Nursing Rhythm Model By Fitzpatrick’s & Rogers
Fitzpatrick’s Rhythm Model Elements
Fitzpatrick
(1989) presented a rhythm model for the field of inquiry for nursing. Person,
environment, health, and nursing are defined and related to the model. All of
these elements have been linked to the idea that meaning is essential to life.
Meaning is seen as the most crucial piece of the human experience and necessary
to enhance and maintain life. Fitzpatrick incorporated Rogers’ (1983)
postulated correlates of human development as the basis to differentiate,
organize, and order life’s reality.
Importance of Model
Fitzpatrick
(1989) recognized the importance of information systems as part of the field of
inquiry within her rhythm model for nursing.
By asserting that nursing
knowledge is fundamentally inseparable from the strategies and structures that
represent it and that nursing informatics comprises a new focus to manage the
technologies involved in nursing, Fitzpatrick suggested that information
systems be linked to nursing knowledge development.
Rogers’ Correlation
Rogers’
(1983) correlates of shorter, higher frequency waves that manifest shorter
rhythms and approach a seemingly continuous pattern serve as Fitzpatrick’s
(1989) foci for hypothesizing the existence of rhythmic patterns.
Rogers’
position that the human life span approximates transformation with human
development aimed toward transcendence has been incorporated within
Fitzpatrick’s descriptions of life perspective. The developmental correlate
whereby time seems timeless represents a beginning of Fitzpatrick’s theorizing
regarding temporal patterns.
Motion patterns have been developed from Rogers’
proposal of motion seeming to be continuous with development. Consciousness
patterns are aligned with Rogers’ idea that one progresses from sleep to
wakefulness and from there to a pattern that is beyond waking.
The correlates
of “visibility” becoming more ethereal in nature and
“heaviness” approaching a more weightless phase serve as the basis
for Fitzpatrick’s perceptual patterns.
Fitzpatrick’s (1989) definitions of
person and environment are from her interpretations of Rogers’ (1983)
developmental correlates and explanations of person and environment. Envisioned
as patterns within a pattern, or rhythms within a life rhythm, Fitzpatrick’s
rhythm patterns serve as the specifications for person and environment.
Occurring within the context of rhythmical person/environment interaction,
indices of holistic human functioning are identified by Fitzpatrick as
temporal, motion, consciousness, and perceptual patterns. Fitzpatrick’s
writings are consistent with Rogers’ position regarding person and environment
being open systems in continuous interaction.
Indices of Human Functioning
Fitzpatrick
(1989) has asserted that the four indices of human functioning are intricately
related to health patterns throughout the life span, and these indices are
rhythmic in nature.
In a projection of Rogers’ (1983) principle regarding the
continuous interaction of persons and their environments, Fitzpatrick
postulated the dynamic concepts of congruency, consistency, and integrity as
complementary with rhythmic patterns.
The nonlinear character of patterns noted
by Rogers has supported Fitzpatrick’s incorporation of Rogers’ specifications
regarding four-dimensionality. Fitzpatrick stated that health is a basic human
dimension undergoing continuous development.
She offered heightened awareness of
the meaningfulness of life as an example of a more fully developed phase of
human health. The ontogenetic and phylogenetic interactions between person and
health are regarded as the essence of nursing.
Fitzpatrick attended not only to
relationships within or between these interactions but also included latent
relationships external to person and health. Nursing interventions were
interpreted as facilitating the developmental process toward health.
Fitzpatrick stated that nursing interventions can be focused on enhancing the
developmental process toward health so that individuals might develop their
human potential.
Integration Between Environment and Individual
Because
person and environment are integral with one another and have no real
boundaries, environment is applied when the term person is used. The human
element is treated as an open, holistic, rhythmic system that is described by
temporal, motion, consciousness, and perceptual patterns.
