Nursing Theory

Theory
Has been defined as a supposition or system
of ideas that is proposed to explain a given
phenomena.
Florence Nightingaless
Environmental Theory
considered the founder of
educated and
scientificnursing and
widely known as "The Lady
with the Lamp
wrote the first nursing
notes that became the
basis of nursing practice
and research. The notes,
entitled Notes on Nursing:
What it is, What is
not (1860)
Considered the first
nursing theorist.
Defined Nursing over 100 years ago:The act of utilizing
the environment of the patient to assist him in his
recovery.
Focuses on changing and manipulating the environment in
order to put the patient in the best possible conditions for
nature to act.
She linked health with 5 environmental factors: fresh air, pure
water, efficient drainage, cleanliness/sanitation and light/direct
sunlight.
Considered a clean, well-ventilated, quiet environment
essential for recovery.
Deficiencies in these 5 factors produce illness or lack of health,
but with a nurturing environment, the body could repair itself.
Hildegard Peplaus
Interpersonal Relations Theory
is a psychiatric nurse,
Introduced her interpersonal
concept in 1952.
Defined Nursing: An
interpersonal process of
therapeutic interactions
between an Individual who is
sick or in need of health
services and a nurse especially
educated to recognize,
respond to the need for help.
Nursing is a maturing force
and an educative instrument
Identified 4 phases of the Nurse Patient relationship:
Orientation individual/family has a felt need and seeks
professional assistance from a nurse (who is a stranger). This is
the problem identification phase.
Identification where the patient begins to have feelings of
belongingness and a capacity for dealing with the problem,
creating an optimistic attitude from which inner strength
ensues. Here happens the selection of appropriate professional
assistance.
Exploitation the nurse uses communication tools to offer
services to the patient, who is expected to take advantage of all
services.
Resolution where patients needs have already been met by
the collaborative efforts between the patient and the
nurse.Therapeutic relationship is terminated and the links are
dissolved, as patient drifts away from identifying with the nurse
as the helping person.
Virginia Hendersons Definition
of the Unique Function of Nursing
Defined
Nursing:Assisting the
individual, sick or well, in
the performance of those
activities contributing to
health or its recovery (or
to peaceful death) that an
individual would perform
unaided if he had the
necessary strength, will
or knowledge.
Identified 14 basic needs :
Breathing normally
Eating and drinking adequately
Eliminating body wastes
Moving and maintaining desirable position
Sleeping and resting
Selecting suitable clothes
Maintaining body temperature within normal range
Keeping the body clean and well-groomed
Avoiding dangers in the environment
Communicating with others
Worshipping according to ones faith
Working in such a way that one feels a sense of accomplishment
Playing/participating in various forms of recreation
Learning, discovering or satisfying the curiosity that leads to normal
development and health and using available health facilities.
Madeleine Leiningers Transcultural
Care Theoryand Ethnonursing
A well-known nurse anthropologist,
put her views on transcultural
nursing in print in the 1970s and
then in 1991 published her book
Culture care diversity and
universality: A theory of Nursing
Nursing is a learned humanistic and
scientific profession and discipline
which is focused on human care
phenomena and activities in order to
assist, support, facilitate, or enable
individuals or groups to maintain or
regain their well being (or health) in
culturally meaningful and beneficial
ways, or to help people face
handicaps or death.
Transcultural nursing as a learned subfield or
branch of nursing which focuses upon the
comparative study and analysis of cultures with
respect to nursing and health-illness caring
practices, beliefs and values with the goal to
provide meaningful and efficacious nursing care
services to people according to their cultural
values and health-illness context.
Focuses on the fact that different cultures have
different caring behaviors and different health and
illness values, beliefs, and patterns of behaviors.
Awareness of the differences allows the nurse to
design culture-specific nursing interventions.
In order for nurses to assist people of diverse
cultures, Lenienger presents three
intervention modes:
1. Culture care preservation and maintenance .
2. Culture care accommodation, negotiation, or
both
3. Culture care restructuring and repatterning.
Dorothea Orems General Theory of Nursing

