Research Paper on Non-Disease: Exploring Newman's HEC Model in Nursing Practice

Introduction

Margaret Newman suggested a novel concept of health care in a dialectical style, including the proposition that a disease can potentially fuse with its opposite that is commonly known as Non-Disease (Endo, 2017). This paper aims at offering a comprehensive analysis of Newman's HEC (Health as Expanding Consciousness) model, along with its potential application within the context of nursing practice. The rationale for selecting Newman as the theorist is due to her synthesized view on the association between disease and non-disease phenomena bring forth a novel health concept that signifies both illness and health as realities that involve a transformative and unitary process (Endo, 2017). As such, the incorporation of Newman's disease concept is an essential facet of providing health care in the profession of nursing practice.

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In her early twenties, Newman was involved with the responsibility of offering care for her mother following her diagnosis of amyotrophic lateral sclerosis (Endo, 2017), which is a degenerative neurological illness that progressively weakens muscle mobility except for the extraocular muscles (Boylan, Ross, & Sorenson, 2017). Newman took care of her mother for five years, which reflected a transformative process, in which she learned the skill of coping up with the course of her mother's care and got fully engrossed in the present (Endo, 2017). The analysis of Endo (2017) included the fact that even though the five-year duration Newman spent time with her mother was restrictive, tiring, and stressful, it also involved an experience of intense love in diverse ways. Following the demise of her mother, Newman made a vital decision to educate herself about the Nursing profession, after which she worked as a registered nurse professional (Endo, 2017). Newman furthered her studies to a doctoral level at the New York University, where she encountered with her colleague known as Martha Rogers with whom they share the prevailing view that illness and health are not two distinctive realities but involve a transformative and unitary process (Endo, 2017).

Summary of Newman's HEC Theory

Newman's HEC theory embraces both a transformative as well as a unitary paradigm of the nursing profession as offering care based on the human care experience (Endo, 2017; Mitsugi, 2019). The principal assumptions of the HEC theory involve three distinct concepts. Firstly, the theory assumes that health is primarily an evolving unitary pattern that involves both the entire illness as well as the precise configurations associated with the condition (Endo, 2017). Secondly, the model assumes that consciousness is characterized by the entire transformational process revealed within the developing pattern (Endo, 2017). The third assumption of the HEC model involves the proposition that a pattern is accountable for the identification of the association between an individual and the environment process, which is characterized by meaning (Endo, 2017).

Based on the three assumptions noted above, the central thesis of the model, therefore, emphasizes the concept of a pattern. The term pattern in this context refers to the information, which illustrates the whole appreciation of the understanding of every relationship at once (Mitsugi, 2019). Additionally, wholeness is another concept incorporated within the pattern identified in the assumptions of Newman's HEC theory. As Endo (2017) noted, the pattern concept is continually evolving. The basis for this reasoning is that every observable pattern comprises enfolded information, which will eventually unfold because patterns are time-specific (Endo, 2017). According to Newman, the theory was stimulated by the concern for those who health as the absence of disability or disease is not possible. This implies individuals facing loss, deliberation, uncertain and death in the long run, especially those associated with chronic illnesses. The theory of health as expanding consciousness also includes the health of all people regardless of the presence of disease as it maintains that all individuals in any situation, no matter how hopeless or disordered they may look, are part and parcel of the universal process of promoting consciousness.

According to Endo (2017), Newman explains nursing as a process of evaluating the patient in relation to the approach of understanding consciousness and the environment. I most cases, nurses use their understanding of people to develop a higher level of consciousness which help identify the disease process, medication, and prevention. The theory also explains the interrelation between movement time, and space with the notion that space and time are a temporal pattern of the patient, which brings out a complementary relationship. This implies that people are continuously changing through space and time, which brings out a unique pattern of reality. Newman explains that illnesses, and health are synthesized in the sense that it is the different fusion state of being (with disease and without disease) is what constitutes health. She, therefore, feels that people are centers of consciousness with the environment as the universe of open systems. The theory also implies that nursing is generally caring in the human health experience and can be viewed as a partnership between the patient and the nurse. Conclusively, Health as Expanding Consciousness is considered a grand nursing theory since health forms the core part of the theory, and it is also a way of spreading awareness on the individual self and the environment. The theory is also essential because it can be applied in various settings in the bid to generate caring interventions. The only drawback is that it is qualitative, multidimensional and abstract with no profound look into the environment within the model.

