MARTHA ROGERS
1914-1994
Science of Unitary Human Beings
Martha Elizabeth Rogers was born in Dallax Texas on May 12, 1914,
the oldest of four children in a family which strongly valued education.
The family moved to Knoxville, TN where she attended the University
of Tennessee in l93l taking undergraduate science courses for 2 years.
But then she entered nursing school at Knoxville General Hospital,
received her nursing diploma in 1936. She completed a BSN in Public
Health Nursing from George Peabody College (Nashville) in l937.
She worked as a public health nurse, first in Michigan, then in
Connecticut. In l945 she earned her master's degree in public health
nursing supervision from Teacher's College Columbia University. She
was director of the Visiting Nurses Association in Phoenix, AZ. She
returned East in 1951 earning a M.P.H. from the Johns Hopkins
University while teaching at Catholic University. She continued on at
Johns Hopkins and completed a Sc.D in 1954.
She then began her long tenure with the Division of Nursing
Education at New York University. Her strong background
in sciences guided NYU to develop the nursing program as
a distinct body of scientific knowledge.
MARTHA E. ROGERS'S SCIENCE OF
UNITARY HUMAN BEINGS
Patients are considered "unitary human beings," who
cannot be divided into parts, but have to be looked at as a
whole. Humans are viewed as integral with the universe
and have the capacity to participate in the process of
change.
Patient can’t be separated from his or her
environment when addressing health and treatment.
By practicing nursing with this view of the
coexistence of the human and his or her
environment, a nurse can apply this theory to treat
patients and help them in the process of change
toward better health.
ROGERS' MOTIVATION
Rogers believed that there
was a unique body of
knowledge for nursing and
she set out to develop that,
based on the strong belief
that a true picture of human
beings cannot be obtained by
looking at the parts, or even
the sum of the parts, a
traditional view widely
known as holism.
METAPARADIGM
Human Being
According to Martha Rogers patients "cannot be divided into parts, but have to be looked at
as a whole." Patients are considered "unitary human beings.”
Environment
Martha Rogers believed that the human and environment coexisted. Patients could not be
separated from their environment when addressing health and treatments.
Health
Rogers defined health as an expression of the life process. To that end, illness and health are
part of the same continuum, and the events occurring throughout the patient’s life show how
the patient is achieving his or her health potential.
Nursing
Nursing in the Science of Unitary Human Beings contains two dimensions: the science of
nursing, which is the knowledge specific to the field of nursing that comes from scientific
research; and the art of nursing, which involves using the science of nursing creatively to help
better the life of the patient.
CHARACTERISTICS OF LIFE PROCESS
Energy field is the fundamental unit of all, both the living and
unliving. It provides a way to view the patient and his or her
environment as wholes, and it continuously changes in intensity,
density, and extent.
Openness refers to the fact that the human and environmental
fields are constantly exchanging their energies. That is, there are
no boundaries that block the flow of energy between fields.
Pattern is the distinguishing characteristic of an energy field that
is seen as a single wave. It’s an abstraction, and simply serves to
give identify to the field.
Pan dimensionality is a domain that has no spatial or temporal
attributes.
Rogers stated the principles of homeodynamics are
based on the said building blocks. These principles
help individuals to understand life and the mechanisms
affecting life. They also provide knowledge on how to
intervene and redirect the clients. The principles of
homeodynamics are resonancy, helicy, and integrality
Resonancy is the continuous change from the lower to higher
frequency wave pattern in the energy fields. 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.
Integrality explains that there is a continuous and mutual process
between human field and environmental field. This principle is
divided into two i.e., reciprocity (wholeness, openness,
continuous, and mutual interaction between human being and
his environment) and synchrony (simultaneous change in human
and environmental fields)
Helicy is explains that 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 the same at any two moments; rather, it
is continually new or different.
Case description Mrs Geetha, a 70 years old female, was admitted to the Intensive
Care Unit (ICU) in an unresponsive state and was diagnosed to have septicemia. She
was a known case of hypertension and diabetes mellitus for seven years. She had right
sided hemiplegia due to a stroke a year ago. She was on regular treatment.
On admission, she was treated in the ICU for three days and then shifted to the general
medical ward. In the ICU she was drowsy, not able to verbalize her feelings. She stares
blankly. Her face looked anxious. She was fed through nasogastric tube, Foley’s
catheter was draining urine, and bowel pattern was regular. A decubitus ulcer was
present on the sacral region. She had restricted movements of the right side. After
regaining her consciousness and when her condition was stable, she was shifted to
medical ward.
In the ward, she looks more relaxed and able to tolerate fluids orally. Mrs Geetha was a
widow residing with her son. She said, “For seven years my son is spending a lot on my
treatment. My sickness has laid burden on him and his family.” Her son is very
supportive and states, “Our mother has brought us up with lot of difficulties, so we want
to take care of her well.” He added, “My mother is very religious and strong enough to
face the problems of life.” Mrs Geetha was treated in the hospital for three weeks and
then discharged.
