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CHAPTER 23 Margaret A. Newman 453

Dakota (Bunkers, Bendtro, Holmes, et al., 1992). With evolution of the theory, the praxis research
Jacono and Jacono (1996) suggested that student cre- incorporated practice and assisted clients in pattern
ativity could be enhanced if nursing faculty applied recognition (Newman, 1990a). Schorr, Farnham,
the theory recognizing that all experience has the and Ervin (1991) investigated the health patterns in
potential for expanding the creativity (consciousness) 60 aging women, using the theory as a framework. A
of individuals. Picard and Mariolis (2002, 2005) study of music and pattern change in chronic pain
described the application of the health as expanding by Schorr (1993) also supported Newman’s theory of
consciousness theory to teaching psychiatric nursing. health as expanding consciousness. Fryback’s (1991)
Endo and colleagues (2007) describe faculty becom- dissertation revealed that persons with acquired
ing involved with students in a project of pattern immunodeficiency syndrome (AIDS) and human
recognition that resulted in transformation of student immunodeficiency virus (HIV) infection did, in fact,
relationships. Clarke and Jones (2011) discuss describe health within physical, health promotion,
expanding consciousness theory in nursing education and spiritual domains consistent with Newman’s
and practice. theory.
Newman observed that her research not only
Research assisted clients who participated, but she and fellow
At first, Newman’s theory of health was useful in the researchers also gained a better understanding of self
practice of nursing because it contained the concepts as a nurse researcher and insight of the limitations of
of movement and time that are used by the nursing methods in earlier studies. Newman (1994) stated
profession and intrinsic to nursing interventions such that research should center on investigations that are
as range of motion and ambulation (Newman, 1987a). participatory in which client-subjects are partners
Early research with the theory manipulated concepts and co-researchers in the search for health patterns.
of space, time, and movement. Besides Newman, sev- This method of inquiry is called cooperative inquiry or
eral researchers conducted research about time, space, interactive, integrative participation. Newman (1989,
or movement. Newman and Gaudiano (1984) fo- 1990a) developed a method to describe patterns as
cused on the occurrence of depression in older adults unfolding and evolving over time. She used the
and decreased subjective time. Mentzer and Schorr method of interviewing a subject regarding different
(1986) used Newman’s model of duration of time as time frames to establish a pattern for that subject
an index to consciousness in a study of institutional- (Newman, 1987b). Newman (1990a) stated that dur-
ized older adults. Engle (1986) addressed the relation- ing the development of a methodology to test the
ship between movement, time, and assessment of theory of health, “sharing our (researcher’s) percep-
health. Schorr and Schroeder (1989) studied differ- tion of the person’s pattern with the person was
ences in consciousness with regard to time and move- meaningful to the participants and stimulated new
ment, and in another study found that relationships insights regarding their lives” (p. 37). In 1994, she
among type A behavior, temporal orientation, and described a protocol for the research and labeled
death anxiety as manifestations of consciousness had it hermeneutic dialectic. This method allows the pat-
mixed results (Schorr & Schroeder, 1991). During the tern of person-environment to reveal itself without
1980s, Marchione, using health as expanding con- disturbing the unity of the pattern (M. Newman, per-
sciousness, investigated and reported the meaning sonal communication, 2000). From the inception
of disabling events in families, presenting a case study of Newman’s theory in the 1970s until the present,
in which an additional person became part of the numerous nurse practitioners and scientists have
nuclear family. The addition was a disruptive event used the theory to incorporate the concepts into their
for the family and created disturbances in time, nursing practice or to elaborate the theory through
space, movement, and consciousness, suggesting that research. Newman advocates convergence of nursing
Newman’s work with patterns could be used to under- theories as the basis of the discipline (Newman,
stand family interactions (Marchione, 1986). Marchione 2003). She sees health as expanding consciousness as
(1986) and Pharris (2005) both advocate application of emerging from a Rogerian perspective, incorporating
the theory to practice with communities. theories of caring, and projecting a transformative