Introduction: Nursing theories are important for the advancement of its profession and to

fill the gap between nursing theory and practice. Today, it has become important for the nurses to
render efficient, cost effective and high quality care to the clients within the reorganized health care
delivery system. Hence they need to practice theory based nursing and they can apply theories in daily
practice to organize, understand and analyze patient data, to take decision about nursing intervention,
plan patient care, predict patient outcome and evaluate patient outcome.

There are number of theories that can apply according to specific situation. Though the person
receives the care is the central focus of all the theories, but each theorist has defined the major
concepts: The person, environment, health and nursing differently particular to that specific theory.

Martha Roger’s Science of unitary Human Beings

 Born: May 12, 1914, Dallas, Texas.

 Diploma: Knoxvilla General Hospital school of Nursing(1936)

 Graduation in Public Health Nursing, George Peabody College, TN, 1937.

 MA: Teachers college, Columbia University, New York, 1945.

 MPH: Johns Hopkins University, Baltimore, MD,1952

 Doctorate in nursing: Johns Hopkins University, Baltimore, 1945.

 Fellowship: American academy of Nursing.

 Position: Professor Emerita, division of nursing, New York University, Consultant, speaker.

 Died: march 13, 1994

Publications of Martha Rogers:

 Theoretical basis of nursing (Rogers 1970).
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 Nursing science and art: A prospective (Rogers 198).

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 Nursing: Science of unitary, irreducible, Human being update (Rogers 1990).

 Vision of space based nursing ( Rogers 1990)

Rogers nursing theory:

 Nursing is both a science and arts .The uniqueness of nursing, like that of any others science, lies
in the phenomenon central to its focus.
 Nurses long established concern with the people and the world they live is in a natural
forerunner of an organized abstract system encompassing people and the environments.
  The irreducible nature of individuals a different from the sum of the parts.
 The integral need of people and the environment that coordinate with a multidimensional
universe of open system points to a new paradigm; the identity of nursing as a science.
 The purpose of nurses to promote health and wellbeing for all persons whereby they are.

Evolution of abstract system:

 The development of the abstract system was strongly influenced by an early grounding in arts
and background of science and her keen interest in space.
 The science of unitary human being originated as a synthesis of facts and ideas from multiple
sources of knowledge.
 The uniqueness is in the central phenomena: people and environment.
 The Rogerian view of a causality emerges from an infinite universe of open system

Overview of Rogerian Model:

 Rogers’s model provides the way of viewing the unitary human.
 Humans are viewed as integral with the universe.
 The unitary human being and the environment are one, not dichotomous.
 Nursing focus on people and the manifestations that emerge from the mutual human/
environment field process.
 Change of pattern and organization of the human field and the environment field is propagated
by waves.
 The identification of the pattern provides knowledge and understanding of human experience.
 The manifestations of the field patterning that emerge are observable events.
 Basic characteristics which describe the life process of human: energy field, openness, pattern,
and pan dimensionality.
 Basic concepts include unitary human being, environment, and homeodynamic principles

Basic Concepts of Rogers Model:

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Energy field
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 The energy field is the fundamental unit of both the living and nonliving.
 This energy field “provides a way to perceive people and environment as irreducible wholes”.
 The energy fields continuously vary intensity, density and extent.

Openness:

 The human field and the environment field are constantly exchanging their energy.
 There are no boundaries or barrier that inhibits energy flow between fields.
Pan dimensionality:

 Pan dimensionality is defined as “non linear domain without spatial or temporal attributes”.
 The parameters that human use in language to describe events is arbitrary.
 The present is relative; there is no temporal ordering of lives.

Sub Concepts:
Unitary: unitary refers to being a whole which cannot be Brocken down into parts or irreducible.

Unidirectionality: Where the life process exists along an irreversible space-time continuum.

Synergy: Synergy is defined as the unique behavior of whole system, unpredicted by any behaviors of
their component functions taken separately. Human behavior is synergistic.

Homeodynamics: A dynamics version of homeostatistics(a relative steady state of internal operation in

the living system).
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Homeodynamics principles: it postulates the way unitary human being are perceived. The fundamental
unit of the living system is an energy field.

Resonancy: Resonancy is a continuous dynamic change from lower to higher frequency wave pattern
during human environmental process.

