1.By :Nelson P. Tagab/Zenaida Z. Zagado

2. Theory Has been defined as a supposition or system of ideas that is proposed to explain a given phenomena. 3. Florence NightingalessEnvironmental Theory considered the founder ofeducated and scientificnursingand widely known as "The Lady with the Lamp wrote the first nursing notes that became the basis of nursing practice and research. The notes, entitledNoteson Nursing: What it is, What is not (1860) Considered thefirst nursing theorist. 4. Defined Nursing: The act of utilizing the environmentof the patient to assist him in his recovery. Focuses on changing and manipulating the environment inorder to put the patient in the best possible conditions fornature to act. Identified 5 environmental factors: fresh air, pure water,efficient drainage, cleanliness/sanitation and light/directsunlight. Considered a clean, well-ventilated, quiet environmentessential for recovery. Deficiencies in these 5 factors produce illness or lack ofhealth, but with a nurturing environment, the body couldrepair itself. 5. Hildegard Peplaus InterpersonalRelations Theory isa psychiatric nurse,Introduced her interpersonalconcept in 1952. Defined Nursing: Aninterpersonal processoftherapeutic interactionsbetween an Individual who issick or in need of healthservices and a nurse especiallyeducated to recognize, respondto the need for help. Nursing is a maturing forceand an educative instrument 6. Identified 4 phases of the Nurse Patient relationship: Orientation individual/family has a felt need and seeks professional assistance from a nurse (who is a stranger). This is the problem identification phase. Identification where the patient begins to have feelings of belongingness and a capacity for dealing with the problem, creating an optimistic attitude from which inner strength ensues. Here happens the selection of appropriate professional assistance. Exploitation the nurse uses communication tools to offer services to the patient, who is expected to take advantage of all services. Resolution where patients needs have already been met by the collaborative efforts between the patient and the nurse. Therapeutic relationship is terminated and the links are dissolved, as patient drifts away from identifying with the nurse as the helping person. 7. Virginia Hendersons Definitionof the Unique Function of Nursing Defined Nursing: Assisting the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that an individual would perform unaided if he had the necessary strength, will or knowledge. 8. Identified 14 basic needs : Breathing normally Eating and drinking adequately Eliminating body wastes Moving and maintaining desirable position Sleeping and resting Selecting suitable clothes Maintaining body temperature within normal range Keeping the body clean and well-groomed Avoiding dangers in the environment Communicating with others Worshipping according to ones faith Working in such a way that one feels a sense of accomplishment Playing/participating in various forms of recreation Learning, discovering or satisfying the curiosity that leads to normal development and health and using available health facilities. 9. Madeleine Leiningers Transcultural CareTheory and Ethnonursing A well-known nurse anthropologist,put her views on transcultural nursingin print in the 1970s and then in 1991published her book Culture carediversity and universality: A theory ofNursing Nursing is a learned humanistic andscientific profession and disciplinewhich is focused on human carephenomena and activities in order toassist, support, facilitate, or enableindividuals or groups to maintain orregain their well being (or health) inculturally meaningful and beneficialways, or to help people face handicapsor death. 10. Transcultural nursing as a learned subfield or branchof nursing which focuses upon the comparative studyand analysis of cultures with respect to nursing andhealth-illness caring practices, beliefs and values withthe goal to provide meaningful and efficacious nursingcare services to people according to their culturalvalues and health-illness context. Focuses on the fact that different cultures havedifferent caring behaviors and different health andillness values, beliefs, and patterns of behaviors. Awareness of the differences allows the nurse to designculture-specific nursing interventions. 11. In order for nurses to assist people of diverse cultures,Lenienger presents three intervention modes:1. Culture care preservation and maintenance .2. Culture care accommodation, negotiation, or both3. Culture care restructuring and repatterning. 12. Dorothea Orems General Theory of Nursing Defined Nursing: The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness. Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well-being. Has a strong health promotion and maintenance focus. 