ture and teaching also have the potential to enhance
knowing participation in change. These and other
noninvasive modalities are well described and doc-
umented in both the Rogerian literature (Barrett,
1990; Madrid, 1997; Madrid & Barrett, 1994) and
in the holistic nursing practice literature (Dossey,
1997; Dossey, Guzzetta, & Keegan, 2000).
Evaluation is continuous and is integral both to
pattern manifestation knowing and appreciation
and to voluntary mutual patterning. The nurse is
continuously evaluating changes in patterning
emerging from the human/environmental field
mutual process. While the concept of “outcomes” is
incompatible with Rogers’ notions of unpre-
dictability, outcomes in the Nursing Outcomes
Classification (Moorhead, Johnson, Maas, 2004)
can be reconceptualizied as potentialities of change
or “client potentials” (Butcher, 1997, p. 29), and the
indicators can be used as a means to evaluate the
client’s desired direction of pattern change. At var-
ious points in the client’s care, the nurse can also
use the scales derived from Rogers’ science (previ-
ously discussed) to coexamine changes in pattern.
Regardless of which combination of voluntary pat-
terning strategies and evaluation methods are used,
the intention is for clients to actualize their poten-
tials related to their desire for well-being and bet-
terment.
The unitary pattern-based practice method
identifies that aspect that is unique to nursing and
expands nursing practice beyond the traditional
biomedical model that dominates much of nursing.
Rogerian nursing practice does not necessarily
need to replace hospital-based and medically
driven nursing interventions and actions for which
nurses hold responsibility. Rather, unitary pattern-
based practice complements medical practices and
places treatments and procedures within an
acausal, pandimensional, rhythmical, irreducible,
and unitary context. Unitary pattern-based practice
brings about a new way of thinking and being in
nursing that distinguishes nursing from other
health-care professionals and offers new and inno-
vative ways for clients to reach their desired health
potentials.
SELECTED ROGERIAN THEORIES
In addition to the processes of the unitary pattern-
based practice method, a number of Rogerian the-
ories have been developed that are useful in
informing the pattern manifestation knowing and
appreciation and voluntary mutual patterning
processes.
Theory of Power as Knowing
Participation in Change
Barrett’s (1989) Theory of Power as Knowing
Participation in Change was derived directly from
Rogers’ postulates and principles, and it inter-
weaves awareness, choices, freedom to act inten-
tionally, and involvement in creating changes.
Power is a natural continuous theme in the flow of
life experiences and dynamically describes how
human beings participate with the environment to
actualize their potential. Barrett (1983) pointed out
that most theories of power are causal and define
power as the ability to influence, prevent, or cause
change with dominance, force, and hierarchy.
Power, within a Rogerian perspective, is being
aware of what one is choosing to do, feeling free to
do it, doing it intentionally, and being actively in-
volved in the change process. A person’s ability to
participate knowingly in change varies in given sit-
uations. Thus, the intensity, frequency, and form in
which power manifests vary. Power is neither in-
herently good nor evil; however, the form in which
power manifests may be viewed as either construc-
tive or destructive, depending on one’s value per-
spective (Barrett, 1989). Barrett (1989) stated that
her theory does not value different forms of power,
but instead recognizes differences in power mani-
festations.
The Power as Knowing Participation in Change
Tool (PKPCT), mentioned earlier, is a measure of
one’s relative frequency of power. Barrett (1989)
suggests that the Power Theory and the PKPCT
may be useful in a wide variety of nursing situa-
tions. Barrett’s Power Theory is useful with clients
who are experiencing hopelessness, suicidal
ideation, hypertension and obesity, drug and alco-
hol dependence, grief and loss, self-esteem issues,
adolescent turmoil, career conflicts, marital dis-
cord, cultural relocation trauma, or the desire to
make a lifestyle change. In fact, all health/illness ex-
periences involve issues concerning knowing par-
ticipation in change.
During pattern manifestation knowing and ap-
preciation, the nurse invites the client to complete
the PKPCT as a means to identify the client’s power
pattern. To prevent biased responses, the nurse
should refrain from using the word “power.” TheCHAPTER 13 Applications of Rogers’ Science of Unitary Human Beings 173