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Beings
Martha Rogers Theory
1
Objectives
2
Upon completion of this session you should be able :
1. to identify the theorist- Martha Rogers
2. to discuss the theoretical source of Rogers theory
3. to explain four (04) major concepts, five assumptions and
three major principles of the theory.
4. to analyze nursing metaparadigm with Rogers theory
5. to state the practical implications of Rogers theory
6. ToAnalysis and evaluate the theory based on the chinn and
Kramer's proposed questions
7. to state the limitations of theory
8. to apply the knowledge of Rogers theory for a given scenario
Case
Study
3
Mrs. P. ,a 56 year old female is admitted to the hospital with
irretractable nausea and vomiting post chemotherapy and radiation.
Symptoms include tachycardia with heartrates from 100-160's, nausea
and vomiting, dehydration with headache and fatigue. She is
complaining of generalized pain and weakness with a focus on a
headache.
Mrs. P. is surrounded by multiple family members and several small
children who appear to be well meaning, but are coughing, sneezing,
and talking loudly.
Mrs. P is unfortunately placed in a semi-private room with a roommate
who is preferred to eat instant food for lunch and laughing watching the
loudly tuned TV.
The nurse administers IVP narcotics for her pain and headache and an
IVP antiemetic, but Mrs. P continues to complain of headache.
Questions
4
Considering Rogers' Theory of Unitary Human beings where Rogers states
"nurses are in constant mutual process with those for whom they care and
have opportunities to pattern the environment for change“.
1. What immediate interventions could be initiated for Mrs. P?
2. Using Rogers' theory, what non-pharmacologic interventions could be
utlitized for pain management?
3. In what ways can the nurse alter the way care is provided during the shift
in order to promote improvement in symptoms and provide a calming
environment?
4. What can the nurse do so that family and visitors can help Mrs. P recover
more quickly?
5. What can the nurse do help Mrs. P increase her appetite and help control
nausea and vomiting?
Martha Elizabeth
Rogers
5
Martha Rogers-
Theorist
6
• Born on May 12, 1914, Dallas, Texas, USA
• She was the eldest of four children of Rogers family.
Martha Rogers- Education
7
• Nursing diploma : Knoxville General Hospital School of Nursing in 1936
• Graduated in Public Health Nursing : George Peabody College in 1937
• Master’s degree (MA) : Teachers College at Columbia University in 1945
• MPH: Johns Hopkins University, Baltimore in 1952
• Doctorate in Nursing : From Johns Hopkins University in Baltimore in
1954.
• Rogers was appointed Professor and Head of the Division of Nursing at
New York University and she hold this position for 21 years until her
retirement in 1975.
Professional Work of Prof.
Martha Rogers
8
• Her main focus was on Nursing education
• She also worked as a public health nurse, staff nurse,
a supervisor and education director in Hartford.
• In 1979 she became “professor Emerita”
• In 1988 Society of Rogerian Scholars was formed
• She was honored with numerous awards and
citations for her sustained contributions to nursing
and science.
• In 1996, she was posthumously inducted into
the American Nurses Association’s Hall of Fame.
Publications of Prof. Martha Rogers9
• Her publications include three books and more than
200 articles:
– Educational Revolution in Nursing (1961)
– Reveille in Nursing (1964)
– An Introduction to the Theoretical Basis of Nursing (1970)
• Famous Publications
– Theoretical Basis of Nursing (1970)
– Nursing Science and Art: A Prospective (1988)
– Vision of Space Based Nursing (1990).
– Nursing: Science of Unitary, Irreducible, Human
Beings Update (1990)
Prof. Martha E. Roger’s Theory
“Science of Unitary Human Beings”
10
• Prof. Rogers’ development of the said theory has become
an influential nursing theory in the United States
• The science of unitary human beings comprises of:
– Four major concepts
– Five assumptions and
– Three major principles
Theoretical Source
• The initial idea was gained by the
Florence Nightingale who is
recognized as the mother of modern
nursing with the environmental
theory
• She defined and described the
concepts of ventilation, warmth, light,
diet, cleanliness and the noise as the
main environmental factors.
• Chin and Kramer(2011) revealed that
this theory has impacted to distinct
from medicine and nursing and
recognition of nursing as a profession12
Introduction to the
theoretical basis of
nursing (
Rogers,1970)
Conceptual model
12
Unitary Human
Being
AnthropologySociologyPsychology
Astronomy
Religion
Philosophy Physics
Mathematics
Energy field integral to
the life process
Entirely new system
of thought (Butcher, 1999)
Five assumptionsFour major concepts Three major Homeodynamic principles
Theory of Unitary Human Being
13
• Theory of Unitary Human Being is a conceptual model which;
– Specify a perspective and produce evidence among phenomena
specific to the nursing discipline
– Addresses models broad metaparadigm concepts (human beings,
health, nursing and environment)
– Provides perspectives with different applications
• Rogers conceptual model of nursing rested on a set of basic
assumptions that describes the life process
Four Major Concepts
14
• Rogers postulates that human beings are dynamic energy
fields that are integral with environmental fields
• Both human and environmental fields are identified by
pattern and characterized by a universe of open systems.
• She postulated four major concepts for her model.
Four Major Concepts
15
Energy Field
Openness
Pattern
Pan dimensionality
Energy field
16
• It is inevitable part of life.
• Constitute the both living and the nonliving
• Field is a unifying concept and the energy
signifies the dynamic nature of the field
• Two fields are identified.
• Human field and the environmental
fields(Rogers,1986b)
• Human and environment both have energy
field which is open
i.e. energy can freely flow between human
and environment (Todar- Francenschi, 2008)
Opennes
s
17
• 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 (Rogers, 1983)
Pattern
18
• 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“
(Rogers, 1983)
Pan-dimensionality
19
• 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 (Philips, 2010)
Contd..
20
• Rogers consistently updated the conceptual model through
revision of the homodynamic principles with the scientific and
technological advances.
• Initially, ‘unitary human being’ was called as ‘unitary man’ and
changed due to remove the gender bias (Conceptual models
for nursing practice, 1978).
• The theory of unitary human beings as separate and different
from the term holistic stressed the unique contribution of
nursing to health care.
21
Five Assumptions
22
• In 1970, Rogers identified five assumptions that are also
theoretical assertions supporting her model derived from
literature on human beings, physics, mathematics, and
behavioural sciences (Rogers, 1970).
Five Assumptions
23
Wholeness
Openness
Unidirectionality
Pattern and Organization
Sentience and thought
Wholeness
24
• Can be defined as when a person is thought of being more
than some of its parts that they are different than their history
as well as different from other beings.
Opennes
s
25
• Man and environment are continuously exchanging matter and
energy with one another
Unidirectionality
26
• The life process of human being evolves irreversibly and
unidirectionally along the space time continuum
• i.e. from birth to death
Pattern and Organization
27
• Energy being seen as a wave and have its own identity
• Pattern and organization identify man and reflect his
innovative wholeness
Sentience and thought
28
• Man is characterized by the capacity for imagination,
abstraction, language, thought, sensation and emotion.
Three Major Homeodynamic Principles
29
• Homeodynamics refers to the balance between the dynamic
life process and environment
• These principals help to view human as a unitary human being
Three Major Homeodynamic Principles
Resonancy
30
Helicy
Integrality
Roger’s Theory and Nursing Metaparadigm
31
Unitary Human Being
(Person)
Environment
Health
Nursing
Unitary Human Being (Person)
32
• Rogers defines person as a open system in continuous process with the
open system that is the environment
• She defines unitary human being as an “irreducible, indivisible, pan
dimensional energy field identified by pattern and manifesting
characteristics that are specific to the whole” (Rogers, 1992)
• “Man is a unified whole possessing his own integrity and manifesting
characteristics that are more than different from sum of its parts”
(Rogers, 1970).
• Within a conceptual model specific to nursing’s concern, people and
their environment are perceived as irreducible energy fields integral
with one another and continuously creative in their evolution.
Environment
33
• Rogers (1994a) defines environment as “an irreducible,
pandimensional energy field, not limited by space and time,
identified by its pattern and organization
• Each environmental field is specific to its given human field.
Both change continuously and creatively.
• Environmental fields are infinite, and change is continuously
innovative, unpredictable, and characterized by increasing
diversity.
• Environmental and human fields are identified by wave
patterns manifesting continuous mutual change.
Health
34
• Rogers uses the term health in many of her earlier writings without
clearly defining the term.
• She uses the term passive health to symbolize wellness and the
absence of disease and major illness (Rogers, 1970)
• Her promotion of positive health suggests direction in helping
people with opportunities for rhythmic consistency (Rogers, 1970).
• Later, she wrote that wellness “is a much better term . . . because
the term health is very ambiguous” (Rogers, 1994b).
• Rogers uses health as a value term defined by the culture or the
individual.
Contd..
35
• Health and illness are manifestations of pattern and are
considered “to denote behaviors that are of high value and low
value” (Rogers, 1980)
• Events manifested in the life process indicate the extent to
which a human being achieves maximum health according to
some value system.
• In Rogerian science, the phenomenon central to nursing’s
conceptual system is the human life process.
• The life process has its own dynamic and creative unity that is
inseparable from the environment and is characterized by the
whole (Rogers, 1970).
Nursing
36
• Nursing is both science and art and the nurse is the factor of
healing environment
• Rogerian nursing focuses on people and world in which they
naturally fit for nursing care
• emphasis on wholeness
• Seek to promote interaction between the two energy fields(
Unitary human being and environment) to strengthen the
coherence and integrity of Unitary human being.
• Coordinate the human field with rhythmicities
• Direct and redirect patterns of interaction between two energy
fields maximum heath potential individuals (Rogers, 1970)
Practical Implications of Rogers’ Theory
37
• Theories in nursing give information on definitions of nursing, goals
as well as functions of nursing and also the principles that form the
base for nursing practice (George, 2002).
• As nurses, it is very important to apply the theories in practice
because they guide in providing day today nursing care to clients
(Aranha, 2018).
• Prof. Martha Rogers theory is a kind of ‘systems theory’ and Calista
Roy, Dorothy E Johnson, Betty Newman are also get supported
their views in the theory of unitary human being (Tomey & Alligod,
2006).
38
• Rogers stated the principles of homeodynamics are based on
the above building blocks (Aranha, 2018)..
• These principles help individuals to understand life and the
mechanisms affecting life (Fayyad & Bustos 2012).
• They also provide knowledge on how to intervene and redirect
the clients (George, 2002).
• The principles of homeodynamics are resonancy, helicy, and
integrality (Tomey & Alligod, 2006).
Principle of
Resonancy
39
• Resonancy is the continuous change from
the lower to higher frequency wave
pattern in the energy fields (Aranha,
2018).
• Human beings are perceived as wave
patterns and a variety of life rhythms like
sleep – wake rhythms, hormonal levels,
and fluctuating emotional states can be
linked to the wave patterns (George,
2002).
• The change occurring in these are from
lower to higher frequency (Aranha, 2018).
Contd..
40
• The slinky represents that life process is continuous and it moves
unidirectional from conception to birth in a non-linear plane
(Armstrong, 1995).
• Slinky toy is a spiral which moves in a particular direction only (Fayyad
& Bustos 2012).
• When the spirals are molded they do not come back to its previous
state.
• Similarly, the nature of human change is spiral like, continuously
progressing towards increased diversity (Armstrong, 1995).
• Rogers says that human development is not static, and humans do not
ever return to exactly the same place where they were before (Tomey &
Alligod 2006).
Principle of
Integrality
• The principle of integrality explains that there is a continuous and mutual
process between human field and environmental field (Tomey & Alligod,
2006).
• This principle is divided into two i.e., reciprocity (wholeness, openness,
continuous) and synchrony (simultaneous change in human and
environmental fields)
• e.g. the child playing in the sun on a bright summer day gets a sun burn
(Armstrong, 1995; Fayyad & Bustos 2012).
• This is the process of interaction between sun and a child.
• However, the mutual process between the child and the sun occurs
simultaneously, where he gets Vitamin D along with the ongoing effects of
radiation (George, 2002). 42
Principle of
Helicy
42
• The principle of helicy is defined as "the continuous,
innovative, unpredictable increasing diversity of human and
environmental field patterns (Armstrong, 1995; George, 2002).
43
Contd…
44
• Health is a rhythmic patterning of energy that is mutually
enhancing and expresses full life potentials (Tomey & Alligod,
2006).
• According to Rogers, nursing aims to promote symphonic
interaction between the man and his environment thereby
strengthen the coherence and integrity of the human beings
and to direct and redirect (Armstrong, 1995).
• Patterns of interaction between the energy fields for the
realization of maximum health potentials (George, 2002).
45
46
Therapeutic Touch
• Unitary Human Beings Theory has been
used in many different areas of nursing,
including, hospice, healing centers,
hospitals, out-patient care, and delivery
rooms (Armstrong, 1995).
• Oxford Medical Dictionary gives the
definition of therapeutic touch as: "the
practice of running the hands on or above
a patient's body to restore health (Oxford,
2017).
• It is based on the premise that the human
body is a complex system of energy fields,
which must be channeled and balanced
for optimum health." 48
Nurses use therapeutic touch in many ways:
48
Decrease anxiety level (Tabatabae et al, 2015)
Improve nausea (Motourypour,2016)
Recovery room and post-operative patients to speed healing (George,
2002).
Promote health and healing in premature babies (Armstrong, 1995)
Assist women during childbirth (Tomey & Alligod, 2006)
Tocalm colicky babies (Wurges & Frey, 2009)
Contd…
49
• In a study of 20 infants,10 infants that received therapeutic
touch, massage, and listened to classical music continuously
throughout the day during the first 10 days of their life, had
increased maturation of visual evoked potentials, visual acuity,
and more mature brain processes.
• These were evidenced by maturational changes in EEG activity
and significant changes in the visual cortex (McGrath, 2009).
Contd…
50
• Music has a wide range of therapeutic benefits including,
enhancing personal growth, communication, and self-
expression.
• Music therapy is often used with individuals who have speech
or communication difficulties, autism, mental illness, or have
been sexually abused (Mandleco and Potts, 2012)
51
Critique of the Theory
52
Chinn and Kramer’s Questions
1. What is the purpose of this theory?
2. What are the concepts of this theory?
3. What are the definitions in this theory?
4. What are the relationships in this theory?
5. What is the structure of this theory?
6. What are the assumptions in this theory?
Chinn and Kramer’s Questions
7. How clear is this theory?
8. How simple is this theory?
9. How general is this theory?
10. Is the intended context of the theory congruent with the
practice situation?
11. Are the theory goals and the practice goals congruent?
12. Is there or might there be similarity between the theory
variables and the practice variables?
13. How accessible is the theory?
Chinn and Kramer’s Questions
14. Are the explanations sufficient to be used as a basis for
nursing action?
15. How will the use of the theory influence the practical
function of the nursing unit?
16. How important is the theory?
17. Is there research evidence to support the theory?
How clear is this theory?
• At the beginning the theory was not that clear because it is
abstract and conceptual theory. But most of her later work
provide the clarifications for the gray areas.
Eg
• Roger used the term passive health and wellness without
clearly defining the term (Rogers, 1970) but she described in
her later publications “wellness is a better term … because the
term health is very ambiguous”(Rogers, 1994)
• Rogers changed her wording from “unitary man” to “unitary
human” being to remove the concept of gender (Rogers, 1992)
How simple is this theory?
• Simplicity of a theory is defined by the number of concepts
and relationships.
• The theory of Unitary Human Beings is an abstract conceptual
theory.
• T y che theory of Unitar Human Beings is a omplex theory
How general is this theory?
• Even though The theory of Unitary Human Beings consider as a
nursing theory it is not limited to nursing but used in range of
subject, application and activities.
• Rogerian science emerged from the knowledge bases of
Anthropology, Psychology, Sociology, Physics, Mathematics,
astronomy, religion, philosophy, History, Literature.
(Newman, 1997)
• Theory is very general
Is the intended context of the theory congruent with
the practice situation?
• Rogerian science can be traced to Nightingale’s proposals and
statistical data, “placing the human being with in the
framework of the natural world is the foundation for the scope
of modern nursing” (Rogers, 1970) began nursing’s
investigations of the relationship between human beings and
the environment
(Newman, 1997)
• The Rogerian model is an abstract system of ideas from which
to approach the practice of nursing.
Are the theory goals and the practice
goals congruent?
• The basic building blocks of Rogers model are energy field,
openness, pattern and pandimensionality which provide a new
worldview.
• These concepts form the basis an abstract conceptual system
defining the nursing and health.
• Rogers’s model stressing the totality of experience and
existence which is relevant in today’s health care system where
a continuum of care is more important than the episodic illness
management and hospitalization.
Is there or might there be similarity between
the theory variables and the practice
variables?
• The theory of Unitary Human Beings is an abstract conceptual theory.
• The theory does not directly identify testable empirical variables
• Rogers’ theory emerged from multiple knowledge sources
 The nonlinear dynamics of quantum physics
 Einstein's’ theory of relativity in relation to space- time
 Northrops’ electrodynamic theory
 theories regarding universe of open systems
Eg- she describe human being as a “ irreducible indivisible pandimensional energy field identified by
pattern and manifesting characteristics” (Rogers, 1992)
How accessible is the
theory?
• Rogers’ definitions and clarifications blurs the boundaries
between the theory and practices allowing to exploration and
deepening of the understanding of the totality of human
experience.
• The conceptual model provide directions for scientific research
and relationships among the identified phenomena generate
both grand and middle range theories.
(Fawcett, 2005)
How accessible is the
theory?
Are the explanations sufficient to be used
as a basis for nursing action?
• Nursing is an art and a science
Nursing as a science
 The integrity of people and their environment
Operating from pandimensional universe of open systems
 point to a new paradigm and initiates the identity of
nursing as a science
Nursing as an art
The art of the nursing is the creative use of the science of
nursing for human betterment.
How will the use of the theory influence the
practical function of the nursing unit?
• The professional practice of nursing is creative and imaginative
and exist to serve the people.
• Theory influence the professional practice in nursing, seeks to
promote interactions between human and environmental field
to strengthen the integrity of human field, and to direct and
redirect patterning of the human and environment fields for
realization of maximum health potential
How important is the
theory?
• Theory is important for all the aspect of nursing
Practice
Education
Research
• The theory of Unitary Human Beings is considered as the
foundation for the scope of modern nursing
How important is the theory?
