GRAND THEORY: MARTHA ELIZABETH ROGERS THEORY

Arrenged in order to completing the assignment for

Philosophy and Theory of Nursing course

By:

Class C (International) / Semester I / Batch 2020

Fuzna Dahlia Mudzakiroh (I1J020010)

DEPARTMENT OF NURSING

FACULTY OF HEALTH SCIENCES

GENERAL SOEDIRMAN UNIVERSITY

NOVEMBER

2020
 CHAPTER I
INTRODUCTION

A. Background

Theory is the relationship of several concepts or a conceptual framework, or

definition, which provides a systematic view of symptoms or phenomena by
determining the specific relationship between these concepts with a view to
describing, explaining, predicting and or controlling a phenomenon. Theories can
be tested, modified or used as a guide in research

Nursing theory according to Newman (1979), there are three ways of

approaching the development and formation of nursing theory, namely borrowing
theories from other relevant disciplines with the aim of integrating these theories
into nursing science, analyzing nursing practice situations in order to find
concepts. relating to nursing practice and creating a conceptual framework that
enables the development of nursing theory. Nursing theories have a significant
effect on improving nursing practice, through nursing research, and nursing
practice provides a phenomenon that research needs to be able to strengthen
nursing theory. Nursing theories clearly structured enhance understanding of
existing nursing phenomena and direct the scientific development of nursing
science and practice itself.

The application of nursing theory to the practice of nursing services provides

a basis for work and provides a framework for nurses to perform nursing care.
Nursing theory is currently developing rapidly to become a nursing science
starting from theory in the realm of philosophy, grand theory, middle range theory
and practice theory, this report will discuss about grand theory. One of the nursing
theories that can be applied by nurses in providing nursing care to patients is the
theory of Martha E. Rogers about "Unitary Human Beings". According to Roger
in his theory, he argues that humans are holistic individuals, giving reciprocity to
other individuals and the environment around them. Rogers, views the four
concepts in the nursing paradigm consisting of humans, environment, health, and
nursing as a whole and influencing one another. Nurses as nursing service
providers should be able to provide comprehensive nursing care, adapted to the
situation and conditions of the individual being treated and the environment that
affects the individual.

Nurses must have a sufficient foundation of nursing theory in order to be able

to select and apply appropriate theories and in accordance with environmental
conditions in health care institutions. Based on this, the group will analyze and
discuss Rogers 'theory and its application so that nurses can use a framework in
nursing care to patients based on this theory. Therefore, Martha E.Rogers' theory
and its application in the field really need to be discussed and presented, so that in
Finally, nurses are expected to improve the quality of nursing services in
providing nursing care based on a nursing theory.
B. Formulation of The Problem

The problem formulations in writing this paper are:

1. What is the biography of Martha Elizabeth Rogers?
2. What are the definitions and main concepts of Martha Elizabeth Rogers'
theory of nursing?
3. What is the picture of Martha Elizabeth Rogers' theory of nursing?
4. What is the application of Martha Elizabeth Rogers' theory of nursing?

C. Purpose

 General purpose
Analyze and discuss Rogers' theory and its application so that nurses can use a
framework in nursing care to patients based on this theory.

 Special Purpose
1. Know the biography of Martha Elizabeth Rogers.
2. Explain the definitions and concepts of Martha Elizabeth Rogers' theory of
nursing.
3. Analyzing the nursing conceptual model theory of Martha E. Roger "The
Unitary Human Being".
4. Knowing the picture of the nursing theory of Martha Elizabeth Rogers.
5. Using Rogers theory as an applicable approach in nursing care.

