NURSING THEORY Martha Rogers - The Science of Unitary Human Beings

1. NURSING THEORY MARTHA ROGERS - THE SCIENCE OF UNITARY HUMAN BEINGS AJESH KUMAR
ASSISTANT PROFESSOR M.M COLLEGE OF NURSING M.M UNIVERSITY, MULLANA PICTURE COURTESY
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2. Introduction: • Martha Roger’s theory Science of Unitary Human Beings is mainly focusing on the four
concepts and three principles of homeodynamic that are energy fields, openness, pattern,
pandimensioal, integrality, resonancy, and helicy respectively.

3. Biography: • She was born in Dallas, Texas May 12, 1914; sharing her birthday with Florence
Nightingale. • Her family moved to Knoxville, Tennessee before she turned one. • As a young child she
was very inquisitive to gain more and more knowledge, she had passion of reading books • In 1936 She
attended nursing diploma programme at Knoxville General Hospital • She continued her schooling at
George Peabody College and completed Bachelors of Science in Public Health Nursing in 1937. • She
worked as a Public Health Nurse for two years after obtaining degree in Public Health Nursing.

4. Biography: • After completeing her Masters in Public Health Nursing from Teachers College Columbia
University in 1946, she started working as a public health nurse. • She worked as director of Visiting
Nurses Association in Phoenix, Arizona. • In 1951 she joined Johns Hopkins University, Baltimore and
completed Doctor of Science in 1954 while she was working at Catholic University. • After completing
her Doctor of Science she served as the Head of the Division of nursing at New York University • In 1963
she edited the second journal in Nursing i.e. Nursing Science

5. Biography: • An Introduction to the Theoretical Basis of Nursing was the most famous work of Rogers
which was published in 1970. • In 1975 she retired as Head of the Division of nursing from New York
University • She joined Emeritus University in 1979 as a Professor and continued to work on The Science
of Unitary Human Beings till the time of her demise in March 13, 1994.

6. Assumptions: • Human being is considered as whole which cannot be viewed as subparts. • The life
process of human is irreparable and one way i.e. from birth to death. • Health and illness are the
continuous expression of the life process. • The energy flows freely between the individual and
environment. • Human being possesses the ability to think, imagine, sense, feel, and can use language
for expression. • Human beings have the ability to adapt according to the new changes in the
environment.

7. Major Concepts:

8. Concepts: • All the human beings are viewed as an integral part of universe. • Human beings and the
environment have energy field, nursing action is directed towards patterning and maintaining these
energy fields. Energy fields Pandime nsioal Openness Patter n

9. Energy fields: • it is the inevitable part of life. Human and environment both have energy field which
is open i.e. energy can freely flow between human and environment.
10. Openness: • there is no boundary or barrier that can inhibit the flow of energy between human and
environment which leads to the continuous movement or matter of energy.

11. Pattern: • is the distinguishing character of the energy field.

12. Pandimensioal: • Undeviating field which is not constricted by space or time, it is an infinite domain
without boundary.

13. Principle of Homeodynamics

14. Principle of Homeodynamics: • Homeodynamics refers to the balance between the dynamic life
process and environment. • These principles help to view human as unitary human being. The three
separate principles are integrality, resonancy, and heliecy.

15. Principles of integrality: • Energy fields are dynamic and constantly interact with the human and
environment, which affects our environment and vice versa. • This is the principle on which meditation
and humor works to produce a positive environment.

16. Principles of resonancy: • is an ordered arrangement of rhythm characterizing both human field and
environmental field • Constant change in the way or pattern of the energy field from a lower to higher
frequency. • This movement of energy can be made by human touch, guided imagery activities, drawing,
storytelling and other active use of imagination.

17. Principles of heliecy: • Any minute change in the environment which leads to ripple effect i.e. results
in a larger changes in other field. • This change is constant, unpredictable and there are many factors
which mutually interact and cause the change.

