Nursing Theory 7

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April 5th, 2022

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Nursing Theory 7

Reflect on the tenets of the Theory of Human-becoming and its core concepts and assumptions. Then compare and contrast how the core concepts currently apply to your nursing practice versus how you anticipate they will relate to your future practice as a family nurse practitioner. Please identify at least 2 specific assumptions of the theory in your discussion as outlined in your textbook.

Use the chapters

Chapter 14: Martha E. Roger’s Science of Unitary Human Beings

Chapter 15: Rosemarie Rizzo Parse’s Humanbecoming Paradigm

Textbook

Nursing Theories and Nursing Practice (Parker, Nursing Theories and Nursing Practice)

Authors: Marlaine Smith PhD RN AHN-BC FAAN; Marilyn E. Parker PhD RN FAAN

Edition: 4

I attached the power point referents to this chapters.

Chapter 15

Rosemarie Rizzo Parse’s Humanbecoming School of Thought

Developed by Bonnie Pope (2010)

Updated by D. Gullett (2014)

On completion of this chapter, students will be able to:

Define the discipline and profession of nursing as implicated by Rosemarie Parse.

Articulate Parse’s reasons for changing man-living-health to humanbecoming.

Discuss the nine assumptions underlying the three major themes of Parse’s Humanbecoming Theory.

Describe the two research methods developed by Parse.

Discuss the components of Humanbecoming: The Art.

Identify and discuss the postulates and principles described by Parse and their role in explicating Parse’s Humanbecoming paradigm.

Compare and contrast a simultaneity paradigm, a totality paradigm and Parse’s humanbecoming paradigm.

Introducing the Theorist Rosemarie Rizzo Parse

Distinguished Professor Emeritus at Loyola University Chicago
Fellow in the American Academy of Nursing
Initiated and is immediate past chair of the Nursing Theory–Guided Practice Expert Panel.
Founder and editor of Nursing Science Quarterly
President of Discovery International

Rosemarie Rizzo Parse

Founder of the Institute of Humanbecoming
Graduate of Duquesne University in Pittsburgh
Earned master’s degree and doctorate from the University of Pittsburgh

Academic Positions

Faculty member, University of Pittsburgh
Dean School of Nursing, Duquesne University
Professor and Coordinator of the Center for Nursing Research at Hunter College, New York (1983 to 1993),
Professor and Niehoff Chair in Nursing Research at Loyola University, Chicago (1993 to 2006).

Current Position

Since January 2007, Parse has been a Consultant and Visiting Scholar at the New York University College of Nursing.

Overview

Metaperspective
Original work was named Man-Living-Health: A Theory of Nursing (1981).
When the term mankind was replaced with male gender in the dictionary definition of man, the name of the theory was changed to human becoming (Parse, 1992).

Totality vs Simultaneity Paradigms

The totality paradigm frameworks and theories are more closely aligned with the medical model tradition.
Nurses practicing according to this paradigm are concerned with participation of persons in health care decisions but have specific regimens and goals to bring about change for the people they serve (Parse, 1999b).

In contrast, the simultaneity paradigm views the human as unitary–indivisible, unpredictable, and ever-changing (Parse, 1987, 1998a, 2007b), wherein health is considered a value and a process.
The ontology leads research and practice scholars to focus on, for example, energy and environmental field patterns (Rogers, 1992).
Nurses focus on power in knowing participation (Barrett, 2010; Rogers, 1992).

Third Paradigm

In 2012, Parse identified a third paradigm, the humanbecoming paradigm (Parse, 2012a, 2013a).
This was created in as much as the ontology, epistemology, and methodologies of the humanbecoming school of thought have moved on from the traditional metaparadigm conceptualization and beyond the totality and simultaneity paradigms (Parse, 2013a).

Humanbecoming Paradigm

With the humanbecoming paradigm in the ontology, humanuniverse is an indivisible, unpredictable everchanging cocreation, and living quality is the becoming visible-invisible becoming of the emerging now.
Nurses living the humanbecoming paradigm beliefs hold that their primary concern is people’s perspectives of living quality with human dignity

Fundamental Idea

Humans are indivisible, unpredictable, ever-changing
Precludes any use of terms such as physiological, biological, psychological, or spiritual to describe the human.
Other words often used to describe people, such as, noncompliant, dysfunctional, and manipulative are not consistent with humanbecoming
Humanbecoming and humanuniverse are presented as one word (Parse, 2007b).
Joining the words creates one concept and further confirms the idea of indivisibility.