13. Identified 3 related concepts:1. Self-care activities an Individual performs independently throughout life to promote and maintain personal well-being.2. Self-care deficit results when self-care agency (Individuals ability) is not adequate to meet the known self-care needs.3. Nursing System nursing interventions needed when Individual is unable to perform the necessary self-care activities: 14. Self-care theory is based on four concepts:1. Self care- refers to those activities an individual performs independently throughout life to promote and maintain personal well-being.2. Self care agency- is the individuals ability to perform self care activities. It consists of two agents: a self-care agent(an individual who performs self-care independently) and a dependent care agent (a person other than the individual who provides the care)3. Self-care requisites- are groups of needs or requirements that Orem identified. They are classified as either:a) Universal self-care requisites - those needs that all people haveb) Developmental self-care requisites - 1. maturational: progress toward higher level of maturation. 2. situational: prevention of deleterious effects related to development.c) Health deviation requisites - those needs that arise as a result of a patients condition. Result from illness, injury or disease or its treatment. They include actions such as seeking health care assistance ,carrying out prescribed therapies, and learning to live with the effects of illness or treatment. 15. 4. Therapeutic self-care demand-refers to all self- care activities required to meet existing self-care requisites, or in other words, actions to maintain health and well-being. 16. Self care deficit- results when self care agency is not adequate to meet the known self-care demand. This theory explains not only nursing is needed but also how people can be assisted through five methods of helping: acting or doing for, guiding, teaching, supporting, and providing an environment that promotes individuals abilities to meet current and future demands. 17. Orems 3 types of Nursing Systems:1.Wholly compensatory nurse provides entire self-care for theclient. Example: care of a new born, care of client recovering from surgery in a post-anesthesia care unit2. Partial compensatory nurse and client perform care, client canperform selected self-care activities, but also accepts care done bythe nurse for needs the client cannot meet independently. Example: Nurse can assist post operative client to ambulate, Nurse can bring a meal tray for client who can feed himself3. Supportive-educative nurses actions are to help the clientdevelop/learn their own self-care abilities through knowledge,support and encouragement. Example: Nurse guides a mother how to breastfeed herbaby, Counseling a psychiatric client on more adaptive copingstrategies. 18. Imogene Kings Goal Attainment Theory Nursing is a process of action, reaction,and interaction whereby nurse andclient share information about their perception in the nursing situation 19. King used a systems approach in the developmentof her dynamic interacting systems framework and inher subsequent Goal-Attainment Theory. She developed a general systems framework and atheory of goal attainment where the framework refersto the three interacting systems -individual orpersonal, group or interpersonal, and society or social,while the theory of goal attainment pertains to theimportanceof interaction,perception,communication, transaction, self, role, stress, growthand development, time, and personal space. King emphasizes that both the nurse and the clientbring important knowledge and information to therelationship and that they work together to achievegoals. 20. The relationship of three interacting systems led toKings Theory of Goal Attainment are the personalsystem (individual), the interpersonal system (nurse-patient dialogue), and the social system (the family,the school, and the church). Each system is givendifferent concepts.1) The concepts for the personal system are:perception, self, growth and development, bodyimage, space, and time. These are fundamentals inunderstanding human being because this refersto how the nurse views and integrates self basedfrom personal goals and beliefs. 21. Among all these concepts, the most important isperception, because it influences behavior. King summarized the connections among theseconcepts as An individual Perception of self, of bodyimage, of time, of space influences the way he or sheresponds to object and events in his/her life. As individuals grow and develop through the lifespanexperiences with changes in structure and function oftheir bodies over time influence their perceptions ofself2. Personal systems are individuals, who are regardedas rational, sentient, social beings. 22. Concepts related to the personal system are:a) Perception a process of organizing, interpreting, and transforming information from sense data and memory that gives meaning to ones experience, represents ones image of reality, and influences ones behavior.b) Self a composite of thoughts and feelings that constitute a persons awareness of individual existence, of who and what he or she is.c) Growth and development cellular, molecular, and behavioral changes in human beings that are a function of genetic endowment, meaningful and satisfying experiences, and an environment conducive to helping individuals move toward maturity.d) Body imagea persons perceptions of his or her body.e) Timethe duration between the occurrence of one event and the occurrence of another event.f) Spacethe physical area called territory that exists in all directions.g) Learninggaining knowledge. 