• The theory of Unitary Human Beings provides a stimulus and
direction for research and theory development in nursing
science (Fawcett, 2000).
Is there research evidence to support
the theory?
• In 1988 Scholars who were interested and support this theory
joined together and form the Society of Rogerian Scholars.
Is there research evidence to support the
theory?
• In 1993 Society of Rogerian Scholars began to publish The
Journal of Rogerian Nursing Sciences.
Further Development
• Rogers (1986a) believed that knowledge development within her model
was a “never-ending process” using “a multiplicity of knowledge from
many sources
• Explorations by Rogerian scholars into transcendence and universality
exemplify this belief in a unifying wholeness (Phillips, 2010).
• Fawcett (2005) identified the following three rudimentary theories
developed by Rogers from the Science of Unitary Human Beings
1. Theory of accelerating evolution
2. Theory of rhythmical correlates of change
3. Theory of paranormal phenomena
• Continued explication and testing of these theories and the
homeodynamic principles by nurse researchers contributes to nursing
science knowledge. 72
Limitations
72
• Difficult to understand (Sitzman, K., & Wright Eichelbereger,L.,
2016)
• Critics (Walker, CA., 2011)
• Limited amount of Research
Summary
73
• The Rogerian model emerged from a broad historical base and
has moved to the forefront as scientific knowledge has evolved.
• Understanding the concepts and principles of the Science of
Unitary Human Beings requires a foundation in general
education, a willingness to let go of the traditional, and an
ability to perceive the world in a new and creative way
• Emerging from a strong educational base, this model provides a
challenging framework from which to provide nursing care
• The abstract ideas expounded in the Rogerian model and their
congruence with modern scientific knowledge spur new and
challenging theories that further the understanding of the
unitary human being.
Case
Study
74
Mrs. P. ,a 56 year old female is admitted to the hospital with irretractable
nausea and vomiting post chemotherapy and radiation. Symptoms include
tachycardia with heartrates from 100-160's, nausea and vomiting,
dehydration with headache and fatigue. She is complaining of generalized
pain and weakness with a focus on a headache.
Mrs. P. is surrounded by multiple family members and several small
children who appear to be well meaning, but are coughing, sneezing, and
talking loudly.
Mrs. P is unfortunately placed in a semi-private room with a roommate
who is preferred to eat instant food for lunch and laughing watching the
loudly tuned TV.
The nurse administers IVP narcotics for her pain and headache and an IVP
antiemetic, but Mrs. P continues to complain of headache.
Questions
75
Considering Rogers' Theory of Unitary Human beings where Rogers states
"nurses are in constant mutual process with those for whom they care and
have opportunities to pattern the environment for change“.
1. What immediate interventions could be initiated for Mrs. P?
2. Using Rogers' theory, what non-pharmacologic interventions could be
utlitized for pain management?
3. In what ways can the nurse alter the way care is provided during the shift
in order to promote improvement in symptoms and provide a calming
environment?
4. What can the nurse do so that family and visitors can help Mrs. P recover
more quickly?
5. What can the nurse do help Mrs. P increase her appetite and help control
nausea and vomiting?
Answers
76
1. An immediate change in the environment. If the patient has a
headache it would be beneficial to remove loud noises. If the
patient is nauseated facilitation of removal foul/obnoxious
smells could aid in the reduction of symptoms. Checking into
the availability of a private room to produce a calming
atmosphere that ensures a noise reduction and provide a
better environment for healing.
2. Calm quiet environment. Nursing can utilize comforting
therapeutic touch, guided imagery or massage therapy.
Answers
77
3. Limit interruptions to Mrs. P's rest by grouping tasks together, for
example, give medications and take vital signs together instead of
separately. Limit the number of visitors until acute symptoms have
improved and the patient is ready to visit. Lower lights or turn them off,
offer music to help distract and drown out the noise in the hallway, keep
the door closed, and warm blankets/cool compresses as needed.
4. The nurse needs to educate the family & visitors on chemotherapy and its
effects. Hand washing is the most important. Educate the reasoning that
every visitor who is sick in any way must stay home so the patient does
not become iller.
Answers
78
5. facilitation of removal foul/obnoxious smells, guided imagery,
try rescheduling meals, Incorporate Healthy Snacks, Eat More
of Favorite Foods, Use Herbs and Spices, Limit Beverages With
Meals
References
79
• American Association for the History of Nursing. Martha E Rogers Available at:
https://www.aahn.org/rogers
• Aranha, P.R. (2018). Application of Rogers’ system model in nursing care of a
client with cerebrovascular accident. Manipal Journal of Nursing and Health
Sciences, 4(1), 50-56.
• Armstrong, M.A., & Kelly, A.E. (1995). More than the sum of their parts:
Martha Rogers and Hildegard Peplue. Archives of Psychiatric Nursing, 9 (1),
40-44.
• Barrett, E.A.M. & Malinski, V.M,1994, Martha E. Rogers 80 Years of
Excellence. New York, NY: Society of Rogerian Scholars, Inc. Press.
• Fayyad, S., & Bustos, M. (2012). Martha E. Rogers: Science of Unitary Human
Beings Theory. Retrieved from http://martharogerstheory. blogspot.com
References
80
• George, J. B. (2002). Nursing Theories, A base for professional nursing
practice. USA; A Pearson Education.
• Howard Butcher 2018, Martha E. Rogers' Nursing Science, The Science
of Unitary Human Beings 2.0 Available at
https://pressbooks.uiowa.edu/rogeriannursingscience/chapter/chapter-
1-2/
• Martha E. Rogers By Gil Wayne, BSN, R.N. -September 9, 2014 Available
at : https://nurseslabs.com/martha-e-rogers/
References
81
• Rogers, M. E. (1970). An introduction to the theoretical basis of nursing.
Philadelphia: F.A. Davis.
• Rogers, M. E. (1986a). Science of unitary human beings. In V.M. Malinski (Ed.),
Explorations in Martha Rogers’ science of unitary human beings (pp. 3–8). Norwalk,
(CT): Appleton-Century-Crofts.
• Rogers, M. E. (1989). Nursing: A science of unitary human beings. In J. P.Riehl-Sisca
(Ed.), Conceptual models for nursing practice (3rd ed., pp. 181–188). Norwalk,
(CT):Appleton-Century-Crofts.
