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2. Intent or purpose of the study:
➢ Posit an idea of nursing rooted in the human sciences as an alternative to ideas of
nursing grounded in the natural sciences.
➢ “to explain how the meaning in any situation is related to the particular constituents
of that situation” (McEwen, 2011, p.194)
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o Pandimentionality- “a nonlinear domain without spatial or temporal
attributes”. The universe encompasses infinite dimensions, providing an
understanding of nonlocality, acausality, and unpredictability.
➢ Based on Roger’s principles and concepts and the works of Heidegger, Sartre and
Merleau-Ponty on existential-phenomenological thought
➢ Existential-phenomenological thought
• Tenets
o Intentionality
o Human subjectivity
• Concepts
o Coconstitution
o Coexistence
o Situated freedom
• Fundamental tenet to ontology of human becoming is the individual’s participation
in health
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REVISED ASSUMPTIONS MEANING
1. The human is coexisting while coconstituting Human lives with others mutually evolving with the
rhythmical patterns with the universe universe. Human pattern and the universe pattern
are unique and distinct but are rhythmical and
together coexist
2. The human is open, freely choosing meaning in Human, in open process with the universe, chooses
situation, bearing responsibility for decisions ways of becoming in situation and is accountable
for these choices. Human gives up other choices
and is therefore both enabled and limited by the
choices made. The human remains responsible for
all the outcomes of choices made, even though
these outcomes may be unknown at the time of
original choice
3. The human is unitary, continuously Human is unitary and cannot be divided into parts.
coconstituting patterns of relating Coconsituting patterns of relating are illuminated
through speech, words, symbols, silence, gesture,
movement, gaze, posture and touch
4. The human is transcending multidimensionally Human, in conjunction with the human-universe
with the possible mutual process, chooses to move beyond the
actual, the contextual situation, with possibilities.
This movement is unidirectional; it is not
repeatable or reversible. A human moves beyond
who one is via the mutual human-universe process
in imaging possibilities. The human transcends the
possibles by experiencing events in context. This
experiencing opens or illuminates other
possibilities that the human reaches toward while
continually becoming through choosing
5. Becoming is unitary human-living-health There is a continuous movement that both enables
and limits becoming in the human-universe mutual
process. The human’s view of the options or
choices one makes is based on personal history as
that human knows it. An experience of a situation,
though cocreated, belongs to only one person. The
unique perspective of each human becomings’
experiencing the human-universe mutual process is
health
6. Becoming is a rhythmically coconstituting Human becoming is the rhythmical process of
process of the human-universe process changing through the mutual connecting-
separating of human with universe. In each
connecting, there is also separating, and with each
separating, there is also connecting. This is
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paradoxical and it coconstitutes the emergence of
health as relative present
7. Becoming is the human’s pattern of relating Becoming is the human’s style of living chosen
value priorities cherished ideals, which are values-prized beliefs.
Value priorities are the preferred prized beliefs.
Becoming o health is a synthesis of the human’s
values selected from multidimensional experiences
cocreated in mutual process with the universe
8. Becoming is an intersubjective process of Becoming is moving beyond with the possible
transcending with the possible through a subject-to-subject mutual human-
universe process. Moving beyond with possible
means experiencing the familiar while at the same
time struggling with the unfamiliar of an imaged
not-yet
9. Becoming is unitary human’s emerging Becoming is the human’s multidimensional
changing in process with the universe. The
human’s coexisting multidimensional experience
with the universe powers the creation of individual
patterns of relating that arise as rhythms of human
becoming. Human health is continuously changing
in diverse ways.
➢ The original 9 assumptions are further synthesized into three assumptions on human
becoming
3. Human Becoming is contrascending Human becoming is moving beyond the self at all
multidimensionally with the unfolding levels of the universe as dreams become realities.
possibilities Contrascending is moving beyond with others and
the universe multidimensionally.
Multidimensionally refers to the various levels of
the universe that humans experience all at once
and choose possibles from the various situations.
Synthesis of (4,8 and 9)
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➢ Distinctives of theory
a. The belief that humans are more and different than the sum of their parts
b. Human beings evolve mutually with the environment
c. Human beings cocreate personal health by choosing meaning in situations
d. Human beings convey meanings that are personal values, which reflect their
dreams and hopes
➢ Principles (3 main themes)
a) Meaning- linguistic and imagined content of something and the interpretation that
one gives to something. It arises with the human-universe process and refers to
ultimate meaning or purpose in life and meaning moments of everyday living
b) Rhythmicity- paced, paradoxical patterning of the human-universe mutual process.
