Martha RogersScience of Unitary Human Beings

Martha RogersScience of Unitary Human Beings

Susie Clabots, Kristi Eilers, Liz Hopewell, Sarah Kline, Robin Simmons

Susie Clabots, Kristi Eilers, Liz Hopewell, Sarah Kline, Robin Simmons

BackgroundBackgroundDiploma in nursing, 1936Bachelor of Science degree, 1937MSN from Teacher’s College, 1945Doctorate degree in science at John

Hopkins University, 1954Public Health NurseVisiting NurseHead of Nursing, NYU

Diploma in nursing, 1936Bachelor of Science degree, 1937MSN from Teacher’s College, 1945Doctorate degree in science at John

Hopkins University, 1954Public Health NurseVisiting NurseHead of Nursing, NYU

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OriginsOrigins

1. Evolutionary theory

2. General systems theory

3. Physics

4. Adaptation

5. More specifically, her love of science fiction and…

6. Music (Meleis, 2007)

1. Evolutionary theory

2. General systems theory

3. Physics

4. Adaptation

5. More specifically, her love of science fiction and…

6. Music (Meleis, 2007)

Central QuestionsCentral Questions1. What is the focus of nursing?

2. What knowledge gives

nursing an identity?

3. Who is the nursing client?

4. What is the relationship between man and environment?

5. What are the phenomena of concern in nursing?

6. What knowledge is needed to develop the science of nursing?

1. What is the focus of nursing?

2. What knowledge gives

nursing an identity?

3. Who is the nursing client?

4. What is the relationship between man and environment?

5. What are the phenomena of concern in nursing?

6. What knowledge is needed to develop the science of nursing?

Four Basic Concepts (Meleis, 2007)Four Basic Concepts (Meleis, 2007)

1. Energy fields

2. Openness

3. Pattern

4. Four-dimensionality

1. Energy fields

2. Openness

3. Pattern

4. Four-dimensionality

Energy FieldsEnergy Fields

• Fundamental unit of living and non-living.

• Energy refers to dynamic nature, i.e., continuous motion or change.

• Infinite.• Humans and environment do not

HAVE energy fields. THEY ARE ENERGY FIELDS.

• Fundamental unit of living and non-living.

• Energy refers to dynamic nature, i.e., continuous motion or change.

• Infinite.• Humans and environment do not

HAVE energy fields. THEY ARE ENERGY FIELDS.

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OpennessOpenness

• Openness is a characteristic of both humans and environment.

• Transcend time and space.• The energy fields of man and

environment are integral with one another.

• Openness is a characteristic of both humans and environment.

• Transcend time and space.• The energy fields of man and

environment are integral with one another.

PatternPattern

• Characteristics of an energy field perceived as a single wave (pg 235).

• Refers only to an energy field (man and environment).

• Changes continuously.

• Characteristics of an energy field perceived as a single wave (pg 235).

• Refers only to an energy field (man and environment).

• Changes continuously.

Four-DimensionalityFour-Dimensionality

Energy fields (man and environment) are not bound by time or space.

Also referred to as pandimensionality

Energy fields (man and environment) are not bound by time or space.

Also referred to as pandimensionality

Important DefinitionsImportant Definitions

Unitary: Her theory is called the science of Unitary Human Beings. Unitary refers to being a whole which cannot be broken down into parts, or irreducible.

Nursing: While the energy fields of man and environment are outside of time, nursing takes place along a space-time continuum (Meleis, 2007).

Unitary: Her theory is called the science of Unitary Human Beings. Unitary refers to being a whole which cannot be broken down into parts, or irreducible.

Nursing: While the energy fields of man and environment are outside of time, nursing takes place along a space-time continuum (Meleis, 2007).

Essence of TheoryEssence of TheoryThe energy field of the human being interacts

with the energy field environment. (The human being and the environment cannot be understood in isolation of each other).

Nursing Client: Human beings-environment energy fields relationship.

Nursing therapeutics: “Repatterning of man and environment for more effective fulfillment of life’s capabilities” (Meleis, 2007).

The energy field of the human being interacts with the energy field environment. (The human being and the environment cannot be understood in isolation of each other).

Nursing Client: Human beings-environment energy fields relationship.

Nursing therapeutics: “Repatterning of man and environment for more effective fulfillment of life’s capabilities” (Meleis, 2007).

