A unitary field pattern portrait of dispiritedness in later life.
The purpose of this investigation was to enhance theory and understanding of the phenomenon of dispiritedness in later life within the context of Rogers' Science of Unitary Human Beings' using a research method congruent with the ontological and epistemological tenets of Rogers' nursing science. Eleven persons 52 to 92 years of age who identified themselves as being in later life and having experienced dispiritedness participated in a 40 to 70 minute in-depth interview which focused on their experiences, perceptions, and expressions of dispiritedness. A field pattern profile was created for each participant. The unitary field pattern portrait of dispiritedness in later life was created through a process of mutual construction using the hermeneutic-dialectic circle and two phases of pattern synthesis. Ten unitary themes of resonating human-environmental field patterning emerged from the 11 field pattern profiles and were synthesized to form the unitary field pattern portrait. The portrait was interpreted within Rogers' nursing science to create the theoretical unitary field pattern portrait: Dispiritedness in later life is experiencing the oscillating h dissipating energy expressed as a perception of emptiness and patterns of dwindling vitality: experiencing dissonant rhythmicity amidst adversity and uncertainty expressed as feeling out of synchrony with the universe: integrality experienced as fractured expressed as disengaging from life's flow openness and pandimensionality perceived as collapsing expressed as increasing restrictiveness, ambiguity, and apprehension; continuing to participate knowingly in change while wanting to relinquist the will to live; and in a continuous rhythm with inspiritedness accelerating movement toward patterns of greater diversity manifested by visioning infinite potentials and creating innovative ways of actively participating in the later life process.
Dispiritidness, Rogerian nursing science research methodology, aging process
The evolution of nursing as a scientific discipline is predicated on the development of conceptualizations of phenomena central to its concern from a unique nursing science perspective. If nursing is to develop a scientific knowledge base, inquiry within nursing must be guided by nursing's conceptual systems (Fawcett, 1989; Parse, 1987; Smith, 1992), Rogers' (1970, 1988, 1992). The Science of Unitary Human Beings is specific to the nursing discipline rooted in the scientific and metaphysical emerging worldview of wholeness. Rogers' nursing science provided the ontological and epistemological foundation for the research method used in this investigation and guided the conceptualization of dispiritedness.
Phenomenon of Interest; Dispiritedness
The phenomenon investigated in this study was the nature of dispiritedness in later life. Dispiritedness describes a personal experience and does not have the connotation of a diagnostic category, disease, mental illness, or abnormality (Bugental, 1980), The phrase, "my spirits are low," is a common expression reflecting the phenomenon of dispiritedness. There are few references to dispiritedness in the health literature. Jourard (1971), an existential-humanistic psychologist, described "dispiritation" (p. 9) as a phenomenon related to, yet different from, depression by emphasizing the subjectivity of dispiritedness. Jourard further characterized dispiritedness as feelings of hopelessness, purposelessness, meaninglessness, worthlessness, low self-esteem, and isolation. Bugental and Bugental (1984), also existential-humanistic psychologists, extended Jourard's work by identifying dispiritedness and defining it as a "condition of blocked intentionality" (p. 50).
Dispiritedness is also viewed as a common human experience. Periods of being in low spirits are a normal occurrence in the fife process of human beings (Bugental, 1980). Bugental (1980) explained that "change is a common characteristic of all living things and ... our bodies are constantly flowing and evolving"; when "flow is interrupted to some extent, the person experiences a drop in spirits" (p. 52). A "dysphoric, blue, unhappy tone ... a complaint of a lack of energy and inability to mobilize oneself to act ... a recurrent sense of blunted intention" is characteristic of "low-spirited times" (Bugental, 1980, pp. 51-52).
Identifying and establishing initial features of dispiritedness is fundamental to using the concept in research and theory development. Clarifying the initial features produced a set of criteria that were used to determine if the phenomenon exists in a particular situation. Based on a review and synthesis of definitions, descriptions, and literature on dispiritedness, the tentative criteria distinguishing the phenomenon of dispiritedness were: a sense of meaninglessness, purposelessness, and valuelessness in one's life; a sense of hopelessness and disconnectedness; dysphoria; a loss of will, energy, and vitality; feelings of low spirits, dejection, and lost enthusiasm (Bugental, 1980; Bugental & Bugental, 1984; Jourard, 1971).