CHAPTER II
DISCUSSION

BIOGRAPHY MARTHA E. ROGERS

Martha Elizabeth Rogers was born on May 12, 1914 in Dallas, Texas. He
began his undergraduate career when he entered the University of Tennessee at
Knoxville in 1931. He entered the nursing school at Knoxville General Hospital in
September 1936. He received his Diploma in Nursing in 1936 and received his BS
from the George Peabody College in Masville in 1937. In in 1945 he received his
MA in Public Health Surveillance from the Teaching Faculty of Columbia
University, New York. He is the Executive Director of the nursing ministry in
Phoenix, AZ. He left Arizona in 1951 and returned to continue his studies at Johns
Hopkins University, Baltimre MD with an MPH degree in 1952 and a Sc.D in
1954. He was appointed Head of Nursing at New York University in 1954. He
officially stepped down as Professor and Head of Nursing in 1975 after 21 years
in service. In 1979 he retired honorably with the title of Professor and continued
to actively develop the world of nursing until his death on 13 March 1994.
 In her theory, Martha Rogers (1970), considers humans (human unity) as a
source of energy that is one with the universe. Humans are in constant interaction
with the environment (Lutjens, 1995). In addition, humans are a whole unit that
has self-integrity and exhibits characteristics that are more than just a combination
of several parts (Roders 1970). The whole human being is "the four sources of
energy dimensions identified by the pattern and manifestation of specific
characteristics that show unity and which cannot be reviewed based on the
constituent parts" (Maminer Toey, 1994). The four dimensions used by Martha E.
Rogers of energy sources, openness, order and organization, and the four
dimensions of humans are used to determine principles about how to develop.

DEFINITION OF NURSING ACCORDING TO MARTHA E. ROGERS

Nursing is a humanist / humanitarian science that describes and clarifies that

human beings are in the intact strategy and in the development of hypotheses in
general by estimating the basic principles for practical science. Nursing is the
science of humanity, studying nature and its relationship with human
development. Rogers said that activities are based on the principles of creativity,
art and imagination. Rogers stated that nursing activities are activities that are
rooted in abstract science, intellectual thinking, and conscience. Rogers
emphasized that nursing is a scientific discipline in its activities promoting the
application of skills and technology. Nursing activities include assessment,
intervention,

BASIC ASSUMPTIONS

The basis of Rogers' theory is the science of the origin of humans and the
universe such as Anthropology, Sociology, Religion, Philosophy, historical
development and mythology. Rogers theory focuses on the process of human life
as a whole. Nursing Science is the study of Human, Nature and Human
Development directly. (Tomey & Alligood, 1998)

Based on the conceptual framework developed by Rogers, there are five

assumptions about humans, namely:
1. Unifield whole is greater and different than the sum of part.
Humans are a complete system that is a whole process that is complete from
themselves and differs from one another in several parts and is the sum of the
parts.
2. Mutual exchange of matter and energy.
Humans and the environment are always changing continuously, including both
energy. Individuals and the environment exchange energy and materials with each
other. Some individuals define the environment as a factor external to an
individual and is a unified whole of all things.
3. Unidirectionality: life process does not reverse nor repeat.
That the process of human life is constant and interdependent in one continuous
space and time. As a result, an individual will never return or become as originally
expected.
4. Pattern and organization identify the human field.
Patterns and organizations identify pbehavior in individuals is an innovative form
of unity
5. Human beings have abstraction, imagery, language, and thought, sensation
and emotion.
Humans are characterized by the ability to think abstractly, imagine, speak
language, sensations and emotions. Of all the forms of life in the world, only
humans are able to think and accept and consider the vastness of the world.

The five assumptions above, definitions, and hemodynamic principles are at

the core of Martha E. Rogers's theory which is part of Building Blocks, which
consists of: (Tomey & Alligood, 1998).
a. Energy Fields
The energy field is the basic unit of life and non-life, such as human energy and
environmental energy. This building is unlimited, consisting of living things and
their environment. These two components cannot be reduced, humans cannot be
separated from their environment.
b. Universe of Open System.
The concept of the universe of open systems holds that energy fields are infinite,
open, and integral with one another (Rogers, 1983). The human and
environmental fields are in continuous process and are open systems.
c. Pattern
The nature of the pattern changes continuously and is innovative, unique and
blends with the building's own environment. A constant, unchanging pattern can
be an indication of illness or illness.
d. Pandimensionality (Four dimensions)
Rogers defines pandimensionality as a nonlinear domain without spatial or
temporal attributes, or as Phillips (2010) notes: "essentially a spaceless and
timeless reality". The term pandimensional provides for an infinite domain
without limit. It best expresses the idea of a unitary whole

Here there are elements that are related to each other, namely humans and
their environment. As a living system and energy source, individuals are able to
extract energy and information from the environment and use energy and
information for the environment. Because of this exchange of individuals is an
open system that underlies and limits Martha E. Roger's main assumptions.