Defined Nursing:The act of

assisting others in the
provisionand management
of self-careto
maintain/improve human
functioning at home level
of effectiveness.
Focuses on activities that
adult individuals perform on
their own behalf to maintain
life, health and well-being.
Has a strong health promotion
and maintenance focus.
Identified 3 related concepts:
1. Self-care activities an Individual performs
independently throughout life to promote and
maintain personal well-being.
2. Self-care deficit results when self-care
agency (Individuals ability) is not adequate to
meet the known self-care needs.
3. Nursing System nursing interventions
needed when Individual is unable to perform
the necessary self-care activities:
Self-care theory is based on four concepts:
1. Self care- refers to those activities an individual performs
independently throughout life to promote and maintain personal
well-being.
2. Self care agency- is the individuals ability to perform self care
activities. It consists of two agents: a self-care agent(an individual
who performs self-care independently) and a dependent care agent
(a person other than the individual who provides the care)
3. Self-care requisites- are groups of needs or requirements that
Orem identified. They are classified as either:
a) Universal self-care requisites - those needs that all people have
b) Developmental self-care requisites - 1. maturational: progress
toward higher level of maturation. 2. situational: prevention of
deleterious effects related to development.
c) Health deviation requisites - those needs that arise as a result
of a patient's condition. Result from illness, injury or disease or its
treatment. They include actions such as seeking health care
assistance ,carrying out prescribed therapies, and learning to live
with the effects of illness or treatment.
4. Therapeutic self-care demand-refers to
all self-care activities required to meet
existing self-care requisites, or in other
words, actions to maintain health and well-
being.
Self care deficit- results when self care
agency is not adequate to meet the known
self-care demand. This theory explains not
only nursing is needed but also how people
can be assisted through five methods of
helping: acting or doing for, guiding,
teaching, supporting, and providing an
environment that promotes individuals
abilities to meet current and future demands.
Orems 3 types of Nursing
Systems:
1. Wholly compensatory nurse provides entire self-care for
the client.
Example: care of a new born, care of client recovering from
surgery in a post-anesthesia care unit
2. Partial compensatory nurse and client perform care,
client can perform selected self-care activities, but also accepts
care done by the nurse for needs the client cannot meet
independently.
Example: Nurse can assist post operative client to ambulate,
Nurse can bring a mealtray for client who can feed himself
3. Supportive-educative nurses actions are to help the
client develop/learn their own self-care abilities through
knowledge, support and encouragement.
. Example: Nurse guides a mother how to breastfeed her
baby,Counselinga psychiatric client on more adaptive coping
strategies.
Imogene Kings Goal
Attainment Theory
Nursing is a process of
action, reaction, and
interaction whereby
nurse and client share
information about their
perception in the
nursing situation
King used asystemsapproach in the development
of her dynamic interacting systems framework and in
her subsequent Goal-Attainment Theory.
She developed a general systems framework and a
theory of goal attainment where the framework refers
to the three interacting systems -individual or
personal, group or interpersonal, and society or social,
while the theory of goal attainment pertains to the
importance of interaction, perception, communication,
transaction, self, role, stress, growth and
development, time, and personal space.
King emphasizes that both the nurse and the client
bring important knowledge and information to the
relationship and that they work together to achieve
goals.
The relationship of three interacting systems
led to Kings Theory of Goal Attainment are the
personal system (individual), the interpersonal
system (nurse-patient dialogue), and the social
system (the family, the school, and the church).
Each system is given different concepts.
1) The concepts for thepersonal systemare:
perception, self, growth and development,
body image, space, and time. These are
fundamentals in understanding human being
because this refers tohow the nurse views
and integrates self based from personal goals
and beliefs.
Among all these concepts, the most important
is perception, because it influences behavior.
King summarized the connections among
these concepts as An individual Perception of
self, of body image, of time, of space
influences the way he or she responds to
object and events in his/her life.
As individuals grow and develop through the
lifespan experiences with changes in structure
and function of their bodies over time
influence their perceptions of self
2. Personal systems are individuals, who are
regarded as rational, sentient, social beings.
Concepts related to the personal system are:
a) Perception a process of organizing, interpreting, and
transforming information from sense data and memory that
gives meaning to one's experience, represents one's image of
reality, and influences one's behavior.
b) Self a composite of thoughts and feelings that constitute a
person's awareness of individual existence, of who and what he
or she is.
c) Growth and development cellular, molecular, and
behavioral changes in human beings that are a function of
genetic endowment, meaningful and satisfying experiences,
and an environment conducive to helping individuals move
toward maturity.
d) Body imagea person's perceptions of his or her body.
e) Timethe duration between the occurrence of one event and
the occurrence of another event.
f) Spacethe physical area called territory that exists in all
directions.
g) Learninggaining knowledge.
The concepts associated for theinterpersonal
systemare: interaction, communication,
transaction, role, and stress.
King refers to two individuals as dyads, three as
triads and four or more individuals as small
group or large group .
This showshow the nurse interrelates with a
co-worker or patient, particularly in a nurse-
patient relationship.
Communication between the nurse and the
client can be verbal or nonverbal. Collaboration
between the Dyads (nurse-patient) is very
important for the attainment of the goal.
The concepts associated with this system are:
a) Interactionsthe acts of two or more persons in mutual
presence; a sequence of verbal and nonverbal behaviors that
are goal directed.
b) Communicationthe vehicle by which human relations are
developed and maintained; encompasses intrapersonal,
interpersonal, verbal, and nonverbal communication.
c) Transactiona process of interaction in which human beings
communicate with the environment to achieve goals that are
valued; goal-directed human behaviors.
d) Rolea set of behaviors expected of a person occupying a
position in a social system.
e) Stressa dynamic state whereby a human being interacts
with the environment to maintain balance for growth,
development, and performance, involving an exchange of
energy and information between the person and the
environment for regulation and control of stressors.
f) Copinga way of dealing with stress.
 action
reaction

