1. Margaret Newman’s Theory of Health as Expanding Consciousness
Julie Kalendek, RN
Lisa Little, RN
Nattallie Masso, BSN, RN
Wilmington University MSN 6501

2. Margaret Newman
Dr. Newman studied nursing at the University of Tennessee, Memphis
She received her graduate degree at the University of California in medical-surgical nursing, and received her master’s degree in 1964.
She earned her PhD at New York University in 1972, where she studied with Martha Rogers
She served as a director of nursing at a clinical research center, and taught nursing at Penn State University ( ) and at University of Minnesota ( )
In 1978 Dr. Newman began to articulate her ideas on the theory of health in nursing.

3. Margaret Newman’s Theory Health as Expanding Consciousness
According to Newman’s theory, no matter how terrible a person’s situation, the person can tune into their own self-consciousness and become one with herself or himself and find a greater meaning and opportunity for connectedness with others.
Consciousness = informational capacity of the system
System = the human being
Interconnectedness of all living organisms
Health and Illness as a unitary process
Health and evolving pattern of consciousness are the same
Persons are identified by their pattern ( the pattern of health and disease)
Link to Newman’s web page here

4. Ideas from Martha Rogers
Many of Newman's thoughts came from the work of Martha Rogers
Defined energy fields as the fundamental unit of living things
Person, family and environment exist as an interconnected, unitary whole
A unitary human being is “pandimensional” and is manifested by “characteristics that are specific to the whole and which cannot be predicted from knowledge of the parts” (Rogers, 1990, as quoted in Pharris, 2005, p. 218)

5. Health as Expanding Consciousness
Margaret Newman wrote many articles describing and refining her theory of Health as Expanding Consciousness
In her article “The Pattern that Connects,” she describes the nature and development of nursing knowledge:
“Development of nursing knowledge has evolved from an emphasis on parts to focus on the unitary pattern as a whole…….Praxis research with the intent of pattern recognition reveals the nature of nursing practice… focus on pattern represents a shift to a higher dimension which includes and transcends previous nursing knowledge” (Newman, 2002).

6. The Importance of Pattern
Health and Illness
The Importance of Pattern
Health encompasses disease and non-disease states
When disease is present, it is a manifestation of the underlying pattern of the person
This pattern is present before the physiological changes of the disease are manifested
“Health is the expansion of consciousness”
(Newman, 1979, as quoted in Pharris, 2005, p. 219)
According to Newman, health and illness are “expressions of the life process”
Are NOT opposite ends of a spectrum
Are NOT opposite sides of a coin
“A world of opposites is a world of conflict” (Newman, 2003, p. 240)
“At the highest level of consciousness, all opposites are reconciled” (Newman, 2003, p. 241)

7. Theory Applied to Nursing
“Our nursing responsibility is to help patients let go of the artificial boundaries they have imposed on their lives and get in touch with the whole” (Newman, 2003).
-Parts of a person’s underlying pattern, that emerge from interaction:
-Physical signs and appearances
-Mental/cognitive insights
-Emotional expressions
-Spiritual insights
-Nurses must strive for pattern recognition and knowing the patient on a deep level
-Nurse –client relationship often begins in times of disruption, uncertainty, and unpredictability
-Newman recognizes that nurses are change by their interactions with patients, just as patients are changed by their interactions with the nurses.

8. Research Completed Margaret Newman's Theory
Moch (1990)
Studied women with breast cancer
Focused on their relationships with significant others
Discovered a pattern of “health within illness” (Moch, 1998)

9. Research continued…………………………..
Yamashita (1999)
Studied caregivers of people with schizophrenia
Discovered themes of “struggling alone” and “lack of connectedness,” especially from health care providers
Pattern recognition helped them to discover new coping mechanisms
Result: reported feeling deepened connection with providers and with person with schizophrenia (Yamashita, 1999)
Neill (2002)
Studied women with rheumatoid arthritis
During second interview phase, after reviewing diagram, gave patients a camera to record what was meaningful to them
Third interview involved using the pictures to focus on points of personal growth (Neill, 2002)

10. Research continued…………………………...
Pharris (2002)
Worked with youth incarcerated for homicide
Used pattern recognition process for community dialogue
Brought together youth with juvenile detention staff, social workers, ED nurses and physicians, youth workers, and educators
Youth reported increased feelings of connectedness, improved relationships, and changed behaviors (Pharris, 2002)
Pharris and Endo (2007)
Nurses in hospital unit learn about HEC theory
Encouraged to journal about their experiences and to identify moments of expanding consciousness in their patients and themselves
Nurses come together for regular meetings to share insights (Pharris & Endo, 2007)

11. Applied to Personal Practice
“I try to maintain awareness of not only how I am affecting my patient, but to also reflect on how all of my patients affect me. This attitude keeps me open to connecting in new situations and to many kinds of people. It helps me to try and focus on the whole person, not just their current condition.” (Julie Kalendek)
“Each day by encouraging my patients to give it their all, and reach a higher power to recover from their heart surgery. Giving them positive reinforcement, letting them know that each day will get better, giving them hope that they can live a full life, once they make it through the recuperation period. This encouragement helps my patients connect with their inner strength and inner being and helps them move on. (Lisa Little)
"Keeping a positive attitude in the work field, and applying a holistic approach to my field to help patient's get through tough moments, making sure they know that I am here for them" (Nattallie Masso)

12. “It is time to break with a paradigm of health that focuses on power, manipulation, and control and move to one of reflective, compassionate consciousness”
(Newman, 1997, as quoted in Pharris, 2005, p. 220).

13. References
Jones, D. A. (2006). Newman’s health as expanding consciousness [Electronic version]. Nursing Science Quarterly, 19(4),
Moch, S. D. (1998). Health within illness: concept development through research and practice [Electronic version]. Journal of Advanced Nursing, 28(2),
Neill, J. (2002). Transcendence and transformation in the life patterns of women living with rheumatoid arthritis [Electronic version]. Advances in Nursing Science, 24(4),
Newman, M. A. (2010). Overview. In Health as expanding consciousness. Retrieved March 22, 2010, from &task=view&id=5&Itemid=6
Newman, M. A. (2003). A world of no boundaries [Electronic version]. Advances in Nursing Science, 26(4),
Newman. M. A. (2002). The pattern that connects [Electronic version]. Advances in Nursing Science, 24(3), 1-7.
Pharris, M. D. (2005). Margaret A. Newman’s theory of health as expanding consciousness and its applications. In M. E. Parker (Ed.), Nursing theories and nursing practice (2nd ed.). (pp ). Philadelphia: F. A. Davis.
Pharris, M. D. (2002). Coming to know ourselves as a community through a nursing partnership with adolescents convicted of murder [Electronic version]. Advances in Nursing Science, 24(3),
Pharris, M. D. and Endo, E. (2007). Flying free: the evolving nature of nursing practice guided by the theory of health as expanding consciousness [Electronic version].Nursing Science Quarterly, 20(2),
Yamashita, M. (1999). Newman’s theory of health applied in family caregiving in Canada [Electronic version]. Nursing Science Quarterly, 12(73),