The Ontology

The assumptions, postulates, and principles of the humanbecoming school of thought (Parse, 2007b).

Principles

Humans construct personal realities with unique choosings arising with illimitable humanuniverse options
Rhythmical humanuniverse patterns of relating
Revealing–concealing, Enabling-limiting, Connecting–separating
Humans are ever-changing, that is, moving on with the possibilities of their intended hopes and dreams.
Powering, originating, transforming.

Humanbecoming Research Methodologies

Sciencing humanbecoming is coming to know
It is an ongoing inquiry to discover and understand the meaning of lived experiences
Three research methods
Two basic research methods

The Basic Research Methods

The Parse Method (Parse, 1987, 1990, 1992, 1995, 1997a, 1998a, 2001)
Studying lived experiences from participants’ descriptions
The Humanbecoming Hermeneutic Method (Cody, 1995; Parse, 1995, 1998a, 2001, 2005).
Studying lived experiences from written texts and art forms

Humanbecoming: The Art

The Goal of the Nurse
Living the humanbecoming beliefs is true presence in bearing witness and being with others in their changing health patterns.

True Presence

Lived nurse with person, family, and community in illuminating meaning, synchronizing rhythms, and mobilizing transcendence (Parse, 1987, 1992, 1994a, 1995, 1997a, 1998a).
The nurse with individuals or groups is in true presence with the unfolding meanings as persons explicate, dwell with, and move on with changing patterns of diversity.

True Presence (continued)

“True presence is an intentional reflective love, an interpersonal art grounded in a strong knowledge base” (Parse, 1998a, p 71).
Distinct from authentic presence, transforming presence, presencing, and other terms in the literature
True presence is a powerful humanuniverse connection.
Lived in face-to-face discussions, silent immersions, and lingering presence

Humanbecoming: The Art

Humanbecoming nurses live the art of the science of humanbecoming.
The term nursing practice is antithetical to the ontology.
Nurses come to persons in true presence with an availability to be with and bear witness, as persons illuminate the meaning of the situation, synchronize rhythms, and mobilize transcendence (Parse, 1981, 1987, 1998a, 2007b).

Humanbecoming Nurses

Believe persons know their way and live their health situations according to their unique value priorities.
Ask what is most important for the moment
Explore meanings, wishes, intents, and desires related to the situation from the perspective of the recipients
Humanbecoming nurses are with persons in ways that honor their wishes and desires

Research & Practice

The humanbecoming school of thought is a guide for research, practice, education, and administration in settings throughout the world.
Scholars from five continents have embraced the belief system and live humanbecoming in a variety of venues, including health care centers and university nursing programs

Website

http://www.humanbecoming.org/

References

Barrett, E.A.M. (2010). Power as knowing participation in change: What’s new and what’s next. Nursing Science Quarterly, 23, 47-55.

Parse, R. R. (1981). Man-living-health: A theory of nursing. New York: John Wiley & Sons.

Parse, R. R. (1987). Nursing science: Major paradigms, theories, and critiques. Philadelphia: W. B. Saunders.

Parse, R. R. (1990). Parse’s research methodology with an illustration of the lived experience of hope. Nursing Science Quarterly, 3, 9–17.

Parse, R. R. (1992). Human becoming: Parse’s theory of nursing. Nursing Science Quarterly, 5, 35–42.

Parse, R. R. (Ed.). (1995). Illuminations: The human becoming theory in practice and research. New York:

National League for Nursing Press.

References

Parse, R. R. (1997a). The human becoming theory: The was, is, and will be. Nursing Science Quarterly, 10, 32–38.

Parse, R. R. (1998a). The human becoming school of thought. Thousand Oaks, CA: Sage.

Parse, R. R. (1999b). Nursing: The discipline and the profession. Nursing Science Quarterly, 12, 275.

Parse, R. R. (2001). Qualitative inquiry: The path of sciencing. Sudbury, MA: Jones and Bartlett.

Parse, R. R. (2005). The human becoming modes of inquiry: Emerging sciencing. Nursing Science Quarterly, 18, 297–300.