23. The concepts associated for the interpersonalsystem are: interaction, communication, transaction,role, and stress. King refers to two individuals as dyads, three as triadsand four or more individuals as small group or largegroup . This shows how the nurse interrelates with a co-worker or patient, particularly in a nurse-patientrelationship. Communication between the nurse and the client canbe verbal or nonverbal. Collaboration between theDyads (nurse-patient) is very important for theattainment of the goal. 24. The concepts associated with this system are:a) Interactionsthe acts of two or more persons in mutual presence; a sequence of verbal and nonverbal behaviors that are goal directed.b) Communicationthe vehicle by which human relations are developed and maintained; encompasses intrapersonal, interpersonal, verbal, and nonverbal communication.c) Transactiona process of interaction in which human beings communicate with the environment to achieve goals that are valued; goal-directed human behaviors.d) Rolea set of behaviors expected of a person occupying a position in a social system.e) Stressa dynamic state whereby a human being interacts with the environment to maintain balance for growth, development, and performance, involving an exchange of energy and information between the person and the environment for regulation and control of stressors.f) Copinga way of dealing with stress. 25. action reaction Disturbance(problem) Interpersonal Mutual goal setting and decision making dyad Exploration if means to achieve the(Nurse-client)-goalinteraction Agreement on means to achievethe goalsTransaction directly observable Goal attainmentKings definition of interaction and transaction 26. 3.The final interacting system is the social system. This shows how the nurse interacts with co workers,superiors, subordinates and the client environment ingeneral. These are groups of people within the community orsociety that share a common goals, values and interests. It provides a framework for social interaction andrelationships and establishes rules of behavior and coursesof action. Social systems are organized boundary systems of socialroles, behaviors, and practices developed to maintainvalues and the mechanisms to regulate the practices androles. 27. The concepts related to social systems are:a) Organizationcomposed of human beings with prescribed roles and positions who use resources to accomplish personal and organizational goals.b) Authoritya transactional process characterized by active, reciprocal relations in which members values, backgrounds, and perceptions play a role in defining, validating, and accepting the authority of individuals within an organization.c) Powerthe process whereby one or more persons influence other persons in a situation.d) Statusthe position of an individual in a group or a group in relation to other groups in an organization.e) Decision makinga dynamic and systematic process by which goal-directed choice of perceived alternatives is made and acted upon by individuals or groups to answer a question and attain a goal.f) Controlbeing in charge. 28. Among the three systems, the conceptual framework ofInterpersonal system had the greatest influence on thedevelopment of her theory. She stated that Although personal systems and socialsystems influence quality of care, the major elements in atheory of goal attainment are discovered in theinterpersonal systems in which two people, who are usuallystrangers, come together in a health care organization tohelp and to be helped to maintain a state of health thatpermits functioning in roles 29. Finally according to her, nursings focus is on the care of the patient, and its goal is the health care of patients and groups of patients. 30. Callista Roys Adaptation Theory SisterCallistaRoy definesadaptation as the process andoutcome whereby the thinking andfeeling person uses consciousawareness and choice to createhuman andenvironmentalintegration. This model comprises the fourdomain concepts of person, health,environment, and nursing andinvolves a six step nursing process 31. 1) Roys models sees the person as "a biopsychosocialbeing in constant interaction with a changingenvironment The person is an open, adaptive system who usescoping skills to deal with stressors.2) Roy sees the environment as "all conditions,circumstances and influences that surround and affectthe development and behaviour of the person". Roy describes stressors as stimuli and uses the termresidual stimuli to describe those stressors whoseinfluence on the person is not clear . 32. 3) Originally, Roy wrote that health and illness are on acontinuum with many different states or degrees possible.More recently, she states that health is the process of beingand becoming an integrated and whole person4) Roys goal of nursing is "the promotion of adaptation ineach of the four modes, thereby contributing to thepersons health, quality of life and dying with dignity".These four modes are physiological, self-concept, rolefunction and interdependence. 