Helicy: All energy patterns are unpredictable, continuous, nonlinear providing increasing diversity. It is
compared with the slinky, which represents the continuous, open life process, moving unidirectional
from conception to death in a non linear plane.
Integrity (Synchrony+ Reciprocity ): Integrity is the mutual, continuous relationship of the human energy
field and the environmental field; one affects the other. Molding occurs by the continous repatterning of
both fields by resonance waves at the same time.

Whereas Reciprocacy is the inseparability of man-environment energy field that predicts the
sequential changes In life process which are continuous and Synchrony is the changes in human
behavior, determined by the simultaneous interaction of the human- environmental field at any given
points in space-time.

Nursing clients: Human beings and environmental energy fileds relationship.

Nursing therapeutics: Repatterning of man and environment for more effective fulfillments of life’s
capabilities.

Metaparadigm/Major concepts: The paradigm of Rogerian Unitary Humanbeings are:

Unitary Human Being (person):

 A unitary human being is an “irreducible, indivisible, pan dimensional(four- dimensional)energy

field identified by pattern and manifesting characteristics that are specific to the whole and
which cannot be predicted from knowledge of the parts” and “ a unified whole having its own
distinctive characteristics which cannot be perceived by looking at, describing, or summarizing
the parts.
 The people has the capacity to participate knowledge and probabilistically in the process of
change.

Environment:

 The environment is an “irreducible, pan dimensional energy field identified by pattern and
integral with the human field”
 The filed coexist and are integral. Manifestation emerges from this field and is perceived.

Health:
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 Rogers defined health as an expression of the life process; they are the “ characteristics and
behavior emerging out of the mutual, simultaneous interaction of the human and
environmental fields’
 Health and illness are the part of the same continuum.

Rogers Concept of Nursing:

 Nursing is a learned profession-it is a science and art.

 Nursing is the study of unitary. Irreducible, indivisible human and environmental energy fields.
  The art of Nursing involves the imaginative and creative use of nursing knowledge.
 The purpose of nurse is to promote health and well being for all persons and group wherever
they are using the art and science of nursing.
 The health services should be community based.
 Rogers challenges nurses to consider nursing needs of all people, including future generation as
life continuous to evolve from earth to space and beyond.
 Her view provides a different world view that encompasses a practice of nursing for the present
time and for the imagined and for the yet to be imagined future.
 Rogers envisions a nursing practice of noninvasive modalities, such as therapeutic touch,
humour, guided imagery, use of colour, light, music , meditation focusing on health potential of
the person.
 Professional practice in nursing seeks to promote symphonic interaction between man and
environment, to strengthen the coherence and integrity of the human field, and to direct and
redirect pattering of the human and environmental fields for realization of maximum health
potential.
 Nursing intervention seeks to coordinate environmental field and field rhythmicities,
participates in the process of change, to help people move toward better health.
 Nursing aims to assist people in achieving their maximum potential.
 Nursing practice should be emphasized on pain management, supportive psychotherapy
motivation for rehabilitation.
 Miantenence and promotion of health, prevention of disease, nursing diagnosis, intervention,
and rehabilitation encompasses the scope of nursing.

Assumptions about people and Nursing:

 Nursing exist to service people. It is the direct and overriding responsibility to the society.
 The safe practice of nursing depends on the nature and amount of scientific nursing knowledge
the individual brings to practice. The imaginative and intellectual judgment with which such
knowledge is made in service to the mankind.
 People need knowledgeable nursing.
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Homeodynamic principles:
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 The principles of homeodynamic postulates the way of preventing unitary human being.
 The fundamental unit of the living system is an energy field.
 Three principle of homeodynamic
 Resonancy
 Helicy
 Integrality
Resonance:
 Resonance is an ordered arrangement of rhythm characterizing both human field and
environmental field that undergoes continuous dynamic metamorphosis in the human
environment process.
Helicy:
 Helicy describes the unpredictable, but continuous. Nonlinear evolution of energy fields as
evidenced by non repeating rhythmic ties.
 The principle of Helicy Postulates an ordering of the humans evolutionary emergence.

Integrity:
 Integrity covers the mutual, continuous relationship of the human energy field and the
environmental field.
 Changes occur by the continuous repatterning of the human and environmental fields by
resonance waves.
 The fields are one and integrated but unique to each other.

Rogerian theories:
Rogerian theories-Grand theories:

 The theory of accelerating evolution.

