Pattern recognition as a nursing intervention with Japanese women with ovarian cancer

Newman's theory of health as expanding consciousness: an evolutionary concept analysis

BACKGROUND

The health as expanding consciousness (HEC) theory posits that health and disease are interconnected components of a comprehensive process aimed at expanding consciousness.

AIM

The objective of this study is to introduce the concept, research status and applications of HEC and offer a comprehensive understanding of its various key components.

DATA SOURCES

Databases including EMBASE, PubMed, ScienceDirect, ProQuest, Wiley, Web of Science, Sinomed, China National Knowledge Infrastructure, Wanfang, and CQVIP, covering the period from 1986 to 2023.

METHOD

Employing Rodgers' evolutionary concept analysis approach, this study included and analysed 70 studies.

RESULTS

The characteristics of HEC comprise aspects such as movement, time, space, energy, rhythm, and paradigm of health. The antecedents of HEC encompass disease, chaos, binding, centring, and choice point. Consequences associated with HEC include self-transcendence, unbinding, decentring, expanded consciousness, real freedom, pattern recognition, absolute consciousness, and death.

CONCLUSION

This study has identified substitute terms, related concepts, attributes, antecedents, consequences, and empirical references associated with HEC. The findings provide valuable information applicable across various domains of nursing, encompassing practice, education, research, and management.

Life Patterns of Family Caregivers of Patients With Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a terminal disease that greatly affects patients and the family caregivers who provide most of their care. Despite the psychological, physical, and financial strain placed on ALS caregivers, few research efforts have been directed to this caregiving phenomenon. The purpose of this research study, utilizing Newman's health as expanding consciousness as the theoretical framework and research method, was to advance understanding of the experience of ALS family caregivers for the advancement of nursing science. Nine patterns of the whole across all family caregivers emerged from the data, showing important implications for nursing research and practice.

Development and Psychometric Evaluation of the Patient's Perception of Nurse-Patient Relationship as Healing Transformations Scale (RELATE Scale)

A 3-phase study was conducted to develop and psychometrically evaluate the Patients' Perceptions of their Nurse-Patient Relations as Healing Transformations (RELATE) Scale. There is a lack of tools measuring nurse-patient relationship dynamics from a unitary-transformative paradigm to evaluate the patient's experience of what works to enhance their well-becoming. The 35-item scale was completed by 311 adults with chronic illness. The Cronbach α for the 35-item scale was 0.965 suggesting good internal consistency. Principal components analyses yielded a 17-item, 2-component solution explaining 60.17% of the total variance. This theoretically driven and psychometrically sound scale will contribute to quality-of-care data.

Margaret Newman's Theory of Health as Expanding Consciousness and a Nursing Intervention from a Unitary Perspective

This mini-review aims to introduce Margaret Newman's theory of health as expanding consciousness and caring partnership as a nursing intervention. Emanating from a unitary and transformative perspective of nursing, caring partnership enables nurses to identify with cancer patients as well as to help the patients find meaning in their situation and their lives. In genuine patient-nurse interactions, both patients and nurses experience higher levels of consciousness.

Nursing Education on Women’s Health Care in Australia, Japan, South Korea, and Thailand

Only within the last 3 decades have a select number of countries addressed issues surrounding the all-inclusive health and well-being of women. This factor has had a major influence on nursing education within these countries and the subsequent development of curricula. Because the preparation of nurses is pivotal in shaping a society’s health care agenda, this article compares and contrasts demographic characteristics, curricular frameworks, the role of the nurse, quality control of nursing curricula, and the focus of nursing courses related to women’s health care among the countries of Australia, Japan, South Korea, and Thailand. Recommendations based on infant mortality rates, life expectancy, leading causes of death, and country-based health care issues are provided to inform and guide the future focus of nursing education courses on women’s healthcare within these countries.

Integrative Review on the Use of Newman Praxis Relationship in Chronic Illness

Over the past 20 years, many Newman scholars across the globe have investigated health as expanding consciousness with persons living with chronic illness. This integrative review examines the use of the concept, relationship, and its seven dimensions-health, caring, consciousness, mutual process, patterning, presence, and meaning with persons with chronic illness when engaged in health as expanding consciousness praxis. A regular and sustained pattern of publication of studies that included the seven dimensions was found. Relationships among the dimensions of a Newman praxis relationship, chronic illness, and health as expanding consciousness are discussed.

