9 Instruments for Advancing Unitariology

This Chapter is to be developed

For each tool:
A) The development of the tool should be described
b) Psychometric Properties
c) References to studies using each tool
d) Applications to practice situations
e) Where/how the tool can be be accessed

9.1 Introduction

9.2 Methodological Issues in Rogerian Tool Development

9.3 Human Field Motion Tool (Ference, 1979)

9.4 Power as Knowing Participation in Change Tool (Barrett, 1984)

As a doctoral student at New York University in the 1970’s, working with Dr. Martha E. Rogers who served on her dissertation committee, Elizabeth A. M. Barrett developed both her power theory (see Chapter 6, section 4) and the second measurement tool derived from Rogerian nursing science. The Power as Knowing Participation in Change tool (PKPCT) can be used in both research and practice. From a research perspective, the tool has been used primarily in quantitative studies but can also be used in qualitative studies, with answers not numerically tabulated but as a focus for discussion. Today it is the most widely used Rogerian science-based tool.

One of the main assumptions in the Science of Unitary Human Beings is that humans cannot initiate or stop change but they can participate in the process of ongoing change (see earlier discussion of the science). From this assumption Barrett developed a new theory of power and a tool to operationalize power as knowing participation in change. Defined consistently over time, power is “the capacity to participate knowingly in the nature of change as manifest by awareness (A), choices (C ), freedom to act intentionally (F), and involvement in creating change (I)” (Barrett, 2003, p. 21). “In the causal, physical, material worldview, power says: ‘If I do this, then that will happen. ‘ In the causal, unitary, spiritual worldview, power says: ‘If I do this, I will see what happens‘ ” (Barrett, 2010, p. 50).

The four power dimensions are inseparable, meaning unitary, and illuminate the power profile of an individual or group. “Changes in the power profile are nonlinear and indicate (1) the nature of the awareness of experiences, (2) the type of choices made, (3) the degree to which freedom to act intentionally is operating, and (4) the manner of involvement in creating specific changes” (Barrett, 2003, p. 22). These changes, consistent with Rogerian  nursing science, are unpredictable, creative, and innovative.

Tool development for her dissertation, completed in 1983, consisted of three stages: three judges’ studies, a pilot study (N = 267), and the validation study (N = 625). The judges’ studies were done to determine words or phrases that were theoretically consistent, then to develop a semantic differential tool, first of 3 bipolar adjective pairs then refined to 38 pairs. Pilot study data were factor analyzed to determine those most discriminating for aspects of power, which emerged as a unitary dimension. Content validity was further assured by factor loadings at or above .40. The revised instrument was used in the final study. The PKPCT Version II has since been used in numerous studies.

Reliabilities computed by Cronbach’s alphas have usually been reported as above .85 (Barrett, Caroselli, Sullivan Smith, & Woods Smith, 1997). Test-retest reliabilities have been assessed ranging from .61 to .78 (Barrett, 1996). The judges’ studies provided content validity for the tool. Construct validity, assessed during the validation study using factor analysis, ranged from .56 to .70, supported later by Trangenstein’s (1988) study.

Barrett (2015) noted that some 100 studies have been conducted to date, and the tool has been translated into Korean, Japanese, French, German, Portuguese, Danish, and Swedish. Caroselli and Barrett (1998) and Kim (2009) have published reviews of power as knowing participation in change research. Multiple studies are in progress, many being conducted by doctoral students.

The following are only a few examples but give an idea of the wide range of areas explored. Heelen-Fancher (2016) studied the interrelationships of power, attitudes toward intermittent fetal monitoring, and perceived barriers to research utilization with 248 labor and delivery nurses’ attitudes toward patient advocacy. Power emerged as the most important variable for patient advocacy. Wall (2000) looked at power, hope, and exercise vs. no exercise in 97 men and women with surgical resection of lung cancer, finding a significant increase in power over time in the exercise group and a positive relationship between power and hope. Larkin (2007) looked at power and self defined  health promoting goals in 49 women and men with chronic physical illnesses who participated in either traditional or Ericksonian hypnotherapeutic support groups. She found a significant increase in power and  health promoting goals in both groups. Kim, Park, and Kim (2008) looked at power, well-being, and meditation in 63 healthy Korean women and men, finding a significant relationship between power and meditation over time and a positive correlation between power and well-being. Kim, Kim, Park, Park, & Lee (2008) looked at power and well-being in 881 healthy Korean adults, finding a significant positive correlation between power and well-being. Farren (2010) explored power, uncertainty, self-transcendence, and quality of life in 104 women survivors of breast cancer. Power and uncertainty explained 17% of the variance in quality of life and 18% of the variance in self-transcendence. Siedliecki and Good (2006) explored power, pain, depression or disability in 60 adults with chronic non-malignant pain who either did or did not participate in music groups. They found statistically significant differences between the groups for power, pain, and depression or disability and non-significant differences between the two music groups.