Environment Energy Field

Human Being Energy Field

Clinical ApplicationsClinical ApplicationsOthers have expanded on Rogers’ theory.

Use of an assessment frameworkLiving in the Relative PresentExperiencing comfort from past/presentShared CommunicationSense of RhythmConnection to EnvironmentSense of Self-Identity

Others have expanded on Rogers’ theory.Use of an assessment framework

Living in the Relative PresentExperiencing comfort from past/presentShared CommunicationSense of RhythmConnection to EnvironmentSense of Self-Identity

Clinical Applications (cont.)Clinical Applications (cont.)Creation of Nursing Diagnoses

Disturbed Energy Field

Nursing InterventionsTherapeutic TouchMeditation/ImageryLight, Color and Music Therapy

Creation of Nursing DiagnosesDisturbed Energy Field

Nursing InterventionsTherapeutic TouchMeditation/ImageryLight, Color and Music Therapy

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Martha’s You Tube VideoMartha’s You Tube Video

http://www.youtube.com/watch?v=NbNEbh8YY70 http://www.youtube.com/watch?v=NbNEbh8YY70

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http://library.utmem.edu/exhibits/newman/ www.medweb.uwcm.ac.uk

Evolution of Science of Unitary Human BeingsEvolution of Science of Unitary Human Beings 1970: Rogers describes principles of homeodynamics as: reciprocity,

synchrony, helicy, and resonancy.

Rogers identifies people as the central phenomenon of interest to nursing.

Rogers describes characteristics of humans to be unified wholes, continually exchanging energy with the environment.

1986: Ference’s Field Motion Test (Research)

Barrett’s Human Field Power Test (Research)

Newman’s Theory of Health as Expanding Consciousness (Theory)

1992: Rogers’ principles change to: integrality, helicy, and resonancy.

Rogers modifies characteristics to be human and environmental energy fields, openness, pattern, and pandimensionality.

1970: Rogers describes principles of homeodynamics as: reciprocity, synchrony, helicy, and resonancy.

Rogers identifies people as the central phenomenon of interest to nursing.

Rogers describes characteristics of humans to be unified wholes, continually exchanging energy with the environment.

1986: Ference’s Field Motion Test (Research)

Barrett’s Human Field Power Test (Research)

Newman’s Theory of Health as Expanding Consciousness (Theory)

1992: Rogers’ principles change to: integrality, helicy, and resonancy.

Rogers modifies characteristics to be human and environmental energy fields, openness, pattern, and pandimensionality.

1997: Carboni’s Rogerian Process of Inquiry (Research)

Bultemeier’s Photo-Disclosure Method (Research)

1998: Parse’s Human Becoming Theory (Theory)

Barrett’s Health Patterning (Practice)

2005: Butcher’s Unitary Field Pattern Portrait (Practice)

Cowling’s Unitary Appreciative Inquiry (Practice)

Evolution of Science of Unitary Human Beings

Identified people and the world they live in as the core focus of nursing (Fawcett, 1995).

Focus on patterns and repatterning.

Introduced concept of energy to nursing theory (Meleis, 2007).

Emphasized nursing as a unique empirical science.

Advocated nursing-specific body of knowledge.

Nursing Theory Pioneer

Scope of the Science of Unitary Human Beings

Scope of the Science of Unitary Human Beings

Relatable to ADLs and daily human needs (Meleis, 2007)

Inspiration for environment-patient interactionist theories and practice methods.

Therapeutic touchBarret’s theory of power as “knowing participation

in change” (Malinski, 2006)Zahourek’s theory of intentionality (Malinski,

2006)

Relatable to ADLs and daily human needs (Meleis, 2007)

Inspiration for environment-patient interactionist theories and practice methods.

Therapeutic touchBarret’s theory of power as “knowing participation

in change” (Malinski, 2006)Zahourek’s theory of intentionality (Malinski,

2006)

Increasing Popularity of Roger’s TheoryIncreasing Popularity of Roger’s TheoryNursing focus on holismEmpowers the patient and the

professional nurse as agents for change

Nursing focus on holismEmpowers the patient and the

professional nurse as agents for change

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www.societyofrogerianscholars.org

Conceptual ProblemsConceptual Problems“This is a theory whose complexity of the primitive concepts has undermined the clarity of the relationship between the concepts as well as the boundaries” – Meleis, p. 404.

