2. OBJECTIVES
Become familiar with nursing theorist Martha
Rogers
Identify the concepts of this Nursing Theory
Understand how Roger’s theory can be applied to
clinical situations
2
3. Background
Eldest of four children
Born on May 12, 1914 in Dallas, Texas
Died : March 13 , 1994
Parents :
Bruce Taylor Rogers
Lucy Mulholland Keener Rogers
3
5. Credentials of the Theorist
Diploma :Knoxville General Hospital School of Nursing
(1936)
Graduation in Public Health Nursing, George Peabody
College, Nashville , Tennessee (1937)
MA in Public Health Nursing Supervision : 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
5
6. Rural public health nurse in Michigan
Visiting nurse supervision, education, and practice
in Connecticut
Established the Visiting Nurse Service of Phoenix,
Arizona
Professor and head of the Division of Nursing at New
York University (1945-1975)
Professor Emerita (1979)
6
7. Rogers publication include 3 books and more than
200 articles.
She lectured in 46 states.
Received honorary doctorates from such renowned
institutions as Duquesne University, University of
San Diego, Iona College, Fairfield University, Emory
University, Adelphi University, Mercy College, and
Washburn University of Topeka.
7
8. “Inspiring Leadership in the Field of Intergroup
Relations” by Chi Eta Phi Sorority
“In Recognition of Your Outstanding Contribution to
Nursing” by New York University
“For Distinguished Service to Nursing” by Teachers
College
New York University houses the Martha E. Rogers
Center for the Study of Nursing Science
In 1996, Rogers was posthumously inducted into the
American Nurses Association Hall of Fame
8
9. Origins
Rogers was one of the first nurse scholars to
explicitly identify the person (unitary man) as the
central phenomena of nursing concern
1970 – Science of Unity Human Beings (SUHB)
Rogers realized there had to be something to know
in nursing that required increased education for its
transmission
(Fawcett interview, n.d.)
9
10. Purpose
• SUHB theory offers a new look at nursing,
providing a framework for practice, education and
research that moves away from the traditional
medical model approach to the delivery of nursing
care
(Fawcett interview, n.d.)
To promote human-environment field patterning
and the nursing process
(n.a., 2009, para.
11)
10
13. The “Slinky”
Imagine the life process moving along the “Slinky”
spirals with the human field occupying space along
the spiral and extending out in all directions from
any given location along a spiral. Each turn of the
spiral exemplifies the rhythmical nature of life, while
distortions of the spiral portray deviations from
nature’s regularities. Variations in the speed of
change through time may be perceived by narrowing
or widening the distance between spirals.
13
14. Major Concepts
Human-unitary human beings
“Irreducible, indivisible, multidimensionality energy
fields identified by pattern and manifesting
characteristics that are specific to the whole and
which cannot be predicted from the knowledge of the
parts.”
14
15. Health
“Unitary human health signifies an irreducible human
field manifestation. It cannot be measured by the
parameters of biology or physics or of the social
sciences.
Nursing
“The study of unitary, irreducible, indivisible human
and environmental fields: people and their world.”
15
16. Scope of Nursing
Nursing aims to assist people in achieving their
maximum health potential. Maintenance and
promotion of health, prevention of disease, nursing
diagnosis, intervention, and rehabilitation
encompass the scope of nursing’s goals.
Nursing is concerned with people-all people-well
and sick, rich and poor, young and old. The arenas of
nursing’s services extend into all areas where there
are people: at home, at school, at work, at play; in
hospital, nursing home, and clinic; on this planet
and now moving into outer space.
16
17. Environmental Field
“An irreducible, indivisible, pandimensional energy field indentified by
pattern and integral with the human field.”
Energy Field
“The fundamental unit of the living and non-living. Field is a unifying
concept. Energy signifies the dynamic nature of the field; a field is in
continuous motion and is infinite.”