Integrative Review of Research Related to Margaret Newman’s Theory of Health as Expanding Consciousness

Since 1978 when Margaret Newman first introduced her theory of health as expanding consciousness, the theory has been widely expanded upon by Newman and nursing scholars around the world. This manuscript provides an integrative review of research related to the theory of health as expanding consciousness and analyzes strengths, limitations, and directions for the future. A consistent method of praxis within a unitary, participatory worldview was found. Health as expanding consciousness praxis provides a lens for guiding and interpreting meaning and has cross-cultural appeal and utility.

Principle-based concept analysis: recognition in the context of nurse-patient interactions

AIM

This paper is a report of a principle-based concept analysis of recognition in the context of nurse-patient interactions.

BACKGROUND

Recognition is a concept employed in practice and research. Since nursing is patient-centred and care is problem-driven, the specificity and accuracy of recognition may have an impact on how nurses label patient phenomena, interventions initiated and patient outcomes.

DATA SOURCES

The data set included 98 English language articles published from 1997 to 2008 and retrieved through Medline and CINAHL searches.

METHODS

Principle-based concept analysis was used to examine the state of the science according to major perspectives of the philosophy of science. Conceptual components were integrated into a theoretical definition and the process of recognition was conceptually modelled.

FINDINGS

The scientific literature dealing with recognition in the context of nurse-patient interactions relies on implied meaning. Recognition is a process marked by an awareness of evidence coupled with the formulation of a conceptual label summarizing the identified pattern of patient phenomena. Contextual features of the nurse, patient and organization are relevant during nurse-patient interactions, resulting in pivotal points in nursing care. These pivotal points are the moments of recognition when the nurse consciously applies a summary label to interpreted evidence. Outcomes of recognition include a choice to act or not to act, each option carrying significant outcomes for nurses, patients, and at times, organizations.

CONCLUSION

A working definition was produced that will serve as a foundation for future concept-driven research to advance the concept toward greater precision and usefulness in nursing science.

Identifying Patterns in Partnership With Students Who Want to Quit Smoking

Students who wanted to quit smoking were invited to partner with teachers/support persons to identify the meaningful patterns of their lives. The theoretical framework guiding the study was Newman’s theory of health as expanding consciousness from the perspective of the unitary-transformative paradigm in nursing science. Student participants shared the meaningful relationships and events of their lives with their supportive partners, and together they reflected on the patterns of the students’ lives. Two similarities among the individual patterns were found: a difficult experience in interpersonal relationships at some point in their lives and the initiation of smoking in their search for connectedness with friends. In the dialectic process, students experienced insight regarding their evolving patterns and made transformative changes in their lives, reflecting varying levels of tobacco control.

Life patterns of women transitioning through menopause: a Newman research study

The purpose of this study was recognition of a unitary pattern emergent within the lives of women transitioning through menopause. This research as praxis method study included 10 women transitioning through menopause. The findings showed that participants recognized unitary pattern within their unique life patterns. Unitary pattern also emerged through three themes which were coming to terms with losses and unexpected gains, increasing awareness of time passing, and concentrating on health and vitality. The findings were connected to the theory of health as expanding consciousness, thereby contributing to nursing knowledge, expanding the theory, and enhancing understanding of unitary pattern.

Health as expanding consciousness with families with a child with special healthcare needs

Families have health experiences that become enfolded within their life patterns. Based within Newman's conceptualization of health as expanding consciousness, the purpose of this study was to develop knowledge about the nurse-client process of facilitating health in families who have a child with special healthcare needs. The research as praxis method was used to answer the research question, What is the evolving pattern of the nurse-client process that facilitates health as expanding consciousness in families who have a child with special healthcare needs?

Recognizing health with pregnant Cambodian American women by finding meaning in relationship

Late entry to prenatal care is a complex problem disproportionately affecting immigrant and refugee women living in Western-style countries. Improving the health and well-being of these women and their children is a critical need. Utilizing Newman's praxis research approach, this study explored engaging 6 Cambodian American women living with pregnancy in the process of finding meaning. Dialoguing on important events and relationship from childhood to present day, patterns of health emerged. Considering data across participants, 3 preliminary themes were illuminated. Study provides new knowledge about environmental disruptions and promoting health.

A Process Model of Healing and Personal Transformation in Persons With Chronic Skin Wounds

Utilizing Newman’s research as praxis process, this research examined the patterns of those living with chronic skin wounds. Ten men and 8 women, primarily of retirement age and living with chronic skin wounds for a year or more, reflected upon important relationships and life events during two in-depth interviews and a self-expressive drawing. Emerging from each participant’s pattern was the link among human development, expanding consciousness, and processing a serious physical threat. Considering data across participants, five themes emerged from the data with evolution of a process model of wholistic healing that has implications for advanced nursing practice.