This can be visualized as the ebb and flow of waves coming into shore. Rhythmical
patterns moving in one direction are shown and hidden all at once as a flowing
process as cadence changes with new experiences
c) Transcendence- reaching beyond with possibles- the hopes and dreams as seen in
multidimensional experiences. The possibles are options from which to choose
personal ways of becoming
PRINCIPLES CONCEPTS
I. Structuring meaning ▪ IMAGING, VALUING, LANGUAGING
multidimensionally is ▪ Imaging- knowing and includes both explicit and tacit knowledge
cocreating reality ▪ Valuing- process of living cherished beliefs while adding to one’s
through the personal worldview
languaging of valuing ▪ Languaging- reflects images and values through speaking and
and imaging movement
▪ Meaning changes or is stretched to different possibilities based on
lived experiences
▪ Cocreating- human-environment mutual participation in the creatin of
the pattern of each
▪ The nurses guide individuals and families to relate the meaning of a
situation by making the meaning more explicit
II. Cocreating ▪ REVEALING-CONCEALING, ENABLING-LIMITING, CONNECTING-
rhythmical SEPARATING
patterns of ▪ These paradoxes are rhythmical patterns and are not opposites; they
relating is living are two aspects of the same rhythm and exist simultaneously one in
the paradoxical the foreground and the other in the background
unity of revealing- ▪ In interpersonal relationship, one reveals part of the self but conceals
concealing and other parts (reveals joy, conceals sorrow)
enabling-limiting ▪ Making choices or decisions enables an individual in some ways but
while connecting- limits in others (choose to stay at home enable to be with family but
separating limits one from attending at party)
▪ Connecting and separating is a rhythmical process of moving together
and moving apart
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▪ Moving with the flow of the individual/ family leading them to
recognize the harmony that exists within its own lived context.
▪ The nurse would not try to calm or balance rhythms or attempt to
help the family adapt
III. Cotranscending ▪ POWERING, ORIGINATING, TRANSFORMING
with the possibles ▪ Powering- energizing force the rhythm of which is the pushing-
is powering resisting of interhuman encounters
unique ways of ▪ Originating- inventing new ways of conforming not conforming in the
originating in the certainty-uncertainty of living. It is creating ways of distinguishing
process of personal uniqueness by living out the paradoxical rhythms all at once
transforming ▪ Transforming- changing of change and is recognized by increasing
diversity
▪ Mobilizing transcendence- moving beyond the meaning of the
moment with what is not yet. Propelling toward the possibles in
transforming
▪ The nurse would guide individuals and/or families to plan for the
changing of lived health patterns
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• Human beings reveal and conceal all-at-once through their choices, actions, and
words.
• Patterns of revealing-concealing are co-created in that they vary in relation to
who is present and what is happening.
• Enabling limiting- This concept concerns the choices people make moment to moment
and the inherent opportunities and limitations that accompany those personal choices.
• The concept is connected with the notion of doors opening and closing as people
make choices and move on in life.
• People often comment about the unanticipated opportunities that come from
hardship. Enabling-limiting is about choice, consequence, and discovery.
• Connecting-separating- concerns the ways people can be with others while at the same
time being separate from them, or how people can be together without being in the
same location.
• Connecting-separating is also about the ways people are with projects and ideas.
• As people choose to participate in one project or as they choose to embrace a
particular idea, there is at the same time a separating from that idea and other
possible projects.
• People connect and separate with people, ideas, and situations. In this way, they
show their unique patterns of humanbecoming.
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• The shift may be a choice to change one’s attitude about a certain situation, or
the shift may be a change in how one lives day-to-day routines or habits.
• The paradox familiar unfamiliar is embedded in the process of transforming.
When new ideas or situations are encountered, people logically look for
connections to what they already know—to what is familiar.
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b. Synchronizing rhythms
c. Mobilizing transcendence
2. Processes
a. Explicating
b. Dwelling with
c. Moving beyond
Nurse- interpersonal guide who acts in true presence, an active, energetic way of being with.
