Margaret A. Newman: The Newman Theory

 Margaret A. Newman: The Newman Theory

Background

Theorist’s Background

The following is a review that introduces Margaret A. Newman and her Theory of health. The scope of the Theory touches on the expanding of consciousness.  This emanates from a unitary in addition to a transformative perspective in nursing. As medical technology evolves, patients are in great need of a caring connection with nurses.

Nonetheless, nurses often cannot establish such connections due to their demanding work schedule, time and energy requirements for a treatment-focused care (Endo, 2017). Despite this, Newman theory on health care establishes the connection that nurses requires that allows them to care for their patients in addition to helping them find meaning in their difficult situations. Primarily, this Theory is fundamental for nursing managers and family-based nurses. To understand the ideological and philosophical contribution of Margaret Newman, the following section delves into theory development touching on her background as an inspiration factor.

Margaret A. Newman is a prominent nursing theorist and leader. She is recognized for the creation of the Theory of Health as Expanding Human Consciousness in the 20^th century. Her inspiration resonates with her life having to care for people at an early age. Margaret was born on October 10, 1933, in Memphis, Tennessee (Endo, 2017). At the time, her mother was a secretary at a Baptist Church, which meant that Margaret Newman was raised as a Christian. It was through such a moral upbringing that allowed Margaret to volunteer to join missionary service later in her life. It was at this point that she realized the greater need to connect with the patient not only from a professional standpoint but a holistic one.

To be specific, Margaret reports that she noticed that people’s spiritual needs were far more critical than any other obligation. Ironically, Margaret did not know what she wanted to become when she left high school. But, fate would have her assist one of her college roommates who was a nurse in caring for the injured victims after a tornado struck. It was this encounter that made Margaret realizes her vocation in life. At this point, she took time off to reconsider taking nursing as a full-time career (Borden, 2010). Therefore, she opted to go back home where news of her mother’s illness, chronic irreversible health condition, amyotrophic lateral sclerosis would jolt her into the profession. She decided to become a primary caregiver to her mother, where she realized that “simply having a chronic disease does not make a person unhealthy.” It was at this juncture that Margaret was convinced that her mother could still experience health in spite of her having a degenerative neurological disease (Borden, 2010). In her theoretical understanding, she postulated that her mother’s life was confined to the condition but not ‘defined’ by it. She further postulated that during the progression of the disease process, while she was caring for her mother, she started experiencing the same symptoms. She indicated in her article that she began feeling ‘movement’ in time, space, and consciousness. It was at this point that one realizes that both mother and daughter started feeling a connection and came to understand each other better and in a more profound aspect. For this reason, Margaret decided that she would go back to school and become a nurse.

The journey to her success in being a renowned theorist was filled with achievements in various fields of study. In 1954, Margaret was awarded a baccalaureate degree in Economics and English from Baylor University in Texas (Borden, 2010). In the mid-1950s, she decided to become a nurse after caring for her mother, who, as noted above, suffered from degenerative neurological disease (Borden, 2010). As a result, she enrolled at the University of Tennessee, where she attained the Bachelor of Science in Nursing (BSN) in 1962. Notable achievements, consequently, include a Master’s degree in medical-surgical nursing from the University of California in San Francisco and 1971, earning a Ph.D. at the New York University, which immediately after began teaching at the same university. In the mid-1950s, Margaret served as a joint director of the clinical research center and also an assistant professor at the University of Tennessee in Memphis. While at New York University, she met another nursing theorist, Martha Rodgers, who became her mentor and inspired her to create the Theory of expanding Human Consciousness (Borden, 2010).  Consequently, in 1984, she became the nurse theorist at the University of Minnesota.