18. Metaparadigm in Nursing Person Environment Health Nursing

19. Person: • a unitary human being is open systems which continuously interact with environment. A
person cannot be viewed as parts, it should be considered as a whole.

20. Environment: • it includes the entire energy field other than a person. • These energy fields are
irreducible, not limited by space and time, identified by its pattern and organization

21. Health: • Not clearly defined by Roger. It is determined by the interaction between energy fields i.e.
human and environment. • Bad interaction or misplacing of the energy leads to illness.

22. Nursing: • Is both science and art. • It constantly maintains the energy field which is conducive for
patient. • Nursing action directs the interaction of person and environment to maximize health
potential.

23. Application of SUBH: PRACTICE EDUCATION RESEARCH Monday, April 20, 2015 23

24. Clinical Practice: • Nursing action is always focused on unitary human being and change the energy
field between human and environment. • Nursing interventions include all the noninvasive actions such
as guided imaginary, humor, therapeutic touch, music etc. which are used to increase the potential of
human being.

25. Clinical practice cont… • The more importance should be on the management of pain, supportive
psychotherapy and rehabilitation of the human being.

26. Clinical practice cont… Nursing Assessment & Diagnosis Interventions and Rehabilitation Prevention
of Illness Maintennace of Health Promotion of Health

27. Nursing Education: • Emphasis should be given on the understanding of the patient and self, energy
field and environment. • Training should lay more focus on teaching non- invasive modalities such as
therapeutic touch, meditation, humor, regular in-service education programme etc.

28. Nursing Research: • Rogerian theory has been used in many research works and has always been
found testable and applicable in research.

29. Nursing process according to SUBH: Monday, April 20, 2015 29 Pattern appraisal Mutual patterning
Evaluation

30. Pattern appraisal: • It is an inclusive assessment of human and environment energy fields, its
organization of energy field, and identification of areas of dissonance. • Nurses validate the entire
appraisal along with the client.

31. Mutual patterning: • It is the proper patterning of the energy fields between the human and
environment. • It is the mutual interaction between the client and nurse • Patterning can be done by
suggesting the various alternatives, educating, empowering, encouraging etc. depending on the client’s
condition and needs.

32. Mutual patterning cont.. • Pattern appraisal include appraisal of nutrition, rest and sleep, exercises,
discomfort, and relation with others. • The pattering activities can be therapeutic touch, meditation,
humor, imaginery etc.

33. Evaluation: • Evaluation is done by repeating the pattern appraisal after the mutual patterning to
determine the extents of dissonance and harmony. •

34. Clinical scenario: • Mr. X is a 54 years old male admitted in the Male Psychiatric ward with the
diagnosis of major depression secondary to the diagnosis of Myocardial Infraction (MI). • He was very
tense and sobbing during the history collection. • He was accompanied by his wife and son. Even though
his wife was anxious but still she was supportive and helpful. • Mr. X was diagnosed with MI four
months back and underwent the angioplasty three months ago. • Currently he is on Statins and
Antihypertensives.

35. Clinical scenario: • He started to show the sings and symptoms of depression from the past one
month. • He used to sit alone, diminished the activities of daily living, regular crying spells, decreased
chat, self muttering, insomnia, anorexia, body aches, least bothered about personal hygiene, two days
before he attempted suicide by hanging on ceiling fan. • His present findings based on the assessment
shows that he is very tearful, socially withdrawn, nutritional status is impaired, crying spells, sad mood,
and risk for committing suicide.

36. Assessment(PatternAppraisal) • Mr. X is experiencing the pattern of dissonance. i.e. depression with
suicidal ideation, MI, pain, fear , sleep pattern disturbances, impaired nutritional status, tendencies to
commit suicide and appraisal is essential for all of these symptoms. MutualPatterning: • It is the mutual
interaction between Mr. X and nurse for changing the pattern and making his all emerging pattern as
unitary pattern. • Therapeutic touches, meditation, guided imagery, are the pattering activities planned
for Mr. X. • Therapeutic touch is implemented which will cure the pain, promote the speedy recovery
and building trust on nurse. • Social withdrawn can be managed by using humor, participating in small
group activities and this will help him to develop self confidence. • Advices are given for changing the
dietary pattern and improving the personal hygiene. • Involvement of family for the environment
pattering. Evaluation • Repeating the pattern appraisal after the mutual patterning to determine the
extents of dissonance and harmony. • Current symptoms experiencing by Mr. X is shared with him and if
changes is needed in the mutual patterning that can be incorporated or implement the same.

