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THEORIES IN NURSING

MARTHA ROGER’S SCIENCE OF UNITARY HUMAN BEINGS

INTRODUCTION

Dr Martha Rogers was born on 12th May 1914 at Texas. She completed
her Diploma in Nursing, followed by Graduation in Public Health Nursing. She did
MA from Teachers college, Columbia University, New York and Masters in Public
Health Nursing and Doctorate in nursing from Johns Hopkins University,
Baltimore. She was awarded the Fellowship of American Academy of Nursing.
She held prestigious positions as Professor, Division of Nursing, New York
University, Consultant and Speaker.

Her early nursing practice was in rural public health nursing and in visiting
nurse supervision. She then established the Visiting Nurse service of Phoenix.
She published 3 books and 200 articles and lectured in 46 states. She received
honorary doctorates in Science and Letters and had received many awards and
citations for her contributions in nursing.

She was stimulating, challenging, controversial, idealistic, visionary,


prophetic, philosophic, academic, outspoken, humorous, blunt and ethical. Her
contributions towards leadership in nursing is remarkable. She is considered as
one of the most original thinkers in nursing. She died on 13th March 1994

She published the following books:

 Theoretical basis of nursing

 Nursing science and art :a prospective

 Nursing :science of unitary, irreducible, human beings update

 Vision of space based nursing


Overview of the theory

Martha Rogers considered the individual (unitary human being) as an


energy field coexisting within the universe. The individual is in continuous
interaction with the environment and is a unified whole, possessing personal
integrity and manifesting characteristics that are more than the sum of the parts.
The unitary human being is a “four dimensional energy field identified by pattern
and manifesting characteristics that are specific to the whole and which cannot
be predicted from the knowledge of parts”. The four dimensions used in this
theory - energy fields, openness, pattern and organisation, and dimensionality -
are used to derive principles related to human development.

BASIC ASSUMPTIONS OF ROGERIAN MODEL

Five basic assumptions underlay Rogers' conceptual framework are:

• Wholeness (Energy field),


• openness,
• unidirectionality ,
• pattern and organization, and
• sentience and thought.

On the basis of these five assumptions on human being, Rogers identified four
building blocks: the energy field, openness, pattern and pandimensionality.

a) Energy field

These are irreducible, indivisible, pan dimensional unitary human beings


and environments that are identified by pattern and manifesting characteristics
that have specific to the whole and cannot be predicted from knowledge of the
parts. Human and environmental energy fields are integral with each other.
Rogers defines the energy field as “the fundamental unit of the living and
nonliving”. She identifies two energy fields of concern to Nurses, which are
distinct but not separate:

• the human field or unitary human being; and


• the environmental field

The human being is considered a unified whole processing his own integrity
and manifesting characteristics which is more than and different from the sum of
its parts. The human field can conceptualised as one person, or group, family or
community. The human and environmental fields are irreducible; they cannot be
broken down into component parts or subsystems. Parts have no meaning in
unitary science. For example, the unitary human is not described as bio-psycho-
socio-cultural or body-mind-spirit entity. Each field is identified by pattern, defined
as “the distinguishing characteristic of an energy field perceived as a single
wave”. Patten manifestations and characteristics are specific to the whole.
Because of their wholeness, the individual’s life process is a dynamic course that
is continuous, creative, evolutionary and uncertain, resulting in highly variable
and constantly changing patterning.

The fields are pandimensional, defined as “a non-linear domain without


spatial temporal attributes”. Eg- paranormal phenomena.

b) Openness

This is a characteristic of and and environmental energy fields; energy


fields are continuously and completely open. That means the person and the
environment are continuously exchanging matter and energy with each other.
This constant interchange of materials and energy between the individual and the
environment characterises each of them as open systems.

In an open universe, there are no boundaries other than perceptual ones.


