Summary of Margaret Newman’s and Rosemarie Parse’s Grand Theories of Nursing Introduction to Grand Theories of Nursing The three commonly used levels of nursing theory are: grand nursing theories, middle-range theories and micro or practice theories. The levels are related to the theory’s degree of abstraction in its purpose, concept, and definitional components…
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The development of grand nursing theories helped to distinguish the discipline from the medical model, catalysed the extensive growth of nursing knowledge, and provided a framework for organizing nursing knowledge and nurse education curricula. Further, grand theories offer an alternative to practising solely on the basis of tradition or intuition, thus helping to professionalize nursing practice. Thesis Statement: The purpose of this paper is to summarise Margaret Newman’s and Rosemarie Parse’s grand nursing theories, examining their aim, their application to patient care and nursing, their key elements, and their strengths and weaknesses. Margaret Newman’s Theory of Health as Expanding Consciousness Margaret Newman’s 1990 theory of health as expanding consciousness arose from her insights on long-term illness. She believed that through the invalid’s expansion of consciousness, they gained a deeper appreciation for life and more meaningful relationships. This abstract model required recognition of the life pattern, acceptance of illness as part of the life pattern, and health as an expansion of consciousness. The pattern of expanding consciousness evolves irrespective of the form or direction it may take. Through this realization, illness and disease lose their demoralizing power (Rich, 2011). The theorist believed that the focus of nursing is on the nurse-patient relationship. Pattern-recognition is the key element of nursing practice and interventions. The more expanded the consciousness of the nurses, the more readily they are able to enter a transformative relationship with clients, to help the latter regain health by minimizing disease and emphasizing health (Newman, 1999). The purpose of this theory of health as expanding consciousness, is to underscore the human experiences of transformation through time and space to a more highly organized pattern of the whole. Newman’s perspective of health and illness as a unitary process moving through variations of order-disorder, was built on Rogers’ 1970 life process model with a holistic and unitary view of humans, and from Young’s idea of the acceleration of evolution of consciousness. According to Newman, consciousness pertained to all information of a system that related to its capacity to interact with its environment. “Consciousness as the essence of all things that exist, including humans” (Kim, 2006, p.297), is a part of time and space, and is reflected in movement. Newman’s theory considers health as a synthesis of the fusion of disease and non-disease, that is health consists of both wellness and illness. Disease and nondisease form “a larger wholeness that takes on a new and different form that is not diminished by illness” (Rich, 2011, p.290); this health creates a more inclusive consciousness. Therefore, the key characteristics of Newman’s theoryare: Health includes illness or patholgy; these pathological conditions are a manifestation of the total pattern of the individual; the pattern of the individual that eventually establishes itself as pathology existed as a primary feature before the occurrence of structural or functional changes; by removing the pathology the individual’s pattern cannot be changed; “if becoming ill is the only way an individual’s pattern can manifest itself, then that is health for that person”
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