From her achievement, the gradual acceptance and evaluation of her contribution have been placed under various scopes of researcher analysis. According to Newman, the range of the concept of health was based on a persuasive manner. In other words, she expounded on the idea that ‘disease fuses with its opposite, absence of diseases, and on the other hand, non-disease brings forth the new concept of health.” Younas and Parveen (2017) examine Newman’s Theory providing an argumentative concept about it. On one end, they poise the Theory for expanding on the consciousness and usefulness of the Theory concerning research in nursing and its practice. On the other hand, they criticize the Theory concerning nursing education based on its limitations on spiritual, psychological, and social aspects of care. According to the review, Younas and Parveen (2017) determine that usefulness determines how medicine in nursing has evolved so far since, pertinence to its theory development, was only relevant in the previous century.

Margaret, in her article on expounding about her Theory, indicated that other theories at the time supported the elaborations on support in nursing treatment. For instance, Bohm’s Theory on implicate order and Young’s Theory on the evolution of consciousness. The conventional thinking per these theories was that underlying patterns in disease manifestation in patients — similar observations in research support Margaret’s thinking. Butts and Rich (2013) concur indicating that historical over-reliance on treating patients through physical attributes has not always resulted in the best results. Therefore, the achievement of consciousness is supported by Endo (2017) reiterating on caring for the patient as a nursing intervention from a unitary perspective. Thus, the wide acceptance of Margaret Newman’s Theory has been congruent with the ideological thinking of nursing intervention as not only a physical consequence but a holistic one.

 

The phenomenon of Concern (bold)

The main concern by Margaret was stimulated concern regarding individuals whose health is based on the absence of disease. The Theory developed by Margaret Newman expounded on the previous Rogers’ Theory on unitary human beings. With this regard, the Theory on health as expanding consciousness was stimulated by the concern for those whom their health as the absence of disease or disability is not possible (Newman, 2010). Nurses are often relating to such individuals: these are people facing uncertainty, debilitation, loss or death with chronic illness. Hence, the Theory, according to Margaret, was progressed to include the health of all individuals regardless of the presence or absence of disease. In other words, the Theory asserts that every patient in every situation, regardless of their physical limitations, is part of the universal process of expanding consciousness (Newman, 2010). This is defined as the process of becoming more of oneself and finding greater meaning in life.

Theory Description

            The Grand Theory is a theory that was developed through retroductive reasoning. To understand how the meaning of retroductive reasoning is required. Retroductive reasoning is the argument presented to explain the proposed account of an observed fact or a group of facts, based upon a type of similarity or co-occurrence. This is not limited by space or time. The reason for determining Margaret’s Theory as retroductive is based on the fact that the grand Theory of nursing provides the claim that every individual in every situation regardless of their distortion is part of a universal process that involves the expansion of consciousness (Newman, 2010). Endo (2017) supports this assumption indicating that Margaret determined that a person should be more focused on finding greater meaning in life and determining new dimensions of connectedness with those around them. Butts and Rich (2013) report that nursing practice embraces a unitary and transformative paradigm of nursing, which is about caring for the human health experience. Therefore, the overall concept is based on health as a unitary pattern, consciousness, and pattern defined by the person and their environment, which is characterized by meaning.

 

Concepts

The theory has the following assumptions:

1. Health is an expansion of consciousness.
2. The removal of the pathology itself will not change the pattern of an individual.
3. The pattern of a person eventually manifests itself through the pathology as a primary repercussion and then exists before any changes, whether structural or functional.
4. The pathological conditions can be considered as a manifestation of the total pattern of the individual patient.
5. Health includes conditions described as illness or in medical terms, pathology.

The basic relationships of the assumptions presented by the author have determinate words. They are defined from a practical operational standpoint. According to Endo (2017), the focus is on the pattern. Pattern refers to the ‘information that depicts the whole comprehension of the meaning of all the relationships at once’ (Newman, 2010). Butts and Rich (2013) agree with this, indicating that the Theory emphasizes wholeness, which is the definition of the pattern. The interesting aspect of the Theory is that Margaret provided a correlative assumption on her Theory’s thinking. For instance, in nursing, trend is continuously evolving. In my current practice, for instance, I often observe a pattern that is time-specific and contain information that is enfolded, which eventually unfolds itself. In other words, I mean that evolution and transformation of the pattern occurs throughout the interaction of the patient with their environment. This occurs when the nurse develops a relationship with the patient especially during the chaotic times. Hence, as the theory states, nursing intervention states that intervention is based on the evolution of pattern. Therefore, it is determined from an observational point of view, that the Newman theory is consistent in how it developed its Theory as connection with terminologies was the main conceptual frameworks of the Theory.