 The theory of paranormal phenomena.
 The theory of rhythm cities

Theory of Paranormal Phenomena:

 This theory focus on the explanations for precognition, dejavu, clairvoyance, telepathy, and
therapeutic touch.
 Clairvoyance is rational in a four dimensional human field in contiguous mutual, simultaneous
interaction with a four dimensional world; there is neither linear time nor any separation of
human and the environment fields.
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The theory of Accelerating Evolution:

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 Theory postulates that evolutionary change is speeding up and that the range of discovery of life
process is widening. Rogers explained that higher wave frequencies are associated with
accelerating human development.

Theory of Rhythmicity:

 Focus on the human field rhythms.

 (These rhythms are different from the biological, psychological rhythm).
  Theory deals with the manifestations of the whole unitary man as change in human sleep wake
patterns, indices of human field motion perception of time passing, and other rhythmic
development.

Theories derived from the science of Unitary Human Beings:

 The perspective rhythm model (Patrick 1983).
 Theory of health as expanding consciousness(Neomann,1986)
 Theory of creativity, actualization and empathy (Alligood 1991)
 Theory of self transcendence (Reed1997).
 Power as knowing participation in change (Barrett 1998).

Roger’s contribution to nursing knowledge:

 Rogers was one of the first nurse scholars to explicitly identify the person (unitary man) as the
central phenomena of nursing concern.
 Nursing abstract system is a matrix of concepts relevant to the life process in man.
 Rogers conceptual system provides a body of knowledge in nursing that will have relevance for
all workers concerned with people, but with special relevance for nurses; because it matters to
human beings; consequently to nurses.
 In the evolution it is properly subjected to reformulation and changes as the knowledge grows
the conceptual data will be more clearer and it will take new dimensions.
 The utilization of Rogerian model is used as a guide for theory development, research, nursing
education, and in the direct patient care practice.

Rules for Nursing research Guided by the Rogerian theory:

Rules for research:
 The Rogerian research requires both basic and applied research.
 The phenomena to be studied are unitary human being and their environment interaction.
 Study participants may be any person or group, with the provision that both person and
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environment are taken into account.

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Research methodology:

 Qualitative and quantitative methods can be applied,

 Experimental researches are questionable because she rejects the notion of casualty.
 Case study and longitudinal research are better than cross sectional study.
 Research instrument that are directly derived from science of unitary human beings should be
used .
 Data analysis – multivariate analysis (canonical correction studies).
Research tools derived from science of unitary human beings:

 Perceived field motion scale.

 Human field rhythm scale.
 Temporal experience scale.
 Assessment of dream experience scale.
 Person environment participation scale,
 Leddy healthiness scale.
 Mutual exploration of the healing human environment field scale.
 Garon assessment of pain scale
 Family assessment tool.
 Community health assessment tool

Rules for nursing education guided by Rogerian Theory:

Focus of the Curriculum:

 Nursing education can be for professional nursing, technical nursing.

 The focus is the transmission of the body of knowledge.
 Teaching and practicing therapeutic touch.
 Conducting regular in-service education.

Nursing programs:

 Baccalaureate degree program.

 Master program
 Doctoral program.
 The major concepts are – principal of Resonancy, Helcy, Integrality.
 The faculty in the nursing education must be prepared at doctoral level.

Teaching-Learning Strategies:

 Emphasis should be on developing self awareness as an aspect of the clients environmental

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energy field and the dynamic role of nurse pattern manifestation on the client.
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 Emphasis on laboratory study- the lab setting include home, schools, industry, clinics, hospitals,
other places where people lives.
 Importance of use of media in education.

Rules for nursing Administration guided by Rogerian Theory:

Purpose of nursing services:

 Nursing services is the center of any health care system.

 The purpose of nursing services is health promotion.
Characteristic of nursing services:

 The administrators should hold higher degrees in nursing and licensed.

 Leaders must be visionary and willing to enhance innovative and creative change.
 Leaders should be able to identify the patterning toensure the integrated behaviors for client
and employees.

Management strategies and administrative policies:

 Administrative policies foster an open and supportive administrative climate that enhances staff
members self esteem, actualization and freedom of choice ad provide opportunity for staff
development and continuing education.
 The ultimate goal is the client’s well-being.

Rules for independent practitioner guided by Rogerian Model:

 Nursing is an independent science.
 Nurse assumes the role of potentiator of care.
 She proposes the independent role in various setting like school, industry, community space
(by 2050D).
 Independent practitioner is an advanced practice registered nurse whose focus on well-being or
mutual patterning of individual, family, community across the life span, risks developing
dissonance/ illness.