As noted earlier, the tool can be used in health patterning practice as a focus for discussion as well as for research. The best ways to access information on uses in practice are to read Barrett’s (2015) work and the power stories she provided on her website, drelizabethbarrett.com. Anyone interested in accessing the tool for research can contact Dr. Violet Malinski at viomalin@optimum.net.

References

Barrett, E. A. M. (2015). Barrett’s theory of power as knowing participation in change. In M. C. Smith & M. E. Parker (Eds.), Nursing theories and nursing practice (4th ed., pp. 495-508). Philadelphia: Davis.

Barrett, E. A. M. (2010). Power as knowing participation in chance: What’s new and what’s next. Nursing Science Quarterly, 23, 47-54.

Barrett, E. A. M. (2003). A measure of power as knowing participation in change. In O. L. Strickland & C. Dilorio, (Eds.), Measurement of nursing outcomes (Vol. 3: Self care and coping, pp. 21-39). New York: Springer.

(Section under development.)

Barrett, E. A. M. (1996). Investigation of the principle of helicy: The relationship of human field motion and power. In V. M. Malinski (Ed.), Explorations on Martha Rogers’ Science of Unitary Human Beings (pp. 173-188). Norwalk, CT: Appleton-Century-Crofts.

Barrett, E. A. M., Caroselli, C., Sullivan Smith, A., & Woods, D. (1997). Power as knowing participation in change: Theoretical, practice, and methodological issues, insights, and ideas. In M. Madrid (Ed.), Patterns of rogerian knowing (pp. 31-46). New York: National League for Nursing.

Caroselli, C., & Barrett, E. A. M. (1998). A review of the power as knowing participation in change literature. Nursing Science Quarterly, 11, 9-16.

Farren, A. T. (2010).  Power, uncertainty, self-transcendence, and quality of life in breast cancer survivors. Nursing Science Quarterly, 23, 63-71.

Heelen-Fancher, L. M. (2016). Patient advocacy in an obstetric setting. Nursing Science Quarterly, 29, 316-327.

Kim. T. S. (2009). The theory of power as knowing participation in change: A literature review update. Visions: The Journal of Rogerian Nursing Science, 16, 19-39.

Kim, T., Park, J., & Kim, M. (2008). The relation of meditation to power and well-being in Korean adults. Nursing Science Quarterly, 21, 49-58.

Kim, T., Kim, C., Park, K., Park, Y., & Lee, B. (2008). The relation of power and well-being in Korean adults. Nursing Science Quarterly, 21, 247-254.

Larkin, D. M. (2007). Ericksonian hypnosis in chronic care support groups: A Rogerian exploration of power and self-defined health promoting goals. Nursing Science Quarterly, 20, 357-369.

Siedliecki, S. L.., & Good, M. (2006). Effect of music on power, pain, depression, and disability. Journal of Advanced Nursing, 54, 553-562.

Trangenstein, P. A. (1988). The relationships of power and diversity to  job satisfaction and job involvement: An empirical investigation of Rogers’ principle of integrality. Unpublished doctoral dissertation, New York University, New York.

Wall, L. M. (2000). Changes in hope and power in lung cancer patients who exercise. Nursing Science Quarterly, 13, 234-242.

9.5 Diversity of Human Field Pattern Scale (Hasting-Tolsma, 1992)

9.6 Temporal Experience Scale (Paletta, 1990)

9.7 Mutual Exploration of the Healing Human Field-Environmental Field Relationship (Carboni, 1992)

9,8 Human Field Image Metaphor Scale (Johnson, 1993, 1994)

9.9 Index of Field Energy (Gueldner, Bramlett, Johnson, & Guillor, 1996)

9.10 Person-Environment Participation Scale (Leddy, 1995)

9.11 Assessment of Dream Experience Scale (Watson, 1999)

9,12 Perceived Field Motion scale( Yarcheski, Mahon, & Yarcheski, 2002)

9.13 Well-being Picture Scale-revised (Gueldner, Michele, Bramlett, Liu, Johnson et al, 2005)

9.14 Human Field Rhythms Scale