Health as Expanding Consciousness: Seven Women Living With Multiple Sclerosis or Rheumatoid Arthritis

The meaning of health as expanding consciousness is explored through stories of seven women who developed multiple sclerosis or rheumatoid arthritis during their lives. Using Newman’s hermeneutic-dialectic approach, unstructured interviews were conducted over a 2-year period. Analysis and interpretation of narratives concerning person-environment interactions revealed turning points and separate choice points before four new ways of living including finding simple pleasures, being positive, gaining self-control, and self-differentiation, were found. Support for Newman’s stages of expanding consciousness and more comprehensive descriptions of self-transcendence in space and time are presented. Implications for theory development and theory-guided practice are offered.

Partnering of Researcher and Practicing Nurses for Transformative Nursing

The purpose of this praxis research was to address the process of a researcher’s partnering with practicing nurses to incorporate Newman’s theory of health as expanding consciousness as a guide for nursing practice. Initially the nurses were bound by their commitment to help clients within a philosophy of cure, but as they began to engage in a caring relationship of pattern recognition with clients, they experienced the clients’ transformations in a way that was transformative for them and that pervaded the total realm of their nursing practice. The process illustrates the immediate applicability of Newman’s theory.

The relational core of nursing practice as partnership

BACKGROUND

Consideration of the relational core of nursing has gained significance in today's health systems, where the work of nurses is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. This has led to disregard for individual experiences of living life with diverse health conditions.

AIM

The aim of this paper is to articulate the relational core of nursing practice as partnership.

DISCUSSION

The relational core of nursing practice is explicated as a process of professional partnership, focusing on the evolving dialogue between nurse and patient. In partnership, the dialogue is open, caring, mutually responsive and non-directive. The nurse attends to that which is of concern to patients in relation to their health predicaments and the meaning in the health experience unfolds. Nurse and patient reach insight that represents more useful ways of comprehending and acting on their health predicaments.

CONCLUSIONS

Partnership represents theoretically-driven practice that invites nurses to meet patients where they are in understanding their health predicaments and what can be done about them. As such, partnership strengthens the resolve of nurses to resist the pressures of contemporary health service delivery to provide a technical form of practice and it protects the relational core of a fully professional practice.

An emerging model of behavior change in women maintaining weight loss

This study is based on and expands Newman's theory of health as expanding consciousness with women who maintained weight loss for at least 1 year. The researcher engaged in two in-depth interviews with twenty women. Individual patterns for participants who maintained weight loss revealed a personal journey of self-discovery and control with initial chaos, choice, and then emergence of behaviors reflecting expanded consciousness. Looking across participants, six patterns emerged from the data with evolution of a model of change that has implications for nursing practice at defined times within the change process of weight loss.

Quality of life for women living with a gynecologic cancer

The purpose of this research study was to enhance understanding about quality of life from the perspective of women living with a gynecologic cancer. Parse's human becoming theory provided the theoretical perspective and guided the descriptive exploratory methodology that was used. Participants were 14 women diagnosed with a gynecologic cancer. Through analysis-synthesis processes, four themes were identified, which provide the following unified description: Quality of life is treasuring loving expressions while affirming personal worth, as consoling immersions amid torment emerge with expanding fortitude for enduring. The findings suggest implications for quality care that honors persons' experiences.

Nursing praxis within Margaret Newman's theory of health as expanding consciousness

Nursing praxis was explored from the perspective of one Newman scholar. She shared her evolving perspectives on research as a doctoral candidate and as a member of a hospital-based praxis team she went on to develop with colleagues focusing on women with cancer. Using Newman's research method, the team interviewed families regarding meaningful persons and events in their lives. They then conducted another study in the form of action research. The praxis team found that Newman's theory resonated throughout nursing practice. Newman nursing praxis integrates theory, practice, and research.

Nurse-parent dialogue: illuminating the evolving pattern of families with children who are medically fragile

Guided by Newman's theory of health as expanding consciousness, this study explored the pattern of nurse-parent interaction in families with children who were medically fragile by applying the hermeneutic, dialectic method of interviewing and analysis. Living with children who are medically fragile was manifested by continual uncertainity. Families changed from trying to gain control of their uncertainty to learning to live in the uncertainty, as they evolved through an initial p[eriod of disruption and disorganization to organization at another level. This required new ways of relating to friends, family, healthcare providers, and the community, expanding the consciousness of the family.