Population of Focus
Jourard (1971) postulated that aging was a potentially dispiriting process. Elderly persons often make statements such as "I lost my spirit;" "my spirits are low; " "my spirits are broken;" and "I feel dispirited." Jourard contended that social conditions can also be so devoid of opportunities for inspiriting satisfactions that a person can become demoralized or dispirited. "Forcible retirement can produce demoralization, and under such conditions, depression--loss of spirit--is common" (Jourard, 1971, p. 85). However, there is no research on the phenomenon of dispiritedness. A primary goal of this study was to enhance understanding of the nature of dispiritedness as described by participants who have experienced dispiritedness in later life. The term, later life, defies definition. There is general consensus among gerontologists that later life probably begins in the mid to later COs. However, Silverstone and Hyman (1992) stated that many gerontologists believe that somewhere in their 50s, individuals begin to pick up the message that they are getting old. Those who considered themselves to be in later life, even if they were in their 50s, were eligible as potential participants in this study.
The unitary field pattern portrait (UFPP) research method is a phenomenological-hermeneutic research method developed specifically for nursing research guided by Rogers' Science of Unitary Human Beings. The method (see Figure 1) is a unique synthesis of Guba and Lincoln's (1989) constructivist-phenomenological methodology and Cowling's (1989, 1990, 1993a) Unitary Pattern-Based Practice methodology (Butcher, 1994a, 1994b). The method provides a motion lens with a nursing filter for viewing significant human-environmental phenomena. The phases of the (UFPP) research method include: initial engagement, the identification of Rogers' nursing science as the a priori perspective used to guide the method and interpretation of findings, immersion, intensity sampling, natural setting, pattern appraisal with use of pandimensional modes of awareness, field pattern profile construction, use of the hermeneutic-dialectic circle to create a mutually shaped pattern profile, unitary field pattern portrait construction using a process of creative pattern synthesis, and lastly, theoretical unitary field pattern portrait construction through the process of evolutionary interpretation. A detailed description of how the UFPP research method was derived from Rogers's ontology and epistemology is described in Butcher 0 994b).
[FIGURE 1 OMITTED]
Scientific rigor was maintained throughout the study by employing Guba and Lincoln's (1989) criteria for establishing trustworthiness in qualitative research. The credibility criterion was met in this study through prolonged engagement, persistent observation, multiple sources of data, participant checks, and peer debriefing. Prolonged engagement was accomplished by the researcher's immersion into the phenomenon of dispiritedness through reading numerous vivid personal accounts of older persons and engaging with persons who have experienced dispiritedness in later life for extended periods in natural settings where dispirited older persons may commonly live. Persistent observation was attained through focusing on the appraisal of manifestations of field patterning during the pattern appraisal process. Multiple sources of data were used in addition to interview data, including the researcher's field notes and the inclusion of participant's descriptions of artifacts (notes, poetry, and art work from participants) that offered additional understanding of the phenomenon. Participant checks occurred throughout pattern synthesis by sharing the field pattern profile with each participant for validation and revision. The researcher maintained a dynamic dialogue with peers and other researchers and regularly consulted with dissertation committee members during creative pattern synthesis and evolutionary interpretation of the data. A debriefer (committee mentor) monitored the developing construction to assure the researcher's construction was not over-shadowing the participants' constructions. An audit trail was maintained so that all constructions could be traced to original sources, and the processes of pattern synthesis can be confirmed. A detailed description of the setting, sample, and vivid field pattern profiles facilitates transferability judgments.
Initial engagement is the process of intense interest and passionate searching and surfacing of a research question central to the well-being of unitary human beings. After 18 months of intense searching of the literature on depression in later life, the phenomenon of dispiritedness in later life emerged as the focus of inquiry. In conversation with numerous older adults, nursing colleagues, psychiatrists, and nursing scholars, the researcher confirmed the presence of dispiritedness in later life as an experience unique from the current [C]SM-1 V diagnosis of depression. However, no research existed which provided a description and conceptualization of dispiritedness from the perspective of persons in later life.
A Priori Nursing Science
All research flows from some theoretical perspective (Cuba & Lincoln, 1989). The Rogerian mutual process epistemology recognizes the integrality and inseparability of the researcher-researched into (Butcher, 1994b). The Science of Unitary Human Beings served as the researcher's a priori nursing science. The researcher's theoretical perspective permeates all aspects of the research process, and the interpretation of the findings reflects the researcher's theoretical orientation. Interpreting qualitative findings from a theoretical perspective grounded in nursing science allowed for development of knowledge specific to the nursing discipline.
