untitled

client’s situation and should be expressed in as
many of the client’s own words as possible. Relevant
particularistic data such as physiological data inter-
preted within a unitary context may be included
in the pattern profile. Cowling (1990, 1993b) also
identified additional forms of pattern profiles, in-
cluding single words or phrases and listing pattern
information, diagrams, pictures, photographs, or
metaphors that are meaningful in conveying the
themes and essence of the pattern information.
Seventh, the primary source for verifying pat-
tern appreciation and profile is the client. Verifying
can occur by sharing the pattern profile with the
client for revision and confirmation. During verifi-
cation, the nurse also discusses options, mutually
identifies goals, and plans mutual patterning strate-
gies. Sharing the pattern profile with the client en-
hances participation in the planning of care and
facilitates the client’s knowing participation in the
change process (Cowling, 1997).
The eighth constituent identifies knowing par-
ticipation in change as the foundation for health
patterning. Knowing participation in change is
being aware of what one is choosing to do, feeling
free to do it, doing it intentionally, and being ac-
tively involved in the change process. The purpose
of health patterning is to assist clients in knowing
participation in change (Barrett, 1988). Ninth, pat-
tern appreciation incorporates the concepts and
principles of unitary science, and approaches for
health patterning are determined by the client. Last,
knowledge derived from pattern appreciation re-
flects the unique patterning of the client (Cowling,
1997).

THE UNITARY PATTERN-BASED
PRACTICE METHOD

Butcher (1997, 1999a, 2001) synthesized Cowling’s
Rogerian practice constituents with Barrett’s
practice method to develop a more inclusive
and comprehensive practice model. The unitary
pattern-based practice methodconsists of two non-
linear and simultaneous processes: pattern manifes-
tation appreciation and knowing, and voluntary
mutual patterning. The focus of nursing care
guided by Rogers’ nursing science is on recognizing
manifestations of patterning through pattern mani-
festation knowing and appreciationand by facilitat-
ing the client’s ability to participate knowingly in
change, harmonizing person/environment integral-

ity, and promoting healing potentialities and well-

being through voluntary mutual patterning.

Pattern Manifestation

Knowing and Appreciation

Pattern manifestation knowing and appreciation

is the process of identifying manifestations of

patterning emerging from the human/environmen-

tal field mutual process and involves focusing on

the client’s experiences, perceptions, and expres-

sions. “Knowing” refers to apprehending pattern

manifestations (Barrett, 1988), whereas “apprecia-

tion” seeks for a perception of the “full force of pat-

tern” (Cowling, 1997).

Pattern is the distinguishing feature of the

human/environmental field. Everything experi-

enced, perceived, and expressed is a manifestation

Pattern is the distinguishing feature of

the human/environmental field. Everything

experienced, perceived, and expressed is a

manifestation of patterning.

of patterning. During the process of pattern mani-

festation knowing and appreciation, the nurse and

client are coequal participants. In Rogerian prac-

tice, nursing situations are approached and guided

by a set of Rogerian-ethical values, a scientific base

for practice, and a commitment to enhance the

client’s desired potentialities for well-being.

Rogerian ethics are pattern manifestations

emerging from the human/environmental field

mutual process that reflect those ideals concordant

with Rogers’ most cherished values and are indica-

tors of the quality of knowing participation in

change (Butcher, 1999b). Thus, unitary pattern-

based practice includes making the Rogerian values

of reverence, human betterment, generosity, com-

mitment, diversity, responsibility, compassion,

wisdom, justice-creating, openness, courage, opti-

mism, humor, unity, transformation, and celebra-

tion intentional in the human/environmental field

mutual process (Butcher, 1999b, 2000).

Unitary pattern-based practice begins by creat-

ing an atmosphere of openness and freedom so

clients can freely participate in the process of

knowing participation in change. Approaching the

nursing situation with an appreciation of the

uniqueness of each person and with unconditional

love, compassion, and empathy can help create an

170 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration