Rogers Theory
Rogers Theory
Rogers Theory
NURSING
BENGALURU-29.
Date of Submission:
Introduction
Nursing is a professional discipline focused on the study of human health and healing
through caring. Nursing practice is based on the knowledge of nursing, which consists of its
philosophies, theories, concepts, principles, research findings, and practice wisdom. Nursing
theories are patterns that guide the thinking about nursing. All nurses are guided by some
implicit or explicit theory or pattern of thinking as they care for their patients. Too often, this
pattern of thinking is implicit and is colored by the lens of diseases, diagnoses, and treatments.
This does not reflect practice from the disciplinary perspective of nursing. The major reason for
the development and study of nursing theory is to improve nursing practice and, therefore, the
Theories are a set of interrelated concepts that give a systematic view of a phenomenon
(an observable fact or event) that is explanatory & predictive in nature. Theories are composed of
concepts, definitions, models, propositions & are based on assumptions. They are derived
through two principal methods; deductive reasoning and inductive reasoning. Nursing theorists
use both of these methods. Theory is “a creative and rigorous structuring of ideas that projects a
“organize the relationship among the concepts to describe, explain, predict, and control practice”.
Theory is a creative and rigorous structuring of ideas that projects a tentative, purposeful,
that pertains to nursing. The conceptualization is articulated for the purpose of describing,
and focused nursing phenomena that frame, give meaning to, and help explain specific and
Inferential concepts
Abstract concepts
Models are representations of the interaction among and between the concepts showing
patterns.
Propositions are statements that explain the relationship between the concepts.
result. During a process one takes systemic & continuous steps to meet a goal & uses
A particular theory or conceptual frame work directs how these actions are carried out.
The delivery of nursing care within the nursing process is directed by the way specific
conceptual frameworks & theories define the person (patient), the environment, health &
nursing.
The terms ‘model’ and ‘theory’ are often wrongly used interchangeably, which further
confounds matters.
In nursing, models are often designed by theory authors to depict the beliefs in their
They provide an overview of the thinking behind the theory and may demonstrate how
theory can be introduced into practice, for example, through specific methods of
assessment.
Models are useful as they allow the concepts in nursing theory to be successfully applied
Their main limitation is that they are only as accurate or useful as the underlying theory.
Importance of nursing theories
1. Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn
and Jacobs1978).
2. It should provide the foundations of nursing practice, help to generate further knowledge
and indicate in which direction nursing should develop in the future (Brown 1964).
3. Theory is important because it helps us to decide what we know and what we need to
know (Parsons1949).
4. It helps to distinguish what should form the basis of practice by explicitly describing
nursing.
5. The benefits of having a defined body of theory in nursing include better patient care,
enhanced professional status for nurses, improved communication between nurses, and
6. The main exponent of nursing – caring – cannot be measured, it is vital to have the theory
8. This can be seen as an attempt by the nursing profession to maintain its professional
boundaries.
particular phenomenon.
logical in nature.
generalizable.
increasing the general body of knowledge within the discipline through the research
consistent with other validated theories, laws, and principles but will leave open
HUMAN BEINGS
s
Martha E. Rogers, one of nursing’s foremost scientists, was a staunch advocate for
nursing as a basic science from which the art of practice would emerge. A common refrain
throughout her career was the need to differentiate skills, techniques, and ways of using
knowledge from the actual body of knowledge needed to guide practice to promote well-being
for humankind. Rogers identified the human–environmental mutual process as nursing’s central
She repeatedly emphasized the need for nursing science to encompass human beings in
space and on Earth. Who was this visionary who introduced a new worldview to nursing? Martha
Elizabeth Rogers was born in Dallas, Texas, on May 12, 1914, a birthday she shared with
Florence Nightingale. Her parents soon returned home to Knoxville, Tennessee, where Martha
and her three siblings grew up. Rogers spent 2 years at the University of Tennessee in Knoxville
before entering the nursing program at Knoxville General Hospital. She then attended George
Peabody College in Nashville, Tennessee, where she earned her bachelor of science degree in
Rogers spent the next 13 years in rural public health nursing in Michigan, Connecticut,
and Arizona, where she established the first visiting nurse service in Phoenix, serving as its
executive director (Hektor, 1989/1994). In 1945, recognizing the need for advanced education,
she earned a master’s degree in nursing from Teachers College, Columbia University, in the
program developed by another nurse theorist, Hildegard Peplau. In 1951, she left public health
nursing in Phoenix to return to academia, this time earning both a master’s of public health and a
doctor of science degree from Johns Hopkins University in Baltimore, Maryland. In 1954, after
her graduation from Johns Hopkins, Rogers was appointed head of the Division of Nursing at
New York University (NYU), beginning the second phase of her career overseeing
baccalaureate, master’s, and doctoral programs in nursing and developing the nursing science she
During the 1960s, she successfully shifted the focus of doctoral research from nurses and
their functions to humans in mutual process with the environment. She wrote three books that
the landmark An Introduction to the Theoretical Basis of Nursing (1970). From 1963 to 1965,
she edited Nursing Science, a journal that was far ahead of its time; it offered content on theory
development and the emerging science of nursing, as well as research and issues in education
and practice. Rogers died in 1994, leaving a rich legacy in her writings on nursing science, the
space age, research, education, and professional and political issues in nursing.
The historical evolution of the Science of Unitary Human Beings has been described by
Malinski and Barrett (1994). This chapter presents the science in its current form and identifies
work in progress to expand it further. Rogers’ Worldview Rogers (1992) articulated a new
worldview in nursing, one that was commensurate with new knowledge emerging across
disciplines, which rooted nursing science in “a pandimensional view of people and their world”.
Rogers (1992) described the evolution from older to newer worldviews in such shifting
emergent, and closed to open systems. She pointed out that in a universe of open systems, energy
fields are continuously open, infinite, and integral with one another.
creative, innovative, and unpredictable. Rogers identified the unique focus of nursing as “the
irreducible human being and its environment, both defined as energy fields”. “Human”
encompasses both Homo sapiens and Homo spatialis, the evolutionary transcendence of
humankind as we voyage into space; environment encompasses outer space, the cosmos itself.