Fitzpatrick’s (1989)
conception of person is augmented by awareness of the meaningfulness of life or
health. The meaningfulness of life is manifest through a series of life crisis
experiences with potential for growth in one’s meaning for living. Nursing’s
central concern is focused on the person in relation to the dimension of
meaning within health.
Fitzpatrick’s
(1989) conceptualizations have been investigated by graduate students in
nursing at the master’s and doctoral level.
Studies looking at temporality in
combination with adult and elderly populations, temporality in association with
psychiatric clients, temporality in pregnant adolescents, and temporality in
relation to terminally ill individuals provide a base for the existence of
temporal patterns.
However, from a holistic perspective of life span, use of
the model is absent in nursing research focused on infants” and children’s
notions of temporality.
Age Based Differences
Both
younger and elderly groups have been addressed in investigating motion (Roberts
& Fitzpatrick, 1983). Nevertheless, patterns of consciousness have been
examined exclusively in older age groups (Floyd, 1982).
Different
types of perceptual patterns, including for example, perception of color and
music, have been investigated. Because one’s perception would seem to be
dependent on the present pattern of consciousness, these studies seem to be
related to patterns of consciousness.
Empirical
support for the existence of non-linear temporal patterns emerged from a number
of research endeavors and helped to identify the need to generate questions
about ways to measure the experience of time.
The prevalence of temporal
distinctions on the basis of differences in development were apparent in at
least one study (Fitzpatrick & Donovan, 1978). A sense of timelessness was
described as being characteristic of behaviors identified among the dying.
Pressler,
Wells, and Hepworth (1993) investigated methodological issues relevant to very
preterm infant (< 30 weeks gestation) outcomes based on the idea of the
existence of micro rhythms within some larger rhythmic pattern.
By applying
time series techniques and fuzzy subsets to the analysis of longitudinal data
collected in the neonatal intensive care unit (NICU) environment, this study
examined single-subject results for generalization across individuals.
In
general terms, the sequelae and risks associated with the NICU for very preterm
neonates indicate that information processing deficits, attention deficit, and
hyperactivity disorders are not uncommon during the preschool and school-age
years.
It is speculated that these problems might reflect these infants’
inabilities to cope with stressors or care received while in the NICU
environment. Shiao (1993) investigated perceptual patterns of low-birth-weight
infants in neonatal intensive care in terms of routine care interrupting
breathing, oxygen saturation, and feeding rhythms.
Yarcheski and Mahon (1995)
examined human field patterns (as described by Rogers) in relation to perceived
health status in healthy adolescents and found results consistent with the life
perspective rhythm model.
More recently, numerous qualitative researchers have
used Fitzpatrick’s model to compare and contrast their findings, particularly
in phenomenological studies that examine participants’ experience of phenomena
(see Chiu, 1999; Cowan, C., 1995; Criddle , 1993; Montgomery, 2000, 2001 ;
Moore, SL, 1997; Pasquali , EA, 1999; Ross, 1996).
Fitzpatrick Hypothesis
Borrowing
from some of her own ideas about temporality, Fitzpatrick (1989) has
hypothesized the field of inquiry for nursing knowledge development by
outlining nursing inquiry of the past. She has traced major historical
milestones of nursing research and identified important events leading up to
present-day research in nursing.
Collaboration With Interdisciplinary Teaching
In
cooperation with two colleagues, Fitzpatrick (Fitzpatrick, Wykle , &
Morris, 1990) attempted to specify the field of inquiry for nursing in the area
of geriatric mental health.
Through the development of collaborative,
interdisciplinary teaching, research, and practice relationships, Fitzpatrick
and colleagues (1990) described how organizational theory could be used to
support the development of a collaboration model for promoting the mental
health of elderly persons across care settings.
Intervention research with
elderly populations was used to determine ways for improving the understanding,
treatment, and rehabilitation of the mentally ill. The significance of
Fitzpatrick’s ideas lies in how rhythmic methodologies might be used to develop
nursing knowledge and provide external validity to the model.