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Martha Rogers theory.

MARTHA ROGERS SCIENCE OF UNITARY HUMAN BEINGS


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Introduction

Born :May 12, 1914, Dallas, Texas

Diploma :Knoxville General Hospital School of Nursing(1936)

Graduation in Public Health Nursing, George Peabody College, TN, 1937

MA :Teachers college, Columbia university, New York, 1945

MPH :Johns Hopkins University, Baltimore, MD, 1952

Doctorate in nursing :Johns Hopkins University, Baltimore, 1954

Fellowship: American academy of nursing

Position: Professor Emerita, Division of Nursing, New York University, Consultant,


Speaker

Died : March 13 , 1994

Publications of Martha Rogers

Theoretical basis of nursing (Rogers 1970)

Nursing science and art :a prospective (Rogers 1988)

Nursing :science of unitary, irreducible, human beings update (Rogers 1990)

Vision of space based nursing (Rogers 1990)

Rogers nursing theory

Nursing is both a science and art. the uniqueness of nursing, like that of any other
science, lies in the phenomenon central to its focus.

Nurses long established concern with the people and the world they live is in a natural
forerunner of an organized abstract system encompassing people and the environments.

The irreducible nature of individuals is different from the sum of the parts.

The integral ness of people and the environment that coordinate with a multidimensional
universe of open systems points to a new paradigm :the identity of nursing as a science.

The purpose of nurses is to promote health and well-being for all persons wherever they
are.

Evolution of abstract system

The development of the abstract system was strongly influenced by an early grounding in
arts and background of science and her keen interest in space

The science of unitary human beings originated as a synthesis of facts and ideas from
multiple sources of knowledge

The uniqueness is in the central phenomena : people and environment

The Rogerian view of a causality emerges from an infinite universe of open

system
Overview of Rogerian model

Rogers model provides the way of viewing the unitary human being

Humans are viewed as integral with the universe

The unitary human being and the environment are one ,not dichotomous

Nursing focus on people and the manifestations that emerge from the mutual human
/environmental field process

Change of pattern and organization of the human field and the environmental field is
propagated by waves

The manifestations of the field patterning that emerge are observable events

The identification of the pattern provide knowledge and understanding of human


experience

Basic characteristics which describes the life process of human :energy field, openness,
pattern, and pan dimensionality

Basic concepts include unitary human being ,environment, and homeodynamic principles

Concepts of Rogers model

Energy field

The energy field is the fundamental unit of both the living and nonliving

This energy field "provide a way to perceive people and environment as irreducible
wholes"

The energy fields continuously varies in intensity, density, and extent

Openness

The human field and the environmental field are constantly exchanging their energy

There are no boundaries or barrier that inhibit energy flow between fields

Pattern

Pattern is defined as the distinguishing characteristic of an energy field perceived as a


single waves

"pattern is an abstraction and it gives identity to the field"

Pan dimensionality

Pan dimensionality is defined as "non linear domain without spatial or temporal


attributes"

The parameters that human use in language to describe events are arbitrary.

The present is relative ;there is no temporal ordering of lives.

Unitary Human Being (person)

A unitary human being is an "irreducible, indivisible, pan dimensional (four-dimensional)


energy field identified by pattern and manifesting characteristics that are specific to the
whole and which cannot be predicted from knowledge of the parts" and "a unified whole
having its own distinctive characteristics which cannot be perceived by looking at ,
describing, or summarizing the parts"

The people has the capacity to participate knowingly and probabilistically in the process
of change

Environment

The environment is an "irreducible ,pan dimensional energy field identified by pattern


and integral with the human field"

The field coexist and are integral. Manifestation emerge from this field and are perceived.

Health

Rogers defined health as an expression of the life process; they are the "characteristics
and behavior emerging out of the mutual, simultaneous interaction of the human and
environmental fields"

Health and illness are the part of the sane continuum.