Traditional roles of care giver, advocate, counselor and leader do not appear to be congruent
with her theory.
Nursing Science Quarterly (Parse 1989)- Fundamentals essential for fully practicing the art of
nursing.
▪ Know and use nursing frameworks ▪ Connect with others
and theories ▪ Take pride in self
▪ Be available to others ▪ Like what you do
▪ Value the other as a human ▪ Recognize the moments of joy in the
presence struggles of living
▪ Respect differences in view ▪ Appreciate mystery and be open to
▪ Own what you believe and be new discoveries
accountable for your actions ▪ Be competent in your chosen area
▪ Move on to a new and untested ▪ Rest and begin anew
NURSING PROCESS- evolves from the discipline of philosophy and does not flow from an
ontological base in the discipline of nursing.
Steps of the nursing process are the problem-solving method and are not unique to nursing.
The nurse is the authority on health and that the person adapts or can be “fixed”, are not
congruent with the theory of human becoming.
Strengths Weaknesses
1. Logical flow from construction of her 1. Lack of articulation with the body of
assumptions to the deductive derivation of knowledge and psychomotor skills that
principles, theoretical structures, practice most nurses and society generally attribute
dimensions, and research processes. to the practice of professional nursing.
2. It focuses on all individuals, not only those
defined by societal norms as being ill. The
individual in the nurse-person relationship
uncovers the meaning of his or her lived
experience.
3. The nurse is in true presence with the client
and together they illuminate meaning,
synchronize rhythms, and mobilize
transcendence.
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4. It would speed a transformation from the
mechanistic approach to health care to one
that has a unitary perspective of the health
care of humans.
5. Assumption about humans freely choosing
personal meaning in the process of relating
value priorities.
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with the environment…gives meaning to situations and is responsible for
choices in moving beyond what is…. experiencing the what was, is, and will
be all at once
Nursing as basic science- with own body of distinct knowledge
Focus- optimal well-being of unitary human beings and quality of life
THEORY ANALYSIS
1. Theoretical and operational definitions of concepts; statements or propositions
▪ Nurses are to guide individuals and their families “in choosing
possibilities in changing the health process” (McEwen & Wills, 2011,
p.194). The nurse does not practice from a position of changing the
individual’s behavior but rather works with the individual and family.
2. Explicit linkages: Links between concepts were described above
3. Is the theory logically organized? Theory clearly stated and organized
4. Theory model or diagram
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6. Statement or prediction of outcomes or consequences
▪ Nurses guide patients and co-create ways of being to promote health
and well being
• This knowledge base is essential for nurses using humanbecoming to guide their
practice. Parse (1998) states, “The art of living humanbecoming is guided by the
theoretical principles that espouse the human as free agent and meaning-giver,
choosing rhythmical patterns of relating while reaching for personal hopes and dreams”
(pp. 68-69).
Purpose of Nursing
• Quality of life, from Parse’s view, is the whatness that makes life what it is. It
encompasses the meanings, feelings, and thoughts of life experiences (Parse, 1994).
• Parse (1998) says that “quality or whatness is the essence of something—in this case,
the essence of life, the core substance that makes a life different and uniquely
irreplaceable” (p. 69).
• From this understanding of quality of life, the nurse expresses a profound respect for
each person’s reality as it is expressed in the nurse-person process.
• Judgment about the person’s reality, in any form, diminishes respect for that individual’s
quality of life and living.
• The nurse guided by humanbecoming approaches a patient with the intent to be truly
present with the person as she struggles with a critical life situation.
• Humanbecoming guides the nurse to approach a patient with openness, as an
unknowing stranger who has opportunities to bear witness to a patient’s unfolding
experience and to provide service as directed by the patient as he/she lives his/her value
priorities.
• Practice with humanbecoming is a participatory experience in that the nurse’s choices in
relation to speaking and acting are guided by the patient as she expresses his/her
concerns, issues, wishes, hopes, and desires.
• The three principles of humanbecoming underpin the beliefs that the nurse holds about a
patient and his/her situation.
• The nurse caring for a patient in a critical situation holds the following three beliefs:
1. The patient structures the meaning of his/her health experience.
2. The patient lives his/her becoming in paradoxical patterns that involve others in her
life. A patient reveals and conceals her values as she connects and separates with
others and with ideas in the enabling-limiting process of moving beyond.