Therefore human and environment are not separated by boundaries. She
emphasises that the person and environment are energy fields, but they do not
have energy fields, such as the aura surrounding them.

c) Pattern

The distinguishing characteristic of an energy field. Patten is perceived as


a single wave that gives identity to the field and reveals itself through its
manifestations. Each human field pattern is a unique and is integral with its own
unique environmental field pattern. It is an abstraction that cannot be seen; what
is seen or experienced are manifestations of field pattern. Patten manifestations
reveal the relative diversity, low and high-frequency patterning of the human-
environmental mutual field process.

d) Pandimensionality

A non-linear domain without spatial temporal attributes. The interchanges


occur in pandimensionally and non-linear domain that is not bound by space or
time.

PRINCIPLES OF HOMEODYNAMICS

On the basis of five basic assumptions, and for building blocks, she
grounded her principles of homeodynamics which describes the nature of change
in the human-environmental field process. They are:

• Integrality
• Resonancy and
• Helicy

a) Resonancy

It specifies the “continuous change from lower to higher frequency wave


patterns in human and environmental fields”. It presents the way change occurs.
The change in the pattern of human beings and environment is propagated by
waves that move from longer waves of lower frequency to shorter waves of
higher frequency. The life process in human beings is a symphony of rhythemical
vibrations oscillating at various frequencies. It is the identification of the human
field and the environmental field by wave patterns and manifesting continuous
change from longer waves of lower frequency to shorter waves of high-frequency

b) Integrality

This emphasises the “continuous mutual human field and environmental


field process”. It states that the changes in life process are a result of the
interaction between the two fields.

c) Helicy

Asserts that human and environmental field patterns are continuous,


innovative, and unpredictable, and are characterised by increasing diversity. It
deals with the nature and direction of change in human environmental field.
Because of the constant interchange, an open system is never exactly the same
at any two moments. The life process evolves through a constant series of
change in a rhythmical manner. The rhythms are not repeated and the changes
incorporate the past and lead to new patterns. This process and these patterns
are unpredictable, dynamic, and increasingly diverse. This results in ever
increasing diversity and complexness.

Thus the principles of homeodynamics are a way of viewing human beings


in their wholeness.
PARADIGM OF ROGERS THEORY

There are four main topics that are addressed by nursing theorists:
people, the environment, health and nursing. Rogers' conceptual framework can
be analyzed using these four topics.

a) People

She presents five assumptions about human beings in relation to nursing


metaparadigm which includes :

• the human being is a unified being with individuality


• he is in continuous exchange of energy with the environment
• the life process evolves irreversibly and unpredictably in
Pandimensionality
• there is a pattern of life and
• the human being is capable of abstraction, imagery, language, thought,
sensation and emotion

b) Environment

It consists of totality of patterns existing external to the individual.. It's an


irreducible, indivisible, pan dimensional energy field identified by pattern and
integral with the human field.

c) Health

She did not address specifically to health. It is viewed in terms of choosing


actions that lead to the fulfilment of a person's potential.

d) Nursing

Nursing is an art and signs that humanistic and humanitarian. The goal of
nursing is to participate in the process of change so that people may benefit.
Nursing tries to direct the interaction of the person and the environment in order
to maximize health potential.

Nursing is a learned profession, a science and an art. A basic science,


“study of unitary irreducible, indivisible human and environmental fields, people
and their world”. In the sense of art, nursing is the “creative use of science of
nursing for human betterment, imaginative and creative use of nursing
knowledge for human betterment”

IMPLICATIONS FOR NURSING PRACTICE

Nursing practice is directed towards promoting the health and well-being


of all persons, wherever they are. The Rogerian practice methodology
encompasses two phases:

1. Patten manifestations appraisal -the continuous process of identifying


manifestations of the human and environmental fields that relates to
current health events. Experiences of patten manifestations are
accompanied by perception and are expressed in such diverse forms as
the verbal responses, response to questionnaires, and personal ways of
living and relating. Relevant pattern information includes sensations,
thoughts, feelings, awareness, imagination, memory, introspective insight,
intuitive apprehensions, recruiting themes, and issues that pervade one's
life, metaphors, visualisations, images, nutrition, work and play, exercise,
substance use, sleep / wake cycle, safety, decelerated/accelerated field
rhythms, space-time shifts, interpersonal networks, and professional
healthcare access and use.
2. Deliberative mutual patterning -the continuous process whereby the
nurse with a client patterns the environmental field to promote harmony
related to the health events. The nursing helps to create an environment
where healing conditions are optimal and invites clients to heal
themselves as they participate in various modalities used in deliberative
mutual patterning including non-invasive modalities such as therapeutic
touch, imaginary, meditation, relaxation, unconditional love, attitudes of
hope, humour, and upbeat moods, and the use of sound, colour, and
motion

IMPLICATIONS FOR NURSING EDUCATION

Education for nursing practice requires a commitment to lifelong learning.


Education for professional nursing occurs at the B Sc, M Sc, and Doctoral levels
in college and university settings. The purpose of professional nursing
educational programmes is to provide the knowledge and tools necessary for
nursing practice. The liberal arts and sciences are a predominant component of
curriculum. The principles of residency, helicy, and integrality represent the major
integrating concepts of the nursing courses

NURSING PROCESS

Using the guidelines of principles of homeodynamics, the professional


practice of nursing would seek to promote symphonic integration of human
beings and their environment, to strengthen the coherence and integrity of the
human field, and to direct and indirect patterning of human and environmental
field for the realisation of maximum health. These goals would be reflected in the
nursing process.

Individualised nursing care is necessary to achieve maximum health


potential in a positive fashion. Nursing is then working with clients, not to or for
the client.

CONCLUSION

Rogers uses multiple concepts related to each other that are not easily
understood. Her conceptual model is abstract and is therefore generalisable and
powerful. It is usually considered a grand theory on a macro theory. It is broader
in scope and attempts to explain everything.

The difficulty in understanding the principles, the lack of operational


definitions, and inadequate tools for measurement of the major limitations to the
effective utilisation of this theory.

A science of unitary human beings identifies nursing’s uniqueness and


signifies the potential of nurses to fulfil their social responsibility in human
services
________________________________________________________

Martha Rogers' theory has three principles of homeodynamic. First,


Integrality- a human energy and environmental energy are integrated, one affects
the other. Second, Helicy- all energy patterns are continuous and unpredictable
providing increasing diversity. Lastly, Resonance- a continuous change in energy
fields from lower to higher frequency patterning which is best represented by our
wake-sleep cycles.
Concepts of Roger’s 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 is 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 same continuum. The multiple events taking place along life's axis
denote the extent to which man is achieving his maximum health potential and
vary 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,


and the creative use of its knowledge is the art of its practice
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,


déjàvu, 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

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 continues
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, and 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

Roger’s 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 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
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, Masters, and Doctoral


program

• The major concepts are – principle 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 and its purpose health promotion
Characteristics of nursing personnel

The administrators should hold higher degrees in


nursing and licensed, should 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 to achieve the ultimate goal of
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

• Independent practitioner is an advanced


practice 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 ICU’s

 Old age homes

 Neuropsychiatric units
 AREA WHERE ROGERIAN MODEL IS NOT
APPLICABLE

 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
HANDOUT ON NURSING PROCESS USING ROGERIAN MODEL

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
o 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

BIBLIOGRAPHY

1.Martha Roger’s science of unitary human beings, currentnursing.com/theory/


unitary human beings/htm
2. Martha Roger’s and the science of unitary human beings,www.universitip.com/
Martha Roger’s science of unitary human beings/160234709.html

3. The science of unitary human beings: a current perspective,


nsq.sagepub.com/cgi/content/abstract

4. welcome to the society of Rogerian scholers,


www.societyofrogerianscholars.com

5. a nursing theory link page, healthsci.clyton.edueichilberger.nursing.htl