• Tomey, A. M., & Alligod, M. R. (2006). Nursing theorists and their work, Philadelphia;
Mosby
Thank You
82

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Martha rogers theory

  • 2. Objectives 2 Upon completion of this session you should be able : 1. to identify the theorist- Martha Rogers 2. to discuss the theoretical source of Rogers theory 3. to explain four (04) major concepts, five assumptions and three major principles of the theory. 4. to analyze nursing metaparadigm with Rogers theory 5. to state the practical implications of Rogers theory 6. ToAnalysis and evaluate the theory based on the chinn and Kramer's proposed questions 7. to state the limitations of theory 8. to apply the knowledge of Rogers theory for a given scenario
  • 3. Case Study 3 Mrs. P. ,a 56 year old female is admitted to the hospital with irretractable nausea and vomiting post chemotherapy and radiation. Symptoms include tachycardia with heartrates from 100-160's, nausea and vomiting, dehydration with headache and fatigue. She is complaining of generalized pain and weakness with a focus on a headache. Mrs. P. is surrounded by multiple family members and several small children who appear to be well meaning, but are coughing, sneezing, and talking loudly. Mrs. P is unfortunately placed in a semi-private room with a roommate who is preferred to eat instant food for lunch and laughing watching the loudly tuned TV. The nurse administers IVP narcotics for her pain and headache and an IVP antiemetic, but Mrs. P continues to complain of headache.
  • 4. Questions 4 Considering Rogers' Theory of Unitary Human beings where Rogers states "nurses are in constant mutual process with those for whom they care and have opportunities to pattern the environment for change“. 1. What immediate interventions could be initiated for Mrs. P? 2. Using Rogers' theory, what non-pharmacologic interventions could be utlitized for pain management? 3. In what ways can the nurse alter the way care is provided during the shift in order to promote improvement in symptoms and provide a calming environment? 4. What can the nurse do so that family and visitors can help Mrs. P recover more quickly? 5. What can the nurse do help Mrs. P increase her appetite and help control nausea and vomiting?
  • 6. Martha Rogers- Theorist 6 • Born on May 12, 1914, Dallas, Texas, USA • She was the eldest of four children of Rogers family.
  • 7. Martha Rogers- Education 7 • Nursing diploma : Knoxville General Hospital School of Nursing in 1936 • Graduated in Public Health Nursing : George Peabody College in 1937 • Master’s degree (MA) : Teachers College at Columbia University in 1945 • MPH: Johns Hopkins University, Baltimore in 1952 • Doctorate in Nursing : From Johns Hopkins University in Baltimore in 1954. • Rogers was appointed Professor and Head of the Division of Nursing at New York University and she hold this position for 21 years until her retirement in 1975.
  • 8. Professional Work of Prof. Martha Rogers 8 • Her main focus was on Nursing education • She also worked as a public health nurse, staff nurse, a supervisor and education director in Hartford. • In 1979 she became “professor Emerita” • In 1988 Society of Rogerian Scholars was formed • She was honored with numerous awards and citations for her sustained contributions to nursing and science. • In 1996, she was posthumously inducted into the American Nurses Association’s Hall of Fame.
  • 9. Publications of Prof. Martha Rogers9 • Her publications include three books and more than 200 articles: – Educational Revolution in Nursing (1961) – Reveille in Nursing (1964) – An Introduction to the Theoretical Basis of Nursing (1970) • Famous Publications – Theoretical Basis of Nursing (1970) – Nursing Science and Art: A Prospective (1988) – Vision of Space Based Nursing (1990). – Nursing: Science of Unitary, Irreducible, Human Beings Update (1990)
  • 10. Prof. Martha E. Roger’s Theory “Science of Unitary Human Beings” 10 • Prof. Rogers’ development of the said theory has become an influential nursing theory in the United States • The science of unitary human beings comprises of: – Four major concepts – Five assumptions and – Three major principles
  • 11. Theoretical Source • The initial idea was gained by the Florence Nightingale who is recognized as the mother of modern nursing with the environmental theory • She defined and described the concepts of ventilation, warmth, light, diet, cleanliness and the noise as the main environmental factors. • Chin and Kramer(2011) revealed that this theory has impacted to distinct from medicine and nursing and recognition of nursing as a profession12
  • 12. Introduction to the theoretical basis of nursing ( Rogers,1970) Conceptual model 12 Unitary Human Being AnthropologySociologyPsychology Astronomy Religion Philosophy Physics Mathematics Energy field integral to the life process Entirely new system of thought (Butcher, 1999) Five assumptionsFour major concepts Three major Homeodynamic principles
  • 13. Theory of Unitary Human Being 13 • Theory of Unitary Human Being is a conceptual model which; – Specify a perspective and produce evidence among phenomena specific to the nursing discipline – Addresses models broad metaparadigm concepts (human beings, health, nursing and environment) – Provides perspectives with different applications • Rogers conceptual model of nursing rested on a set of basic assumptions that describes the life process
  • 14. Four Major Concepts 14 • Rogers postulates that human beings are dynamic energy fields that are integral with environmental fields • Both human and environmental fields are identified by pattern and characterized by a universe of open systems. • She postulated four major concepts for her model.
  • 15. Four Major Concepts 15 Energy Field Openness Pattern Pan dimensionality
  • 16. Energy field 16 • It is inevitable part of life. • Constitute the both living and the nonliving • Field is a unifying concept and the energy signifies the dynamic nature of the field • Two fields are identified. • Human field and the environmental fields(Rogers,1986b) • Human and environment both have energy field which is open i.e. energy can freely flow between human and environment (Todar- Francenschi, 2008)
  • 17. Opennes s 17 • 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 (Rogers, 1983)
  • 18. Pattern 18 • 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“ (Rogers, 1983)
  • 19. Pan-dimensionality 19 • 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 (Philips, 2010)
  • 20. Contd.. 20 • Rogers consistently updated the conceptual model through revision of the homodynamic principles with the scientific and technological advances. • Initially, ‘unitary human being’ was called as ‘unitary man’ and changed due to remove the gender bias (Conceptual models for nursing practice, 1978). • The theory of unitary human beings as separate and different from the term holistic stressed the unique contribution of nursing to health care.