Disturbance(problem)

Interpersonal Mutual goal setting and

decision making
dyad Exploration if means to
(Nurse- achieve the goal

client)- Agreement on means to

achieve the goals
interaction Transaction directly
observable

Goal attainment

Kings definition of interaction and

transaction
3.The final interacting system is thesocial system.
This showshow the nurse interacts with co workers,
superiors, subordinates and the client environment in
general.
These are groups of people within the community or
society that share a common goals, values and interests.
It provides a framework for social interaction and
relationships and establishes rules of behavior and courses
of action.
Social systems are organized boundary systems of social
roles, behaviors, and practices developed to maintain
values and the mechanisms to regulate the practices and
roles.
The concepts related to social systems are:
a) Organizationcomposed of human beings with prescribed
roles and positions who use resources to accomplish
personal and organizational goals.
b) Authoritya transactional process characterized by active,
reciprocal relations in which members' values, backgrounds,
and perceptions play a role in defining, validating, and
accepting the authority of individuals within an organization.
c) Powerthe process whereby one or more persons influence
other persons in a situation.
d) Statusthe position of an individual in a group or a group in
relation to other groups in an organization.
e) Decision makinga dynamic and systematic process by
which goal-directed choice of perceived alternatives is made
and acted upon by individuals or groups to answer a
question and attain a goal.
f) Controlbeing in charge.
Among the three systems, the conceptual framework
of Interpersonal system had the greatest influence
on the development of her theory.
She stated that Although personal systems and social
systems influence quality of care, the major elements
in a theory of goal attainment are discovered in the
interpersonal systems in which two people, who are
usually strangers, come together in a health care
organization to help and to be helped to maintain a
state of health that permits functioning in roles
Finally according to her, nursing's focus is
onthe care of the patient, and its goal is
the health care of patients and groups of
patients.
Callista Roys Adaptation
Theory
Sister Callista Roy defines
adaptation as the process and
outcome whereby the thinking
and feeling person uses
conscious awareness and choice
to create human and
environmental integration.
This model comprises the four
domain concepts of person,
health, environment, and nursing
and involves a six step nursing
process
1) Roy's models sees the person as "a
biopsychosocial being in constant interaction
with a changing environment
. The person is an open, adaptive system who
uses coping skills to deal with stressors.
2) Roy sees the environment as "all
conditions, circumstances and influences that
surround and affect the development and
behaviour of the person".
.Roy describes stressors as stimuli and uses
the term 'residual stimuli' to describe those
stressors whose influence on the person is not
clear .
3) Originally, Roy wrote that health and illness are
on a continuum with many different states or
degrees possible. More recently, she states that
health is the process of being and becoming an
integrated and whole person
4) Roy's goal of nursing is "the promotion of
adaptation in each of the four modes, thereby
contributing to the person's health, quality of life and
dying with dignity". These four modes are
physiological, self-concept, role function and
interdependence.
A. In the Physiologic mode, adaptation involves the
maintenance of physical integrity. Basic human needs
such as nutrition, oxygen, fluids, and temperature
regulation are identified with this mode.
.In assessing a family, the nurse would ask how the family
provides for the physical and survival needs of the family
members.
B. A function of the Self-concept mode is the need for
maintenance of psychic integrity. Perceptions of ones
physical and personal self are included in this mode.
.Families also have concepts of themselves as a family unit.
Assessment of the family in this mode would include the
amount of understanding provided to the family members,
the solidarity of the family. the values of the family, the
amount of companionship provided to the members, and
the orientation (present or future) of the family.
C. The need for social integrity is emphasized in the
Role function mode. When human beings adapt
to various role changes that occur throughout a
lifetime, they are adapting in this mode.
According to Hanson, the familys role can be
assessed by observing the communication
patterns in the family.
Assessment should include how decisions are
reached, the roles and communication patterns of
the members, how role changes are tolerated,
and the effectiveness of communication.
For example, when a couple adjusts their lifestyle
appropriately following retirement from full-time
employment, they are adapting in this mode.
D.The need for social integrity is also emphasized in the
interdependence mode.
Interdependence involves maintaining a balance between
independence and dependence in ones relationships with
others.
Dependent behaviors include affection seeking, help
seeking, andattention seeking.
Independent behaviors include mastery of obstacles and
initiative taking.
According to Hanson, when assessing this mode in