Rogers was aware that the world looks very different from the vantage point of this newer view
She pointed out that we are already living in a new reality, one that is “a synthesis of
rapidly evolving, accelerating ways of using knowledge”, even if people are not always fully
aware that these shifts have occurred or are in process. She urged that nurses be visionary,
looking forward and not backward and not allowing themselves to become “stuck” in the
present, in the details of how things are now, but envision how they might be in a universe where
Rogers cautioned that although traditional modalities of practice and methods of research
serve a purpose, they are inadequate for the newer worldview, which urges nurses to use the
knowledge base of Rogerian nursing science creatively to develop innovative new modalities and
Rogers (1992) identified four fundamental postulates that form the basis of the new reality:
•Energy fields
•Openness
•Pattern
Rogers (1990) defined the energy field as “the fundamental unit of the living and the non-
living,” noting that it is dynamic, infinite, and continuously moving. Although Rogers did not
define energy per se, Todaro Franceschi’s (1999) wide-ranging philosophical study of the
enigma of energy sheds light on a Rogerian conceptualization of energy. She highlighted the
communal, transformative nature of energy, noting that energy is everywhere and is always
Energy transformation is the basis of all that is, both in living and dying. Rogers
identified two energy fields of concern to nurses, which are distinct but not separate: the human
field and the environmental field. The human field can be conceptualized as person, group,
family, or community. The human and environmental fields are irreducible; they cannot be
broken down into component parts or subsystems. For example, the unitary human is neither
maintained that each field, human and environmental, is identified by pattern, defined as “the
distinguishing characteristic of an energy field perceived as a single wave”. Pattern
manifestations and characteristics are specific to the whole, the unitary human–environment in
mutual process. Change occurs simultaneously for human and environment. The fields are pan
Pan dimensional reality transcends traditional notions of space and time, which can be
commonly labeled “paranormal” that are, in Rogerian nursing science, manifestations of the
changing diversity of field patterning and examples of pan dimensional awareness. The postulate
of openness resonates throughout the preceding discussion. In an open universe, there are no
boundaries other than perceptual ones. Therefore, human and environment are not separated by
boundaries.
The energy of each flows continuously through the other in an unbroken wave. Rogers
repeatedly emphasized that person and environment are themselves energy fields; they do not
have energy fields, such as auras, surrounding them. In an open universe, there are multiple
potentials and possibilities. People experience their world in multiple ways, evidenced by the
diverse manifestations of field patterning that continuously emerge. Rogers described pattern as
changing continuously while giving identity to each unique human–environmental field process.
Although pattern is an abstraction, not something that can be observed directly, “it
reveals itself through its manifestations”. Individual characteristics of a particular person are not
mutual process as a unitary, irreducible whole. They reveal innovative diversity flowing in lower
and higher frequency rhythms within the human– environmental mutual field process. Rogers
identified some of these manifestations as lesser and greater diversity; longer, shorter, and
seemingly continuous rhythms; slower, faster, and seemingly continuous motion; time
experienced as slower, faster, and timeless; pragmatic, imaginative, and visionary; and longer
unitive experiences attained in meditation, precognition, déjà vu, intuition, tacit knowing,
mystical experiences, clairvoyance, and telepathy. She explained “seems continuous” as “a wave
frequency so rapid that the observer perceives it as a single, unbroken event”. This view of the
Principles of Homeodynamics
Homeodynamics conveys the dynamic, everchanging nature of life and the world. Her
change from lower to higher frequency wave patterns in human and environmental fields”.
Although she verbalized the need to delete the “from–to” language, which seems to imply
linearity and directionality, Rogers never actually deleted it in print. However, it is important to
remember that this process is nonlinear and nondirectional because in a pandimensional universe
Resonancy specifies the nonlinear, continuous flow of lower and higher frequency wave
patterning in the human–environmental field process, the way change occurs. Both lower and
higher frequency awareness and experiencing are essential to the wholeness of rhythmical
patterning. As Phillips described it, “[W]e may find that growing diversity of pattern is related to
When the rhythmicities of lower-higher frequencies work together, they yield innovative, diverse
patterns.”
environmental field patterns. It describes the creative and diverse nature of ongoing change in
specifies the process of change within the integral human–environmental field process where
person and environment are unitary, thus inseparable. Together the principles suggest that the
innovatively, and unpredictably, flowing in lower and higher frequencies. Rogers believed that
they serve as guides both to the practice of nursing and to research in the science of nursing.
Rogers clearly stated her belief that multiple theories can be derived from the science of
unitary human beings. They are specific to nursing and reflect not what nurses do but an
understanding of people and our world (Rogers, 1992). Nursing education is identified by
transmission of this theoretical knowledge, and nursing practice is the creative use of this
knowledge. “Research is done in relation to the theories” to illuminate the nature of the human–
Rogers derived the theory of accelerating change, formerly known as the theory of
accelerating evolution, to illustrate that the only “norm” is accelerating change. Higher frequency
field patterns that manifest growing diversity open the door to wider ranges of experiences and
behaviors, calling into question the very idea of “norms” as guidelines. Human and
environmental field rhythms are accelerating. We experience faster environmental motion now
It is common for people to experience time as rapidly speeding by. People are living
longer. Rather than viewing aging as a process of decline or as “running down,” as in an entropic
worldview, this theory views aging as a creative process in which field patterns show increasing
diversity in such manifestations as sleeping, waking, and dreaming. “In fact, as evolutionary
diversity continues to accelerate, the range and variety of differences between individuals also
increase; the more diverse field patterns evolve more rapidly than the less diverse ones”.
The theory of accelerating change provides the basis for reconceptualizing the aging
process. Rogers used the principle of helicy and the theory of accelerating change to put forward
the notion that aging is a continuously creative process of growing diversity of field patterning.