33. A. Inthe Physiologic mode, adaptation involves themaintenance of physical integrity. Basic human needssuch as nutrition, oxygen, fluids, and temperatureregulation are identified with this mode. In assessing a family, the nurse would ask how the familyprovides for the physical and survival needs of the familymembers.B. A function of the Self-concept mode is the need formaintenance of psychic integrity. Perceptions of onesphysical and personal self are included in this mode. Families also have concepts of themselves as a family unit.Assessment of the family in this mode would include theamount of understanding provided to the family members,the solidarity of the family. the values of the family, theamount of companionship provided to the members, andthe orientation (present or future) of the family. 34. C. The need for social integrity is emphasized in theRole function mode. When human beings adapt tovarious role changes that occur throughout a lifetime,they are adapting in this mode. According to Hanson, the familys role can be assessedby observing the communication patterns in thefamily. Assessment should include how decisions arereached, the roles and communication patterns of themembers, how role changes are tolerated, and theeffectiveness of communication. For example, when a couple adjusts their lifestyleappropriately following retirement from full-timeemployment, they are adapting in this mode. 35. D.The need for social integrity is also emphasized in theinterdependence mode. Interdependence involves maintaining a balance betweenindependence and dependence in ones relationships withothers. Dependent behaviors include affection seeking, helpseeking, and attention seeking. Independent behaviors include mastery of obstacles andinitiative taking. According to Hanson, when assessing this mode infamilies, the nurse tries to determine how successfully thefamily lives within a given community. The nurse would assess the interactions of the family withthe neighbors and other community groups, the supportsystems of the family, and the significant others . 36. The goal of nursing is to promote adaptation of theclient during both health and illness in all four of themodes. Actions of the nurse begin with the assessmentprocess, The family is assessed on two levels. First, thenurse makes a judgment with regard to the presence orabsence of maladaptation. Then, the nurse focuses the assessment on the stimuliinfluencing the familys maladaptive behaviors. Thenurse may need to manipulate the environment, anelement or elements of the client system, or both inorder to promote adaptation . 37. Roy employs a six-step nursing process whichincludes: assessment of behaviour, assessment ofstimuli, nursing diagnosis, goal setting,intervention and evaluation. In the first step, the persons behaviour in each of thefour modes is observed. This behaviour is thencompared with norms and is deemed either adaptiveor ineffective. The second step is concerned with factors thatinfluence behaviour. Stimuli are classified as focal,contextual or residual. 38. The nursing diagnosis is the statement of theineffective behaviours along with the identification ofthe probable cause. In the fourth step, goal setting is the focus. Goals needto be realistic and attainable and are set incollaboration with the person. Intervention occurs as the fifth step, and this is whenthe stimuli are manipulated. It is also called the doingphase. In the final stage, evaluation takes place. The degree ofchange as evidenced by change in behaviour, isdetermined. Ineffective behaviours would bereassessed, and the interventions would be revised 39. Jean Watsons The Philosophy and Science of Caring The Philosophy and Science of Caring has four major concepts: human being, health, environment/society, and nursing.Jean Watson refers to the human being as "a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in general a philosophical view of a person as a fully functional integrated self. Human is viewed as greater than and different from the sum of his or her parts." 40. 1) Health is defined as a high level of overall physical, mental, and social functioning; a general adaptive-maintenance level of daily functioning; and the absence of illness, or the presence of efforts leading to the absence of illness.2) Watsons definition of environment/society addresses the idea that nurses have existed in every society, and that a caring attitude is transmitted from generation to generation by the culture of the nursing profession as a unique way of coping with its environment.3) The nursing model states that nursing is concerned with promoting health, preventing illness, caring for the sick, and restoring health. It focuses on health promotion, as well as the treatment of diseases. Watson believed that holistic health care is central to the practice of caring in nursing. She defines nursing as "a human science of persons and human health- illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions." 41. 4) The nursing process outlined in the model contains thesame steps as the scientific research process: assessment,plan, intervention, and evaluation. The assessment includes observation, identification, andreview of the problem, as well as the formation of ahypothesis. Creating a care plan helps the nurse determine howvariables would be examined or measured, and what datawould be collected. Intervention is the implementation of the care plan anddata collection. Finally, the evaluation analyzes the data, interprets theresults, and may lead to an additional hypothesis. 