According to Martha E. Roger, the science of nursing is directly related to the

process of human life and aims to explain and predict naturalness and its
relationship with development. To strengthen his theory, Martha E. Rogers
combines the concept of the whole human being with the principles of
homeodynamics which he later put forward. Hemodynamic principles consist of
three things, namely:
a. Resonancy
This principle talks about nature and the changes that occur between humans and
the environment. Resonance can be described as a wave pattern represented by
changes from the lowest frequency to the higher frequency of the changing wave.
b. Helicy
The principle which states that the natural state and the relationship between
humans and the environment are sustainable, innovative, is indicated by the
increase in the types of human and environmental behavior patterns that give rise
to sustainable, beneficial, simultaneous interactions between humans and the
environment, not expressing rhythm.
c. Integrality
Is a process of beneficial interaction between humans and their environment on an
ongoing basis.

COMPARISON WITH OTHER THEORY

The principle of hemodynamics is easier than systems theory in general. The

principle of hemodynamics is helicy compared to the principle of equifinalli and
negetropy. Equifinally is an open system that may be achieved depending on the
circumstances and is determined by a measurement that has a goal. The principles
of hemodynamics provide guidance to determine the relationship between
individual development and nature as a healthy response to problems that occur.

Success in using the principles of hemodynamics requires the consideration

of nurses and involves both the nurse and the client in the nursing process. If
something outside the individual is part of the environment then the nurse
becomes part of the client environment. Nursing works with clients not for clients.
This includes the nursing process by showing that nurses care about humans as a
whole, not only one aspect, one problem, or limited to meeting their needs.

PARADIGMA MARTHA E. ROGERS

Rogers put a set of basic assumptions that describe the process of human life.
The assumptions that are the main keys of Martha E. Rogers regarding the four
central concepts are as follows:
1. Nursing
Nursing is a learned profession and is both a science and an art. It is an empirical
science and, like other sciences, it lies in the phenomenon central to its focus.
Rogerian nursing focuses on concern with people and the world in which they live
a natural fit for nursing care, as it encompasses people and their environments.
The integrality of people and their environments, operating from a
pandimensional universe of open systems, points to a new paradigm and initiates
the identity of nursing as a science. The pur-pose of nursing is to promote health
and well-being for all persons. The art of nursing is the creative use of the science
of nursing for human betterment (Rogers, 1994b). "Professional practice in
nursing seeks to promote symphonic interaction between human and
environmental fields, to strengthen the integrity of the human field, and to direct
and redirect patterning of the human and environmental fields for realization of
maximum health potential" (Rogers, 1970, p. 122). Nursing exists for the care of
people and the life process of humans.
2. Health.
The term health is used as a value term defined by culture or individuals. Health
and disease are manifestations of patterns and are considered to exhibit high and
low-value behavioral patterns. Rogers views the concept of health-sickness as an
expression of human interaction with the environment in a fundamental process
(Fitzpatrick and Whall, 1986).
3. Environment
Rogers defines the environment as “an irreducible, pandimensional energy field
identified by pattern and manifesting characteristics different from those of the
parts. Each environmental field is specific to its given human field. Both change
continuously and creatively”. Environmental fields are infinite, and change is
continuously innovative, unpredictable, and characterized by increasing diversity.
Environmental and human fields are identified by wave patterns manifesting
continuous mutual change.
4. Human
Humans are a complete unit and have different characteristics and characteristics.
The process of dynamic human life always interacts with the environment,
influences each other and is influenced or as an open system. Rogers also
conceptualized humans as units capable of participating creatively in change.
(Meleis, 2007).

USE OF THE ROGERS PRINCIPLE IN THE NURING PROCESS

If the nursing profession is viewed as caring for humanity, the principles of

homeodynamics provide guidelines for predicting the nature and direction of
individual development in response to health problems. Successful use of
homeodynamic principles requires the nurse's consideration in engaging clients in
the nursing process. (Alligood, 2006).