On discharge, she was able to tolerate soft diet. Foleys catheter was retained. Family
members were taught about the care to be taken at home. They were referred to
social workers. Mrs Geetha was able to sit with support in the bed, move her left limbs,
but was dependent on others for all other activities of daily living.
The role of the nurse is to serve people. Rogers
proposes non-invasive modalities for nursing,
such as therapeutic touch, humor, music,
meditation, guided imagery, and even the use of
color. The interventions of nurses are meant to
coordinate the rhythm between the human and
environmental fields, help the patient in the
process of change, and help patients move toward
better health. The practice of nursing, according to
Rogers, should be focused on pain management,
and supportive psychotherapy for rehabilitation.
Martha Roger's Science of Unitary Human
Beings Theory has been used in many different
areas of nursing, including, hospice, healing
centers, hospitals, out-patient care, and delivery
rooms.
Taber's 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. 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."
DOROTHEA
OREM’S SELF CARE
DEFICIT THEORY
Sister Callista Roy:
Adaptation Model of Nursing
Sister Callista L. Roy
• Sister Callista Roy (born October 14, 1939) is a highly respected nurse
theorist, writer, lecturer, researcher, teacher and member of the
religious community.
• Education History
• Post Doctoral Fellow, Neuroscience Nursing - University of California,
San Francisco
• M.S., M.A., Ph.D. Pediatric Nursing, Sociology - University of
California, Los Angeles
• B.A. with a major in Nursing - Mount Saint Mary's College
Adaptation Model of Nursing
• Roy’s model sees the individual as a set of interrelated systems that
maintain a balance between these various stimuli.
• Centers on the person as a biopsychosocial adaptive systems that
employs a feedback cycle of:
• Input – stimuli
• Throughput- control process
• Output- adaptive response
Adaption: responding positively to environmental changes
Major Concepts of the Adaptation Model
• Person
• “Human systems have thinking and feeling capacities, rooted in
consciousness and meaning, by which they adjust effectively to
changes in the environment and, in turn, affect the environment.”
• Environment
• “The conditions, circumstances and influences surrounding and
affecting the development and behavior of persons or groups, with
particular consideration of the mutuality of person and health
resources that includes focal, contextual and residual stimuli.”
Classification of stimuli:
• Focal stimuli are that confront the human system and require the
most attention. (Main problem)
• Contextual stimuli are characterized as the rest of the stimuli present
with the focal stimuli and contribute to its effect.
• Residual stimuli are the additional environmental factors present
within the situation but whose effect is unclear. This can include
previous experience with certain stimuli.
• Health
“Health is not freedom from the inevitability of death, disease,
unhappiness, and stress, but the ability to cope with them in a
competent way.”
• Nursing
• “[The goal of nursing is] the promotion of adaptation for individuals
and groups in each of the four adaptive modes, thus contributing to
health, quality of life, and dying with dignity.”
Internal Processes
The regulator subsystem is a person’s physiological coping mechanism.
The body attempts to adapt via regulation of our bodily processes,
including neurochemical and endocrine systems.
The cognator subsystem is a person’s mental coping mechanism. A
person uses his brain to cope via self-concept, interdependence, and
role function adaptive modes.
Four Adaptive Modes
• The subsystem’s four adaptive modes are how the regulator and
cognator mechanisms are manifested; in other words, they are the
external expressions of the above and internal processes.
• Physiological-Physical Mode
• Self-Concept Group Identity Mode
• Role Function Mode
• Interdependence Mode
Physiological-Physical Mode
• Physical and chemical processes are involved in the function and
activities of living organisms. These are the actual processes put in
motion by the regulator subsystem.
• This mode’s basic need is composed of the needs associated with
oxygenation, nutrition, elimination, activity and rest, and protection.
• This model’s complex processes are associated with the senses, fluid
and electrolytes, neurologic function, and endocrine function.
Self-Concept Group Identity Mode
• In this mode, the goal of coping is to have a sense of unity, meaning
the purposefulness in the universe, and a sense of identity integrity.
This includes body image and self-ideals.
Role Function Mode
• This mode focuses on the primary, secondary, and tertiary roles that a
person occupies in society and knowing where they stand as a
member of society.
• Needs is social integrity
• Knowing who one is in relation to others so one can act.
• Involves role development and role taking processes.
Interdependence Mode
• This mode focuses on attaining relational integrity through the giving
and receiving of love, respect and value.
• This is achieved with effective communication and relations.
Levels of Adaptation
• Integrated Process
The various modes and subsystems meet the needs of the
environment. These are usually stable processes (e.g., breathing,
spiritual realization, successful relationship).
• Compensatory Process
The cognator and regulator are challenged by the environment’s needs
but are working to meet the needs (e.g., grief, starting with a new job,
compensatory breathing).
• Compromised Process
The modes and subsystems are not adequately meeting the
environmental challenge (e.g., hypoxia, unresolved loss, abusive
relationships).
IMOGENE KING’S
GENERAL SYSTEMS FRAMEWORK
NURSING CONCEPTUAL MODEL
DOROTHY JOHNSON
BEHAVIORAL SYSTEM MODEL