Rules for nursing practice guided by Rogerian Theory:

Areas of Rogerian model application
Settings:
 All spheres of life
 School
 Industry
 Family
 Community
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
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Space
Specialties:
 Pediatrics
 Psychiatry
 Oncology
 Burns
 Geriatrics
 Neurology.
 Cardiology
  Rehabilitative medicine.

Specialized areas of practice:

 Neonatal ICU.
 Pediatric ICU.
 Post operative unit.
 Pre operative unit.
 Palliative care unit
 Rehabilitation center.
 Burns unit.
 Adult ICU’s
 Old age homes
 Neuropsychiatric units

Area where Rogerian Model is not applicable:

 Operation theatres

Purpose of Nursing Practice:

 To promote well-being for all person’s wherever they are.

 To assist both the client and nurse to increase their awareness of their own rhythm.

Setting for practice:

 From community to Hospital to outer space.

Legitimate participants:

 People of all ages both as individual human energy fields and group energy field.

Nursing Process- Health patterning practice method:

 Assessment
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 Voluntary mutual patterning.

 Evaluation
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For the nurse:

 Pattern appraisal
 Mutual patterning of Human and environmental fields.
 Evaluation

For the patient:

 Self reflection
  Patterning activities
 Personal appraisal.

Science of Unitary Human Beings and Nursing Process:

The nursing process has three steps in Rogers’ Theory of Unitary Human Beings: assessment, voluntary
mutual patterning, and evaluation.

The assessment areas are the total pattern of events at any given point in space-time, simultaneous
states of the patient and his or her environment, rhythms of the life process, supplementary data,
categorical disease entities, subsystem pathology, and pattern appraisal. The assessment should be a
comprehensive assessment of the human and environmental fields.

Assessment:

Areas of assessment.
 Simultaneous state of the individual and the environment.
 Total pattern of events at any given point in space-time.
 Rhythms of life process.
 Supplementary data.
 Categorical disease entities.
 Subsystem pathology.
 Pattern appraisal.

It is a comprehensive assessment:

 Human field patterns of communication, exchange, rhythms, dissonance.

 Environmental fields pattern of communication, Rhythms, dissonance, harmony.
 Intuitive reflection of self.
 Validate with self.
 Validate with the client.
 Mutual patterning of human and environmental field.
 Sharing knowledge.
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 Offering choices.
 Empowering the client.
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 Fostering patterning
 Evaluation.
 Repeat pattern appraisal
 Identify dissonance and harmony
 Validate appraisal with the client.
 Self reflection for the client.
 Pattern appraisal include appraisal of multiple lifestyle rhythms such as;
 Nutrition
  Work/ Leisure activities
 Exercise
 Sleep/ Wake Cycles.
 Relationships
 Discomfort or pain
 Fear or hopes.

Mutual patterning of human and environmental field: Mutual patterning of the human and
environmental fields includes:

 sharing knowledge
 offering choices
 empowering the patient
 fostering patterning
 evaluation
 repeat pattern appraisal, which includes nutrition, work/leisure activities, wake/sleep cycles,
relationships, pain, and fear/hopes
 identify dissonance and harmony
 validate appraisal with the patient
 self-reflection for the patient
.

Evaluation:

 Repeat pattern appraisal.

 Identify dissonance and harmony.
 Validate appraisal with the client.
 Self-reflection with the client.
 Pattern appraisal include appraisal of multiple lifestyle rhythms such as;
 Nutrition.
 Work/ leisure activity
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 Exercise
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 Sleep/wake cycles.
 Relationship
 Discomfort or pain
 Fear/ hope.

Patterning activities for the client:

 Meditation
 Imagery.
 Journaling
  Modifying the surroundings.

Strengths:
 Martha Rogers’ concepts provide a worldview from which nurses may derive theories and
hypotheses and propose relationships specific to different situations.
 Rogers’ theory is not directly testable due to a lack of concrete hypotheses, but it is testable in
principle.

Weaknesses:
 Rogers’ model does not define particular hypotheses or theories, for it is an abstract, unified,
and highly derived framework.
 Testing the concepts’ validity is questionable because its concepts are not directly measurable.
 The theory was believed to be profound and was too ambitious because the concepts are
extremely abstract.
 Rogers claimed that nursing exists to serve people. However, nurses’ roles were not clearly
defined.
 The purpose of nurses is to promote health and well-being for all persons wherever they are.
However, Rogers’ model has no concrete definition of a health state.