The multiple events taking place along life's axis denote the extent to which man is
achieving his maximum health potential and very in their expressions from greatest
health to those conditions which are incompatible with the maintaining life process

Nursing

The concept Nursing encompasses two dimensions

Independent science of nursing

An organized body of knowledge which is specific to nursing is arrived at by scientific research


and logical analysis

Art of nursing practice

The creative use of science for the betterment of the human


The creative use of its knowledge is the art of its practice
Assumptions about people and nursing

Nursing exists to serve people..it is the direct and overriding responsibility to the
society

The safe practice of nursing depends on the nature and amount of scientific nursing
knowledge the individual brings to practice.the imaginative, intellectual judgment
with which such knowledge is made in service to the man kind

People needs knowledgeable nursing

Homeodynamic principles

The principles of homeodynamic postulates the way of perceiving unitary human beings

The fundamental unit of the living system is an energy field

Three principle of homeodynamic

Resonancy

Helicy

integrality

Resonance

Resonance is an ordered arrangement of rhythm

characterizing both human field and environmental

field that undergoes continuous dynamic

metamorphosis in the human environmental process

Helicy

Helicy describes the unpredictable, but continuous, nonlinear evolution of energy fields
as evidenced by non repeating rhythmicties

The principle of Helicy postulates an ordering of the humans evolutionary emergence

Integrality

Integrality cover the mutual, continuous relationship of the human energy field and the
environmental field .

Changes occur by by the continuous repatterning of the human and environmental fields
by resonance waves

The fields are one and integrated but unique to each other

Rogerian theories

Rogerian theories-Grand theories

The theory of accelerating evolution

The theory of paranormal phenomena

The theory of rhythmicities

Theory of paranormal phenomena

This theory focus on the explanations for precognition, djvu, clairvoyance, telepathy,
and therapeutic touch

Clairvoyance is rational in a four dimensional human field in continuous mutual,


simultaneous interaction with a four dimensional world; there is no linear time nor any
separation of human and the environmental fields

The theory of accelerating evolution

Theory postulates that evolutionary change is speeding up and that the range of diversity
of life process is widening. Rogers explained that higher wave frequencies are associated
with accelerating human development

Theory of Rhythmicity

Focus on the human field rhythms

(these rhythms are different from the biological ,psychological rhythm)

Theory deals with the manifestations of the whole unitary man as changes in human sleep
wake patterns, indices of human field motion, perception of time passing, and other
rhythmic development

Theories derived from the science of unitary human beings

The perspective rhythm model (Patrick 1983)

Theory of health as expanding consciousness (Neuman, 1986)

Theory of creativity, actualization and empathy (Alligood 1991)

Theory of self transcendence (Reed1997)

Power as knowing participation in change (Barrett 1998)

Rogers concepts of nursing

Nursing is a learned profession-it is a science and art

Nursing is the study of unitary. Irreducible, indivisible human and environmental energy
fields

The art of nursing involves the imaginative and creative use of nursing knowledge

The purpose of nurses is to promote health and well-being for all person and groups
wherever they are using the art and science of nursing

The health services should be community based

Rogers challenges nurses to consider nursing needs of all people ,including future
generation of space kind ;as life continuous to evolve from earth to space and beyond.

Her view provides a different world view that encompasses a practice of nursing for the
present time and for the imagined and for the yet to be imagined future

Rogers envisions a nursing practice of noninvasive modalities, such as therapeutic touch,


humor, guided imagery, use of color, light, music, meditation focusing on health potential
of the person.

Professional practice in nursing seeks to promote symphonic interaction between man


and environment, to strengthen the coherence and integrity of the human field, and to
direct and redirect patterning of the human and environmental fields for realization of
maximum health potential

Nursing intervention seeks to coordinate environmental field and human field


rhythmicities, participates in the process of change , to help people move toward better
health

Nursing aims to assist people in achieving their maximum potential.

Nursing practice should be emphasized on pain management, supportive psychotherapy


motivation for rehabilitation.

Maintenance and promotion of health, prevention of disease, nursing diagnosis,


intervention, and rehabilitation encompasses the scope of nursing

Rogers contribution to nursing knowledge

Rogers was one of the first nurse scholars to explicitly identify the person (unitary man)
as the central phenomena of nursing concern

Nursing abstract system is a matrix of concepts relevant to the life process in man

Rogers conceptual system provides a body of knowledge in nursing that will have
relevance for all workers concerned with people, but with special relevance for nurses;
because it matters to human beings; consequently to nurses

In the evolution it is properly subjected to reformulation and change as the knowledge


grows, the the conceptual data will be more clearer and it will take new dimensions

The utilization of Rogerian model is used as a guide for theory development, research,
nursing education, and in the direct patient care practice