Therefore, aging is not a process of decline or running down. Rather, field patterns become
increasingly diverse as we age as older adults need less sleep; are more satisfied with personal
relationships; are better able to handle their emotions; are better able to cope with stress; and
elements for a “unitary model of aging as emerging brilliance” that includes replacing ageist
stereotypes with new positive images of aging and developing policies, lifestyles, and
technologies that enhance successful aging and longevity. Within a unitary view of aging, later
life becomes a potential for growth, “a life imbued with splendor, meaning, accomplishment,
active involvement, growth, adventure, wisdom, experience, compassion, glory, and brilliance”.
she suggests that experiences commonly labeled “paranormal” are actually manifestations of
changing diversity and innovation of field patterning. They are pan dimensional forms of
awareness, examples of pan dimensional reality that manifest visionary, beyond waking
potentials. Meditation, for example, transcends traditionally perceived limitations of time and
Therapeutic Touch provides another example of such pan dimensional awareness. Both
participants often share similar experiences during Therapeutic Touch, such as a visualization of
common features that evolves spontaneously for both, a shared experience arising within the
mutual process both are experiencing, with neither able to lay claim to it as a personal, private
experience. The idea of a pan dimensional or nonlinear domain provides a framework for
phenomena become “normal” rather than “paranormal.” Dean Radin, director of the Conscious
Research Laboratory at the University of Nevada in Las Vegas, suggests that an understanding of
nonlocal connections along with the relationship between awareness and quantum effects
Dossey (1993, 1999), Nadeau and Kafatos (1999), Sheldrake (1988), and Talbot (1991) explicate
healing, and prayer. Tart (2009), in his excellent text The End of Materialism: How Evidence of
the Paranormal Is Bringing Science and Spirit Together, reviews the research supporting
experiences, postmortem survival, and mystical experiences. Murphy (1992) in his highly
referenced and researched text presents the evidence supporting what he refers to as emergent
extraordinary human abilities such as placebo effects, paranormal experiences, spiritual healing,
The relevance of these experiences and practices to nursing is in the number that occur in
health-related contexts, and Rogers’s nursing science provides a theoretical and scientific
understanding that accounts for the occurrence of paranormal experiences. Within a nonlinear–
nonlocal context, paranormal events are our experience of the deep nonlocal interconnections
that bind the universe together. Existence and knowing are locally and nonlocally linked through
nonlinear–nonlocal potential of creating new energy patterns. Distance healing, the healing
power of prayer, Therapeutic Touch, out-of-body experiences, phantom pain, precognition, déjà
vu, intuition, tacit knowing, mystical experiences, clairvoyance, and telepathic experiences are a
few of the energy field manifestations patients and nurses experience that can be better
field patterning in unitary human beings, discussed earlier. Here Rogers suggested that evolution
offered some manifestations of this relative diversity, including the rhythms of motion, time
the theories that Rogers derived, a number of others have been developed by Rogerian scholars
derived from Rogers’ science of unitary human beings, chaos theory (Briggs & Peat, 1989; Peat,
unpredictable change. Any crisis may be viewed as a turbulent event in the life process. Nurses
often work closely with clients who are in a “crisis.” Turbulent life events are often chaotic in
The theory of kaleidoscoping in life’s turbulence is described in more detail in the Bonus
content for the chapter. Other theories derived from Rogers’s nursing science include Reed’s
1995a), Bultemeier’s (1997) theory of perceived dissonance, the theory of enlightenment (Hills
& Hanchett, 2001), Alligood and McGuire’s theory of aging (2000), Butcher’s theory of aging as
emerging brilliance (2003), and Zahourek’s (2004, 2005) theory of intentionality in healing.
New worldviews require new ways of thinking, sciencing, languaging, and practicing.
unitary field patterns. The principles of homeodynamics provide a way to understand the process
of human–environmental change, paving the way for Rogerian theory–based practice. Rogers
Therefore, people are always whole, regardless of what they are experiencing in the
moment, and therefore do not need nurses to facilitate their wholeness. Rogers identified
noninvasive modalities as the basis for nursing practice now and in the future. She stated that
nurses must use “nursing knowledge in non-invasive ways in a direct effort to promote well-
being”. This focus gives nurses a central role in health care rather than medical care. She also
noted that health services should be community based, not hospital based. Hospitals are properly
used to provide satellite services in specific instances of illness and trauma; they do not provide
health services.
(1986) identified the living–dying process as one characterized by rhythmical patterning, opening
the door to new ways of studying and working with the dying process. For example, Todaro-
coincidences, in many who were grieving the loss of a spouse, a pioneering effort in delineating a
unitary view of death and dying. From the results of her qualitative study, she described how
such experiences help the bereaved to relate to their deceased loved ones in a new, meaningful
way, one that is potentially healing, rather than in the traditional view of learning to let go and
move on.