Diagram

Figure 1: The process of caring partnership based on Newman theory of health as expanding consciousness

            In interpretation, the concepts are defined in a more explicit standpoint. The basis of this argument is based on the fact that Newman determines or re-defines nursing according to the nursing process of recognizing that a patient is connected to their environment (Newman, 2010). For this reason, the definition of nursing practice is often denoted by the understanding of consciousness, which is the main concept of the Theory. To be specific, understanding pattern is a crucial view in nursing. For example, the manifestation of a disease depends on the pattern of the individual. So the pathology of the disease exists even before the symptoms appear. Hence, the removal of disease symptoms does not change the individual structure. Hence, it can be determined that the assumptions and concepts presented in the Theory are from an explicit understanding of the practicality of nursing practice.

Evaluation

Assumption

The following section presents the identification of the explicit and implicit assumptions underlying the Theory. Implicit is the suggestion presented in the Theory. An implicit belief in the Theory is that removal of the pathology in itself will not change the pattern of the individual. Younas and Parveen (2017) concur stating that there is no concrete proof that indicates the removal of pathology does not change the pattern of an individual. On the other hand, the explicit assumptions are based on (1) health encompasses conditions described as illness or pathology, (2) pathological conditions are determined as a manifestation of the total pattern of a patient, (3) the pattern of an individual eventually manifests itself as pathology (primary) and structural and functional changes, (4) becoming ill is the only way an individual pattern can be manifested in itself and (6) health is an expansion of consciousness (Newman, 2010). Studies that opt to review Newman’s Theory suggest that the above assumption has in-depth definitions of what is an illness and how it coincides with the unitary concept expounded in the Theory.

Metaparadigm

Metaparadigm is a set of theories and ideas that provide a framework for how the nursing discipline functions. The four main metaparadigms are people, nursing, environment, and health.

• The metaparadigm, person, determine the practice of satisfying the needs of a person through human care. The emphasis is on the individuality of people based on the set of unique and unpredictable set of needs (Branch et al., 2016). The correlation of the metaparadigm with Newman’s Theory is positive. It is explicitly expounded on the assumption the pattern of an individual eventually manifests itself as pathology (primary) and structural and functional changes (Newman, 2010).
• The other metaparadigm is health. Branch et al. (2016) define it as more than curing an illness. Margaret’s core ideology is to engage with the patient from spiritual, psychological, environmental, and physical aspects (Newman, 2010). Therefore, the paradigm is congruent with the Theory.
• Nursing is another metaparadigm. Nursing requires the establishment of a relationship with the patient. Margaret’s Theory of expanding Human Consciousness encompasses the aspect of nursing and patient relationship (Newman, 2010). It advocates for the nurse to be more involved in the patient through analysis of their presence, their pattern and wholeness. Therefore, the nursing concept is found within the Theory.
• The final concept is the environment. Branch et al. (2016) define the environment as the setting that affects the patient’s ability to heal, inclusive of how well the nurses affect the healing process. The core thinking of Newman’s Theory is about how the environment and the patient are inter-related.

Clarity

Studies that evaluate the applicability and trustworthiness of the Newman theory have one thing in common: they all determine that the Theory is consistent and lucid. The Theory provides a new paradigmatic view on nursing intervention. According to Endo (2017) there is a mutual process of inquiry about the patient. This is one of the main concepts in nursing. In my field of expertise being a nurse case manager has always taught me to form a relationship with the patient. The benefit to doing so, allows the patient to have comfort within their environment by forming a good rapport with the nurse. Butts and Rich (2013) agree with this, stating that the Theory seeks to emphasize understanding the psychological, social, physical, religious, and spiritual influences. The biography written by Borden (2010) explains that Margaret’s main intent was to accentuate on scaring more about the patient than focusing on the conventional training of curing the illness. Furthermore, the prominence is on the definition of the pattern, unification of the incidence of pathology and environment of the patient and their consciousness. Therefore, the Theory can be described as being lucid in its definition within the nursing practice with specificity to intervention.

