nursing from St. Paul University Philippines (2021). His distinguished career began with 11 years of intensive clinical practice as a Registered Nurse in psychiatric care at a prefectural hospital in Japan. His profound contributions to the global nursing discipline were internationally acknowledged in 2013, notably through his induction as the first Japanese Fellow of the American Academy of Nursing (FAAN). At the core of Dr. Tanioka’s research is the exploration of “Human Technologies” in nursing, which seeks to harmoniously fuse the perspectives of nursing caring science with cutting-edge science and technology. He has made substantial, long-standing contributions to cross-cultural scholarship by translating the foundational theories of Nursing as Caring (NAC) and Technological Competency as Caring in Nursing (TCCN) into Japanese. Through this ongoing work, he continues to offer vital guidance for preserving human dignity and establishing high-quality, person-centered caring processes within increasingly technological healthcare environments.

Acknowledgements

We wish to express our gratitude to Dr. Anne Boykin and Dr. Savina Schoenhofer for the encouragement and motivation they have given us to undertake this collaborative project. Their vision and unwavering support have been a source of inspiration, guiding us to pursue this work with commitment and hope. We trust that the fruits of this collaboration will contribute to the advancement of nursing, strengthening its identity as a discipline of caring and human solidarity.