shared nature of this process, for the one grieving is also dying a little just as the one dying is
patterning flowing now swiftly now gently, spiraling creatively through shifting rhythms of now-
else when elsewhere, becoming in solitude and silence alone-all one, timeless-boundary less”
Pan dimensional awareness and experience of this rhythm means recognition that there is no
potentials. Unfortunately, a number of ideas relevant to nursing practice that Rogers discussed
verbally never made it into print, for example, healing, intentionality, and expanded views on
Therapeutic Touch. In three audiotaped and transcribed dialogues among Rogers, Malinski, and
Meehan on January 26, 1988, for example, she described healing as a process, everything that
happens as persons actualize potentials they identify as enhancing health and wellness for
themselves. Todaro-Franceschi (1999) described healing in a similar way, with nurses knowingly
participating in the healing process by helping people actualize “their unique potentials—
mutual process. Rogers also reminded us that change is a neutral process, neither good nor bad,
one that we cannot direct but in which we participate. In this vein, in the transcribed dialogue
among Rogers, Malinski, and Meehan on Therapeutic Touch, Rogers described this modality as
a neutral process, one that facilitates the patterning most commensurate with well-being for the
Touch. Rather than intentionality, Rogers suggested knowing participation as most congruent
with her thinking, seeing intentionality as too closely tied to will and intent. However, she did
Rogers also questioned the concept of spirituality, which she saw as too often confused
with religiosity. Smith (1994) and Malinski (1991, 1994) have both explored a Rogerian view of
spirituality. Barrett (2010) suggested that the interrelationships of pandimensionality,
consciousness, and spirituality will become clearer and increasingly important. She defined
consciousness “as the Spirit in all that is, was, and will be” and spirituality “as experiencing the
Spirit in all that is, was, and will be”. Phillips created the terms energy spirit and Homo pan
In a discussion about the big bang, he suggested that if energy is indeed unitary,
discussions of physical energy are not only incomplete but inaccurate. Phillips speculated, “What
if the big bang was a cataclysm of spirit integral with energy that was not separated into physical
and spirit, but made their presence as a unitary whole. Then, we have a new phenomenon known
as energy spirit, one word. This energy spirit was the origin of the universe and human beings
Energy spirit thus replaces any discussion of mind body spirit. Already of no relevance to
Rogerian nursing science, perhaps mind body spirit can be replaced now with energy spirit
continuously changing, it is possible that we will see the emergence of new, unanticipated
discipline is the development of specific practice and research methods evolving from the
discipline’s extant conceptual systems. Rogers (1992) asserted that practice and research
methods must be consistent with the science of unitary human beings to study irreducible human
postulates and principles if they are to be consistent with Rogerian science. The goal of nursing
practice is the promotion of well-being and human betterment. Nursing is a service to people
wherever they may reside. Nursing practice—the art of nursing—is the creative application of
substantive scientific knowledge developed through logical analysis, synthesis, and research.
Since the 1960s, the nursing process has been the dominant nursing practice method. The nursing
process is an appropriate practice methodology for many nursing theories. However, there has
been some confusion in the nursing literature concerning the use of the traditional nursing
In early writings, Rogers (1970) did make reference to nursing process and nursing
diagnosis. But in later years she asserted that nursing diagnoses were not consistent with her
scientific system. Rogers stated: “Nursing diagnosis is a static term that is quite inappropriate for
a dynamic system. . . . it [nursing diagnosis] is an outdated part of an old worldview, and I think
by the turn of the century, there are going to be new ways of organizing knowledge.”
cause and effect (i.e., “related to”) relationships inconsistent with a “nonlinear domain without
spatial or temporal attributes”. The nursing process is a stepwise sequential process inconsistent
with a nonlinear or pan dimensional view of reality. In addition, the term intervention is not
consistent with Rogerian science. Intervention means to “come, appear, or lie between two
things”.
The principle of integrality describes the human and environmental field as integral and
in mutual process. Energy fields are open, infinite, dynamic, and constantly changing. The
human and environmental fields are inseparable, so one cannot “come between.” The nurse and
the client are already inseparable and interconnected. Outcomes are also inconsistent with
The principle of helicy describes the nature of change as being unpredictable. Within an
energy-field perspective, nurses in mutual process assist clients in actualizing their field
potentials by enhancing their ability to participate knowingly in change. Given the inconsistency
of the traditional nursing process with Rogers’ postulates and principles, the science of unitary
human beings requires the development of new and innovative practice methods derived from
and consistent with the conceptual system. A number of practice methods have been derived
Barrett’s Rogerian practice methodology for health patterning was the first accepted
alternative to the nursing process for Rogerian practice. It was followed by Cowling’s
conceptualization.
Rogerian practice models. Cowling refined the template and proposed that “pattern
appreciation” was a method for unitary knowing in both Rogerian nursing research and practice.
Cowling preferred the term appreciation rather than assessment or appraisal because appraisal is
associated with evaluation. Appreciation has broader meaning, which includes “being fully
aware or sensitive to or realizing; being thankful or grateful for; and enjoying or understanding
method to develop a more inclusive and comprehensive practice model. In 2006, Butcher
expanded the “praxis” model by illustrating how the Rogerian cosmology, ontology,
epistemology, esthetics, ethics, postulates, principles, and theories all form an “interconnected
nexus” informing both Rogerian-based practice and research models. The unitary pattern– based
practice consists of two nonlinear and simultaneous processes: pattern manifestation appreciation
and knowing, and voluntary mutual patterning. The focus of nursing care guided by Rogers’s
manifestation knowing and appreciation and by facilitating the client’s ability to participate
manifestations of patterning emerging from the human– environmental field mutual process and
involves focusing on the client’s experiences, perceptions, and expressions. “Knowing” refers to
apprehending pattern manifestations (Barrett, 1988), whereas “appreciation” seeks a perception
pattern manifestation knowing and appreciation, the nurse and client are coequal participants. In
Rogerian practice, nursing situations are approached and guided by a set of Rogerian-ethical
values, a scientific base for practice, and a commitment to enhance the client’s desired
freedom so that clients can freely participate in the process of knowing participation in change.
Approaching the nursing situation with an appreciation of the uniqueness of each person and
with unconditional love, compassion, and empathy can help create an atmosphere of openness
and healing patterning (Butcher, 2002; Malinski, 2004). Rogers (1966/1994) defined nursing as a
(1) recognizing the interconnectedness of the nurse and client by being able to fully understand
(3) not only grieving in another’s sorrow and pain but also rejoicing in another’s joy (Butcher,
2002).
Pattern manifestation knowing and appreciation involves focusing on the experiences,
communion and dialogue. In most situations, the nurse can initially ask the client to describe his
or her health situation and concern. The dialogue is guided toward focusing on uncovering the
client’s experiences, perceptions, and expressions related to the health situation as a means to
involves the rawness of living through sensing and being aware as a source of knowledge and
includes any item or ingredient the client senses (Cowling, 1997). The client’s own observations
and description of his or her health situation includes his or her experiences. “Perceiving is the
observation, and interpreting. Asking clients about their concerns, fears, and observations is a
perceptions that reflect human field patterning. In addition, expressions are any form of
information that comes forward in the encounter with the client. All expressions are energetic
laboratory values, and vital signs are examples of energetic manifestations of human–
environmental field patterning. Because all information about the client– environment–health
situation is relevant, various health assessment tools, such as the comprehensive holistic
assessment tool developed by B. M. Dossey, Keegan, and Guzzetta (2004), may also be useful in
pattern knowing and appreciation. However, all information must be interpreted within a unitary
context.