An energy field identifies the conceptual boundaries of man. This field
is electrical in nature, is in continual state of flux, and varies
continuously in its intensity, density, and extent. (Rogers, 1970)
17
18. Subconcepts
Openness
“Refers to qualities exhibited by open systems;
human beings and their environment are open
systems.”
Pandimensional
“A nonlinear domain without spatial or temporal
attributes.”
18
19. Synergy is defined as the unique behavior of whole
systems, unpredicted by any behaviors of their
component functions taken separately.
Human behavior is synergistic.
Pattern
“The distinguishing characteristic of an energy field
perceived as a single wave.”
19
20. Principles of Homeodynamics
Homeodynamics should be understood as a
dynamic version of homeostasis (a relatively steady
state of internal operation in the living system).
Principle of Reciprocity
Postulates the inseparability of man and environment
and predicts that sequential changes in life process
are continuous, probabilistic revisions occurring out
of the interactions between man and environment.
20
21. Principle of Synchrony
This principle predicts that change in human
behavior will be determined by the simultaneous
interaction of the actual state of the human field and
the actual state of the environmental field at any
given point in space-time.
21
22. Principle of Integrality (Synchrony +
Reciprocy)
Because of the inseparability of human beings and
their environment, sequential changes in the life
processes are continuous revisions occurring from the
interactions between human beings and their
environment.
Between the two entities, there is a constant mutual
interaction and mutual change whereby simultaneous
molding is taking place in both at the same time.
22
23. Principle of Resonancy
It speaks to the nature of the change occurring
between human and environmental fields. The life
process in human beings is a symphony of
rhythmical vibrations oscillating at various
frequencies.
It is the identification of the human field and the
environmental field by wave patterns manifesting
continuous change from longer waves of lower
frequency to shorter waves of higher frequency.
23
24. Principle of Helicy
The human-environment field is a dynamic, open
system in which change is continuous due to the
constant interchange between the human and
environment.
This change is also innovative. Because of constant
interchange, an open system is never exactly the
same at any two moments; rather, the system is
continually new or different. (Rogers, 1970)
24
25. Science of Unitary Human Beings
• Five basic assumptions underlay Rogers'
conceptual framework:
1. Wholeness
2. Openness
3. Unidirectionality
4. Pattern and Organization
5. Sentience and Thought
(Rogers as cited in Barrett, 2009, para. 4)
25
26. Science of Unity Human Beings
There are four main topics (metaparadigms) that are
addressed by nursing theorists:
1. People
2. Environment
3. Health
4. Nursing
(Rogers as cited in Barrett, 2009, para. 5)
26
28. Application to Nursing
Promote health
Positive optimistic approach
“The study of unitary, irreducible, indivisible human
& environmental fields: people and their world.”
(Rogers as cited in McEwen & Wills, 2007, p.204)
28
29. Application to Environment
Continually exchanging energy with the unitary
human being
Constant state of change
Helix
Represents environment energy field
Co-existing & interactive with unitary human
29
31. Application to Person
Unitary energy system
Whole entity – sum of the parts
Continually exchanging energy with the
environment
“These energy fields may be described as open
systems, with each person having his/her own
unique pattern of energy which constitutes the
person’s identity.”
(Tettero, Jackson, & Wilson, 1993, p.777)
31
36. Strengths
Rogers’ concepts provide a worldview from which
nurses may derive theories and hypotheses and
propose relationships specific to different situations.
Rogers’ work is not directly testable due to lack of
concrete hypotheses, but it is testable in principle.
36
37. Weaknesses
It is an abstract, unified, and highly derived
framework and does not define particular
hypotheses or theories.
Concepts are not directly measurable thus testing the
concepts’ validity is questionable.
It is difficult to comprehend because the concepts
are extremely abstract.
Nurses’ roles were not clearly defined.
No concrete definition of health state.