Overly esoteric “…one is also faced with the limitations of the existing English language in describing pandimensionality of a human being field and the influence of the tremendous acceleration of change on humanity.” (Rogers, 1980a)

Vague definitions leading to debate even among Rogerian scholars. Example: the TT HEF (human energy field) vs. the Rogerian HEF.

Conceptual Problems (cont.) Conceptual Problems (cont.) Central Concepts (i.e. energy fields) have limited practical

application.

Contraindications in the theory occur. Example: “delineating the boundary of the human field” with instruments (p. 113) but also states that the human field extends to infinity without boundaries.

Criticized as a “closed system” in which most studies are conducted and/or published within Rogerian scholar circles and publications.

Central Concepts (i.e. energy fields) have limited practical application.

Contraindications in the theory occur. Example: “delineating the boundary of the human field” with instruments (p. 113) but also states that the human field extends to infinity without boundaries.

Criticized as a “closed system” in which most studies are conducted and/or published within Rogerian scholar circles and publications.

The Science of Rogerian Nursing The Science of Rogerian Nursing Not only is nursing theory an articulation of phenomena and their relationships, but such articulation has to be communicated to colleagues in ways that make it possible to test, evaluate, interpret and use these articulations.” (Meleis, p. 41)

Rogers labeled her work as a “science”, or conceptual model. “She reinforced the idea that nursing is based on a science.”

(Meleis, p. 406) However, she was openly critical of evidence-based practice. References to quantum physics are apparent attempts to legitimize

the concepts. Existing scientific methodology fails to capture the

“immeasurable” components of the theory.

Not only is nursing theory an articulation of phenomena and their relationships, but such articulation has to be communicated to colleagues in ways that make it possible to test, evaluate, interpret and use these articulations.” (Meleis, p. 41)

Rogers labeled her work as a “science”, or conceptual model. “She reinforced the idea that nursing is based on a science.”

(Meleis, p. 406) However, she was openly critical of evidence-based practice. References to quantum physics are apparent attempts to legitimize

the concepts. Existing scientific methodology fails to capture the

“immeasurable” components of the theory.

Research Studies…or Lack ThereofResearch Studies…or Lack Thereof “Nursing theorists also tend to avoid crucial experiments

which could jeopardize the theory in the rare cases where the theory is coherent enough to permit testing; or, as noted for therapeutic touch, reinterpret the theory to make it possible to test.” (Raskin)

The research studies conducted tend to be qualitative and/or anecdotal in nature, with poorly defined or irreproducible outcomes.

Infamous study published in JAMA (1998) cast serious doubts on efficacy of TT.

Two meta-analyses and a systematic review relating to TT concluded that any conclusion of effects are qualified by a methodological concern ( Peters, 1999; Winstead-Fry &Kijek. 1999; Astin et al., 2000).

“Nursing theorists also tend to avoid crucial experiments which could jeopardize the theory in the rare cases where the theory is coherent enough to permit testing; or, as noted for therapeutic touch, reinterpret the theory to make it possible to test.” (Raskin)

The research studies conducted tend to be qualitative and/or anecdotal in nature, with poorly defined or irreproducible outcomes.

Infamous study published in JAMA (1998) cast serious doubts on efficacy of TT.

Two meta-analyses and a systematic review relating to TT concluded that any conclusion of effects are qualified by a methodological concern ( Peters, 1999; Winstead-Fry &Kijek. 1999; Astin et al., 2000).

Final Resolution (?)Final Resolution (?) “Perhaps it is becoming clear that there are no

answers, in the sense of last word or final resolutions, within the system. The world view underlying the Science of Unitary Human Beings, one of total openness and continuous change fosters ongoing inquiry” (Malinski, 1986).

“Perhaps it is becoming clear that there are no answers, in the sense of last word or final resolutions, within the system. The world view underlying the Science of Unitary Human Beings, one of total openness and continuous change fosters ongoing inquiry” (Malinski, 1986).

References (1)References (1) Astin J.A., Harkness E. & Ernst E. (2000) The efficacy of ‘distant healing’: a systematic

review of randomized trials. Annals of Internal Medicine, 132, 903–910. Fawcett, J. (1995). Analysis and evaluation of conceptual models of nursing (3rd ed.). F.A.

Philadelphia, PA: Davis.

