RESEARCH
ARTICLE

This thesis was added
14 July 2002

The Presenting Symptoms Associated With Arachnoiditis And The Experience Of Living With Them In Everyday Life

A thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University

by Christine Hopkins - 1998

Chapter Three: Theoretical rationale - the Science of Unitary Human Beings and arachnoiditis.

Introduction

This study, in seeking to explore and describe the symptoms and the experience of living with those symptoms in everyday life, requires a theoretical perspective that can encompass the descriptions revealed at interview within a nursing framework. Such a framework is provided by the science of unitary human beings (Rogers, 1970), which gives nursing an organised abstract system encompassing people and their environments (Rogers, 1986). Within this system, it is the nurse’s role is to work with people in a mutual process to maximise potential well-being throughout their lives.

Martha Rogers, 1914-1994: a brief biographical note.

Martha Rogers, Professor Emerita at New York State University, Doctor of Nursing, Doctor of Physics and holder of nine honary doctorates, advisor to the NASA space programme, is proclaimed by those who support her work as a nurse visionary, prophet and risk taker (Barrett, 1994). Prior to 1970, Rogers’ works concerned themselves largely with the need for a change in the education of professional nurses (Rogers, 1961, 1963a, 1963b, 1964), with a reiterated insistence that preparation for professional practice required a nursing programme with its own university based faculty leading to qualifications comparable to those of other faculties. Rogers (1970) then published a seminal work proposing the science of unitary human beings as a fundamentally new framework for a scientific knowledge base that was unique to nursing and on which education in such a faculty could be based. Concepts and principles were subsequently further refined and developed by Rogers (1980, 1986, 1988, 1990, 1992, 1993, 1994) to maintain internal consistency within the framework and congruence with new scientific thinking, such as chaos theory. Often spoken of as Rogerian science, the science of unitary human beings provided a scientifically based framework allowing nurses to express new thoughts and to develop new ways of creatively practising their profession. Both during Rogers’ lifetime, and since her death, colleagues, known as Rogerian scholars, have undertaken basic and applied research to test and develop principles and theoretical perspectives so as to expand the growing body of nursing knowledge framed within the science of unitary human beings. Such development was considered by Rogers (1986) to be a never-ending process, providing nursing with an organised abstract system encompassing people and their environments. She maintained that research should be done in relation to theories and that theoretical perspectives should be commensurate with new realities (Rogers, 1994).

The Science of Unitary Human Beings

The science of unitary human beings as a world view utilises its own abstract concepts and principles in a conceptual system specific to nursing, (Rogers, 1970, 1980, 1986, 1988, 1992, 1994). Underpinning this conceptual system is a humane and optimistic view of life’s potentials, postulated as a capacity for people to participate knowingly in the process of change, with the nature and direction of that change embodied in the principles of homeodynamics. Key concepts and principles basic to the science of unitary human beings are as follows.

Energy fields.

Energy fields are the fundamental unit of the living and nonliving universe (Rogers, 1986). Field is a unifying concept and energy signifies the dynamic nature of the field (Rogers, 1986, 1988, 1992). A field is in continuous motion and is infinite. Objects, whether living or non-living, do not have energy fields, they are energy fields (Rogers, 1992). Although there can be millions of fields (Rogers, quoted in Malinski, 1986), within the science of unitary human beings two energy fields are identified. These are human fields and environmental fields (Rogers, 1986).

Environmental fields

The environmental field is an irreducible, pandimensional energy field identified by pattern and integral with the human field (Rogers, 1992, 1994). The environmental energy field is everything within which the human energy field is embedded, including political systems, medical systems, spiritual systems and social systems. An environmental energy field is specific to its given human field (Rogers, 1986).

Human fields (Unitary human beings)

Basic to the science of unitary human beings is the unitary human being as an energy field integral with the environmental energy field. Unitary human beings are perceived as irreducible, indivisible, pandimensional energy fields identified by pattern and manifesting characteristics that are specific to the whole and which cannot be predicted from knowledge of the parts (Rogers, 1992).