42. Watsons model makes sevenassumptions: Caring can be effectively demonstrated and practiced onlyinterpersonally. Caring consists of carative factors that result in the satisfactionof certain human needs. Effective caring promotes health and individual or familygrowth. Caring responses accept the patient as he or she is now, as well aswhat he or she may become. A caring environment is one that offers the development ofpotential while allowing the patient to choose the best action forhim or herself at a given point in time. A science of caring is complementary to the science of curing. The practice of caring is central to nursing. 43. The first three carative factors are the "philosophicalfoundation" for the science of caring, while theremaining seven derive from that foundation. The tenprimary carative factors are: The formation of a humanistic-altruistic system of values,which begins at an early age with the values shared byparents. The system of values is mediated by the nurses lifeexperiences, learning gained, and exposure to thehumanities. It is perceived as necessary to the nursesmaturation which in turn promotes altruistic behaviortoward others. The installation of faith-hope, which is essential to thecarative and curative processes. When modern science hasnothing else to offer a patient, a nurse can continue to usefaith-hope to provide a sense of well-being through a beliefsystem meaningful to the individual. 44. The cultivation of sensitivity to ones self and to others,which explores the need of nurses to feel an emotion as itpresents itself. The development of a nurses own feeling isneeded to interact genuinely and sensitively with patients.By striving to become more sensitive, the nurse is moreauthentic. This encourages self-growth and self-actualization in both the nurse and the patients whointeract with the nurse. The nurses promote health andhigher-level functioning only when they form person-to-person relationships. The development of a helping-trust relationship, whichincludes congruence, empathy, and warmth. The strongesttool a nurse has is his or her mode of communication,which establishes a rapport with the patient, as well ascaring by the nurse. Communication includes verbal andnonverbal communication, as well as listening thatconnotes empathetic understanding. 45. The promotion and acceptance of the expression ofboth positive and negative feelings, which need to beconsidered and allowed for in a caring relationshipbecause of how feelings alter thoughts and behavior.The awareness of the feelings helps the nurse andpatient understand the behavior it causes. The systematic use of the scientific method forproblem-solving and decision-making, which allowsfor control and prediction, and permits self-correction.The science of caring should not always be neutral andobjective. 46. The promotion of interpersonal teaching-learning,since the nurse should focus on the learning process asmuch as the teaching process. Understanding thepersons perception of the situation assists the nurse toprepare a cognitive plan. The provision for a supportive, protective and/orcorrective mental, physical, socio-cultural, andspiritual environment, which Watson divides intointerdependent internal and external variables,manipulated by the nurse in order to provide supportand protection for the patients mental and physicalhealth. The nurse must provide comfort, privacy, andsafety as part of the carative factor. 47. Assistance with satisfying human needs based on ahierarchy of needs similar to Maslows. Each need isequally important for quality nursing care and thepromotion of the patients health. In addition, all needsdeserve to be valued and attended to by the nurse andpatient. The allowance for existential-phenomenological forces,which helps the nurse to reconcile and mediate theincongruity of viewing the patient holistically while at thesame time attending to the hierarchical ordering of needs.This helps the nurse assist the patient to find strength andcourage to confront life or death. Phenomology is a way ofunderstanding the patient from his or her frame ofreference. Existential psychology is the study of humanexistence. 48. Watsons hierarchy of needs begins with lower-order biophysical needs, which include the need for food and fluid, elimination, and ventilation. Next are the lower-order psychophysical needs, which include the need for activity, inactivity, and sexuality. Finally, are the higher order needs, which are psychosocial. These include the need for achievement, affiliation, and self- actualization. 49. Betty Neumans Systems Model Health is a condition inwhich all parts andsubparts are in harmonywith the whole of theclient. Developed this modelbased on the individualsrelationship to stress,the reaction to it, andreconstitutionfactorsthat are dynamic innature. Reconstitution is thestate of adaptation tostress. 50. KEY CONCEPTS Viewed the client as an open system consisting of a basicstructure or central core of energy resources whichrepresent concentric circles Each concentric circle or layer is made up of the fivevariable areas which are considered and occursimultaneously in each client concentric circles. These are:1. Physiological - refers of bodily structure and function.2. Psychological - refers to mental processes, functioningand emotions.3. Sociocultural - refers to relationships; andsocial/cultural functions and activities.4. Spiritual - refers to the influence of spiritual beliefs.5. Developmental - refers to lifes developmentalprocesses. 