In the immersion phase the researcher was steeped in the topic of dispiritedness. The researcher was absorbed in literature, poetry, music, motion pictures, photographs, journal writings, dialogues with self and others, and art work that drew the investigator closer to the topic of dispiritedness and revealed its multiple meanings. Immersion enhanced the researcher's initial understanding of the nature of dispiritedness. For example, the researcher read numerous vivid personal accounts which reflected later life, viewed movies depicting features of dispiritedness, and engaged in dialogue with elderly persons who identified with the experience of low spirits. Examples of motion pictures depicting later life included "Cocoon" (20th Century Fox/Zanuck-Brown, 1985) and "A Women's Tale" (Orion Pictures, 1991). The researcher read a number of anthologies on aging (Berman, 1989; Booth, 1992; Fowler & McCutcheon, 1991) as well as books of poetry such as "When I am an Old Women I Shall Wear Purple" (Martz, 1987). The intense immersion in mutual process allowed the investigator to encounter, examine, and fully participate in a rhythmic flow with the phenomenon in order to initially depict the experience in its many aspects, core themes, and essences.
Patton (1990) stated "an intensity sample consists of information-rich cases that manifest the phenomenon of interest intensely (but not extremely)" (p. 171). Extreme or deviant cases may be so unusual as to distort the manifestations of the phenomenon of interest. Following the logic of intensity sampling, the researcher sought rich examples of dispiritedness in later life, but not unusual cases. An assumption of this study was that individuals who identified themselves as having experienced low spirits can provide the best description of the phenomenon. Following approval from the university's IRB, the researcher asked faculty members, support staff at the university, and co-workers at a hospital if they knew of any persons in later life who have experienced "low spirits." Once a referral was obtained, the researcher either called or approached potential participants to answer questions they might have concerning the study. The tentative criteria of dispiritedness were used to assist the researcher in determining if potential participants experienced dispiritedness rather than some other experience. Potential participants were asked if they had ever experienced a sense of meaninglessness, a loss of will, energy, vitality, low spirits, or lost enthusiasm. In all cases, potential participants viewed themselves as being in later life and believed they could describe their experiences, perceptions, and expressions associated with feeling dispirited.
Eleven persons who identified themselves as having experienced dispiritedness agreed to participate in the study. There were no specific exclusion criteria regarding the potential participants' sex, ethnic background, or medical health status. No participants were taking any mood altering medications and no participants had any serious medical conditions. All participants were required to speak English. The age of nine female and two male participants ranged from 52 to 92 years of age. Two participants were in their 50s, two in their 60s, three in their 70s, and the other participants each were 82, 87, and 92 years of age. The two male participants were in their 70s. All participants maintained their own home and had no major health problems. Three of the four employed participants were contemplating retirement. Four participants lived alone and four were widowed.
All interviews were conducted by the investigator in natural environmental settings chosen by the participants. Conducting the pattern appraisal process in a natural setting chosen by the participant assured that the study of dispiritedness occurred in mutual process with the participant's natural environment. Settings chosen for pattern appraisal were diverse. Seven interviews were conducted in the homes of participants; three at participants' places of employment, and one interview was conducted in a participant's hospital room the day before being discharged from the hospital.
A person's experiences, expressions, and perceptions are pattern manifestations emerging from the human-environmental field mutual process (Cowling, 1990, 1993a, 1993b). Pattern appraisal is the process of acquiring knowledge about the participant's experiences, perceptions, and expressions. The human instrument was used in pattern appraisal. The process of reflection and synthesis integral to personal knowing is consistent with the use of self. The researcher acted as the human instrument by obtaining descriptions of the phenomenon of dispiritedness through an in-depth interview conducted in a person-to-person encounter between researcher and participant.
An important ingredient in the pattern appraisal process involved efforts directed toward creating an atmosphere of trust and relaxation. The investigator actively listened, conveyed unconditional acceptance, and remained fully open to human-environmental field process. Pattern appraisal involved the use of an informal conversational interview style that fostered spontaneous generation of questions and conversations. An informal conversational interview is consistent with the rhythm and flow of mutual process and aims toward encouraging expression, elucidation, and disclosure of the participants' experiences, perceptions, and expressions of dispiritedness. An open-ended approach allowed participants the time and space to explore the topic in a manner that promoted discovery, depth, and richness. During the pattern appraisal process, the researcher acted as a facilitator, clarifier, and evoker as a means to allow the participant's depictions of dispiritedness to unfold. Throughout the pattern appraisal process, the researcher utilized all forms of knowledge including pandimensional modes of awareness such as tacit knowing and intuition.
While some general questions were formulated in advance, genuine dialogue cannot be planned and arise from a stance of genuineness. Examples of general questions concerning the experience of dispiritedness included: "How would you describe what it's like to feel dispirited? "Describe for me any feelings you may have had when feeling dispirited." Examples of open-ended questions concerning the participants' perceptions of dispiritedness were: "How do you know when you are in low spirits?" "How do things change when you feel dispirited?" "What helps you most when you are in low spirits?" "Do things around you look different when you are in low spirits?"