37
39. Clarity
Major elements of Rogers’ work:
5 key definitions
3 principles of homeodynamics
6 assumptions
This approach appears simplistic
But is difficult for nurses to understand
Too abstract
Parsimony
(McEwen & Wills, 2007)
39
40. Simplicity
• “Ongoing studies and work within the model
have served to simplify and clarify some of the
concepts and relations. However, when the
model is examined in total perspective, some still
classify it as complex”
• More work is required: use in practice, research
and education needed
• May determine that the model is simple
(Tomey & Alligood, 2006)
40
41. Generality
Rogers’ theory is a synthesis of phenomena
Important to nursing
Abstract, unified, and highly derived framework
Does not define particular hypotheses or theories
Instead provides a worldview
Nurses may derive theories and hypotheses and
propose relationships specific to different situations
(McEwen & Wills, 2007)
41
43. Empirical Precision
Early criticism identified
major limitations
Difficult to understand
principles
Lack of working
definitions
Poor tools for
measurement
Deductive in logic
Characteristic lack of
immediate empirical
support
(Tomey & Alligood, 2006)
43
44. Derivable Consequences
Intends to assist in the understanding of human
evolution and human potential
Organized in a manner that place nursing’s identity as
a science
Focus is on the human and environmental connection
as highly significant
Many have used the conceptual model for research
(Tomey & Alligood, 2006)
44
46. References
Fawcett, J. (n.d.). Interview of Martha Rogers nursing theory [Video file]. Retrieved
from http://www.youtube.com/watch?v=V1XN3rPKndE
Heggie, J., Schoenmehl, P., Chang, M., & Grieco, C. (1989). Selection and
implementation of Dr. Martha Rogers' nursing conceptual model in an acute
care setting. Clinical Nurse Specialist: The Journal for Advanced Nursing
Practice, 3(3), 143-147.
Hellwig, S. & Ferrante, S. (1993). Martha Rogers’ model in associate degree
education. Nurse Educator, 18(5), 25-27.
McEwen, N. & Wills, E. (2007). Theoretical basis for nursing (2nd
ed.). Philadelphia,
PA: Lippincott, Williams & Wilkin
n.a. (2009). Martha Rogers. Retrieved from
http://www.scribd.com/doc/17667393/NURSING-THEORIST-MARTHA-
ROGERS
46
47. References
Read, P., Shearer, N., & Nicoll, L. (2004). Perspectives on nursing theory (2nd
ed.).
Philadelphia, PA: Lippincott, Williams & Wilkin
Tettero, I., Jackson, S., and Wilson, S. (1993). Theory to practice: Developing a
Rogerian-based assessment tool. Journal of Advance Nursing, 18(5), 776-782.
doi:10.1046/j.13652648. 1993.18050776.x
Tomey, A. & Alligood, M. (2006). Nursing theorists and their work (6th
ed.). St.
Louis, MO: Mosby Elsevier.
Wright, B. W. (2007). The evolution of Rogers’ s Science of Unitary/Human
Beings: 21st
century reflections. Nursing Science Quarterly, 20(1), 64-67.doi:
10.1177/089-4318406296295
47
Prior to 1970 – Rogers wrote two books prior to 1970, which she actually introduced the ideas of her theories at “an embryonic stage.”Rogers realized – she said this and thought she better get out of this and go back to public health (Fawcett, n.d.).
Read, Shearer, and Nicoll (2009) state that “perhaps one of the reasons why Rogers’ theory has drawn so much attention and stimulated so much debate is because it appears to be nursing’s first attempt to philosophize on a grand scale. Rogerian science attempts to describe the entire universe, while focusing in depth on unitary man within that universe (p. 306).
Roger’s asked herself: What are people like?
What is human development like?
What is evolution?
What is the world we live in?
What do we need to know to serve people?
**All of these are relevant to nursing**
“Nursing seeks to promote symphonic interaction between the environment and man, to strengthen the coherence and integrity of the human beings, and to direct and redirect the patterns of interaction between man and his environment for the realization of maximum health potential” (Fawcett interview, n.d.).