  • 21. 21
  • 22. Five Assumptions 22 • In 1970, Rogers identified five assumptions that are also theoretical assertions supporting her model derived from literature on human beings, physics, mathematics, and behavioural sciences (Rogers, 1970).
  • 24. Wholeness 24 • Can be defined as when a person is thought of being more than some of its parts that they are different than their history as well as different from other beings.
  • 25. Opennes s 25 • Man and environment are continuously exchanging matter and energy with one another
  • 26. Unidirectionality 26 • The life process of human being evolves irreversibly and unidirectionally along the space time continuum • i.e. from birth to death
  • 27. Pattern and Organization 27 • Energy being seen as a wave and have its own identity • Pattern and organization identify man and reflect his innovative wholeness
  • 28. Sentience and thought 28 • Man is characterized by the capacity for imagination, abstraction, language, thought, sensation and emotion.
  • 29. Three Major Homeodynamic Principles 29 • Homeodynamics refers to the balance between the dynamic life process and environment • These principals help to view human as a unitary human being
  • 30. Three Major Homeodynamic Principles Resonancy 30 Helicy Integrality
  • 31. Roger’s Theory and Nursing Metaparadigm 31 Unitary Human Being (Person) Environment Health Nursing
  • 32. Unitary Human Being (Person) 32 • Rogers defines person as a open system in continuous process with the open system that is the environment • She defines unitary human being as an “irreducible, indivisible, pan dimensional energy field identified by pattern and manifesting characteristics that are specific to the whole” (Rogers, 1992) • “Man is a unified whole possessing his own integrity and manifesting characteristics that are more than different from sum of its parts” (Rogers, 1970). • Within a conceptual model specific to nursing’s concern, people and their environment are perceived as irreducible energy fields integral with one another and continuously creative in their evolution.
  • 33. Environment 33 • Rogers (1994a) defines environment as “an irreducible, pandimensional energy field, not limited by space and time, identified by its pattern and organization • Each environmental field is specific to its given human field. Both change continuously and creatively. • Environmental fields are infinite, and change is continuously innovative, unpredictable, and characterized by increasing diversity. • Environmental and human fields are identified by wave patterns manifesting continuous mutual change.
  • 34. Health 34 • Rogers uses the term health in many of her earlier writings without clearly defining the term. • She uses the term passive health to symbolize wellness and the absence of disease and major illness (Rogers, 1970) • Her promotion of positive health suggests direction in helping people with opportunities for rhythmic consistency (Rogers, 1970). • Later, she wrote that wellness “is a much better term . . . because the term health is very ambiguous” (Rogers, 1994b). • Rogers uses health as a value term defined by the culture or the individual.
  • 35. Contd.. 35 • Health and illness are manifestations of pattern and are considered “to denote behaviors that are of high value and low value” (Rogers, 1980) • Events manifested in the life process indicate the extent to which a human being achieves maximum health according to some value system. • In Rogerian science, the phenomenon central to nursing’s conceptual system is the human life process. • The life process has its own dynamic and creative unity that is inseparable from the environment and is characterized by the whole (Rogers, 1970).
  • 36. Nursing 36 • Nursing is both science and art and the nurse is the factor of healing environment • Rogerian nursing focuses on people and world in which they naturally fit for nursing care • emphasis on wholeness • Seek to promote interaction between the two energy fields( Unitary human being and environment) to strengthen the coherence and integrity of Unitary human being. • Coordinate the human field with rhythmicities • Direct and redirect patterns of interaction between two energy fields maximum heath potential individuals (Rogers, 1970)
  • 37. Practical Implications of Rogers’ Theory 37 • Theories in nursing give information on definitions of nursing, goals as well as functions of nursing and also the principles that form the base for nursing practice (George, 2002). • As nurses, it is very important to apply the theories in practice because they guide in providing day today nursing care to clients (Aranha, 2018). • Prof. Martha Rogers theory is a kind of ‘systems theory’ and Calista Roy, Dorothy E Johnson, Betty Newman are also get supported their views in the theory of unitary human being (Tomey & Alligod, 2006).
  • 38. 38 • Rogers stated the principles of homeodynamics are based on the above building blocks (Aranha, 2018).. • These principles help individuals to understand life and the mechanisms affecting life (Fayyad & Bustos 2012). • They also provide knowledge on how to intervene and redirect the clients (George, 2002). • The principles of homeodynamics are resonancy, helicy, and integrality (Tomey & Alligod, 2006).
  • 39. Principle of Resonancy 39 • Resonancy is the continuous change from the lower to higher frequency wave pattern in the energy fields (Aranha, 2018). • Human beings are perceived as wave patterns and a variety of life rhythms like sleep – wake rhythms, hormonal levels, and fluctuating emotional states can be linked to the wave patterns (George, 2002). • The change occurring in these are from lower to higher frequency (Aranha, 2018).
  • 40. Contd.. 40 • The slinky represents that life process is continuous and it moves unidirectional from conception to birth in a non-linear plane (Armstrong, 1995). • Slinky toy is a spiral which moves in a particular direction only (Fayyad & Bustos 2012). • When the spirals are molded they do not come back to its previous state. • Similarly, the nature of human change is spiral like, continuously progressing towards increased diversity (Armstrong, 1995). • Rogers says that human development is not static, and humans do not ever return to exactly the same place where they were before (Tomey & Alligod 2006).
  • 41. Principle of Integrality • The principle of integrality explains that there is a continuous and mutual process between human field and environmental field (Tomey & Alligod, 2006). • This principle is divided into two i.e., reciprocity (wholeness, openness, continuous) and synchrony (simultaneous change in human and environmental fields) • e.g. the child playing in the sun on a bright summer day gets a sun burn (Armstrong, 1995; Fayyad & Bustos 2012). • This is the process of interaction between sun and a child. • However, the mutual process between the child and the sun occurs simultaneously, where he gets Vitamin D along with the ongoing effects of radiation (George, 2002). 42
  • 42. Principle of Helicy 42 • The principle of helicy is defined as "the continuous, innovative, unpredictable increasing diversity of human and environmental field patterns (Armstrong, 1995; George, 2002).