3. In the process of co-transcending with possibles, the patient finds ways to move with
the reality of her life situation. A patient’s way of being with the situation is a unique
expression of her humanbecoming. Unique ways of being with and moving cannot be
dictated by others.
• The nurse will be with the patient as she explores her situation and as she considers her
options.
• The nurse does not judge or label the patient.
• The nurse guided by human becoming explores from the patient’s perspective.
• From these discussions, specific nursing activities that flow from and address the issues
that the patient identifies as important for her would be developed.
• It is essential to note the subtle but important difference between a nurse who makes
recommendations and suggestions based on his or her values and a nurse who invites
the person to lead this process of discussing issues, needs, and possibilities.
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• The reality is that when nurses invite others to clarify their concerns and possibilities, a
different experience unfolds.
• The nurse who is guided by humanbecoming trusts that people will ask the questions
and seek the information that they need to move on and that they will seek answers from
the nurse when they are ready to engage that information.
• From the humanbecoming perspective, nursing is a basic science that complements the
practices of other health professionals.
• Humanbecoming-guided practice does not take more time, although some nurses find
they spend their time differently after they see the difference this practice makes in the
lives of clients.
• Nurses describe instances when they were more vigilant and attentive to the concerns
expressed by patients.
• In several situations, nurses describe how they sought medical intervention earlier than
they would have if not guided by humanbecoming. The differences with
humanbecoming-guided practice happen in the messages given and taken, in the words
spoken and not spoken, and with the intent to be present with another without judgment
or expectation.
• Living the art of nursing, as defined in the Humanbecoming School of Thought, is not
easier than traditional nursing.
• Indeed, it calls for critical thinking, courage, and maturity. However, the theory offers a
repeating pattern of meaningful nursing practice.
• Individuals, families, and groups let nurses know in many different ways that their
humanbecoming practice makes a difference.
THEORY EVALUATION
1. Congruence with nursing standards: The origin comes from Parse’s own experience in
nursing and from principles of human sciences
2. Congruence with nursing interventions or therapeutics: Theory has been used to guide
practice in acute care with positive outcome for both patient and family (Legault &
Ferguson-Pare, 1999), utilized at the state level for practice regulation (Benedict,
Bunkers, Damgaard Hohman, & VanderWoude, 2000)
3. Evidence of empirical testing/research support/validity: Noh (2004) studied quality of life
for individuals with serious mental illness and Bunkers and Daly (1999) studied hope for
families living with coronary disease.
4. Evidence that the theory has been used: above annotations of the paper
5. Social relevance: The theory is pertinent to persons, groups and families.
6. Transcultural relevance: Parse’s theory has been a guide for practice in many countries
including: Canada, Finland, South Korea, Sweden, Australia (McEwen & Wills, 2011).
7. Contribution to Nursing: Research is currently ongoing utilizing Parse’s theory (McEwen
& Wills, 2011). And although the theory has many ideas and principles, they are
organized, logical, and balanced in a way to explain human ways of being (McEwen &
Wills, 2011).
8. Conclusions and Implications: Current nursing practice establishes the nurse as an
advocate for the patient. This theory supports the patient nurse relationship and assists
the individual in creating their own destiny, taking an active role in their destiny. A reality
that would make many patients feel empowered when they otherwise would feel
powerless.
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References:
George, J. (2008) Nursing Theories: The Base for Professional Nursing Practice (5 th ed.).
California: Pearson Education Inc.
McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing (4th ed.). Philadelphia: Wolters
Kluwer Health/Lippincott Williams & Wilkins.
Smith, M. C., & Parker, M. E. (2015). Nursing theories & nursing practice. Philadelphia, PA: F.A.
Davis Company.
https://sites.google.com/site/shunu530team3/rosemarie-rizzo-parse/evaluation-of-theory
Misc:
1. https://www.omicsonline.org/proceedings/applying-parse-s-theory-to-a-female-patient-
suffering-from-a-pneumothorax-54207.html
2. https://www.researchgate.net/publication/269770557_Theory_to_Practice_The_Humanb
ecoming_Leading-Following_Model
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3. https://www.ncbi.nlm.nih.gov/pubmed/9555426
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