families, the nurse tries to determine how successfully the
family lives within a given community.
The nurse would assess the interactions of the family with
the neighbors and other community groups, the support
systems of the family, and the significant others .
 The goal of nursing is to promote adaptation of
the client during both health and illness in all four
of the modes.
Actions of the nurse begin with the assessment
process, The family is assessed on two levels.
First, the nurse makes a judgment with regard to
the presence or absence of maladaptation.
Then, the nurse focuses the assessment on the
stimuli influencing the familys maladaptive
behaviors. The nurse may need to manipulate the
environment, an element or elements of the
client system, or both in order to promote
adaptation .
Roy employs a six-step nursing process which
includes: assessment of behaviour,
assessment of stimuli, nursing diagnosis,
goal setting, intervention and
evaluation.
In the first step, the person's behaviour in
each of the four modes is observed. This
behaviour is then compared with norms and is
deemed either adaptive or ineffective.
The second step is concerned with factors that
influence behaviour. Stimuli are classified as
focal, contextual or residual.
 The nursing diagnosis is the statement of the
ineffective behaviours along with the identification
of the probable cause.
In the fourth step, goal setting is the focus. Goals
need to be realistic and attainable and are set in
collaboration with the person.
Intervention occurs as the fifth step, and this is
when the stimuli are manipulated. It is also called
the 'doing phase'.
In the final stage, evaluation takes place. The degree
of change as evidenced by change in behaviour, is
determined. Ineffective behaviours would be
reassessed, and the interventions would be revised
Jean Watsons The Philosophy and
Science of Caring
The Philosophy and Science of
Caring has four major concepts:
human being, health,
environment/society, and nursing.
Jean Watsonrefers to the human
being as "a valued person in and
of him or herself to be cared for,
respected, nurtured, understood
and assisted; in general a
philosophical view of a person as a
fully functional integrated self.
Human is viewed as greater than
and different from the sum of his
or her parts."
1) Health is defined as a high level of overall physical, mental,
and social functioning; a general adaptive-maintenance level
of daily functioning; and the absence of illness, or the
presence of efforts leading to the absence of illness.
2) Watson's definition of environment/society addresses the
idea that nurses have existed in every society, and that a
caring attitude is transmitted from generation to generation
by the culture of the nursing profession as a unique way of
coping with its environment.
3) The nursing model states that nursing is concerned with
promoting health, preventing illness, caring for the sick, and
restoring health. It focuses on health promotion, as well as
the treatment of diseases. Watson believed
thatholistichealth care is central to the practice of caring in
nursing. She defines nursing as "a human science of persons
and human health-illness experiences that are mediated by
professional, personal, scientific, esthetic and ethical human
transactions."
4) Thenursing processoutlined in the model contains
the same steps as the scientific research process:
assessment, plan, intervention, and evaluation.
The assessment includes observation, identification,
and review of the problem, as well as the formation of
a hypothesis.
Creating acare planhelps the nurse determine how
variables would be examined or measured, and what
data would be collected.
Intervention is the implementation of the care plan
and data collection.
Finally, the evaluation analyzes the data, interprets
the results, and may lead to an additional hypothesis.
Watson's model makes seven
assumptions:
Caring can be effectively demonstrated and practiced only
interpersonally.
Caring consists of carative factors that result in the
satisfaction of certain human needs.
Effective caring promotes health and individual or family
growth.
Caring responses accept the patient as he or she is now, as
well as what he or she may become.
A caring environment is one that offers the development of
potential while allowing the patient to choose the best action
for him or herself at a given point in time.
A science of caring is complementary to the science of curing.
The practice of caring is central to nursing.
The first three carative factors are the
"philosophical foundation" for the science of
caring, while the remaining seven derive from
that foundation. The ten primary carative
factors are:
The formation of a humanistic-altruistic system of
values, which begins at an early age with the values
shared by parents. The system of values is mediated by
the nurse's life experiences, learning gained, and
exposure to the humanities. It is perceived as necessary
to the nurse's maturation which in turn promotes
altruistic behavior toward others.
The installation of faith-hope, which is essential to the
carative and curative processes. When modern science
has nothing else to offer a patient, a nurse can continue
to use faith-hope to provide a sense of well-being
through a belief system meaningful to the individual.
The cultivation of sensitivity to one's self and to others, which
explores the need of nurses to feel an emotion as it presents
itself. The development of a nurse's own feeling is needed to