  • 43. 43
  • 44. Contd… 44 • Health is a rhythmic patterning of energy that is mutually enhancing and expresses full life potentials (Tomey & Alligod, 2006). • According to Rogers, nursing aims to promote symphonic interaction between the man and his environment thereby strengthen the coherence and integrity of the human beings and to direct and redirect (Armstrong, 1995). • Patterns of interaction between the energy fields for the realization of maximum health potentials (George, 2002).
  • 45. 45
  • 46. 46
  • 47. Therapeutic Touch • Unitary Human Beings Theory has been used in many different areas of nursing, including, hospice, healing centers, hospitals, out-patient care, and delivery rooms (Armstrong, 1995). • Oxford Medical Dictionary gives the definition of therapeutic touch as: "the practice of running the hands on or above a patient's body to restore health (Oxford, 2017). • It is based on the premise that the human body is a complex system of energy fields, which must be channeled and balanced for optimum health." 48
  • 48. Nurses use therapeutic touch in many ways: 48 Decrease anxiety level (Tabatabae et al, 2015) Improve nausea (Motourypour,2016) Recovery room and post-operative patients to speed healing (George, 2002). Promote health and healing in premature babies (Armstrong, 1995) Assist women during childbirth (Tomey & Alligod, 2006) Tocalm colicky babies (Wurges & Frey, 2009)
  • 49. Contd… 49 • In a study of 20 infants,10 infants that received therapeutic touch, massage, and listened to classical music continuously throughout the day during the first 10 days of their life, had increased maturation of visual evoked potentials, visual acuity, and more mature brain processes. • These were evidenced by maturational changes in EEG activity and significant changes in the visual cortex (McGrath, 2009).
  • 50. Contd… 50 • Music has a wide range of therapeutic benefits including, enhancing personal growth, communication, and self- expression. • Music therapy is often used with individuals who have speech or communication difficulties, autism, mental illness, or have been sexually abused (Mandleco and Potts, 2012)
  • 51. 51
  • 52. Critique of the Theory 52
  • 53. Chinn and Kramer’s Questions 1. What is the purpose of this theory? 2. What are the concepts of this theory? 3. What are the definitions in this theory? 4. What are the relationships in this theory? 5. What is the structure of this theory? 6. What are the assumptions in this theory?
  • 54. Chinn and Kramer’s Questions 7. How clear is this theory? 8. How simple is this theory? 9. How general is this theory? 10. Is the intended context of the theory congruent with the practice situation? 11. Are the theory goals and the practice goals congruent? 12. Is there or might there be similarity between the theory variables and the practice variables? 13. How accessible is the theory?
  • 55. Chinn and Kramer’s Questions 14. Are the explanations sufficient to be used as a basis for nursing action? 15. How will the use of the theory influence the practical function of the nursing unit? 16. How important is the theory? 17. Is there research evidence to support the theory?
  • 56. How clear is this theory? • At the beginning the theory was not that clear because it is abstract and conceptual theory. But most of her later work provide the clarifications for the gray areas. Eg • Roger used the term passive health and wellness without clearly defining the term (Rogers, 1970) but she described in her later publications “wellness is a better term … because the term health is very ambiguous”(Rogers, 1994) • Rogers changed her wording from “unitary man” to “unitary human” being to remove the concept of gender (Rogers, 1992)
  • 57. How simple is this theory? • Simplicity of a theory is defined by the number of concepts and relationships. • The theory of Unitary Human Beings is an abstract conceptual theory. • T y che theory of Unitar Human Beings is a omplex theory
  • 58. How general is this theory? • Even though The theory of Unitary Human Beings consider as a nursing theory it is not limited to nursing but used in range of subject, application and activities. • Rogerian science emerged from the knowledge bases of Anthropology, Psychology, Sociology, Physics, Mathematics, astronomy, religion, philosophy, History, Literature. (Newman, 1997) • Theory is very general
  • 59. Is the intended context of the theory congruent with the practice situation? • Rogerian science can be traced to Nightingale’s proposals and statistical data, “placing the human being with in the framework of the natural world is the foundation for the scope of modern nursing” (Rogers, 1970) began nursing’s investigations of the relationship between human beings and the environment (Newman, 1997) • The Rogerian model is an abstract system of ideas from which to approach the practice of nursing.
  • 60. Are the theory goals and the practice goals congruent? • The basic building blocks of Rogers model are energy field, openness, pattern and pandimensionality which provide a new worldview. • These concepts form the basis an abstract conceptual system defining the nursing and health. • Rogers’s model stressing the totality of experience and existence which is relevant in today’s health care system where a continuum of care is more important than the episodic illness management and hospitalization.
  • 61. Is there or might there be similarity between the theory variables and the practice variables? • The theory of Unitary Human Beings is an abstract conceptual theory. • The theory does not directly identify testable empirical variables • Rogers’ theory emerged from multiple knowledge sources  The nonlinear dynamics of quantum physics  Einstein's’ theory of relativity in relation to space- time  Northrops’ electrodynamic theory  theories regarding universe of open systems Eg- she describe human being as a “ irreducible indivisible pandimensional energy field identified by pattern and manifesting characteristics” (Rogers, 1992)
  • 62. How accessible is the theory? • Rogers’ definitions and clarifications blurs the boundaries between the theory and practices allowing to exploration and deepening of the understanding of the totality of human experience. • The conceptual model provide directions for scientific research and relationships among the identified phenomena generate both grand and middle range theories. (Fawcett, 2005)
  • 63. How accessible is the theory?
  • 64. Are the explanations sufficient to be used as a basis for nursing action? • Nursing is an art and a science Nursing as a science  The integrity of people and their environment Operating from pandimensional universe of open systems  point to a new paradigm and initiates the identity of nursing as a science Nursing as an art The art of the nursing is the creative use of the science of nursing for human betterment.
  • 65. How will the use of the theory influence the practical function of the nursing unit? • The professional practice of nursing is creative and imaginative and exist to serve the people. • Theory influence the professional practice in nursing, seeks to promote interactions between human and environmental field to strengthen the integrity of human field, and to direct and redirect patterning of the human and environment fields for realization of maximum health potential
  • 66. How important is the theory? • Theory is important for all the aspect of nursing Practice Education Research
  • 67. • The theory of Unitary Human Beings is considered as the foundation for the scope of modern nursing
  • 68. How important is the theory? • The theory of Unitary Human Beings provides a stimulus and direction for research and theory development in nursing science (Fawcett, 2000).