Clinical case study of Radha using Rogerian Conceptual Model:

Radha is a 22 years old female admitted in a psychiatry unit with severe depression secondary to
diagnosis of ovarian malignancy,

 She becomes tearful during history taking.

 Radha is accompanied with her husband and one year old child.
 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
oophorectomy and hysterectomy and hysterectomy 30days ago she is undergoing
chemotherapy due to its metastatic pattern. From past 3weeks Radha started sitting alone,
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decreased ADL, repeated crying spells, decreased talks, neglects hygiene, muttering to self,
decreased sleep, appetite, neglecting her child, complains of severe pain in the body 3days back
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attempted suicide by consuming rat poison.

Current assessment findings: Her general appearance is a teary eyed young
women, ill-kempt, clinging to her husband, looking perplexed, poor nutritional intake, when
asked about her illness she cries inconsolably. On repeated asking expresses sadness of mood.

Nursing care of Radha with Roger’s Model:

  With Rogerian model, the process of caring Radha begins with pattern appraisal.
 Nursing care involve pattern appraisal, mutual patterning, and evaluating.

Pattern appraisal:

 This visible rhythmical pattern is a manifestation of evolution towards dissonance.

 Radha has pattern manifestation of dissonance, depression with suicidal ideation, ovarian
malignancy, pain.
 Radha has a low educational background.
 A pattern activity of healing is noted through reports of a positive operative course.
 Patterning has to be directed towards reduction in perceived dissonance with her personal and
environmental field.
 Pain is a manifestation of perceived dissonance.
 Decreased environmental energy transfer is visible by decreased talking and crying.
 Radha has manifestation of fear. Her knowledge links her illness to her personal belief of being
punished for her past sins.
 Appraisal is needed in her sleep patterns, nutrition and her perception of self.
 Appraisal is needed in her sleep patterns, nutrition and her perception of self.
 Appraisal can be grouped into exchanging patterns, communications patterns and relating
pattern.
 The nurse has to spend time with Radha to foster her healing.
 During the process nurse must rely on personal intuition and insight regarding the emerging
pattern.
 All the pattern forms the unitary patterns of Radha.

Mutual patterning:
 The process is mutual between the nurse and Radha.
 The surgery performed, medication she is receiving are patterning modalities.
 Patterning activities planned by the nurse for Radha……..therapeutic touch, humor, meditation,
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imagery
 Radha needs to be assessed fully regarding her ability to understand and agree with different
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patterning modalities.
 Therapeutic touch can be introduced to Radha.
 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 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.
 Options are introduced relating to increase communication and hygiene patterns.
 The entire family is involved in power as knowing participation in change.

Evaluation:

 The evaluation process centers on the perceptions of dissonance that exist after the mutual
patterning activities.
 The appraisal process is repeated.
 Manifestation of worry, pain, fear, sadness of mood 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 and indicated based on the evaluation

Conclusion:
The Science of Unitary Human Beings is highly generalizable as the concepts and ideas are not confined
to a specific nursing approach, unlike the usual way of other nurse theorists defining the major concepts
of a theory.

Rogers gave much emphasis on how a nurse should view the patient. She developed principles that
emphasize that a nurse should view the client as a whole.

Her statements, in general, made us believe that a person and his or her environment are integral to
each other. A patient can’t be separated from his or her environment when addressing health and
treatment. Her conceptual framework has greatly influenced nursing by offering an alternative to
traditional nursing approaches.
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Bibliography
1. Raj Bhaskara d Elakkuvana; Nursing theories a practical View; Second Edition; jaypee; New
Delhi; Pp 96-109.

2. Rao Sridhar; Community Health nursing; first edition(2017); AITBS Publishers; Delhi; Pp.9-10

3.Vati Jogendra: Nursing foundation(concepts and perspectives; 1st edition(2015); Jaypee

Brothers Medical Publishers(P)Ltd(New Delhi); Pp 236-238.

4. Khan Yaseen S; A concise Text Book of Advanced Nursing Practice; 2 nd Edition (reprint 2020)
EMMESS (Bangalore); Pp.450-457.

5. https.// nurseslabs.com/Martha-s-rogers-theory-unitary-human-beings.

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SUBJECT: ADVANCE NURSING PRACTICE

Class presentation on
 Martha Roger’s Science of Unitary Human beings.

Submitted to Submitted By
Madam M. Samanta Narjina Begam
Senior Lecturer 1 st Year
College of Nursing m.sc Nursing Student
N.B.M.C& H CON, NBMC & H
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