A unitary context refers to conceptualizing all information as energetic/dynamic
rhythmically and a causally, and reflects the whole. Data are not divided or understood by
dividing information into physical, psychological, social, spiritual, or cultural categories. Rather,
a focus on experiences, perceptions, and expressions is a synthesis more than and different from
appreciation of new kinds of information that may not be considered within other conceptual
The nurse is open to using multiple forms of knowing, including pan dimensional modes
of awareness (intuition, meditative insights, tacit knowing) throughout the pattern manifestation
knowing and appreciation process. Intuition and tacit knowing are artful ways to enable seeing
connectedness with the environment, ideas of one’s own personal myth, and sense of integrity
1986). A person’s hopes and dreams, communication patterns, sleep–rest rhythms, comfort–
situation.
The nurse can also use a number of pattern appraisal scales derived from Rogers’s
postulates and principles to enhance the collecting and understanding of relevant information
specific to Rogerian science. For example, nurses can use Barrett’s (1989) power as knowing
participation in change tool as a way of knowing clients’ energy field patterns in relation to their
capacity to knowingly participate in the continuous patterning of human and environmental fields
Watson’s (1993) assessment of dream experience scale can be used to know and
appreciate the clients’ dream experiences, and Ference’s (1979, 1986) human field motion tool is
an indicator of the wave frequency pattern of the energy field. Hastings-Tolsma’s (1992)
diversity of human field pattern scale may be used as a means for knowing and appreciating a
clients’ perception of the diversity of their energy field pattern, Johnston’s (1994) human image
metaphor scale can be used as a way of knowing and appreciating the clients’ perception of the
wholeness of their energy field, and the well-being picture scale for adults (Gueldner et al., 2005;
Johnson, Guadron, Verchot, & Gueldner, 2011) and for children (Terwillinger, Gueldner, &
Bronstein, 2012) afford a way to measure a person’s sense of unitary well-being. Paletta (1990)
developed a tool consistent with Rogerian science that measures the subjective awareness of
temporal experience.
The pattern manifestation knowing and appreciation is enhanced through the nurse’s
ability to grasp meaning, create a meaningful connection, and participate knowingly in the
client’s change process. “Grasping meaning entails using sensitivity, active listening, conveying
unconditional acceptance, while remaining fully open to the rhythm, movement, intensity, and
configuration of pattern manifestations”. Through integrality, nurse and client are always
However, a meaningful connection with the client is facilitated by creating a rhythm and
flow through the intentional expression of unconditional love, compassion, and empathy.
Together, in mutual process, the nurse and client explore the meanings, images, symbols,
metaphors, thoughts, insights, intuitions, memories, hopes, apprehensions, feelings, and dreams
associated with the health situation. Rogerian ethics are integral to all unitary pattern–based
practice situations. Rogerian ethics are pattern manifestations emerging from the human–
environmental field mutual process that reflect those ideals concordant with Rogers’ most
cherished values and are indicators of the quality of knowing participation in change.
Thus, unitary pattern–based practice includes making the Rogerian values of reverence,
intentional in the human–environmental field mutual process. When initial pattern manifestation
knowing and appreciation is complete, the nurse synthesizes all the pattern information into a
The nurse weaves together the expressions, perceptions, and experiences in a way that
tells the client’s story. The pattern profile reveals the hidden meaning embedded in the client’s
human–environmental mutual field process. Usually the pattern profile is in a narrative form that
describes the essence of the properties, features, and qualities of the human–environment–health
situation. In addition to a narrative form, the pattern profile may also include diagrams, poems,
patterning. The goal of voluntary mutual patterning is to facilitate each client’s ability to
healing potentialities, lifestyle changes, and well-being in the client’s desired direction of change
The process is mutual in that both the nurse and the client are changed with each
encounter, each patterning one another and coevolving together. “Voluntary” signifies freedom
of choice or action without external compulsion (Barrett, 1998). The nurse has no investment in
changing the client in a particular way. Whereas patterning is continuous, voluntary mutual
patterning may begin by sharing the pattern profile with the client. Sharing the pattern profile
with the client is a means of validating the interpretation of pattern information and may spark
further dialogue, revealing new and more in-depth information. Sharing the pattern profile with
the client facilitates pattern recognition and also may enhance the client’s knowing participation
in his or her own change process. An increased awareness of one’s own pattern may offer new
voluntary mutual patterning strategies as a means to facilitate the client’s actualization of his or
her human–environmental field potentials. A wide variety of mutual patterning strategies may be
used in Rogerian practice, including many “interventions” identified in the Nursing Intervention
However, “interventions,” within a unitary context, are not linked to nursing diagnoses
and are reconceptualized as voluntary mutual patterning strategies, and the activities are
strategies to nursing diagnoses, the strategies emerge in dialogue whenever possible out of the
Furthermore, Rogers placed great emphasis on modalities that are traditionally viewed as
holistic and noninvasive. In particular, the use of sound, dialogue, affirmations, humor, massage,
storytelling, literature, poetry, movement, and dance are just a few of the voluntary mutually
In addition, patterning modalities have been developed that are conceptualized within the
science of unitary human beings such as Butcher’s metaphoric unitary landscape narratives
(2006b) and written emotional expression, Therapeutic Touch (Malinski, 1993), guided imagery
(Butcher & Parker, 1988; Levin, 2006), magnet therapy (Kim, 2001), and music (Horvath, 1994;
Johnston, 2001). Sharing of knowledge through health education and providing health education
literature and teaching also have the potential to enhance knowing participation in change. These
and other noninvasive modalities are well described and documented in both the Rogerian
(Barrett, 1990; Madrid, 1997; Madrid & Barrett, 1994) and the holistic nursing practice literature
The nurse continuously apprehends changes in patterning emerging from the human–
environmental field mutual process throughout the simultaneous pattern manifestation knowing
and appreciation and voluntary mutual patterning processes. Although the concept of “outcomes”
Nursing Outcomes Classification (Moorhead, Johnson, Maas, & Swanson, 2013) can be
reconceptualized as potentialities of change or “client potentials” and the indicators can be used
as a means to evaluate the client’s desired direction of pattern change. At various points in the
client’s care, the nurse can also use the scales derived from Rogers’s science (previously
patterning strategies and evaluation methods is used, the intention is for clients to actualize their
The unitary pattern–based practice method identifies the aspect that is unique to nursing
and expands nursing practice beyond the traditional biomedical model dominating much of
nursing. Rogerian nursing practice does not necessarily need to replace hospital-based and
medically driven nursing interventions and actions for which nurses hold responsibility. Rather,
unitary pattern–based practice complements medical practices and places treatments and
Unitary pattern–based practice provides a new way of thinking and being in nursing that
distinguishes nurses from other health care professionals and offers new and innovative ways for
Research is the bedrock of nursing practice. The science of unitary human beings has a
long history of theory-testing research. As new practice theories and health patterning modalities
evolve from the science of unitary human beings, there remains a need to test the viability and
usefulness of Rogerian theories and voluntary health patterning strategies. The mass of Rogerian
research has been reviewed in a number of publications (Butcher, 2008; Caroselli & Barrett,
1998; Dykeman & Loukissa, 1993; Fawcett, 2013; Fawcett & Alligood, 2003; Kim, 2008;
Malinski, 1986a; Phillips, 1989; Watson, Barrett, HastingsTolsma, Johnston, & Gueldner, 1997).