37. Critique of the SUBH:

38. Simplicity: • although the concepts seems to quite difficult to understand. • It’s a parsimonious
theory. • Parsimony refers to theory based on simple assumption but proves to be very valuable.

39. Clarity: • overall Rogerian SUBH is considered as complex but still efforts are going on to clarify the
complex concepts.

40. Generality: • The uses on non- invasive modalities are very useful and important to nursing even
today. • SUBH is the foundation of many theories and it can be apply in a variety of setting and all
spheres of life.

41. Empirical precision: • Rogerian theory has been used in many research works and has been found
testable and applicable in research. • But, many limitations have also been identified by the researchers
such as difficult to understand the concepts, lack of operational definitions and instruments for the
proper evaluation of the instruments.

42. Conclusion: • SUBH leads to a new way of seeing the person as a unitary human being and new style
of nursing practice. • This model is applicable in all the setting and every spheres of life. • Rogers
emphasized the need for noninvasive nursing modalities in achieving the health potential, it is very
evident in today’s situation that there is more focus on the alternative system of medicine and
noninvasive nursing actions are in getting much importance.

Martha rogers theory

1. C.M PATEL COLLEGE OF NURSING GANDHINAGAR SUBJECT:ADVANCE NURSING PRACTICE

2. Martha Roger’s theory Presentedby: Ankita.M. Patel First year M.sc Nursing C.M.P College of Nursing
3. Introduction of theorist • Born :May 12, 1914, Dallas, Texas, USA • Diploma : Knoxville General
Hospital School of Nursing(1936) • Graduation in Public Health Nursing : George Peabody College, 1937
• MA :Teachers college, Columbia university, New York, 1945 • MPH :Johns Hopkins University,
Baltimore, 1952 • Doctorate in nursing :Johns Hopkins University, Baltimore, 1954 • Position: Professor
at Division of Nursing, New York University and Consultant, Speaker • Died : March 13 , 1994

4. Publications of Martha Rogers • Theoretical basis of nursing (Rogers 1970) • Nursing science and art
:a prospective (Rogers 1988) • Nursing :science of unitary, irreducible, human beings (Rogers 1990) •
Vision of space based nursing (Rogers 1990)

5. Introduction of theory • The belief of the coexistence of the human and the environment has greatly
influenced the process of change toward better health. • In short, a patient can’t be separated from his
or her environment when addressing health and treatment.

6. • This view lead and opened Martha E. Rogers‘ theory, known as the “Science of Unitary Human
Beings,” which allowed nursing to be considered one of the scientific disciplines • Rogers repeatedly
stated that she did not create a "theory" but rather an abstract system, a science, from which many
theories may be derived.

7. cont… • The science of unitary human beings comprises of five assumption, four major concepts and
three major principles • Major concepts are : Energy field, openness, pattern, and pan dimensionality •
Major principles include resonancy , helicy and integrity. It is also known as homeodynamic principles.

8. Assumptions • Human being is considered as united wholewholeness • A person and his environment
are continuously exchanging energy with each other openness • The life process of human being evolves
irreversibly and unidirectional i.e from birth to death Unidirectionality • Pattern identifies individuals
and reflects their innovative wholeness. Pattern and organization • Humans are the only organisms able
to think, imagine, have language and emotions Sentence and thought

9. Major Concepts Energy field Openness Pattern Pan- dimensionality

10. Energy field • It is inevitable part of life. Human and environment both have energy field which is
open i.e. energy can freely flow between human and environment

11. Openness • There is no boundary or barrier that can inhibit the flow of energy between human and
environment which leads to the continuous movement or matter of energy.