Negentropy

Negentropy is the term used by Rogers to replace the concept of entropy. Entropy is a measure of disorder (Knight, 1989) within closed systems, which eventually run down. In human beings, entropy equates with inevitable death (ibid) which may be held in check for a period of time if equilibrium and homeostasis is maintained. Within a negentropic perspective, human beings are not closed systems that decay in increasing disorder. Integral with an environment of constant changes, human beings are dynamic, capable of increased order and complexity, and constantly evolving new and innovative ways to live with those changes.

Open systems

The science of unitary human beings reflects a universe of open systems in which acausality replaces causality (Rogers, 1986). A universe of open systems postulates the infinite nature of energy fields and the integrality of human and environmental fields. Energy fields are open continuously and the change manifested in them is innovative, homeodynamic and negentropic, rather than homeostatic and entropic.

Pandimensional

Pandimensional (Rogers, 1992, 1994), termed four-dimensional (Rogers, 1970, 1986) and then multidimensional (1990) in earlier Rogerian writings, is the postulate evolved to replace the three dimensional concept prevalent in older world views (Rogers, 1970). It is defined as a non-linear domain without spatial or temporal attributes (Rogers, 1992) and characterises the growing diversity of human and environmental fields in a universe of open systems. The use of a pandimensional pattern recognition creates an awareness of conscious energy patterning utilising energies from a wide range of sources.

Pattern

Pattern is the distinguishing characteristic of the human-environmental field process and manifests as unpredictable, diverse, continuous changes in pattern profiles which reflect the unique integrality of each unitary human being with their own unique environment field pattern (Rogers, 1986). Although pattern is not directly observable, manifestations of field patterning are observable events in the real world (Rogers, 1992) visible as experiences of greater or lesser diversity, of time and motion, of greater or lesser pragmatism, imagination and vision, of longer or shorter periods of sleeping and as variations in the rhythmical patterns of life (Rogers, 1992). Field patterning not only changes over time in any individual, but also differs markedly between individuals, reflecting how a person is in their world at any given point in time. The continual reshaping of patterns reflect the events of the past, hopes for the future and the interactions between the person and their environment in the relative present.

Pattern appraisal

In Rogerian research, pattern appraisal is the process of acquiring information and knowledge about phenomena that manifest human and environmental field patterns in a unitary context. Change is a feature of pattern manifestation. Because constant change is inevitable, it is the nature of the pattern that is important (Rogers, quoted in Malinski, 1986). Rogerian scholars have developed the concept of pattern appraisal in studies and in practice. Such appraisal must reflect the person’s experiences, perceptions and expressions (Barrett, 1990). The person’s expression is the reflection of the integration of their experience and perception (Cowling, 1990). Pattern appraisal is the continuous process of identifying manifestations of the human and environmental fields that relate to current health needs (Barrett, 1988).

Unitary

While Rogerian science can be deemed ‘holistic’ Rogers (1970, 1983, 1990, 1994) uses the word ‘unitary’ instead, because of her belief that holism is a concept that has plagued a great many people unable to consider the segmented world in which they grew up as more than the sum of the parts. Rogers (1994) is adamant that one can no-more get a holistic human being by adding up the parts than a cake can be got by adding up the various ingredients and proclaiming them a cake. A unitary perspective does not focus on the physical, psychological, cultural, social or spiritual parts of a holistic person, instead viewing these aspects as open systems involving a constant mutual process of change.

The principles of homeodynamics

The principles of homeodynamics are three in number and postulate the nature of change. The principle of helicy states that there is a continuous, innovative, nonprobabalistic and increasing diversity of the human environmental field that is characterised by nonrepeating rythmicities. The principle of integrality postulates the continuous mutual human field and environmental field process. The principle of resonancy postulates pattern change and organisation of the human and environmental fields as a symphonic life process of rhythmical variations, in which people are united with the rest of the world in a resonating wave of complex symmetry.

Arachnoiditis and the science of unitary human beings

In light of Rogerian concepts and principles, it is clear that there are major incongruities and inconsistencies between a disease orientated medical framework relating to arachnoiditis as set out in chapter two and a nursing study framed in Rogerian science. Within a Rogerian framework, disease symptoms need to be placed within a perspective focusing on the experience of unitary human beings integral with their environment. Entropic concepts, such as incurability and intractability, can then be considered in a negentropic way that highlights life’s potentials.