51. Basic Structure Energy Resources-This is otherwise known asthe central core, which is made up of the basic survival factorscommon to all organisms. These include the following:1. Normal temperature range body temperature regulation ability2. Genetic structure Hair color and bodily features3. Response pattern functioning of body systems homeostatically4. Organ strength or weakness5. Ego structure6. Knowns or commonalities value system The persons system is an open system - dynamic and constantlychanging and evolving Stability, or homeostasis, occurs when the amount of energy thatis available exceeds that being used by the system. A homeostatic body system is constantly in a dynamic process ofinput, output, feedback, and compensation, which leads to astate of balance 52. Central core of energy resources surrounded by two concentricboundaries or rings referred to as lines of resistance. Lines of Resistance The last boundary that protects the basic structure or itrepresents the internal factors that help client defend against sstressor Protect the basic structure and become activated whenenvironmental stressors invade the normal line of defense. Anexample is that when a certain bacteria enters our system, thereis an increase in leukocyte count to combat infection. If the lines of resistance are effective, the system can reconstituteand if the lines of resistance are not effective, the resultingenergy loss can result in death. Outside the lines of resistance are two lines of defense: 53. 1. Normal Line of Defense Represents clients usual wellness level. Can change over time in response to coping or respondingto the environment, which includes intelligence, attitudes,problem solving and coping abilities. Example is skinwhich is constantly smooth and fair will eventually formcallous over times.2. Flexible Lines of Defense Is the outer boundary to the normal line of defense, theline of resistance, and the core structure. Keeps the system free from stressors and is dependent onthe amount of sleep, nutritional status, as well as thequality and quantity of stress an individual experiences. If the flexible line of defense fails to provide adequateprotection to the normal line of defense, the lines ofresistance become activated. 54. Neuman categorizes Stressors as: Stressors Are capable of producing either a positive or negative effect on the client system.Is any environmental force which can potentially affect the stability of the system:1.Intrapersonal - occur within person, example is infection, thoughtsand feelings2.Interpersonal - occur between individuals, e.g. role expectations3.Extrapersonal - occur outside the individual, e.g. job or financeconcernsA persons reaction to stressors depends on the strength of the lines of defense.When the lines of defense fails, the resulting reaction depends on the strength of the lines of resistance.As part of the reaction, a persons system can adapt to a stressor, an effect known as reconstitution. 55. Reconstitution Is the increase in energy that occurs in relation to thedegree of reaction to the stressor which starts afterinitiation of treatment for invasion of stressors. May expand the normal line of defense beyond its previouslevel, stabilize the system at a lower level, or return it to thelevel that existed before the illness. Nursing interventions focus on retaining or maintainingsystem stability. By means of primary, secondary and tertiary interventions,the person (or the nurse) attempts to restore or maintainthe stability of the system. 56. Prevention Is the primary nursing intervention. Focuses on keeping stressors and the stress response from having a detrimental effect on the body.1.Primary prevention -focuses on protecting the normal line of defense andstrengthening the flexible line of defense. This occur before the system reactsto a stressor and strengthens the person (primarily the flexible line of defense)to enable him to better deal with stressors and also manipulates theenvironment to reduce or weaken stressors. Includes health promotion andmaintenance of wellness.2.Secondary prevention- focuses on strengthening internal lines of resistance, reducing the reaction of the stressor and increasing resistance factors in order to prevent damage to the central core. This occurs after the system reacts to a stressor. This includes appropriate treatment of symptoms to attain optimal client system stability and energy conservation.3. Tertiary prevention -focuses on readaptation and stability, and protects reconstitution or return to wellness after treatment. This occurs after the system has been treated through secondary prevention strategies. Tertiary prevention offers support to the client and attempts to add energy to the system or reduce energy needed in order to facilitate reconstitution. 57. Rosemarie Rizzo Parses Theoryof Human BecomingNursing is a scientific discipline, the practice of which is a performing art 58. Three assumption about Human Becoming:1. Human becoming is freely choosing personal meaning in situation in the intersubjective process of relating value priorities2. becoming is co-creating rhythmic patterns or relating in mutual process in the universe3. Human becomingisco-transcending multidimensionally with emerging possibilities. 