Margaret Newman’s Health As Expanding

Consciousness

Josephine Ann J. Necor, RN

Margaret NewmanBorn on October 10, 1933.Bachelor’s degree -

University of Tennessee in 1962

Master’s degree - University of California in 1964

Doctorate - New York University in 1971

She has worked in - University of Tennessee, New York University, Pennsylvania State University, University of Minnesotat, University of Minnesota

“Health is the expansion of

consciousness.”

- Newman, 1983

Health As Expanding Consciousness

-Middle Range Nursing Theory

THEORETICAL SOURCESMartha Rogers -Theory of Unitary Human Beings

The main basis of the development of Newman’s theory.The health of a human being is a unitary phenomenon,

an evolving pattern of human-environment (Rogers, 1970).

Itzhak  Bentov – The concept of evolution of consciousness“Life is a process of expanding consciousness.

Consciousness is the informational capacity of the system and can be seen in the quality of interaction of the system with the environment” (Bentov, 1978).

THEORETICAL SOURCESArthur Young – The Theory of Process

A person moves through stages of consciousness involving the loss of freedom in the development of self-identity until a turning point is reached when the ‘old rules’ don’t work anymore. The life task is to discover the ‘new rules’ and move toward increasing freedom and higher consciousness (Young, 1976).

David Bohm – The Theory of ImplicateThe explicate order is a manifestation of the implicate

order. (Bohm, 1980)

THEORETICAL SOURCESPrigogine – Theory of Dissipative Structure

A system fluctuates in an orderly manner until the occurrence of a disruptive event, at which time the system moves in seemingly random, disorderly ways until it chooses a new direction at a higher level of organization (Prigogine, 1976).

The theory of health as expanding consciousness was stimulated by concern for those whom health as the

absence of disease or disability is not possible. Nurses often relate to such people: people facing the

uncertainty, debilitation, loss and eventual death associated with chronic illness. (Newman, 2010).

USE OF EMPIRICAL EVIDENCEEvidence for the theory of health emanated from

Newman’s early personal family experiences. Her mother’s struggle with a chronic illness and her dependency on Newman sparked an interest in nursing. From that experience evolved the idea that “illness reflected the life patterns of the person and that what was needed was the recognition of that pattern and acceptance of it for what it meant to that person.”

Research has been conducted on the theoretical sources used.

MAJOR CONCEPTSAND DEFINITIONS

HEALTHRogers’ insistence that health and illness are

simply manifestations of the rhythmic fluctuations of the life process is the foundation for viewing health and illness as a unitary process moving through variations in order-disorder. From this standpoint, one can no longer think of health and illness in the dichotomous way characterized by medical science; that is, health as absence of disease or health as a continuum from wellness to illness. Health and the evolving pattern of consciousness are the same. 

PATTERNA person is identified by her or his pattern,

which reflects the pattern of the person within the larger pattern of the environment. The pattern is evolving through various permutations of order and disorder, including what in everyday language is called health and disease. Pattern recognition emerges from a process of uncovering meaning in a person’s life. Meaning is inherent in pattern, and vice versa.

CONSCIOUSNESSdefined as the informational capacity of the

system (in this case, the human being); that is, the ability of the system to interact with the environment (Bentov, 1978).  Consciousness includes not only the cognitive and affective awareness normally associated with consciousness, but also the interconnectedness of the entire living system, which includes physiochemical maintenance and growth processes as well as the immune system.  This pattern of information, which is the consciousness of the system, is part of a larger, undivided pattern of an expanding universe.

Three Correlates of Consciousness:

MOVEMENTTIMESPACE

The relevance of movement, time and space was part of the original explication and has re-emerged in the evolving patterning of unfolding consciousness.

To see health as the pattern of the whole, one needs to see disease not as a separate entity but as a manifestation of the evolving pattern of person-environment interaction. The paradigm shift is:

From treatment of symptoms to a search for pattern.From viewing disease and disruption as negative to

viewing them as part of the self-organizing process of expanding consciousness.

From viewing the nursing role as addressing the problems of disease to assisting people to get in touch with their own pattern of expanding consciousness.