Partnership in practice

Modern health care has increasingly focused on prescriptive, outcomes-oriented, and cost-effective practices concomitantly obscuring the humanness of the health experience. A reconsideration of partnership between nurse and client as the core of the discipline might call nurses back to what is essential to nursing: a caring relationship centered on that which is meaningful as health. This article points to the significance of the relational nature of partnership, differentiating its features and form from the prevalent understanding associated with prescriptive interventions to achieve predetermined goals and outcomes. The meaning of partnership is presented as nursing practice as it unfolds: a process of nurse and client relationship through which the caring presence of the nurse becomes integral to the health experience of the client as the potential for action. Exemplars provide illustration of this emerging view in practice and research. The article is intended to contribute to the expanding dialogue on nursing practice, inviting discussion of the relevance of partnership in different health systems.

Transcendence and transformation in the life patterns of women living with rheumatoid arthritis

Considering personal life stories as the context for health transitions can enhance understanding of what is meaningful in living with chronic illness. Informed by Margaret Newman's theory of Health as Expanding Consciousness, this interpretive study described the life patterns of three women with rheumatoid arthritis as a process of expanding consciousness. The women's stories revealed transcendence of self-boundaries and personal transformation as new ways of living, including "simple pleasures" and "being positive." Through understanding life patterns within caring nursing partnerships, transitions in an entire life story can be appreciated as complex processes involving transcendence and transformation.

The pattern that connects

Debate over whether nursing is an art or a science culminates in the need for integration of the two as a guide to practice. The historical development of nursing knowledge reveals a spectrum of evolution from physical care to interpersonal relationships to an integrative approach and, most recently, to a unitary perspective. The author proposes pattern as the integrating factor that eliminates the dichotomies of traditional art and science and transforms nursing knowledge to a higher dimension that includes and transcends the knowledge that has gone before. Nursing praxis is presented as integrated theory-research-practice that is consistent with a unitary perspective.

Coming to know ourselves as community through a nursing partnership with adolescents convicted of murder

This research applies Newman's hermeneutic-dialectic method of pattern recognition to the lives of 12 adolescent males convicted of murder who were invited to be co-investigators in the process of understanding patterns of meaningful relationships and experiences in their lives. Comparison of the 12 life patterns revealed a strikingly similar experience of interactions with the community and yielded insight into community pattern. The process of pattern recognition was found to be transformative. This article proposes a unitary-transformative process of community pattern recognition for nurses and communities interested in understanding complex community dynamics and engaging in healthy transformations.

Pattern recognition as a caring partnership in families with cancer

Pattern recognition as a caring partnership in families with cancer The purpose of this study was to address the process of a caring partnership by elaborating pattern recognition as nursing intervention with families with cancer. It is based on Newman's theory of health as expanding consciousness within the unitary-transformative paradigm and is an extension of a previous study of Japanese women with ovarian cancer. A hermeneutic, dialectic method was used to engage 10 Japanese families in which the wife-mothers were hospitalized because of cancer diagnosis. The family included at least the woman with cancer and her primary caregiver. Each of four nurse-researchers entered into partnership with a different family and conducted three interviews with each family. The participants were asked to describe the meaningful persons and events in their family history. The family's story was transmuted into a diagram of sequential patterns of interactional configurations and shared with the family at the second meeting. Evidence of pattern recognition and insight into the meaning of the family pattern were identified further in the remaining meetings. The data revealed five dimensions of a transformative process. Most families found meaning in their patterns and made a shift from separated individuals within the family to trustful caring relationships. One-third of them went through this process within two interviews. The families showed increasing openness, connectedness and trustfulness in caring relationships. In partnership with the family, each nurse-researcher grasped the pattern of the family as a whole and experienced the meaning of caring. Pattern recognition as nursing intervention was a meaning-making transforming process in the family-nurse partnership.

Pattern of expanding consciousness in midlife women: creative movement and the narrative as modes of expression

This study is based on Newman's theory of expanding consciousness; it expands Newman's method to include creative movement as a mode of expression. The researcher engaged in two in-depth interviews and one creative movement group experience with each of 17 midlife women. Results demonstrate expanding consciousness at midlife, with patterns of meaning identified in relationships with others, self, and spirit as well as challenges of loss, illness, and threats to relationships. Activities of consciousness were choosing, balancing, accepting, and letting go. Concepts of flow, turbulence, and a movement dialectic were identified in study findings. Creative movement supported self-awareness.

The rhythm of relating in a paradigm of wholeness

The importance of relating to the rhythm of another person's interactive pattern is integral to helping people move through illness and disruptive events. At times of chaos, a person's rhythm may be irregular and difficult to sense, but transformation to higher levels of organization often occurs at far-from-equilibrium states. Nurses should develop a tolerance for ambiguity and uncertainty and "hang in there" with clients until a new rhythm emerges.