Rules for nursing research guided by the Rogerian theory

Rules for research

The Rogerian research require both basic and applied research

The phenomena to be studied are unitary human beings and their environmental
interaction

Study participants may be any person or group, with the provision that both person and
environment are taken into account

Research methodology

Qualitative and quantitative methods can be applied

Experimental researches are questionable because she rejects the notion of causality

Case study and longitudinal research are better than cross sectional study

Research instruments that are directly derived from science of unitary human beings
should be used

Data analysis multivariate analysis (canonical correlation studies)

Research tools derived from science of unitary human beings

Perceived field motion scale

Human field rhythm scale

Temporal experience scale

Assessment of dream experience scale

Person environment participation scale

Leddy healthiness scale

Mutual exploration of the healing human-environment field scale

Garon assessment of pain scale

Family assessment tool

Community health assessment tool

Rules for nursing education guided by Rogerian theory

Focus of the curriculum

Nursing education can be for professional nursing , technical nursing

The focus is the transmission of the body of knowledge

Teaching and practicing therapeutic touch

Conducting regular in-service education

Nursing programs

Baccalaureate degree program

Masters program

Doctoral program

The major concepts are principal of Resonancy, Helicy, Integrality

The faculty in the nursing education must be prepared at doctoral level

Teaching- learning strategies

Emphasis should be on developing self awareness as an aspect of the clients


environmental energy field and the dynamic role of nurse pattern manifestation on the
client

Emphasis on laboratory study- the lab setting include homes, schools, industry, clinics,
hospitals, other places where people lives

Importance of use of media in education

Rules for nursing administration guided by Rogerian theory

Purpose of nursing services

Nursing services is the center of any health care system

The purpose of nursing services is health promotion

Characteristics of nursing personnel

The administrators should hold higher degrees in nursing and licensed

Leaders must be visionary and willing to embrace innovative and creative change

Leaders should be able to identify the patterning to ensure the integrated behaviors for
client and employees

Management strategies and administrative policies

Administrative policies foster an open and supportive administrative climate that


enhances staff members self esteem , actualization, and freedom of choice and provide
opportunity for staff development and continuing education

The ultimate goal is the clients well-being

Rules for independent practitioner guided by Rogerian model

Nursing is an independent science

Nurse assumes the role of potentiater of care

She proposes the independent role in various setting like school, industry, community,
space (by 2050AD)

Independent practitioner is an advanced practice registered registered nurse who focus on


well-being or mutual patterning of individual, family, community across the life span ,at
risk for developing dissonance/illness

Rules for nursing practice guided by Rogerian theory

Areas of Rogerian model application

SETTINGS

All spheres of life

School

Industry

Family

Community

Space

SPECIALITIES

Pediatrics

Psychiatry

Oncology

Burns

Geriatrics

Neurology

Cardiology

Rehabilitative medicine

SPECIALIZED AREAS OF PRACTICE

Neonatal ICU

Pediatric ICU

Post operative unit

Pre operative unit

Palliative care unit

Rehabilitation center

Burns unit

Adult ICUs

Old age homes

Neuropsychiatric units

AREA WHERE ROGERIAN MODEL IS NOT APPLICABLE


o Operation theaters
Purpose of nursing practice

To promote well-being for all persons, wherever they are

To assist both the client and nurse to increase their awareness of their own rhythm

Setting for practice

From community to hospital to outer space

Legitimate participants

People of all ages both as individual human energy fields and group energy fields

Nursing process- Health patterning practice method

Assessment

Voluntary mutual patterning

Evaluation

For the nurse

Pattern appraisal

Mutual patterning of human and environmental fields

Evaluation

For the patient

Self reflection

Patterning activities

Personal appraisal

Nursing process
Assessment

Areas of assessment

Simultaneous states of the individual and the environment

Total pattern of events at any given point in space time

Rhythms of life process

Supplementary data

Categorical disease entities

Subsystem pathology

Pattern appraisal

It is a comprehensive assessment of:

Human field patterns of communication, exchange, rhythms, dissonance

Environmental fields pattern of communication, rhythms, dissonance, harmony

Intuitive reflection of self


Validation of the appraisal

Validate with self

Validate with the client

Mutual patterning of human and environmental field

Sharing knowledge

Offering choices

Empowering the client

Fostering patterning

Evaluation

Repeat pattern appraisal

Identify dissonance and harmony

Validate appraisal with the client

Self reflection for the client

Pattern appraisal include appraisal of multiple lifestyle rhythms such as:

Nutrition

Work/leisure activities

Exercise

Sleep / wake cycles

Relationships

Discomfort or pain

Fear /hopes

Patterning activities for the client


Meditation
Imagery
Journaling
Modifying the surroundings
Clinical case study of Radha using Rogerian conceptual Model

Radha is a 22years old female admitted in a psychiatry unit with severe depression secondary to
diagnosis of ovarian malignancy
She becomes tearful during history taking
Radha is accompanied with her husband and 1year old child
Her husband appeared anxious but supportive and attentive he is working as an
accountant in their native place
Radha was diagnosed with ovarian cancer 2 months back and underwent bilateral salphingio
oopherectomy and hysterectomy30days ago
She is undergoing chemotherapy due to its Metastatic pattern.
From past 3 weeks Radha started sitting lonely, decreased ADL, repeated crying spells,
decreased talks, neglects hygiene, muttering to self, decreased sleep , appetite, neglecting her
child care, complaints of severe pain in the body,.3 days back attempted suicide by
consuming rat poison.
Current assessment findings .her general appearance is a teary eyed young woman ,illkempt, clinging to her husband ,looking perplexed, not talking..poor nutritional intake, when
asked about her illness.cries inconsolably on repeated asking expressed sadness of mood.
Nursing care of Radha with Rogers model

With rogerian model, the process of caring Radha begins with pattern appraisal

Nursing care involve pattern appraisal, mutual patterning, and evaluation

Pattern appraisal

This visible rhythmical pattern is a manifestation of evolution towards dissonance

Radha has pattern manifestation of dissonance..depression with suicidal ideation,


ovarian malignancy, pain

Radha has a low educational background

A pattern activity of healing is noted through reports of a positive operative course

Patterning has to be directed towards reduction in perceived dissonance with her personal
and environmental field

Pain is a manifestation of perceived dissonance

Decreased environmental energy transfer is visible by decreased talking and crying

Radha has manifestation of fear.her self knowledge links her illness to her personal
belief of being punished for her past sins

Appraisal is needed in her sleep patterns, nutrition and her perception of self

Appraisal can be grouped into exchanging patterns, communication patterns, and relating
patterns

Time between nurse and Radha is needed to foster her healing

During the process nurse must rely on personal intuition and insight regarding the
emerging pattern

All this pattern forms the unitary pattern of Radha

Mutual patterning

The process is mutual between the nurse and Radha

The surgery performed, medication she is receiving are patterning modalities

Patterning activities planned by the nurse for Radha ..therapeutic touch, humor ,
meditation, imagery

Radha needs to be assessed fully regarding her ability to understand and agree with
different patterning modalities

Therapeutic touch can be introduced to Radha

Touch is introduced and incorporated into the management of pain, helps in energy
transmission for healing and .helps in developing trust in the nurse

Teach her how to center the energy and channel her energy to the area of pain

Use humor for increasing socialization and developing self confidence and developing
worthiness

Human environmental patterning needs to involve the other individual who share her
environment including husband and son

Options are introduced relating to increase communication and hygiene patterns

The entire family is involved in power as knowing participation in change

Evaluation

The evaluation process centers on the perceptions of dissonance that exist after the
mutual pattern activities

The appraisal process is repeated

Manifestation of worry, pain, fear, sadness of moos has to be appraised with family
members

A summary of the dissonance and/or harmony that is perceived is then shared with
Radha, and mutual patterning is modified or instituted ad indicated based on the
evaluation

Summary

Biographical sketch of Martha Rogers

Overview of Rogerian concepts

Rogerian terminologies

Rogerian theories

Nursing concepts, nursing process

Perspectives of nursing education, administration, nursing practice

Contribution to nursing knowledge

Clinical example

References

1. George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed.
Norwalk, Appleton & Lange.
2. Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia.
Lippincott Williams& wilkins.
3. Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed.
Philadelphia, Lippincott.
4. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed.
Philadelphia, Lippincott.
5. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing Concepts Process &
Practice 3rd ed. London Mosby Year Book.