Rather than repeat the reviews of Rogerian research, the following section describes
current methodological trends within the science of unitary human beings to assist researchers
interested in Rogerian science in making methodological decisions. Rogers maintained that both
quantitative and qualitative methods may be useful for advancing Rogerian science. Similarly,
Barrett (1996), Barrett and Caroselli (1998), Barrett, Cowling, Carboni, and Butcher (1997),
Cowling (1986), Rawnsley (1994), and Smith and Reeder (1996) have all advocated for the
et al., 1997), Butcher (1994), and Carboni (1995b) have argued that the ontological and
linearity of quantitative methodologies are inconsistent with Rogers’s unitary ontology and
participatory epistemology.
Later, Fawcett (1996) also questioned the congruency between the ontology and
designs; like Carboni (1995b) and Butcher (1994), she concluded that interpretive/qualitative
methods may be more congruent with Rogers’s ontology and epistemology. This chapter
Cowling (1986) was among the first to suggest a number of research designs that may be
ones. There is strong support for the appropriateness of phenomenological methods in Rogerian
science. Reeder (1986) provided a convincing argument demonstrating the congruence between
concerning causality; however, these designs may be appropriate for testing propositions
The researcher must be careful to interpret the findings in a way that is consistent with Rogers’s
Emerging interpretive evaluation methods, such as Guba and Lincoln’s (1989) Fourth
Generation Evaluation, offer an alternative means for testing for differences in the change
process within or between groups (or both) more consistent with the science of unitary human
beings. Cowling (1986) contended that in the early stages of theory development, designs that
generate descriptive and explanatory knowledge are relevant to the science of unitary human
beings. For example, correlational designs may provide evidence of patterned changes among
indices of the human field. Advanced and complex designs with multiple indicators of change
that may be tested using linear structural relations (LISREL) statistical analysis may also be a
means to uncover knowledge about the pattern of change (Phillips, 1990). Barrett (1996)
suggested that canonical correlation may be useful in examining relationships and patterns across
domains and may also be useful for testing theories pertaining to the nature and direction of
change.
cooperative inquiry (Reason, 1994), because of their congruence with Rogers’s notions of
knowing participation in change, continuous mutual process, and integrality. Cowling (1998)
proposed that a case oriented approach is useful in Rogerian research because case inquiry
allows the researcher to attend to the whole and strives to comprehend his or her essence.
In selecting a focus of inquiry, concepts that are congruent with the science of unitary
human beings are most relevant. The focus of inquiry flows from the postulates, principles, and
concepts relevant to the conceptual system. Noninvasive voluntary patterning modalities, such as
guided imagery, Therapeutic Touch, humor, sound, dialogue, affirmations, music, massage,
journaling, written emotional expression, exercise, nutrition, reminiscence, aroma, light, color,
artwork, meditation, storytelling, literature, poetry, movement, and dance, provide a rich source
time experience, and paranormal experiences as they relate to human health and well-being are
also of interest in this science. Feelings and experiences are a manifestation of human–
environmental field patterning and are a manifestation of the whole (Rogers, 1970); thus,
feelings and experiences relevant to health and well-being are an unlimited source for potential
Rogerian research.
Discrete particularistic biophysical phenomena are usually not an appropriate focus for
inquiry because Rogerian science focuses on irreducible wholes. An exception could be the use
of such phenomena, for example blood pressure, as part of diverse data collected to obtain
different views of pattern manifestations and pattern change. For example, see Madrid, Barrett,
and Winstead-Fry’s (2010) study of Therapeutic Touch and blood pressure, pulse, and
respirations in the operative setting with patients undergoing cerebral angiography, and Malinski
and Todaro-Franceschi’s (2011) study of co meditation and anxiety and relaxation in a nursing
school setting.
patterning. However, one cannot use just the numerical data, mere “facts,” so interpretation
would differ accordingly (Rogers, 1989). Researchers need to ensure that concepts and
measurement tools used in the inquiry are defined and conceptualized within a unitary
perspective and congruent with Rogers’s principles and postulates. Diseases or medical
diagnoses are not the focus of Rogerian inquiry. Disease conditions are conceptualized as labels
process.
The Human Field Motion Test (HFMT) is an indicator of the continuously moving
position and flow of the human energy field. Two major concepts—“my motor is running” and
“my field expansion”—are rated using a semantic differential technique (Ference, 1979, 1986).