When first introduced it was considered radical, and difficult to understand, but now is simply thought to be ahead of its time. This conceptual framework has greatly influenced all facets of nursing by offering an alternative to traditional approaches of nursing (n.a., 2009, para. 7).
Although Rogers’ related art to practice, she excludes nursing art as something worthy of study when she discourages the study of nursing practice. It is crucial that nurses understand how they affect patients and how they can facilitate and promote transitions from one state of health to another. To comprehend this fully, nurses need to understand the art of nursing (Read, et al., 2004, p. 503).
First, the human being is considered a unified whole which is more than the sum of its parts. Second, the person and the environment are continuously exchanging matter and energy with each other. Third, the life process exists along an irreversible space time continuum. Fourth, pattern and organization are used to identify individuals and mirror their wholeness. Fifth, human beings are the only organisms able to think abstractly, have language, sensation and emotion.
Wholeness - in which the human being is regarded as a unified
whole which is more than and different from the sum of the parts.
Openness - where the individual and the environment are
continuously exchanging matter and energy with each other.
Unidirectionality - where the life process exists along an
irreversible space time continuum.
Pattern and Organization - which identifies individuals and
reflects their innovative wholeness.
Sentience and Thought - which states that of all life, human
beings, are the only ones capable of abstraction and imagery,
language and thought, sensation and emotion.
(n.a., 2009,
A Person is defined by Rogers as a being and energy field in constant interaction with the environment. A person is an open system, more than the sum of its parts. The environment is an energy field including everything that is not the person. Next, health is viewed in terms of choosing actions that lead to the fulfillment of a person's potential, and lastly, nursing tries to direct the interaction of the person and the environment in order to maximize health potential (Rogers as cited in Barrett, 2009, para. 5).
Denise Starts here:
The influence of one’s own individuality is influenced by one’s own environment and vice versa.
Article by Terrero, Jackson, Wilson wrote that Rogers defined health as “representation of the process of life in which there are no predetermined norms”. When you think about the word “norm” you can compare life expectancy of today to life expectancy to 1900. The term “norm” has also changed from then to now especially as we see diseases that didn’t exist before. We are learning that our health behaviors (actions) and diseases have a domino effect. An example is, having an earache, the earache affects our ear, the pain affects our disposition.
Choices, culture, behavior all affect our health. We relate our level of health to our level of illness.
Promote Health -Have you ever heard a nurse or provider describe how healthy a patient is according to what their health status is? Rogers is first to focus on the patient as whole that included not just body part, but body, mind, and soul.
One goal of nursing is health promotion and as nurses we need to focus on the person as a unified whole. By focusing on the whole person nurses need to individualize their assessment for the patient and also personalize the patients interventions.
Positive optimistic approach will help patients reach what is their idea of greatest level of well-being.
As cited in McEwen & Wills, “quote from slide”
Rogers theory is knowledge base for nurses to guide their evolving practice to understanding relationship between individuals & their environment. Nurses are encouraged to promote their patients health by using methods such as therapeutic touch, imagery, meditation and humor to name a few.
Prior to Rogers, nurses provided patients (receivers of care) focused on functions such as medication administration or dressing change rather than on the whole person. This type of practice took many professionals to care for a patient in isolation and none of whom who actually knew the whole person.
Continually exchanging energy with the unitary human being: The environment is a wave pattern – an abstraction – open system focus on real world and it’s environment. Main point of Roger’s theory relating to the environment is the unique human energy field pattern is integrated with the unique environment field pattern. As one changes, so does the other.
Both are in constant state of change/flux & strength.
Helix – represents environment energy field which co-exist and interacts with unitary human, an example from the article by Tettero, Jackson and Wilson is that the concept of helicy can be compared to the seasons. Summer always follows Spring, and precedes autumn, yet no two summers are exactly alike.
