Nursing theory discussion 7

Chapter 17

Health as Expanding Consciousness:

Margaret Newman Consciousness:

Margaret Newman

Overview of Newman’s Theory of Health as Expanding ConsciousnessHealth as Expanding Consciousness

• Major concepts are health, consciousness, • Major concepts are health, consciousness, patterns of movement and space–time

• Consciousness is the system’s ability to interact with the environment interact with the environment

• Pattern is the “information that depicts the whole and understanding of the meaning of whole and understanding of the meaning of all of the relationships at once”

Overview of Newman’s Theory of Health as Expanding ConsciousnessHealth as Expanding Consciousness

• Movement is reflection of consciousness that indicates inner organization or disorganization indicates inner organization or disorganization of persons; it communicates harmony or person’s pattern with the environment person’s pattern with the environment

• Time is considered an index of consciousness • Dimensions of space–time–movement are • Dimensions of space–time–movement are

complementary and linked to one another

Major Concepts of Nursing According to NewmanAccording to Newman

• Person: a “center of consciousness within an • Person: a “center of consciousness within an overall pattern of expanding consciousness” identified by individual patterns of identified by individual patterns of consciousness, and viewed as participants in the transformative process the transformative process

• Environment: viewed as energy field, universe of open systems, and as event, situation, or of open systems, and as event, situation, or phenomena interacting with the person

Major Concepts of Nursing According to NewmanAccording to Newman

Health: synthesis that occurs due to the fusion • Health: synthesis that occurs due to the fusion of disease and non-disease that forms health; health as concept is “pattern of the whole” health as concept is “pattern of the whole”

• Nursing: within the nurse-patient interaction • Nursing: within the nurse-patient interaction the nurse is seen as a “caring, pattern- recognizing presence” and the nursing process recognizing presence” and the nursing process is a process of pattern recognition

Explicit Assumptions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

Health encompasses disease as a meaningful • Health encompasses disease as a meaningful aspect of health; a manifestation of underlying pattern of person–environment interactionpattern of person–environment interaction

• Pathological conditions can be considered • Pathological conditions can be considered manifestations of total pattern of individual

• Health is the expression of consciousness• Health is the expression of consciousness

Explicit Assumptions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

• The pattern of the individual that eventually manifests itself as pathology is primary and exists prior to structural or functional changes manifests itself as pathology is primary and exists prior to structural or functional changes

• Removal of the pathology in itself will not change the pattern of the individual

• Removal of the pathology in itself will not change the pattern of the individual

• If becoming “ill” is the only way an individual’s pattern can manifest itself, then that is health

• If becoming “ill” is the only way an individual’s pattern can manifest itself, then that is health for that person

Implicit Assumptions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

• Humans are open energy systems • Humans are in continual interconnectedness • Humans are in continual interconnectedness

with a universe of open systems • Humans are continuously active in evolving • Humans are continuously active in evolving

their own pattern of the whole

Implicit Assumptions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

• Humans are intuitive as well as cognitive and affective beings affective beings

• Humans are capable of abstract thinking and sensationsensation

• Humans are more than the sum of their parts

Propositions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

• Patterning of human health experiences • Patterning of human health experiences occurs within the context of the environment

• Consciousness is a manifestation of evolving pattern of person–environment interactionpattern of person–environment interaction

• The evolving pattern of person–environment interaction can be viewed as a process of interaction can be viewed as a process of expanding consciousness

Propositions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

• Movement is a pivotal choice point in the • Movement is a pivotal choice point in the evolution of human consciousness

• When movement is no longer an option, we learn to transcend the limitations of time–learn to transcend the limitations of time– space–movement so as to reach higher levels of consciousness of consciousness

• Movement is a reflection of consciousness • Time is a measure of consciousness • Time is a measure of consciousness

Propositions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

The consciousness that characterizes any form • The consciousness that characterizes any form of life is expressed in its movement

• Manifestations of space–time–movement are indicators of consciousnessindicators of consciousness

• The rhythm of living phenomena is a vivid portrayal of the embeddedness of matter portrayal of the embeddedness of matter (consciousness) in space–time

Propositions of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

A person comes into being from the ground of • A person comes into being from the ground of consciousness and loses freedom as he or she is bound in time and finds identity in space is bound in time and finds identity in space

• Through movement, a person discovers the • Through movement, a person discovers the world of time–space and establishes personal territory territory

Brief Critique of the Health as Expanding Consciousness TheoryExpanding Consciousness Theory

Derived from both inductive and deductive logic • Derived from both inductive and deductive logic • Concepts clearly defined and used consistently • Concepts clearly defined and used consistently

throughout the theory • Broad in scope and has been used in several • Broad in scope and has been used in several

different cultures • Theory is complex and must be understood as a • Theory is complex and must be understood as a

whole rather than by superficially examining the individual concepts in attempt to use the theoryindividual concepts in attempt to use the theory

Newman’s Theory as a Framework for Newman’s Theory as a Framework for Nursing Practice

• Five steps involved in the application of the • Five steps involved in the application of the theory to practice: – Engagement with the patient – Engagement with the patient – Development of the narrative – Follow-up meetings– Follow-up meetings – Application of the theory – Family and community patterns