Examples of indicators of higher human field motion include feeling imaginative, visionary,
transcendent, strong, sharp, bright, and active. Indicators of relative low human field motion
The tool has been widely used in numerous Rogerian studies. The Power as Knowing
Participation in Change Tool (PKPCT) has been used in more than 26 major research studies
(Caroselli & Barrett, 1998) and is a measure of one’s capacity to participate knowingly in change
changes using semantic differential scales. Statistically significant correlations have been found
between power as measured by the PKPCT and the following: human field motion, life
Inverse relations with power have been found with anxiety, chronic pain, personal
distress, and hopelessness (Caroselli & Barrett, 1998). Diversity is inherent in the evolution of
the human–environmental mutual field process. The evolution of the human energy field is
characterized by the creation of more diverse patterns reflecting the nature of change. The
Diversity of Human Field Pattern Scale measures the process of diversifying human field pattern
and may also be a useful tool to test theoretical propositions derived from the postulates and
principles of Rogerian science to examine the extent of selected patterning modalities designed
Other measurement tools developed within a unitary science perspective may be used in a
wide variety of research studies and in combination with other Rogerian measurements. For
example, there are the Assessment of Dream Experience Scale, which measures the diversity of
dream experience as a beyond waking manifestation using a 20-item Likert scale (Watson, 1993;
Watson et al., 1997); Temporal Experience Scale, which measures the subjective experience of
temporal awareness; and Mutual Exploration of the Healing Human Field–Environmental Field
qualitative measure designed to capture the changing configurations of energy field pattern of the
A number of new tools have been developed that are rich sources of measures of
concepts congruent with unitary science. The Human Field Image Metaphor Scale used 25
metaphors that capture feelings of potentiality and integrality rated on a Likert-type scale. For
example, the metaphor “I feel at one with the universe” reflects a high degree of awareness of
integrality; “I feel like a worn-out shoe” reflects a more restricted perception of one’s potential.
Future research may focus on developing an understanding of how human field image changes in
a variety of health-related situations or how human field image changes in mutual process with
The criteria for developing Rogerian research methods are presented in the
supplementary material. They are a synthesis and modification of the Criteria of Rogerian
Inquiry developed by Butcher and the Characteristics of Operational Rogerian Inquiry developed
by Carboni. The criteria are a useful guide in designing research methods that are consistent with
Rogers’s principles and postulates. Two Rogerian research methods were developed using the
criteria and the Unitary Field Pattern Portrait research method and Rogerian Process Inquiry. A
third method developed by Cowling, Unitary Appreciative Inquiry is also described in the bonus
Carboni developed the Rogerian process of inquiry from her characteristics of Rogerian
inquiry. The method’s purpose is to investigate the dynamic enfolding-unfolding of the human
field–environmental field energy patterns and the evolutionary change of configurations in field
patterning of the nurse and participant. Rogerian process of inquiry transcends both matter-
phenomenologists and critical theorists. Rather, this process of inquiry is evolution-centered and
The flow of the inquiry starts with a summation of the researcher’s purpose, aims, and
visionary insights. Visionary insights emerge from the study’s purpose and researcher’s
understanding of Rogerian science. Next, the researcher focuses on becoming familiar with the
participants and the setting of the inquiry. Shared descriptions of energy field perspectives are
identified through observations and discussions with participants and processed through mutual
The researcher uses the Mutual Exploration of the Healing Human Field–Environmental
creatively measure human and environmental energy field patterns. Together, the researcher and
the participants develop a shared understanding and awareness of the human–environmental field
patterns manifested in diverse multiple configurations of patterning. All the data are synthesized
using inductive and deductive data synthesis. Through the mutual sharing and synthesis of data,
The constructs are interpreted within the perspective of unitary science, and a new unitary
theory may emerge from the synthesis of unitary constructs. Carboni also developed special
criteria of trustworthiness to ensure the scientific rigor of the findings conveyed in the form of a
Pan dimensional Unitary Process Report. Carboni’s research method affords a way of creatively
The unitary field pattern portrait (UFPP) research method was developed at the same time
Carboni was developing the unitary process of inquiry and was derived directly from the criteria
of Rogerian inquiry. The purpose of the UFPP research method is to create a unitary
from the pan dimensional human– environmental field mutual process as a means to enhance the
The UFPP research method is part of the unitary pattern–based praxis model illustrating the
There are eight essential aspects and three essential processes in the method. The aspects
include initial engagement, a priori nursing science, immersion, manifestation knowing and
appreciation, the unitary field pattern profile, mutually constructed unitary field pattern profile,
the unitary field pattern portrait, and theoretical unitary field pattern portrait. The UFPP and the
three essential processes are creative pattern synthesis, immersion and crystallization, and
evolutionary interpretation.
1. Initial Engagement: Inquiry within the UFPP begins with initial engagement, which is a
passionate search for a research question of central interest to understanding unitary phenomena
associated with human betterment and well-being. For example, experiences, perceptions, and
emotional expression, exercise, nutrition, reminiscence, aroma, light, color, artwork, meditation,
storytelling, literature, poetry, movement, and dance provide a rich source for UFPP research.
experience, and paranormal experiences as they relate to human health and well-being are also
The UFPP research method can also be used to create a unitary conceptualization and
and well-being within a unitary perspective. New concepts that describe unitary phenomena may
2. A priori nursing science identifies the science of unitary human beings as the researcher’s
perspective. As in all research, the perspective of the researcher guides all aspects and processes
3. Immersion involves becoming steeped in the research topic. The researcher may immerse in
poetry, art, literature, music, dialogue with self and/or others, research literature, or any activity
that enhances the integrality of the researcher and the research topic.
4. Pattern manifestation knowing and appreciation includes participant selection, indepth
dialoguing, and recording pattern manifestations. Participant selection is made using intensive
setting and involves using pan dimensional modes of awareness during in-depth dialoguing. The
activities described earlier in the pattern manifestation knowing and appreciation process in the
However, in the UFPP research method the focus of pattern appreciation and knowing is
on experiences, perceptions, and expressions associated with the phenomenon of concern. The
researcher also maintains an informal conversational style while focusing on revealing the
rhythm, flow, and configurations of the pattern manifestations emerging from the human–
environmental mutual field process associated with the research topic. The dialogue is taped and
transcribed.