 

Congruence

The Newman theory has a lot of similarities with other theories based on its impact with preference to nursing practice. Since I am more inclined to favor nursing practice as a family nurse practitioner, the Theory has more similarities with theories such as Bohm’s Theory on implicate order, Prigogirie’s Theory of dissipative structures, Young’s Theory on evolution of consciousness as well as Martha Rogers’ Theory on unitary of human beings (Newman, 2010; Borden, 2010). Of interest is the Rogers’ Theory which the Newman theory was developed. The two theories share common assumptions about the metaparadigms of nursing with respect to patient, nursing, health and the environment. Margaret, in her article, indicated that she gained motivation to write about her Theory through her mentor, Martha Rogers (Newman, 2010). Therefore, the congruency of Newman’s Theory places it at an advantageous point as it has been widely accepted in nursing practice and intervention.

 

Application

            The Theory is confined to use in combination with the process of pattern recognition. It is regarded as one of the prominent theory assumptions concerning research and practice. It determines how nurses can use research to form a pattern based synthesis of information with patients (Endo, 2017). Hence, it is regarded as an applicatory theory in nursing research and practice.

Level

            In my field of expertise, I plan to be a family nurse practitioner. The main scope of a family nursing practice is to work hand-in-hand with other practitioners to deliver family-focused care. With the Newman theory, it is clear that understanding not only the physiological and pathological aspects of disease in curing a patient, but there is also a need to consider other concepts such as psychological, spiritual and environmental. By combining this research work and my nursing skills, I will be able to always look at a situation from a bird’s eye view in caring for my patients.

Use

            I could use the concept of Newman’s Theory by utilizing data collection to gather information about a patient. Throughout this paper, it is evident that understanding other factors of a patient is critical to diagnosing and treating them. Therefore, I intend to achieve quality care through the integration of the Newman theory assumptions.

Weaknesses

            Throughout the research, there has been no indication of weaknesses surrounding the Theory. However, Younas and Parveen (2017) determined that the limitation with the Theory is that it proved not to be congruent with the issues about spirituality, psychological, and social aspects of nursing care. The argument is that Margaret Newman never provided an in-depth analysis of how such tenets affected patients in the short and long run of the health journey. Nonetheless, there is no dismal on the impact that Newman created in the formulation of this Theory.

Future

            In the future, I plan on integrating the Newman theory in my practice with continued exploration of the potential of health in the expansion of consciousness to transform not only nursing practice but, its education. For instance, I will aspire to create a community action plan in the analysis of findings concerning the tenets of the Theory to either agree or disagree with the Theory based on modernity.

 

 

 

 

 

 

 

 

 

 

 

 

References

Borden, M. E. (2010). Paul Newman: A Biography. ABC-CLIO.

Branch, C., Deak, H., Hiner, C., & Holzwart, T. (2016). Four Nursing Metaparadigms. IU South Bend Undergraduate Research Journal, 16, 123-132.

Butts, J. B., & Rich, K. L. (2013). Philosophies and theories for advanced nursing practice. Jones & Bartlett Publishers.

Endo, E. (2017). Margaret Newman’s Theory of health as expanding consciousness and a nursing intervention from a unitary perspective. Asia-Pacific journal of oncology nursing, 4(1), 50.

Newman, M. (2010). Health as expanding consciousness. Retrieved on November 13, 2010, from health as expanding consciousness: http://www.healthasexpandingconsciousness.org/home/

Younas, A., & Parveen, S. (2017). Finding Patterns of Meaning: Margaret Newman’s Theory of Health as Expanding Consciousness.