MAJOR ASSUMPTIONS1. Health encompasses conditions heretofore

described as illness, or, in medical terms, pathology 

2. These pathological conditions can be considered a manifestation of the total pattern of the individual

3. The pattern of the individual that eventually manifests itself as pathology is primary and exists prior to structural or functional changes

MAJOR ASSUMPTIONS4. Removal of the pathology in itself will not

change the pattern of the individual 

5. If becoming ill is the only way an individual's pattern can manifest itself, then that is health for that person 

6. Health is an expansion of consciousness. 

NURSING PARADIGMS

NursingNursing is “caring in

the human health experience”.

Nursing is seen as a partnership between the nurse and client, with both grow in the “sense of higher levels of consciousness”

Person/Human“The human is unitary, that is

cannot be divided into parts, and is inseparable from the larger unitary field”

“Persons as individuals, and human beings as a species are identified by their patterns of consciousness”…

“The person does not possess consciousness-the person is consciousness”.

Persons are  “centers of consciousness” within an overall pattern of expanding consciousness” 

EnvironmentEnvironment is

described as a “universe of open systems”

Health“Health and illness

are synthesized as health - the fusion on one state of being (disease) with its opposite (non-disease) results in what can be regarded as health”.

“The theory has progressed to include the health of all persons regardless of the presence or absence of disease. The theory asserts that every person in every situation, no matter how disordered and hopeless it may seem, is part of

the universal process of expanding consciousness – a process of becoming more of oneself, of finding greater meaning in life, and of reaching new dimensions of connectedness with other people and the world” (Newman,

2010).

Humans are open to the whole energy system of the universe and constantly interacting with the energy. With this process of interaction humans are evolving their individual pattern of whole.

According to Newman understanding  the pattern is essential. The expanding consciousness is the pattern recognition.

The manifestation of disease depends on the pattern of individual so the pathology of the diseases exists before the symptoms appear so removal of disease symptoms does not change the individual structure.

According to  her nursing is the process of recognizing the individual in relation to environment and it is the process of understanding of consciousness.

The nurse helps to understand people to use the power within to develop the higher level of consciousness.

Thus it helps to realize the disease process, its recovery and prevention.

Newman also explains the interrelatedness of time, space and movement.

Time and space are the temporal pattern of the individual, both have complementary relationship.

Humans are constantly changing through time and space and it shows unique pattern of reality.

STRENGTHSAND

WEAKNESSES

StrengthsCan be applied in any setting“Generates caring interventions”

WeaknessesAbstractMulti-dimensionalQualitativeLittle discussion on environment

ACCEPTANCE BY THENURSING COMMUNITY

PRACTICENewman’s model of Health is useful in the

practice of nursing because it contained concepts used by the nursing profession. Movement and time are an intrinsic part of nursing intervention, that is, range-of-motion, ambulation, turning, coughing, and deep-breathing. These parameters are used each day by the nurse in practice.

EDUCATIONNewman did not advocate one model as the

sole basis for curriculum. Rather, students should have the opportunity to study various approaches to health and nursing and to choose what is relevant to them in their practice and research.

RESEARCHSome researchers have attempted to test Newman’s

propositions of time, space, and movement.

*A negative correlation was found between depression and subjective time – findings do not support an increasing level of consciousness with age.

Cooperative inquiry or interactive, integrative participation - Newman stated that research should center around “participatory investigations in which subjects (clients) are our partners, our core-searchers, in our search for health patterns.”

CRITIQUEClarity - Semantic clarity is evident in the definitions,

descriptions, and dimensions of the concepts of the theory.

Simplicity – The deeper meaning of the theory of health as expanding consciousness is complex; The theory as a whole must be understood, not just the isolated concepts. 

Generality – generalizable; has been applied in several different cultures; applicable across the spectrum of nursing care situations.

CRITIQUEEmpirical Precision – aspects of the theory have been

operationalized and tested within a traditional scientific mode. However, quantitative methods are limited in capturing the dynamic, changing nature of this model. Qualitative approaches are being developed for a full explication of its meaning and application

Derivable Consequences – The domain of health is the nursing process. The model would be useful for guiding nursing practice and differentiating nursing’s area of concern; has received recognitions regarding application to practice

Referenceswww.currentnursing.com

Tomey, A.M., (1994). Nursing Theorists and Their Work. 3rd ed. Missouri: Mosby

http://healthasexpandingconsciousness.org/

THANK YOU!