Nursing Assessment Components Assess the interactions between individuals

and the environment, how the two affect each other. Assess the varying events
during the life process. Assess the rhythm of life patterns and the environment,
change in time and change needs that occur during changes in life patterns that
rhythmically examine life goals. Nursing Diagnostic Components Describe the
merger of energy fields between individuals and the environment. Describe the
various life processes as a whole individual. Describe rhythmic patterns between
the individual and the environment.

Nursing Plan and Implementation Components Creating the best possible

environment for individuals Support or modify the variation of individual life
processes in the context as a whole Support the creation of a rhythmic dynamic
pattern between the individual and the environment. Accept differences as rapid
evolution. Components of Nursing Evaluation Evaluating changes in
environmental and individual integration. Evaluating modifications made in the
various processes of human life. Evaluating rhythmic patterns of individuals and
the environment. Evaluating the expected results

As a result of nursing assessments, conclusions are drawn about

independence. This conclusion represents a nursing diagnosis, the second step in
the nursing process, and it reflects homeodynamic principles. Rhythm, pattern,
diversity, interaction and variation of life processes are clearly visible. Nursing
diagnosis aims to determine the pattern of exchange of these parts in the life
process that includes human-environment relationships (Roger, 1970 in Meleis,
2007).

Resonance requires that the nursing plan be directed to support or modify

various life processes throughout the human being. because the process of human
life is a unidirectional phenomenon, so it cannot return the individual to the
former level of existence, but rather, the nurse helps the individual move forward
to a higher level of more diverse existence. Nursing planning in the helicy part
requires the individual's acceptance of changing strategies for enhancing and
modifying life rhythms and goals. This requires information and the client's active
participation in the nursing process. The concept that says humans are unique and
recognizable because of their ability to feel, gives nurses the opportunity to help
solve their health problems and manage their goals to achieve health.

1) The theory related to the concept creates a different perspective on a

phenomenon. Martha E Roger's framework will provide an alternative in
seeing humans and the world. The theory that nursing uses the principles of
hemodynamics in providing services to human needs or how to view nursing
from one side. An example is the helicy principle which emphasizes patterns
of habit and ritual.

2) The theory must be plausible. Knowing the development that makes sense is
an important developmental logical cause regarding the assumptions on the
principle of hemodynamics.

3) The theory must be simple and sociable. Theory can be socialized since it is
independent of several circumstances. It was stated by Martha E Roger that
the human conception is very simple. Although it provides a connection in
understanding. He added that this theory is based on the use of a very
complex open system.

4) Theory is based on hypothesis and can be tested.

5) The theory of giving and helping to increase scientific stems in scientific

disciplines through research so that the theory is valid.
6) Theory can be used as a guide and improvement in practice.

7) The theory must be consistent with other valid theories, laws and principles
but should avoid open questions that need to be examined.

RELATION OF NURSING THEORY OF MARTHA E. ROGERS WITH

NURSING RESEARCH

The abstract conceptual model proposed by Martha E Rogers is directly

related to nursing research and development. The conceptual model provides
direction and stimulus for the scientific activity. Rogers' model of nursing shows
how unique the reality of the nursing profession is. Researchers who have
assumptions and understandings such as the concept of Martha E Rogers will find
a clear view of what working as a nurse really is like. Martha E Roger clearly
shows that critical needs in nursing are the basis of knowledge in nursing research
activities.

RELATION OF NURSING THEORY OF MARTHA E. ROGERS WITH

NURSING EDUCATION

In 1963, Rogers sparked the idea to re-establish the undergraduated and

graduated programs in nursing education. This is done as a reflection of the
evolution of changes in nursing science. Consistency with the definition he gave
for nursing that nursing is a learned profession, is unique and has a body of
knowledge, so he strongly recommends for nurses to pursue education in nursing.

MARTHA E. ROGERS 'THEORY OF NURSING RELATIONSHIP WITH

NURING PRACTICES

Martha E Rogers revealed that the theory she took from her concept was very
likely to be applied in nursing practice. Malinski (1986) notes that there are seven
trends that exist in nursing practice, all of which are based on the theoretical
concepts put forward by Martha E Rogers:

1. Granting full authority in the nurse client relationship.

2. Accept differences as something normal
3. Adjustments to patterns
4. Using wave modalities such as musical lights, movement in the healing
process.
5. Shows a positive change
6. Extend the assessment phase in the nursing process
7. Receive a comprehensive relationship in life.

