1. Josephine Ann J. Necor, RN

2. Margaret Newman
Born on October 10, 1933.
Bachelor’s degree - University
of Tennessee in 1962
Master’s degree - University
of California in 1964
Doctorate - New York
University in 1971
She has worked in -
University of Tennessee, New
York University, Pennsylvania
State University, University of
Minnesotat, University of
Minnesota

3. “Health is the
expansion of
consciousness.”
- Newman, 1983

4. -Middle Range Nursing
Theory

5. THEORETICAL SOURCES
Martha Rogers -Theory of Unitary Human Beings
The main basis of the development of Newman’s theory.
The health of a human being is a unitary phenomenon, an
evolving pattern of human-environment (Rogers, 1970).
Itzhak Bentov – The concept of evolution of consciousness
“Life is a process of expanding consciousness. Consciousness
is the informational capacity of the system and can be seen in
the quality of interaction of the system with the
environment” (Bentov, 1978).

6. THEORETICAL SOURCES
Arthur Young – The Theory of Process
A person moves through stages of consciousness involving
the loss of freedom in the development of self-identity until a
turning point is reached when the ‘old rules’ don’t work
anymore. The life task is to discover the ‘new rules’ and move
toward increasing freedom and higher consciousness (Young,
1976).
David Bohm – The Theory of Implicate
The explicate order is a manifestation of the implicate order.
(Bohm, 1980)

7. THEORETICAL SOURCES
Prigogine – Theory of Dissipative Structure
A system fluctuates in an orderly manner until the
occurrence of a disruptive event, at which time the system
moves in seemingly random, disorderly ways until it chooses
a new direction at a higher level of organization (Prigogine,
1976).
The theory of health as expanding consciousness was
stimulated by concern for those whom health as the
absence of disease or disability is not possible. Nurses often
relate to such people: people facing the uncertainty,
debilitation, loss and eventual death associated with
chronic illness. (Newman, 2010).

8. USE OF EMPIRICAL EVIDENCE
Evidence for the theory of health emanated from
Newman’s early personal family experiences. Her mother’s
struggle with a chronic illness and her dependency on
Newman sparked an interest in nursing. From that
experience evolved the idea that “illness reflected the life
patterns of the person and that what was needed was the
recognition of that pattern and acceptance of it for what it
meant to that person.”
Research has been conducted on the theoretical sources
used.

10. HEALTH
Rogers’ insistence that health and illness are simply
manifestations of the rhythmic fluctuations of the life
process is the foundation for viewing health and illness
as a unitary process moving through variations in
order-disorder. From this standpoint, one can no
longer think of health and illness in the dichotomous
way characterized by medical science; that is, health as
absence of disease or health as a continuum from
wellness to illness. Health and the evolving pattern of
consciousness are the same.

11. PATTERN
A person is identified by her or his pattern, which
reflects the pattern of the person within the larger
pattern of the environment. The pattern is evolving
through various permutations of order and disorder,
including what in everyday language is called health
and disease. Pattern recognition emerges from a
process of uncovering meaning in a person’s life.
Meaning is inherent in pattern, and vice versa.

12. CONSCIOUSNESS
defined as the informational capacity of the system (in
this case, the human being); that is, the ability of the
system to interact with the environment (Bentov,
1978). Consciousness includes not only the cognitive
and affective awareness normally associated with
consciousness, but also the interconnectedness of the
entire living system, which includes physiochemical
maintenance and growth processes as well as the
immune system. This pattern of information, which is
the consciousness of the system, is part of a larger,
undivided pattern of an expanding universe.

13. Three Correlates of Consciousness:
MOVEMENT
TIME
SPACE
The relevance of movement, time and space was part
of the original explication and has re-emerged in the
evolving patterning of unfolding consciousness.

14. To see health as the pattern of the whole, one needs to
see disease not as a separate entity but as a manifestation
of the evolving pattern of person-environment
interaction. The paradigm shift is:
From treatment of symptoms to a search for pattern.
From viewing disease and disruption as negative to
viewing them as part of the self-organizing process of
expanding consciousness.
From viewing the nursing role as addressing the
problems of disease to assisting people to get in touch
with their own pattern of expanding consciousness.