Parse, R. R. (2007b). The humanbecoming school of thought in 2050. Nursing Science Quarterly, 20, 308.

Parse, R. R. (2012a). New humanbecoming conceptualizations and the humanbecoming community model:

Expansions with sciencing and living the art. Nursing Science Quarterly, 25, 44-52.

References

Parse, R. R. (2012b). “The things we make, make us” Nursing Science Quarterly, 25, 125.

Parse, R. R. (2013a). Living quality: A humanbecoming phenomenon. Nursing Science Quarterly 26 (2)

Rogers, M. E. (1992). Nursing science and the space age. Nursing Science Quarterly, 5, 27–34.

Santopinto, M. D. A., & Smith, M. C. (1995). Evaluation of the human becoming theory in practice with adults and children. In: R. R. Parse (Ed.), Illuminations: The human becoming theory in practice and research (pp. 309–346). New York: National League for Nursing Press.

Chapter 14

Martha E. Rogers’ Science of Unitary Human Beings

Developed by D.J. Dunn (2010)

Updated by D. Gullett (2014)

On completion of this chapter, students will be able to:

Identify and discuss the historical, educational, and personal information relevant to Martha Rogers’ life as a nurse theorist.

Categorize and define the terminology consistent with the Science of Unitary Human Beings nursing theory.

Discuss the application and operationalization of Rogers’ theory to nursing research and practice.

Identify research questions that would be appropriate to a Rogerian framework.

Articulate the theoretical developments that have emerged from Rogers’ initial work.

Suggest appropriate areas of focus for Rogerian inquiry.

Unique Focus of Nursing

Rogers (1994a) identified the unique focus of nursing as “the irreducible human being and its environment, both identified as energy fields” (p 33).
“Human” encompasses both Homo sapiens and Homo spatialis, the evolutionary transcendence of humankind as we voyage into space, and environment encompasses outer space.
This perspective necessitates a new worldview, out of which emerges the Science of Unitary Human Beings, “a pandimensional view of people and their world” (Rogers, 1992/1994, p 257).

Postulates of Rogerian Nursing Science

Energy fields
Openness
Pattern
Pandimensionality (formerly called both four-dimensionality and multidimensionality)

Pattern and Field

Pattern manifestations and characteristics are specific to the whole.
Because human and environmental fields are integral with each other, they cannot be separated.
They are always in mutual process.

Pandimensional Fields

The fields are pandimensional, defined as “a non-linear domain without spatial or temporal attributes” (Rogers, 1992, p 28).
Pandimensional reality transcends traditional notions of space and time, which can be understood as perceived boundaries only.

Pattern

Rogers (1992, 1994a) described pattern as changing continuously while giving identity to each unique human-environmental field process.
Although pattern is an abstraction, not something that can be observed directly, “it reveals itself through its manifestations” (Rogers, 1992, p 29).

Principles of Homeodynamics

Like adaptation, homeostasis—maintaining balance or equilibrium—is an outdated concept in the worldview represented in Rogerian nursing science.
Rogers chose “homeodynamics” to convey the dynamic, ever-changing nature of life and the world.
Her three principles of homeodynamics-resonancy, heliacy, and integrality-describe the nature of change in the human-environmental field.

Resonancy

Resonancy specifies the “continuous change from lower to higher frequency wave patterns in human and environmental fields” (Rogers, 1990a, p 9).
Resonancy presents the way change occurs.

Helicy

Helicy is the “continuous innovative, unpredictable, increasing diversity of human and environmental field patterns” (Rogers, 1990a, p 8).
This principle describes the nature of change.

Integrality

Integrality is “continuous mutual human field and environmental field process” (Rogers, 1990a, p 8).
It specifies the context of change as the integral human-environmental field process in which person and environment are inseparable.

Resonancy-Helicy-Integrality

Together, the principles suggest that the mutual patterning process of human and environmental fields changes continuously, innovatively, and unpredictably, flowing in lower and higher frequencies.
Rogers (1990a, p 9) believed that they serve as guides both to the practice of nursing and to research in the science of nursing.

Theories Derived from the SUHB

Rogers clearly stated her belief that multiple theories can be derived from the Science of Unitary Human Beings.
They are specific to nursing and reflect not what nurses do, but an understanding of people and our world (Rogers, 1992).