  • 69. Is there research evidence to support the theory? • In 1988 Scholars who were interested and support this theory joined together and form the Society of Rogerian Scholars.
  • 70. Is there research evidence to support the theory? • In 1993 Society of Rogerian Scholars began to publish The Journal of Rogerian Nursing Sciences.
  • 71. Further Development • Rogers (1986a) believed that knowledge development within her model was a “never-ending process” using “a multiplicity of knowledge from many sources • Explorations by Rogerian scholars into transcendence and universality exemplify this belief in a unifying wholeness (Phillips, 2010). • Fawcett (2005) identified the following three rudimentary theories developed by Rogers from the Science of Unitary Human Beings 1. Theory of accelerating evolution 2. Theory of rhythmical correlates of change 3. Theory of paranormal phenomena • Continued explication and testing of these theories and the homeodynamic principles by nurse researchers contributes to nursing science knowledge. 72
  • 72. Limitations 72 • Difficult to understand (Sitzman, K., & Wright Eichelbereger,L., 2016) • Critics (Walker, CA., 2011) • Limited amount of Research
  • 73. Summary 73 • The Rogerian model emerged from a broad historical base and has moved to the forefront as scientific knowledge has evolved. • Understanding the concepts and principles of the Science of Unitary Human Beings requires a foundation in general education, a willingness to let go of the traditional, and an ability to perceive the world in a new and creative way • Emerging from a strong educational base, this model provides a challenging framework from which to provide nursing care • The abstract ideas expounded in the Rogerian model and their congruence with modern scientific knowledge spur new and challenging theories that further the understanding of the unitary human being.
  • 74. Case Study 74 Mrs. P. ,a 56 year old female is admitted to the hospital with irretractable nausea and vomiting post chemotherapy and radiation. Symptoms include tachycardia with heartrates from 100-160's, nausea and vomiting, dehydration with headache and fatigue. She is complaining of generalized pain and weakness with a focus on a headache. Mrs. P. is surrounded by multiple family members and several small children who appear to be well meaning, but are coughing, sneezing, and talking loudly. Mrs. P is unfortunately placed in a semi-private room with a roommate who is preferred to eat instant food for lunch and laughing watching the loudly tuned TV. The nurse administers IVP narcotics for her pain and headache and an IVP antiemetic, but Mrs. P continues to complain of headache.
  • 75. Questions 75 Considering Rogers' Theory of Unitary Human beings where Rogers states "nurses are in constant mutual process with those for whom they care and have opportunities to pattern the environment for change“. 1. What immediate interventions could be initiated for Mrs. P? 2. Using Rogers' theory, what non-pharmacologic interventions could be utlitized for pain management? 3. In what ways can the nurse alter the way care is provided during the shift in order to promote improvement in symptoms and provide a calming environment? 4. What can the nurse do so that family and visitors can help Mrs. P recover more quickly? 5. What can the nurse do help Mrs. P increase her appetite and help control nausea and vomiting?
  • 76. Answers 76 1. An immediate change in the environment. If the patient has a headache it would be beneficial to remove loud noises. If the patient is nauseated facilitation of removal foul/obnoxious smells could aid in the reduction of symptoms. Checking into the availability of a private room to produce a calming atmosphere that ensures a noise reduction and provide a better environment for healing. 2. Calm quiet environment. Nursing can utilize comforting therapeutic touch, guided imagery or massage therapy.
  • 77. Answers 77 3. Limit interruptions to Mrs. P's rest by grouping tasks together, for example, give medications and take vital signs together instead of separately. Limit the number of visitors until acute symptoms have improved and the patient is ready to visit. Lower lights or turn them off, offer music to help distract and drown out the noise in the hallway, keep the door closed, and warm blankets/cool compresses as needed. 4. The nurse needs to educate the family & visitors on chemotherapy and its effects. Hand washing is the most important. Educate the reasoning that every visitor who is sick in any way must stay home so the patient does not become iller.
  • 78. Answers 78 5. facilitation of removal foul/obnoxious smells, guided imagery, try rescheduling meals, Incorporate Healthy Snacks, Eat More of Favorite Foods, Use Herbs and Spices, Limit Beverages With Meals
  • 79. References 79 • American Association for the History of Nursing. Martha E Rogers Available at: https://www.aahn.org/rogers • Aranha, P.R. (2018). Application of Rogers’ system model in nursing care of a client with cerebrovascular accident. Manipal Journal of Nursing and Health Sciences, 4(1), 50-56. • Armstrong, M.A., & Kelly, A.E. (1995). More than the sum of their parts: Martha Rogers and Hildegard Peplue. Archives of Psychiatric Nursing, 9 (1), 40-44. • Barrett, E.A.M. & Malinski, V.M,1994, Martha E. Rogers 80 Years of Excellence. New York, NY: Society of Rogerian Scholars, Inc. Press. • Fayyad, S., & Bustos, M. (2012). Martha E. Rogers: Science of Unitary Human Beings Theory. Retrieved from http://martharogerstheory. blogspot.com
  • 80. References 80 • George, J. B. (2002). Nursing Theories, A base for professional nursing practice. USA; A Pearson Education. • Howard Butcher 2018, Martha E. Rogers' Nursing Science, The Science of Unitary Human Beings 2.0 Available at https://pressbooks.uiowa.edu/rogeriannursingscience/chapter/chapter- 1-2/ • Martha E. Rogers By Gil Wayne, BSN, R.N. -September 9, 2014 Available at : https://nurseslabs.com/martha-e-rogers/
  • 81. References 81 • Rogers, M. E. (1970). An introduction to the theoretical basis of nursing. Philadelphia: F.A. Davis. • Rogers, M. E. (1986a). Science of unitary human beings. In V.M. Malinski (Ed.), Explorations in Martha Rogers’ science of unitary human beings (pp. 3–8). Norwalk, (CT): Appleton-Century-Crofts. • Rogers, M. E. (1989). Nursing: A science of unitary human beings. In J. P.Riehl-Sisca (Ed.), Conceptual models for nursing practice (3rd ed., pp. 181–188). Norwalk, (CT):Appleton-Century-Crofts. • Tomey, A. M., & Alligod, M. R. (2006). Nursing theorists and their work, Philadelphia; Mosby