Kenny, J. (2002). Philosophical and Theoretical Perspectives for Advanced Nursing Practice (3rd ed.). Sudbury, Massachusetts: Jones and Bartlett Publishers.

Malinski, V.M. (1986). Explorations of Martha Rogers’ Science of Unitary Human Beings. East Norwalk, CT: Prentice-Hall.

Malinski, V. M., & Manhart Barrett, E. A. (1994). Martha E. Rogers: Her Life and Her Work. Philadelphia: F. A. Davis Company.

Manhart Barret, E. (2000). The Theoretical Matrix for a Rogerian Nursing Practice. Theoria: Journal of Nursing Theory.

Manhart Barrett, E. (1990) Visions of Rogers’ Science-Based Nursing. New York, NY: National League for Nursing.

Meleis, A. I (2007). Theoretical Nursing: Development & Progress. (4th Ed)., Philadelphia, PA: Lippincott Williams & Williams.

Astin J.A., Harkness E. & Ernst E. (2000) The efficacy of ‘distant healing’: a systematic review of randomized trials. Annals of Internal Medicine, 132, 903–910.

Fawcett, J. (1995). Analysis and evaluation of conceptual models of nursing (3rd ed.). F.A. Philadelphia, PA: Davis.

Kenny, J. (2002). Philosophical and Theoretical Perspectives for Advanced Nursing Practice (3rd ed.). Sudbury, Massachusetts: Jones and Bartlett Publishers.

Malinski, V.M. (1986). Explorations of Martha Rogers’ Science of Unitary Human Beings. East Norwalk, CT: Prentice-Hall.

Malinski, V. M., & Manhart Barrett, E. A. (1994). Martha E. Rogers: Her Life and Her Work. Philadelphia: F. A. Davis Company.

Manhart Barret, E. (2000). The Theoretical Matrix for a Rogerian Nursing Practice. Theoria: Journal of Nursing Theory.

Manhart Barrett, E. (1990) Visions of Rogers’ Science-Based Nursing. New York, NY: National League for Nursing.

Meleis, A. I (2007). Theoretical Nursing: Development & Progress. (4th Ed)., Philadelphia, PA: Lippincott Williams & Williams.

References (2)References (2)O’Mathúna, p. A critical evaluation of the theory and practice of therapeutic touch. Blackwell Science Ltd 2002 Nursing Philosophy, 3, pp. 163–176.

Raskin, Jef. "Rogerian Nursing Theory: A Humbug in the Halls of Higher Learning", Skeptical Inquirer 24;5 September/October 2000 pp 30-36. (http://jef.raskincenter.org/published/NursingTheoryForSite.html, accessed 9/25/08)

Rogers, Martha E. 1970. An Introduction to the Theoretical Basis of Nursing. Philadelphia: F.A. Davis Company.

Rosa, L., E. Rosa, L. Sarner and S. Barrett. 1998. "A Close Look at Therapeutic Touch". JAMA 1 April: 1005-1010.

Winstead-Fry P. & Kijek J. (1999) An integrative review and meta-analysis of therapeutic touch research. Alternative Therapies in Health and Medicine, 5, 58–67.

Wright, B.W. (2007) . The evolution of Rogers’ Science of Unitary Human Beings: 21st century reflections. Nursing Science Quarterly. 20(1), 64-67.

O’Mathúna, p. A critical evaluation of the theory and practice of therapeutic touch. Blackwell Science Ltd 2002 Nursing Philosophy, 3, pp. 163–176.

Raskin, Jef. "Rogerian Nursing Theory: A Humbug in the Halls of Higher Learning", Skeptical Inquirer 24;5 September/October 2000 pp 30-36. (http://jef.raskincenter.org/published/NursingTheoryForSite.html, accessed 9/25/08)

Rogers, Martha E. 1970. An Introduction to the Theoretical Basis of Nursing. Philadelphia: F.A. Davis Company.

Rosa, L., E. Rosa, L. Sarner and S. Barrett. 1998. "A Close Look at Therapeutic Touch". JAMA 1 April: 1005-1010.

Winstead-Fry P. & Kijek J. (1999) An integrative review and meta-analysis of therapeutic touch research. Alternative Therapies in Health and Medicine, 5, 58–67.

Wright, B.W. (2007) . The evolution of Rogers’ Science of Unitary Human Beings: 21st century reflections. Nursing Science Quarterly. 20(1), 64-67.