59. These three assumptions focus on meaning, rhythmicity, and contrascendence:1. Meaning arises from a persons interrelationship with the world and refers to happenings to which the person attaches varying degree of significance.2. Rhythmicity is the movement toward greater diversity3. Contrascendence is the process of reaching out beyond the self. 60. Modelof human becoming emphasizes howindividuals choose and bear responsibility for patternsof personal health. Contends that the client , not the nurse , is theauthority figure and decision maker. The nurses role involves helping individuals andfamilies in choosing the possibilities for changing thehealth process. 61. MARTHA ROGERS SCIENCE OF UNITARYHUMAN BEINGS Describedthe irreducible nature ofindividuals as being differentfrom the sum of their parts She theorized that the identityof nursing as a science arisesfrom the integrality of peopleand the environment thatcoordinates withamultidimensional universe ofopen systems 62. Rogers model provides the way of viewing the unitary human being. Humans are viewed as integral with the universe: the unitary human being and the environment are one, not dichotomous 63. The basic characteristics that describe the life processof human include energy field, openness, pattern,and pan-dimensionality. The basic concepts of thetheory include unitary human being, environment,and homeodynamic principles. 64. Concepts of Rogers mode1. Energy field The energy field is the fundamental unit of both the living and nonliving. This energy field "provides a way to perceive people and environment as irreducible wholes". The energy fields continuously varies in intensity, density, and extent.2. Openness The human field and the environmental field are constantly exchanging their energy back and forth. There are no boundaries or barriers that inhibit energy flow between the fields.3. Pattern Pattern is defined as the distinguishing characteristic of an energy field. "Pattern is an abstraction and it gives identity to the field. 65. 4. Pan-dimensionality Pan-dimensionality is defined as "non linear domain without spatial or temporal attributes". The parameters that humans use in language to describe events are arbitrary. The present is relative; there is no temporal ordering of lives.5. Unitary Human Being (person A unitary human being is an "irreducible, indivisible, pan-dimensional (four-dimensional) energy field identified by pattern and manifesting characteristics that are specific to the whole and which cannot be predicted from knowledge of the parts" and "a unified whole having its own distinctive characteristics which cannot be perceived by looking at, describing, or summarizing the parts". The person has the capacity to participate knowingly and probabilistically in the process of change.6. Environment The environment is an "irreducible, pan-dimensional energy field identified by pattern and integral with the human field". The two fields coexist and are integral. Manifestations emerge from this field and are perceived by the person. 66. 7. Health Rogers defined health as an expression of the life process; they are the "characteristics and behavior emerging out of the mutual, simultaneous interaction of the human and environmental fields". Health and illness are the part of the same continuum. The multiple events taking place along lifes axis denote the extent to which man is achieving his maximum health potential and vary in their expressions from greatest health to those conditions which are incompatible with maintaining life processes.8. Nursinga) Nursing as a science The theory asserts the independent science of nursing because an organized body of knowledge which is specific to nursing is arrived at by scientific research and logical analysis.b) Nursing as an art Rogers claimed that the creative use of science for the betterment of humans and the creative use of its knowledge is the art of its nursing. 67. C. Assumptions about people and nursing Nursing exists to serve people. It is the direct and overriding responsibility to the society. The safe practice of nursing depends on the nature andamount of scientific nursing knowledge the individualbrings to practice. People need knowledgeable nursing.9. Homeodynamicprinciples-The principles ofhomeodynamic postulates the way unitary human beingsare perceived. The fundamental unit of the living systemis an energy field.10. Resonancy-Resonancy is an ordered arrangement ofrhythm characterizing both human field andenvironmental field that undergoes continuous dynamicmetamorphosis in the human environmental process. 68. 11. Helicy - Helicy describes the unpredictable, butcontinuous, nonlinear evolution of energy fields asevidenced by non repeating rhythmicties The principle ofhelicy postulates an ordering of humans evolutionaryemergence.12. Integrality - Integrality is the mutual, continuousrelationship of the human energy field and theenvironmental field. Changes occur by the continuousrepatterning of the human and environmental fields byresonance waves. The fields are one and integrated, butunique from each other.