The Science of Irreducible and Unitary Human Being focus is about seeing the whole picture, person plus environment – cannot be understood in isolation of each other.
Person: an irreducible, indivisible, pandimensional energy field identified by patterns of manifesting characteristics that are specific to the whole and cannot be predicted from the parts (Rogers, 1992).
Continuous energy exchange with environment (both open systems)
Capable of abstraction (thought), conscious, responsive, thinking beings
As stated in an article by Tettero, Jackson & Wilson, ”quote”
Seen overlap of the unitary being, environment, health, and nursing.
Provides framework for nursing education, serves as a guide to nursing practice, used in research to determine effectiveness of nursing practice, and continue use of alternative therapy.
This diagram shows the importance of health promotion which is one of the emphasis of Roger’s theory. As nurses we need to educate our patients to maintain their health by promoting positive healthy habits so we prevent illness. As nurses we care of the ill and we need to enable our patients to achieve their highest level of independence prior to discharge.
Rogers (1986) stated the purpose of nursing - - - “Help human beings achieve well being within the potential of each individual, family, or group,” McEwen & Wills, (2007, p.205) Example: Therapeutic touch and imagery for pain control and self-healing.
Dr. Gean Mathwig, nurse leader in Rogers model (as cited in an article by Heggie, Schoenmehl, Chang & Grieco) used Rogers theory when she allowed a cancer patient that was not taking his medications when offered and would stay up at night roaming the halls meanwhile complaining of pain, to make his own choices as to when his activities were done and medications taken. When patients are supported in their decisions and nurses are flexible in meeting individual patient needs, patient outcomes and goals are more obtainable and the patient may then become compliant with the treatments. (There will be more information on this research project later in the presentation).
Pat starts here:
The theory consists of major elements:
5 key definitions
3 principles of homeodynamics
6 assumptions
Approach appears to be simplistic
But is difficult to understand for nurses
Too abstract
While Rogers’ Theory is simple in elements… the elements are not clear due to their abstract level.
PARSIMONY:
Considering clarity needs us to look at the parsimony of the theory.
Our text, McEwen and Wills refers to parsimony as a criterion to evaluate theory. P. 128
We recall parsimony is the complexity of a theory due to the abstract nature of the theory’s elements
Rogers’ Theory is relatively parsimonious
McEwen, N, & Wills, E. (2007). Theoretical basis for nursing (2nd ed.). Philadelphia, PA: Lippincott, Williams & Wilkins
Tomey and Alligood related Rogers’ model is still classified as complex
Continued use in practice, research and education is still required
Proposed that the more work and use with Rogers’ theory a shift to appreciate the model’s elegant simplicity is expected
McEwen and Wills explain that Rogers’ theory is an abstract model which makes it generalizable to nursing practice. p. 205
For these reasons:
Rogers’ theory is a synthesis of phenomena
Important to nursing
Abstract, unified, and highly derived framework
Does not define particular hypotheses or theories
Instead provides a worldview
Therefore, nurses may derive theories and hypotheses and propose relationships specific to different situations
McEwen, N, & Wills, E. (2007). Theoretical basis for nursing (2nd ed.). Philadelphia, PA: Lippincott, Williams & Wilkins
Hellwig and Ferrante, in article from Nurse Educator relate the use of Rogers Theory in the constructs of an associate degree nursing program.
This is the first ADN program to adopt this theory.
Review Slide….
Because of deductive logic in the theory it is not directly testable – testable in principle
The theory draws on a multitude of scientific disciplines, consequently which lacks empirical support
Fawcett (1995) contends Rogers work is a conceptual module rather than a theory which leads to misunderstandings and inappropriate expectations
Tomey, A. & Alligood, M. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby Elsevier.
Conceptual model that is useful in all areas of practice, education and research.
Tomey, A. & Alligood, M. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby Elsevier.
Rogers’ Theory is moving into the next century by nursing scholars and practioners.
Tomey, A. & Alligood, M. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby Elsevier.