Selected Rogerian Theories

In addition to the processes of the unitary pattern–based practice method, a number of Rogerian theories have been developed that are useful in informing the pattern manifestation knowing and appreciation and voluntary mutual patterning processes.

Theory of Accelerating Change

The theory of accelerating change suggests that the only “norm” is accelerating change.
Higher frequency field patterns that manifest growing diversity open the door to wider ranges of experiences and behaviors, calling into question the very idea of “norms” as guidelines.
Human and environmental field rhythms are speeding up.

Theory of Emergence of Paranormal Phenomena

The theory of the emergence of paranormal phenomena suggests that experiences commonly labeled “paranormal” are actually manifestations of the changing diversity and innovation of field patterning.
They are pandimensional forms of awareness, examples of pandimensional reality that manifest visionary, beyond waking potentials.

Manifestations of Field Patterning

Rogers’ third theory, Rhythmical Correlates of Change, was changed to Manifestations of Field Patterning in Unitary Human Beings.
Rogers suggested that evolution is an irreducible, nonlinear process characterized by increasing diversity of field patterning.
She offered some manifestations of this relative diversity, including the rhythms of motion, time experience, and sleeping-waking, encouraging others to suggest further examples.

The Theory of Kaleidoscoping in Life’s Turbulence (Butcher, 1993)

Focuses on facilitating well-being and harmony amid turbulent life events. Turbulence is a dissonant commotion in the human–environmental field characterized by chaotic and unpredictable change. Any crisis may be viewed as a turbulent event in the life process.

Rogerian Science: Practice

The goal of nursing practice is the promotion of well-being and human betterment.
Nursing is a service to people wherever they may reside.
Nursing practice—the art of nursing—is the creative application of substantive scientific knowledge developed through logical analysis, synthesis, and research.

Rogerian View: Nursing Process

Nursing diagnoses are particularistic and reductionistic labels describing cause and effect (i.e., “related to”) relationships inconsistent with “nonlinear domain without spatial and temporal attributes (Rogers, 1992, p 29).

Rogerian View: Nursing Process

The nursing process is a stepwise sequential process inconsistent with a nonlinear or pandimensional view of reality.
In addition, the term “intervention” is not consistent with Rogerian science.

Rogerian View: Nursing Process

Outcomes are also inconsistent with Rogers’ principle of helicy: that expected outcomes infer predictability.
The principle of helicy describes the nature of change as being unpredictable.
Within an energy field perspective, nurses in mutual process assist clients in actualizing their field potentials by enhancing their ability to participate knowingly in change (Butcher, 1997).

Rogerian View: Nursing Process

Given the inconsistency of the traditional nursing process with Rogers’ postulates and principles, the Science of Unitary Human Beings requires the development of new and innovative practice methods derived from and consistent with the conceptual system.

Barrett’s Rogerian Practice Method

Barrett’s two-phase Rogerian practice methodology for health patterning is the accepted alternative to the nursing process for Rogerian practice and is currently the most widely used Rogerian practice model.

Elizabeth Barrett’s Rogerian Practice Method

Barrett’s (1988) practice model was derived from the Science of Unitary Human Beings and consisted of two phases:
Pattern manifestation appraisal
Deliberative mutual patterning

Richard Cowling’s Rogerian Practice Constituents

Cowling (1990) proposed a template comprising 10 constituents for the development of Rogerian practice models.

The Unitary Pattern–Based Praxis Method

Butcher (1997, 1999a, 2001) synthesized Cowling’s Rogerian practice constituents with Barrett’s practice method to develop a more inclusive and comprehensive practice model.
The unitary pattern-based practice method consists of two nonlinear and simultaneous processes:
Pattern manifestation appreciation and knowing, and
Voluntary mutual patterning

Unitary Pattern–Based Practice

Unitary pattern–based practice

begins by creating an atmosphere of openness and freedom so clients can freely participate in the process of knowing participation in change

Approaching the nursing situation with an appreciation of the uniqueness of each person, unconditional love, compassion, and empathy can help create an atmosphere of openness and healing patterning.