15. MAJOR ASSUMPTIONS
1. Health encompasses conditions heretofore described
as illness, or, in medical terms, pathology
2. These pathological conditions can be considered a
manifestation of the total pattern of the individual
3. The pattern of the individual that eventually
manifests itself as pathology is primary and exists
prior to structural or functional changes

16. MAJOR ASSUMPTIONS
4. Removal of the pathology in itself will not change
the pattern of the individual
5. If becoming ill is the only way an individual's pattern
can manifest itself, then that is health for that
person
6. Health is an expansion of consciousness.

18. Nursing
Nursing is “caring in the
human health
experience”.
Nursing is seen as a
partnership between the
nurse and client, with
both grow in the “sense
of higher levels of
consciousness”

19. Person/Human
“The human is unitary, that is
cannot be divided into parts,
and is inseparable from the
larger unitary field”
“Persons as individuals, and
human beings as a species are
identified by their patterns of
consciousness”…
“The person does not possess
consciousness-the person is
consciousness”.
Persons are “centers of
consciousness” within an
overall pattern of expanding
consciousness”

20. Environment
Environment is
described as a “universe
of open systems”

21. Health
“Health and illness are
synthesized as health -
the fusion on one state of
being (disease) with its
opposite (non-disease)
results in what can be
regarded as health”.

23. “The theory has progressed to include the health of all
persons regardless of the presence or absence of disease.
The theory asserts that every person in every situation,
no matter how disordered and hopeless it may seem, is
part of the universal process of expanding consciousness
– a process of becoming more of oneself, of finding
greater meaning in life, and of reaching new dimensions
of connectedness with other people and the world”
(Newman, 2010).

24. Humans are open to the whole energy system of the
universe and constantly interacting with the energy. With
this process of interaction humans are evolving their
individual pattern of whole.
According to Newman understanding the pattern is
essential. The expanding consciousness is the pattern
recognition.
The manifestation of disease depends on the pattern of
individual so the pathology of the diseases exists before the
symptoms appear so removal of disease symptoms does not
change the individual structure.

25. According to her nursing is the process of recognizing
the individual in relation to environment and it is the
process of understanding of consciousness.
The nurse helps to understand people to use the power
within to develop the higher level of consciousness.
Thus it helps to realize the disease process, its recovery
and prevention.

26. Newman also explains the interrelatedness of time,
space and movement.
Time and space are the temporal pattern of the
individual, both have complementary relationship.
Humans are constantly changing through time and
space and it shows unique pattern of reality.

28. Strengths
Can be applied in any setting
“Generates caring interventions”

29. Weaknesses
Abstract
Multi-dimensional
Qualitative
Little discussion on environment

31. PRACTICE
Newman’s model of Health is useful in the practice of
nursing because it contained concepts used by the
nursing profession. Movement and time are an
intrinsic part of nursing intervention, that is, range-of-
motion, ambulation, turning, coughing, and deep-
breathing. These parameters are used each day by the
nurse in practice.

32. EDUCATION
Newman did not advocate one model as the sole basis
for curriculum. Rather, students should have the
opportunity to study various approaches to health and
nursing and to choose what is relevant to them in their
practice and research.

33. RESEARCH
Some researchers have attempted to test Newman’s
propositions of time, space, and movement.
*A negative correlation was found between depression and
subjective time – findings do not support an increasing level
of consciousness with age.
Cooperative inquiry or interactive, integrative participation
- Newman stated that research should center around
“participatory investigations in which subjects (clients) are
our partners, our core-searchers, in our search for health
patterns.”

34. CRITIQUE
Clarity - Semantic clarity is evident in the definitions,
descriptions, and dimensions of the concepts of the theory.
Simplicity – The deeper meaning of the theory of health as
expanding consciousness is complex; The theory as a whole
must be understood, not just the isolated concepts.
Generality – generalizable; has been applied in several
different cultures; applicable across the spectrum of
nursing care situations.

35. CRITIQUE
Empirical Precision – aspects of the theory have been
operationalized and tested within a traditional scientific
mode. However, quantitative methods are limited in
capturing the dynamic, changing nature of this model.
Qualitative approaches are being developed for a full
explication of its meaning and application
Derivable Consequences – The domain of health is the
nursing process. The model would be useful for guiding
nursing practice and differentiating nursing’s area of
concern; has received recognitions regarding application to
practice

36. References
www.currentnursing.com
Tomey, A.M., (1994). Nursing Theorists and Their
Work. 3rd ed. Missouri: Mosby
http://healthasexpandingconsciousness.org/

37. THANK YOU!