12. 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"

13. Pan dimensionality • Pan dimensionality is defined as "non linear domain without spatial or
temporal attributes" • Human being are pan dimensional being and have more than three dimension.

 Theorist - Martha E Rogers

 Born :May 12, 1914, Dallas, Texas, USA
 Diploma : Knoxville General Hospital School of Nursing(1936)
  Graduation in Public Health Nursing : George Peabody College, TN, 1937
 MA :Teachers college, Columbia university, New York, 1945
 MPH :Johns Hopkins University, Baltimore, MD, 1952
 Doctorate in nursing :Johns Hopkins University, Baltimore, 1954
 Fellowship: American academy of nursing
 Position: Professor Emerita, Division of Nursing, New York University, Consultant, Speaker
 Died : March 13 , 1994

Publications of Martha Rogers

 Theoretical basis of nursing (Rogers 1970)

 Nursing science and art :a prospective (Rogers 1988)
 Nursing :science of unitary, irreducible, human beings update (Rogers 1990)
 Vision of space based nursing (Rogers 1990)

Overview of Rogerian model

 Rogers conceptual system provides a body of knowledge in nursing.

 Rogers model provides the way of viewing the unitary human being.
 Humans are viewed as integral with the universe.
 The unitary human being and the environment are one, not dichotomous
 Nursing focus on people and the manifestations that emerge from the mutual human /environmental field process
 Change of pattern and organization of the human field and the environmental field is propagated by waves
 The manifestations of the field patterning that emerge are observable events
 The identification of the pattern provide knowledge and understanding of human experience
 Basic characteristics which describes the life process of human: energy field, openness, pattern, and pan
dimensionality
 Basic concepts include unitary human being, environment, and homeodynamic principles

Concepts of Rogers model

Energy field

 The energy field is the fundamental unit of both the living and nonliving
 This energy field "provide a way to perceive people and environment as irreducible wholes"
 The energy fields continuously varies in intensity, density, and extent.

Openness

 The human field and the environmental field are constantly exchanging their energy
 There are no boundaries or barrier that inhibit energy flow between fields

Pattern

 Pattern is defined as the distinguishing characteristic of an energy field perceived as a single waves
 "pattern is an abstraction and it gives identity to the field"

Pan dimensionality

 Pan dimensionality is defined as "non linear domain without spatial or temporal attributes"
 The parameters that human use in language to describe events are arbitrary.
 The present is relative, there is no temporal ordering of lives.
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 homeodynamics
o Resonancy
o Helicy
o 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

 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

Nursing Paradigms

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"

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

 "an expression of the life process; they are the "characteristics and behavior emerging out of the mutual,
simultaneous interaction of the human and environmental fields"
 Health and illness are the part of the sane continuum.
 The multiple events taking place along life's axis denote the extent to which man is achieving his maximum health
potential and very in their expressions from greatest health to those conditions which are incompatible with the
maintaining life process

Nursing

 Two dimensions Independent science of nursing

 1. An organized body of knowledge which is specific to nursing is arrived at by scientific research and
logical analysis
2. Art of nursing practice:
 The creative use of science for the betterment of the human
 The creative use of its knowledge is the art of its practice

 Nursing exists to serve people.

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

Rogerian theories-Grand theories

 The theory of paranormal phenomena

 The theory of rhythmicities
 The theory of accelerating evolution

Theory of paranormal phenomena

 This theory explains 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.
 Higher wave frequencies are associated with accelerating human development

Theory of Rhythmicity

 Focus on the human field rhythms (these rhythms are different from the biological, psychological rhythm)
 Theory deals with the manifestations of the whole unitary man as changes in human sleep wake patterns, indices
of human field motion, perception of time passing, and other rhythmic development

Theories derived from the science of unitary human beings

 The perspective rhythm model (Patrick 1983)