Unitary Pattern–Based Practice (continued)

A unitary perspective in nursing practice leads to an appreciation of new kinds of information that may not be considered within other conceptual approaches to nursing practice.
The nurse is open to using multiple forms of knowing including pandimensional modes of awareness (intuition, meditative insights, tacit knowing) throughout the pattern manifestation knowing and appreciation process.

Unitary Pattern–Based Practice (cont)

The pattern manifestation knowing and appreciation is enhanced through the nurse’s ability to grasp meaning, create a meaningful connection, and participate knowingly in the client’s change process (Butcher, 1999a).

Unitary Pattern–Based Practice (cont)

Voluntary mutual patterning

process of transforming human/environmental field patterning.
facilitate each client’s ability to participate knowingly in change
harmonize person/environment integrality
promote healing potentialities, lifestyle changes, and well-being in the client’s desired direction of change without attachment to predetermined outcomes

Unitary Pattern–Based Practice (cont)

The process is mutual in that both the nurse and the client are changed with each encounter, each patterning one another and co-evolving together.
Evaluation is continuous and is integral both to pattern manifestation knowing and appreciation and to voluntary mutual patterning.
The nurse is continuously evaluating changes in patterning emerging from the human/environmental field mutual process.

Science of Unitary Human Beings Research

Research is the bedrock of nursing practice.
As new practice theories and health patterning modalities evolve from the SUHB there remains a need to test the viability and usefulness of Rogerian theories and voluntary health patterning strategies

Science of Unitary Human Beings Research

Some debate among Rogerian scholars and researchers concerning the choice of an appropriate methodology in Rogerian research.
Rogers (1994) maintained that both quantitative and qualitative methods may be useful for advancing Rogerian science.

Research

The nature of the question and the phenomena under investigation should guide the selection
Rogers cautioned that neither is totally adequate for the new worldview and encouraged the development of new methods.

Potential Rogerian Research Designs

Cowling (1986) was among the first to suggest a number of research designs that may be appropriate for Rogerian research, including philosophical, historical, and phenomenological ones.
Qualitative and/or phenomenological methodology has demonstrated increasing congruence with Roger’s SUHB; whereas, the assumptions of causality in quantitative methodology is a bit more problematic

Selecting a Focus of Rogerian Inquiry

In selecting a focus of inquiry, concepts that are congruent with the Science of Unitary Human Beings are most relevant.
The focus of inquiry flows from the postulates, principles, and concepts relevant to the conceptual system.

Selecting a Focus of Rogerian Inquiry (continued)

Guided imagery
Therapeutic touch
Humor
Sound
Dialogue
Affirmations
Music
Massage
Journaling

Exercise
Nutrition
Reminiscence
Aroma, light, color, artwork
Meditation
Storytelling, literature, poetry,
Movement and dance

Measuring of Rogerian Concepts

Human Field Motion Test (HFMT)
The Power of Knowing Participation in Change Tool (PKPCT)
Diversity of Human Field Pattern Scale (DHFPS)
Assessment of Dream Experience Scale
Temporal Experience Scale

Rogerian Inquiry

Creativity, mystical experiences, transcendence, sleeping-beyond-waking experiences, time experience, and paranormal experiences as they relate to human health and well-being are also of interest in this science.

Rogerian Process of Inquiry

Carboni (1995b) developed the Unitary Process of Inquiry-

Evolution centered and focuses on changing configurations of human and environmental field patterning
Pandimensional Unitary Process Report-special criteria for trustworthiness to ensure scientific rigor

Rogerian Process of Inquiry

Butcher (1994, 1996, 1998, & 2005) the Unitary Field Pattern Protrait Research Method (UFPP)

Create a unitary understanding of the dynamic kaleidoscopic and symphonic pattern manifestations emerging from the pandimensional human/environmental field mutual process
Part of the Unitary Pattern-based Praxis Method
There are eight essential aspects and three essential processes in the method.

UFPP (continued)

Essential Aspects

Initial engagement
A priori nursing science
Immersion
Manifestations of knowing and appreciation
The unitary field pattern profile
The unitary field pattern portrait
Theoretical unitary field pattern portrait

Essential Processes

Creative Pattern Synthesis
Immersion and Crystallization
Evolutionary Interpretation

Rogerian Science in the Future

There is an ever-growing body of literature demonstrating the application of Rogerian science to practice and research.
Rogers’ nursing science is applicable in all nursing situations.
Rather than focusing on disease and cellular biological processes, the Science of Unitary Human Beings focuses on human beings as irreducible wholes that are inseparable from their environment.