interact genuinely and sensitively with patients. By striving to
become more sensitive, the nurse is more authentic. This
encourages self-growth and self-actualization in both the
nurse and the patients who interact with the nurse. The
nurses promote health and higher-level functioning only when
they form person-to-person relationships.
The development of a helping-trust relationship, which
includes congruence, empathy, and warmth. The strongest
tool a nurse has is his or her mode of communication, which
establishes a rapport with the patient, as well as caring by the
nurse. Communication includes verbal and nonverbal
communication, as well as listening that connotes empathetic
understanding.
The promotion and acceptance of the
expression of both positive and negative
feelings, which need to be considered and
allowed for in a caring relationship because of
how feelings alter thoughts and behavior. The
awareness of the feelings helps the nurse and
patient understand the behavior it causes.
The systematic use of the scientific method
for problem-solving and decision-making,
which allows for control and prediction, and
permits self-correction. The science of caring
should not always be neutral and objective.
The promotion of interpersonal teaching-learning,
since the nurse should focus on the learning
process as much as the teaching process.
Understanding the person's perception of the
situation assists the nurse to prepare a cognitive
plan.
The provision for a supportive, protective and/or
corrective mental, physical, socio-cultural, and
spiritual environment, which Watson divides into
interdependent internal and external variables,
manipulated by the nurse in order to provide
support and protection for the patient's mental and
physical health. The nurse must provide comfort,
privacy, and safety as part of the carative factor.
Assistance with satisfying human needs based on a
hierarchy of needs similar to Maslow's. Each need is
equally important for quality nursing care and the
promotion of the patient's health. In addition, all needs
deserve to be valued and attended to by the nurse and
patient.
The allowance for existential-phenomenological forces,
which helps the nurse to reconcile and mediate the
incongruity of viewing the patient holistically while at
the same time attending to the hierarchical ordering of
needs. This helps the nurse assist the patient to find
strength and courage to confront life or death.
Phenomology is a way of understanding the patient
from his or her frame of reference. Existential
psychology is the study of human existence.
Watson's hierarchy of needs begins with
lower-order biophysical needs, which include
the need for food and fluid, elimination, and
ventilation. Next are the lower-order
psychophysical needs, which include the need
for activity, inactivity, and sexuality. Finally,
are the higher order needs, which are
psychosocial. These include the need for
achievement, affiliation, and self-actualization.
Betty Neuman's Systems Model
Health is a condition in
which all parts and
subparts are in harmony
with the whole of the
client.
Developed this model
based on the
individuals relationship
to stress, the reaction
to it, and reconstitution
factors that are
dynamic in nature.
Reconstitution is the
state of adaptation to
stress.
KEY CONCEPTS
Viewed the client as an open system consisting of a basic
structure or central core of energy resources which
represent concentric circles
Each concentric circle or layer is made up of the five
variable areas which are considered and occur
simultaneously in each client concentric circles. These are:
1. Physiological- refers of bodily structure and function.
2. Psychological- refers to mental processes, functioning
and emotions.
3. Sociocultural- refers to relationships; and
social/cultural functions and activities.
4. Spiritual- refers to the influence of spiritual beliefs.
5. Developmental- refers to lifes developmental
processes.
Basic Structure Energy Resources-This is otherwise known as
the central core, which is made up of the basic survival factors
common to all organisms. These include the following:
1. Normal temperature range body temperature regulation
ability
2. Genetic structure Hair color and bodily features
3. Response pattern functioning of body systems
homeostatically
4. Organ strengthor weakness
5. Ego structure
6. Knowns or commonalities value system
.The person's system is an open system - dynamic and constantly
changing and evolving
.Stability, or homeostasis, occurs when the amount of energy that
is available exceeds that being used by the system.
.A homeostatic body system is constantly in a dynamic process of
input, output, feedback, and compensation, which leads to a state
of balance
Central core of energy resources surrounded by two
concentric boundaries or rings referred to as lines of
resistance.
Lines of Resistance
The last boundary that protects the basic structure or it
represents the internal factors that help client defend against
s stressor
Protect the basic structure and become activated when
environmental stressors invade the normal line of defense. An
example is that when a certain bacteria enters our system,
there is an increase in leukocyte count to combat infection.
If the lines of resistance are effective, the system can
reconstitute and if the lines of resistance are not effective, the
resulting energy loss can result in death.
Outside the lines of resistance are two lines of defense:
1. Normal Line of Defense