 Theory of health as expanding consciousness (Neuman, 1986)
 Theory of creativity, actualization and empathy (Alligood 1991)
 Theory of self transcendence (Reed1997)
 Power as knowing participation in change (Barrett 1998)

14. Homeodynamic principles • Homeodynamics refers to the balance between the dynamic life process
and environment. • These principles help to view human as unitary human being. • Three principle of
homeodynamics – Resonancy – Helicy – integrality
15. 1. Resonancy • Wave patterns are continuously changing in environmental and human energy fields.
2. Helicy • The nature of change is unpredictable, continuous, and an innovative. 3. Integrality • Energy
fields of humans and environment are in a continuous mutual process.

16. Roger’s theory and nursing metaparadigm Person Environment Health Nursing

17. 1. Unitary Human Being (person) • A unitary human being is open systems which continuously
interact with environment. A person cannot be viewed as parts, it should be considered as a whole. 2.
Environment • It includes the entire energy field other than a person. • These energy fields are
irreducible, not limited by space and time, identified by its pattern and organization.

18. 3. Health • Not clearly defined by Rogers. It is determined by the interaction between energy fields
i.e. human and environments. • Bad interaction or misplacing of energy leads to illness. 4. Nursing •
Nursing exists to serve people. • Nursing is both science and art. • It is the direct and overriding
responsibility to the society

19. Application of Roger’s theory in nursing Clinical Practice Nursing education Research

20. Clinical practice • Nursing action is always focused on unitary human being and change the energy
field between human and environment. • Nursing action include all non-invasive actions such as guided
imaginary, humor, therapeutic touch, music etc. which are used to increase the potential of human field.
• The more importance should be on the management of pain, supportive therapy and rehabilitation.

21. • Example in nursing care plan: • Ritu 22 years old female was admitted in psychiatric hospital with
severe depression secondary to diagnosis of ovarian malignancy. She became tearfull while history
taking. Ritu was accompanied by her husband and 1 year old child. Her husband appear anxious but
supportive. Ritu was diagnosed with ovarian cancer 2 month ago and underwent surgery for same. From
past three week ritu started sitting alone, decreased activity of daily living, repeated crying spells,
decreased talk, decreased sleep, neglecting her child care, and also attempted suicide.

22. Nursing education • Emphasis should be given on the understanding of the patient and self, energy
field and environment. • Example : Training should lay more focus on teaching non-invasive modalities
such as therapeutic touch, meditation, humor, regular in service education programme etc.

23. Research • Rogerian theory has been used in many research works and has always found testable
and applicable in research. • Example:- A study to assess the effectiveness of music therapy on stress
reduction among postmenopausal women residing in Hudco Colony, Coimbatore

24. • A Study to Assess the Effectiveness of Yoga Therapy in Reducing Stress among Primary Care Givers
of Psychiatric Patients.

25. Strengths • Rogers’ concepts provide a worldview from which nurses may derive theories and
hypotheses and propose relationships specific to different situations. • Rogers’ theory is not directly
testable due to lack of concrete hypotheses, but it is testable in principle.
26. Weaknesses • Overall this theory is considered as very complex concept and quite difficult to
understand. • Rogers’ model does not define particular hypotheses or theories for it is an abstract,
unified, and highly derived framework. • Testing the concepts’ validity is questionable because its
concepts are not directly measurable. • The theory was believed to be profound, and was too ambitious
because the concepts are extremely abstract. • Rogers claimed that nursing exists to serve people;
however, nurses’ roles were not clearly defined.

27. Summary and Conclusion • The Science of Unitary Human Beings is highly generalizable as the
concepts and ideas are not confined with a specific nursing approach unlike the usual way of other nurse
theorists in defining the major concepts of a theory. • Rogers gave much emphasis on how a nurse
should view the patient. She developed principles which emphasizes that a nurse should view the client
as a whole. • Her statements, in general, made us believe that a person and his or her environment are
integral to each other. That is, a patient can’t be separated from his or her environment when
addressing health and treatment.