Practice

Rogers identified noninvasive modalities as the basis for nursing practice now and in the future.
Nurses must use “nursing knowledge in non-invasive ways in a direct effort to promote well-being” (Rogers, 1994a, p 34).
This focus gives nurses a central role in health care rather than medical care.
Noted that health services should be community based, not hospital based.

Toward the Future

The Science of Unitary Human Beings reflects Rogers’ optimism and hope for the future.
Envisioned humankind poised “on the threshold of a fantastic and unimagined future” (Rogers, 1992, p 33), looking toward space while simultaneously engaging in a transformative Rogerian revolution in health care on Earth.
Goal: Establishment of autonomous Rogerian nursing centers here on Earth and ultimately in space.

Website

www.societyofrogerianscholars.org

References

Barrett, E. A. M. (1998). A Rogerian practice methodology for health patterning. Nursing Science Quarterly, 11, 136–138.

Butcher, H. K. (1993). Kaleidoscoping in life’s turbulence: From Seurat’s art to Rogers’ nursing science. In: M. E. Parker

(Ed.), Patterns of nursing theories in practice (pp. 183–198). New York: National League for Nursing.

Butcher, H. K. (1994). The unitary field pattern portrait method: Development of research method within Rogers’

science of unitary human beings. In M. Madrid & E. A. M. Barrett (Eds.), Rogers’ scientific art of nursing practice (pp.

397–425). New York: National League for Nursing.

Butcher, H. K. (1996). A unitary field pattern portrait of dispiritedness in later life. Visions: The Journal of Rogerian

Nursing Science, 4, 41–58.

Butcher, H. K. (1997a). Energy field disturbance. In G. K. McFarland & E. A. McFarlane, (Eds.), Nursing diagnosis and intervention (3rd ed., pp. 22–33). St. Louis, MO: Mosby.

References (cont)

Butcher, H.K. (1997b). A unitary field pattern portrait of dispiritedness in later life. Visions: The Journal of

Rogerian Nursing Science, 4, 41-58.

Butcher, H. K. (1999a). The artistry of Rogerian practice. Visions: The Journal of Rogerian Nursing Science, 7, 49–

54.

Butcher, H. K. (2001). Nursing science in the new millennium: Practice and research within Rogers’ science of

unitary human beings. In: M. Parker (Ed.), Nursing theories and nursing practice (pp. 205–226). Philadelphia:

F. A. Davis.

Butcher, H. K. (2005). The unitary field pattern portrait research method: Facets, processes and findings.

Nursing Science Quarterly, 18, 293–297.

Carboni, J. T. (1995b). A Rogerian process of inquiry. Nursing Science Quarterly, 8, 22–37.

References (cont)

Cowling, W. R. (1986). The science of unitary human beings: Theoretical issues, methodological challenges, and

research realities. In: V. M. Malinski (Ed.), Explorations on Martha Rogers’ science of unitary human beings

(pp. 65–78). Norwalk, CT: Appleton-Century-Crofts.

Cowling, W. R. (1990). A template for unitary pattern-based nursing practice. In: E. A. Barrett (Ed.), Visions of

Rogers’ science-based nursing (pp. 45–65). New York: National League for Nursing.

Rogers, M. E. (1990a). Nursing: Science of unitary, irreducible human beings: Update 1990. In Barrett, E. A. M.

(Ed.), Visions of Rogers’ science-based nursing (pp. 5–11). New York: National League for Nursing.

Rogers, M. E. (1992). Nursing and the space age. Nursing Science Quarterly, 5, 27–34.

References (cont)

Rogers, M. E. (1994a). The science of unitary human beings: Current perspectives. Nursing Science

Quarterly, 7, 33–35.

Rogers, M. E. (1994b). Nursing science evolves. In: M. Madrid & E. A. M. Barrett (Eds.), Rogers’ scientific art of

nursing practice (pp. 3–9). New York: National League for Nursing.

Smith, M. K. (2002). Human becoming and women living with violence. Nursing Science Quarterly, 15, 302–307.

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