.Represents clients usual wellness level.

.Can change over time in response to coping or responding
to the environment, which includes intelligence, attitudes,
problem solving and coping abilities. Example is skin which
is constantly smooth and fair will eventually form callous
over times.
2. Flexible Lines of Defense

.Is the outer boundary to the normal line of defense, the line
of resistance, and the core structure.
.Keeps the system free from stressors and is dependent on
the amount of sleep, nutritional status, as well as the
quality and quantity of stress an individual experiences.
.If the flexible line of defense fails to provide adequate
protection to the normal line of defense, the lines of
resistance become activated.
Neuman categorizes Stressors as:
Stressors
Are capable of producing either a positive or negative effect on the
client system.
Is any environmental force which can potentially affect the stability
of the system:
1. Intrapersonal- occur within person, example is infection,
thoughts and feelings
2. Interpersonal- occur between individuals, e.g. role expectations
3. Extrapersonal- occur outside the individual, e.g. job or finance
concerns
.A persons reaction to stressors depends on the strength of the lines
of defense.
.When the lines of defense fails, the resulting reaction depends on
the strength of the lines of resistance.
.As part of the reaction, a persons system can adapt to a stressor,
an effect known as reconstitution.
Reconstitution
Is the increase in energy that occurs in relation to the
degree of reaction to the stressor which starts after
initiation of treatment for invasion of stressors.
May expand the normal line of defense beyond its
previous level, stabilize the system at a lower level, or
return it to the level that existed before the illness.
Nursing interventions focus on retaining or
maintaining system stability.
By means of primary, secondary and tertiary
interventions, the person (or the nurse) attempts to
restore or maintain the stability of the system.
Prevention
Is the primary nursing intervention.
Focuses on keeping stressors and the stress response from having a
detrimental effect on the body.
1. Primary prevention-focuses on protecting the normal line of defense and
strengthening the flexible line of defense. This occur before the system
reacts to a stressor and strengthens the person (primarily the flexible line of
defense) to enable him to better deal with stressors and also manipulates
the environment to reduce or weaken stressors. Includes health promotion
and maintenance of wellness.
2. Secondary prevention-focuses on strengthening internal lines of
resistance, reducing the reaction of the stressor and increasing resistance
factors in order to prevent damage to the central core. This occurs after the
system reacts to a stressor. This includes appropriate treatment of symptoms
to attain optimal client system stability and energy conservation.
3. Tertiary prevention-focuses on readaptation and stability, and protects
reconstitution or return to wellness after treatment. This occurs after the
system has been treated through secondary prevention strategies. Tertiary
prevention offers support to the client and attempts to add energy to the
system or reduce energy needed in order to facilitate reconstitution.
Rosemarie Rizzo Parses
Theory of Human Becoming

Nursing is a scientific
discipline, the practice of
which is a performing art
Three assumption about Human
Becoming:
1. Human becoming is freely choosing personal
meaning in situation in the intersubjective
process of relating value priorities
2. becoming is co-creating rhythmic patterns or
relating in mutual process in the universe
3. Human becoming is co-transcending
multidimensionally with emerging
possibilities.
 These three assumptions focus on meaning,
rhythmicity, and contrascendence:
1. Meaning arises from a persons
interrelationship with the world and refers
to happenings to which the person attaches
varying degree of significance.
2. Rhythmicity is the movement toward
greater diversity
3. Contrascendence is the process of
reaching out beyond the self.
Model of human becoming emphasizes how
individuals choose and bear responsibility for
patterns of personal health.
Contends that the client , not the nurse , is
the authority figure and decision maker.
The nurses role involves helping individuals
and families in choosing the possibilities for
changing the health process.
MARTHA ROGERS' SCIENCE OF
UNITARY HUMAN BEINGS
Described
theirreduciblenature of
individuals as being
different from the sum of
their parts
She theorized that the
identity of nursing as a
science arises from
theintegralityof people and
the environment that
coordinates with a
multidimensional universe
of open systems
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
The basic characteristics that describe the life
process of human include energy field,
openness, pattern, and pan-
dimensionality. The basic concepts of the
theory include unitary human being,
environment, and homeodynamic
principles.
Concepts of Rogers' mode

1. Energy field The energy field is the fundamental

unit of both the living and nonliving. This energy field
"provides a way to perceive people and environment
as irreducible wholes". The energy fields continuously
varies in intensity, density, and extent.
2. Openness The human field and the environmental
field are constantly exchanging their energy back
and forth. There are no boundaries or barriers that
inhibit energy flow between the fields.
3. Pattern Pattern is defined as the distinguishing
characteristic of an energy field. "Pattern is an
abstraction and it gives identity to the field.
4. Pan-dimensionality Pan-dimensionality is defined as "non linear
domain without spatial or temporal attributes". The parameters
that humans use in language to describe events are arbitrary. The
present is relative; there is no temporal ordering of lives.
5. 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 person has the
capacity to participate knowingly and probabilistically in the
process of change.
6. Environment The environment is an "irreducible, pan-
dimensional energy field identified by pattern and integral with
the human field". The two fields coexist and are integral.
Manifestations emerge from this field and are perceived by the
person.
7. 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
maintaining life processes.
8. Nursing
a) Nursing as a science The theory asserts the independent science of
nursing because an organized body of knowledge which is specific to
nursing is arrived at by scientific research and logical analysis.
b) Nursing as an art Rogers claimed that the creative use of science for
the betterment of humans and the creative use of its knowledge is the
art of its nursing.
C. 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.
People need knowledgeable nursing.

9. Homeodynamic principles-The principles of

homeodynamic postulates the way unitary human
beings are perceived. The fundamental unit of the living
system is an energy field.
10.Resonancy-Resonancy is an ordered arrangement of
rhythm characterizing both human field and
environmental field that undergoes continuous dynamic
metamorphosis in the human environmental process.
11.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 humans'
evolutionary emergence.
12.Integrality - Integrality is the mutual, continuous
relationship of the human energy field and the
environmental field. Changes occur by the
continuous repatterning of the human and
environmental fields by resonance waves. The fields
are one and integrated, but unique from each other.
THANK YOU