Application of the Model

Since the emergence of HIV/AIDS in the early 1980s, many third world countries have been struggling to control the disorder. The infection has spread rapidly in these countries with its impact creating a major development and public health concerns. For instance, it is estimated that more than 2 million Kenyans are infected by chronic illness and that over a million people have died because of the infection and related illnesses. According to Macharia, Jelagat and Juma (2015), the rate of infection of HIV/AIDS in Kenya is a staggering 5% with some counties such as Migori and Homabay having a prevalence of more than 10% of their population (Macharia et al., 2015). Estimates also suggest that the undiagnosed statistics could be higher, bearing in mind that most people in such countries do not have easy access to healthcare. It is apparent that a diagnosis of the disorder can be devastating to the victim and their families as they face significant social, spiritual, emotional and physical damage ranging from fears of stigma, disruption of family roles, lifestyle changes, and stress from the impact of the treatment. According to Newman, for a newly diagnosed patient, they begin to understand that the time of everyone's life is in the present and that each day is precious. The concerns of stigmatization have challenged since having the infection does not deem one to be unhealthy. People can experience wholeness and health at the same time while experiencing a progressive or chronic disease.

Consequently, these aspects can be related to the case of Martha Rogers, who Newman suggested that his theory of Unitary Human Beings was a core part of the development of her theory. Rogers, and Malinski (1986) indicated that illness and health might not be separate realities but a unitary process (Rogers & Malinski, 1986). The theory of Science of Unitary Human Beings also implies that in constant interaction with the environment, humans are a unified whole since nursing people attain the maximum wellbeing in their potential. Thus, nursing must find strategies to take care of patients to involve the whole person, not only the body part. We also need to instill these aspects during their appointment and every chance we get. It is evident that health is not the opposite of sickness but are both manifestations of a greater picture. Macharia, Jelagat and Juma (2015) suggested that it is a common saying in Kenya that one is either infected or affected since statistics suggest that at least one person knows someone infected (Macharia et al., 2015). In the recent past, people couldn't own up in public in regards to their HIV status. There has been significant improvement as there are scenarios where victims lead a healthy life for more than 30 years.

One of the most significant ideologies of Newman's Health as Expanding Consciousness theory I that space, time and movement are interrelated as important health factors. This means that every remaining faculty must be held with high regard, especially during terminal stages of diminishing health. In the contemporary world, people have realized a new strength in them before diagnoses of chronic illnesses. For instance, one Asampt Wagura lives with the notion "do not take life for granted, celebrate it." As the executive director of Kenya Network of Women with Aids, she has been a pillar of strength for many people living with the chronic illness. She writes diaries in one of the country's leading newspaper, the Daily Nation, and many people look forward her articles in the Wednesday edition. For most infected people, time is a treasure. It is therefore important for them decide on how best to use it in terms of the future and their families. This can entail making realistic goals by considering life expectancy. A profound look into the meaning of their experience and health can be attained through a better connection between the carer and the victim during social support and counseling.

Newman's theory applies to modern-day nursing due to the increasing emphasis on care outside health institutions. Even though health-supporting initiatives can be done outside health institutions, a lot of empowerment and social support is still needed. It is evident that home-based care greatly reduces the workload of healthcare providers at the same time, reducing the burden of local hospitals that care for HIV/AIDS patients. Even though home-based care has been practiced in many African traditional cultures, it is generally a new concept in Kenya. Such measures entail the victim to be psychologically prepared and accept it as part of their medical history. Even though home nursing is not appealing to most nurses in Kenya, it can bring out the advantages of nursing in the patient's environment, as proposed in Newman's theory. This implies that the victim needs to accept the issue before the institution or the nurse takes any action. According to Newman, acceptance and acknowledgment of oneself can result in the new wonderful consciousness where held can be reciprocated by a person. The new consciousness entails involving the patient in every step of the nursing care plan by defining their goals, progress, and how they can achieve them.

Additionally, Newman's Health as Expanding Consciousness theory evaluates making deliberate observations on the patient and reflecting on the observations with the patient. The approach stimulates the victim to respond by evaluating what is important in their subtle needs and unique circumstances. HIV patients greatly appreciate this gesture as they are always affected with stigmatization. They often wish to connect with self and the community in a holistic sense in pursuit of achieve better health outcomes. Macharia, Jelagat, and Juma (2015) suggest that if you give a patient goals and how to achieve them, the patient can push himself towards the desired health outcomes (Macharia et al., 2015). The essence of this new consciousness needs to be understood...