MARTHA E. ROGERS 'THEORY OF NURSING RELATIONSHIP WITH

FUTURE BEHAVIORS
 Rogers (1986) believes that knowledge development in his model is a "never-
ending process" using "a wealth of knowledge from multiple possible sources to
create a kaleidoscope. Rogers' explorations of new philosophy to Buddhist,
Hindu, and aboriginal examples of this belief in essential unity (Madrid, 1997).
Fawcett (2000) identifies the following three basic theories developed by rogers
of the science of human unity: 1. The theory of accelerated evolution 2. The
theory of rhythmic correlation of change 3. The theory of paranormal phenomena
further explanation and testing of homeodynamic theories and principles will
contribute to nursing science.

MARTHA E. ROGERS 'THEORY OF NURSING RELATIONSHIP WITH

RELIGION

The focus of Martah E. Rogers's nursing theory is to see humans as a whole

and exchange energy with their environment. This is like the basic principle of
human relations with nature or other creatures around him, basically there are two:
first, the obligation to explore and manage nature with all its wealth; and second,
humans as nature managers are not allowed to damage the environment, because
in the end it will damage human life itself.

ROGERS 'WEAKNESS ABOUT HOMEODYNAMICS

Although homeodynamic principles are consistent with universal goals, there

are major limitations to the implementation of universal principles. Many people
have difficulty understanding the principles. Despite the basic assumptions given
and principles established, the system remains abstract. Requirements are not
sufficient to be operationalized to provide clear understanding. The difficulty of
defining concept operations as well as bringing the abstractness of concepts and
relationships to an empirical level for testing is troubling for many nurse scientists
(Kim, 1986). An operational definition is necessary for the development of the
hypothesis that a theoretical concept test and for the selection of an adequate
instrument will measure the concepts involved (Hardy, 1974).

At this stage in the development of nursing science, sufficient instruments

would not exist to judge humans in their totality. Without these instruments, the
ability to use or test completely abstract systems is almost impossible.
Furthermore, it is the inability to adequately use or test the system that makes
implementing nursing successfulness difficult. Thus, the use of the principles of
homeodynamics in it is a finite totality. (George, Julia B. 1995: 241)

MARTHA E. ROGERS 'NURSING PROCESS DYNAMISM ILLUSTRATION

CHART

To illustrate the dynamism of the process in nursing, Rogers illustrates in

chart form as follows:
 1. Human Environment
2. Healthy is continuously connected with the individual
3. Prosperous exchange energy with individuals

The profession provides services to all people, maximizes the health

profession in human-equal interaction with the environment Concepts drawn from
human studies and observations provide the basis for the conceptual model.

CHAPTER III
CONCLUSION

In essence, Martha E. Rogers views nursing as a science and supports nursing

research. Nursing therefore develops knowledge from the basic sciences and
physiology, as well as nursing itself. Nursing aims to provide the essence of
abstract knowledge to develop scientific research and logical analysis and the
ability to apply it in nursing practice. The core scientific knowledge of nursing is
the result of the latest findings about humanistic nursing, building on a broad
theoretical basis from a variety of disciplines. Rogers developed the principles of
homeodynamics. Adheres to principles with five basic assumptions:
a. Humans are a unity, the process of individual integrity and embody the
characteristics that are more than and different from the sum of its parts;
b. Individuals and the environment are constantly exchenging matter and
energy with one another;
c. Human life processes develop irreversibly and unidirectionally over time;
d. Identify human patterns and reflect innovative wholes; and
e. The individual is characterized by a capacity for abstraction and image,
language and thinking, sensation and emotion.
The principles of integral, helicy, and resonancy are compared with general
systems theory, development theory, and adaptation theory. Ways to use
principles in the nursing process are explored. Difficulty in understanding the
principles, lack of operational definitions, inadequate instruments for
measurement are the main limitations of the effective use of this theory.
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