The researcher maintains observational, methodological, and theoretical field notes, and a
reflexive journal. Any artifacts the participant wishes to share that illuminate the meaning of the
phenomenon may also be included. Artifacts may include pictures, drawings, poetry, music, logs,
5. Unitary field pattern profile is a rich description of each participant’s experiences, perception,
and expressions created through a process of creative pattern synthesis. All the information
collected for each participant is synthesized into a narrative statement (profile) revealing the
essence of the participant’s description of the phenomenon of concern. The field pattern profile is
in the language of the participant and is then shared with the participant for revision and
validation.
6. Mutual processing involves constructing the mutual unitary field pattern profile by mutually
sharing an emerging joint or shared profile with each successive participant at the end of each
participant’s pattern manifestation knowing and appreciation process. For example, at the end of
the interview of the fourth participant, a joint construction of the phenomenon is shared with the
participant for comment. The joint construction (mutual unitary field pattern profile) at this phase
After verification of the fourth participant’s pattern profile, the profile is folded into the
emerging mutual unitary field pattern profile. Pattern manifestation knowing and appreciation
continues until there are no new pattern manifestations to add to the mutual unitary field pattern
profile. If it is not possible to either share the pattern profile with each participant or create a
mutually constructed unitary field pattern profile, the research may choose to bypass the mutual
processing phase.
7. The UFPP is created by identifying emerging unitary themes from each participant’s field
pattern profile, sorting the unitary themes into common categories, creating the resonating
crystallization, which involves synthesizing the resonating themes into a descriptive portrait of
the phenomenon.
The UFPP is expressed in the form of a vivid, rich, thick, and accurate aesthetic rendition
of the universal patterns, qualities, features, and themes exemplifying the essence of the dynamic
8. The UFPP is interpreted from the perspective of the science of unitary human beings using the
phenomenon from the perspective of nursing science using the Rogers’s postulates and
principles. The theoretical UFPP is expressed in the language of Rogerian science, thereby lifting
the UFPP from the level of description to the level of unitary science. Scientific rigor is
Butcher’s study on the experience of dispiritedness in later life was the first published study
using the UFPP. Ring used the method to investigate and describe changes in pattern
manifestations in individuals receiving Reiki, and Fuller used the UFPP method to create a vivid
School
Industry
Family
Community
Space
SPECIALITIES
Pediatrics
Psychiatry
Oncology
Burns
Geriatrics
Neurology
Cardiology
Rehabilitative medicine
o Neonatal ICU
o Pediatric ICU
o Rehabilitation center
o Burns unit
o Adult ICU’s
o Neuropsychiatric units
o Operation theaters
To assist both the client and nurse to increase their awareness of their own
rhythm
People of all ages both as individual human energy fields and group
energy fields
Mutual patterning
Evaluation
Her husband appeared anxious but supportive and attentive …………he is working as an
accountant in their native place
Radha was diagnosed with ovarian cancer 2 months back and underwent bilateral salphingio
oopherectomy and hysterectomy………30days ago
From past 3 weeks Radha started sitting lonely, decreased ADL, repeated crying spells,
decreased talks, neglects hygiene, muttering to self, decreased sleep , appetite, neglecting her
child care, complaints of severe pain in the body,………….3 days back attempted suicide by
consuming rat poison.
Current assessment findings …….her general appearance is a teary eyed young woman ,ill-
kempt, clinging to her husband ,looking perplexed, not talking…..poor nutritional intake, when
asked about her illness….cries inconsolably …on repeated asking expressed sadness of mood
Nursing care of Radha with Rogers model
With rogerian model, the process of caring Radha begins with pattern appraisal
Pattern appraisal
Patterning has to be directed towards reduction in perceived dissonance with her personal
and environmental field
Radha has manifestation of fear…….her self knowledge links her illness to her personal
sbelief of being punished for her past sins
Appraisal is needed in her sleep patterns, nutrition and her perception of self
Appraisal can be grouped into exchanging patterns, communication patterns, and relating
patterns
During the process nurse must rely on personal intuition and insight regarding the
emerging pattern
Mutual patterning
Radha needs to be assessed fully regarding her ability to understand and agree with
different patterning modalities
Touch is introduced and incorporated into the management of pain, helps in energy
transmission for healing and …….helps in developing trust in the nurse
Teach her how to center the energy and channel her energy to the area of pain
Use humor for increasing socialization and developing self confidence and developing
worthiness
Human environmental patterning needs to involve the other individual who share her
environment including husband and son
Evaluation
The evaluation process centers on the perceptions of dissonance that exist after the
mutual pattern activities
Manifestation of worry, pain, fear, sadness of moos has to be appraised with family
members
A summary of the dissonance and/or harmony that is perceived is then shared with
Radha, and mutual patterning is modified or instituted ad indicated based on the
evaluation
Summary
If nursing’s content and contribution to the betterment of the health and well-being of a society is
not distinguishable from other disciplines and has nothing unique or valuable to offer, then
nursing’s continued existence may be questioned. Thus, nursing’s survival rests on its ability to
make a difference in promoting the health and well-being of people. The science of unitary
human beings offers nursing a new way of conceptualizing health events concerning human
well-being that is congruent with the most contemporary scientific theories. As with all major
theories embedded in a new worldview, new terminology is needed to create clarity and
science to practice and research. Rogers’s nursing science is applicable in all nursing situations.
Rather than focusing on disease and cellular biological processes, the science of unitary human
beings focuses on human beings as irreducible wholes inseparable from their environment. For
30 years, Rogers advocated that nurses should become the experts and providers of noninvasive
biomedical frameworks that are indistinguishable from medical care, nursing will lose an
2. Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia.
Lippincott Williams& wilkins.
3. Meleis Ibrahim Afaf (1997), Theoretical Nursing: Development & Progress 3rd ed.
Philadelphia, Lippincott.
4. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed.
Philadelphia, Lippincott.
5. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process &
Practice 3rd ed. London Mosby Year Book.