Page 351 - Encyclopedia of Nursing Research

318 n NeWMAN’S THeORy OF HeALTH

(Newman, 2008) as the theory of health as 2008). The nurse–patient relationship is a car-
expanding consciousness. Newman’s theory ing, mutual process that creates a shared con-
N was inspired by her own nursing experiences sciousness (Newman et al., 2008). The nurse
and grounded in Rogers’ science of unitary focuses on what is most meaningful to the
human beings. She viewed health as a man- patient. By being fully present and resonant
ifestation of underlying unitary field pattern with the patient, the nurse facilitates pat-
rather than as a health–disease dichotomy. tern recognition. Pattern recognition results
Health was defined as a unitary pattern of in expanded consciousness, through which
the whole, reflecting the dynamic, evolving the nurse and patient are ultimately trans-
human–environment process of expanding formed. The nurse remains nonjudgmental
consciousness, which occurs within a mul- and nonprescriptive, staying engaged with
tidimensional matrix of movement, time, the patient until insight occurs.
and space. Consciousness was defined as the Newman’s highly abstract grand the-
informational capacity of the whole. Nursing ory was published at a time emphasizing
practice was defined as a mutual process of empirical, practice-based nursing theories.
attunement during which the underlying Newman’s theory became more accepted,
patterns of the patient and nurse are identi- particularly by holistic nurses and in coun-
fied, and both individuals are transformed. tries with less linear views of time, as other
Newman was an early eloquent advo- disciplines changed their worldviews to align
cate to identify and develop a paradigm more closely with a unitary-transformative
addressing nursing’s unique knowledge. She paradigm. There is a need for the healing
described a new unitary-transformative par- interpersonal nature of the nurse–patient
adigm and contrasted it with the prevailing relationship as populations age and health
particulate-deterministic and interactive- care becomes more technology oriented. As
integrative paradigms (Newman, Sime, & the population becomes more multicultural,
Corcoran-Perry, 1991). In the unitary- nursing educators are teaching students to
transformative paradigm, “a phenomenon deal with polarities and foster connections
is viewed as a unitary, self-organizing field between different types of people.
embedded in a larger self-organizing field” Newman (1990b) identified the lack of
(Newman et al., 1991, p. 4) and is identified conceptual fit between conventional quan-
by its pattern and interaction with the larger titative research methods and the unitary-
whole. Change is unidirectional and unpre- transformative paradigm. She posited
dictable. Systems move through stages of research as praxis methodology combining
organization and disorganization to increas- research, practice, and theory. In this her-
ingly complex levels. meneutic method, the patient and nurse
Newman first stated that the two pre- mutually identify, describe, and verify the
vailing paradigms were relevant, but not patient’s patterns from narrative data about
sufficient, for nursing practice and nursing the most meaningful people and events in
science (Newman et al., 1991). Later she saw the patient’s life.
the unitary-transformative paradigm as the early quantitative research using conven-
only paradigm for nursing (Newman, 1997). tional methods tested propositions derived
She now considers that the unitary-transfor- from Newman’s conceptual framework of
mative paradigm includes and moves beyond health, focusing on the concepts of movement,
the particulate-deterministic and interactive- time, space, and consciousness (engle, 1996).
integrative paradigms (Newman, 2008). Adults were studied in community and lab-
According to Newman, the nurse– oratory settings. elaboration and refinement
patient relationship is nursing’s unifying of Newman’s theory shifted the research
construct (Newman, Smith, Pharris, & Jones, focus to health as expanding consciousness,