When appraising participants' expressions, the researcher asked: "What happens when you experience this?" "How would anyone know you were feeling dispirited?" Participants were asked if they could draw or paint a picture of dispiritedness what would it look like? In addition, each participant was asked to identify a single word, particular music, poem, story, or phrase that describes the nature of dispiritedness. Pattern appraisal continued until the participant reported they had nothing further to say.
In addition to the descriptive pattern information collected through interviews of each participant, the researcher recorded field notes. The field notes were organized into three categories: observational notes, theoretical notes, and methodological notes. This organization provided a means of effectively reflecting on and processing the patterns as they emerged (on-going synthesis) and as they ultimately came together in the final synthesis (unitary field pattern portrait and theoretical construction). Consistent with characteristics of Rogerian inquiry, the mutuality of the researcher and the participants were reflected in the content of the field notes.
The pattern Profile Construction
The field pattern profile is a rich description of experiences, perceptions, and expressions in the participant's own language. Each pattern profile was constructed using the first phase of creative pattern synthesis. Creative pattern synthesis describes the qualitative processing of pattern manifestations. Patterns are processed within unitary science using synthesis rather than analysis (Rogers, personal communication, July 31, 1992). To accomplish field pattern profile construction through pattern synthesis, each taped interview was transcribed onto a microcomputer using a word processing package. The Ethnograph 3.0 (Seidel, 1986) computer program was then used to manage transcribed dialogue by identifying text segments that related to the experiences, perceptions, and expressions of dispiritedness. Inclusion of contextual comments allowed for inclusion of both human and environmental field patterns inherent in Rogers' unitary perspective. Contextual comments such as observations or descriptors by the researcher were helpful in including any observational field notes that were later used in pattern synthesis.
A selective, or highlighting, approach (van Manen, 1990) was used to identify the essential thematic statements. When using a highlighting reading approach, the researcher asked, "What statements or phrases seem particularity essential or revealing about dispiritedness?" (van Manen, 1990, p. 93). The Ethnograph 3.0 (Seidel, 1986) was used only to identify thematic statements and group the statements and phrases together. A field pattern profile was constructed for each participant by synthesizing the thematic statements and phrases into a descriptive narrative which depicted the experiences, perceptions, and expressions of dispiritedness. It is important to note the field pattern profile was expressed in participant's language. After the field pattern profile was constructed, the researcher either met with the participant individually or conversed with the participant over the phone to share the field pattern profile for comment, revision, and confirmation. Of the 11 Pattern Profiles, one is included in this paper (see Table 1).
A key feature of the (UFPP) Research method is the mutual shaping of the emerging field pattern profile using the hermeneutic dialectic circle described by Guba and Lincoln (1989). After the first field pattern profile was validated by the first participant, the researcher engaged in pattern appraisal with the second participant. The same process described above was repeated with the second participant, except, at the end of the second interview, the second participant was asked to comment on the first field pattern profile. The comments of the second participant on the pattern profile were used to identify common and universal human-environmental pattern manifestation of dispiritedness in later life.
After validation of the second participant's field pattern profile, the researcher synthesized the two field pattern profiles into one unified, mutually derived field pattern profile using the hermeneutic-dialectic process. The process was dialectic because there was a comparison and contrast of possible divergent views with an aim of achieving a higher level synthesis of all participant field pattern profiles. The process is hermeneutic (interpretive) in that each participant considered and interpreted the construction of other participants' descriptions of dispiritedness in relation to his/her own experience. After the interview with the third participant was completed, the participant was asked to comment on the synthesized construction of participants one and two. This process was respectively followed for each new participant. The final participant read and commented on the synthesized construction of the previous 10 participants. Therefore, at the end of pattern appraisal, there were 11 individual pattern profiles and one synthesized, mutually shaped field pattern profile.
The process of constructing a pattern profile for each participant and a mutually shaped construction continued until pattern repetition was attained. Pattern repetition was reached when no new information or themes emerged from participants that were not already part of the mutually shaped pattern profile, and there was redundancy in pattern information. Redundancy referred to the duplication and repetition of experiences, perceptions, and expressions of the participant's descriptions of dispiritedness compared to what had been previously described by the other participants. Pattern repetition was reached after the ninth interview. Two additional interviews were conducted to assure pattern repetition was fully reached. The final mutually shaped pattern profile, therefore, was a synthesis of all 11 pattern profiles and its final length was 4 pagers. Due to its length, it was not included in this paper.
Unitary Field Pattern Portrait Construction A second phase of pattern synthesis was used to construct the unitary field pattern portrait. The second phase of pattern synthesis was a hermeneutic and phenomenological process of synthesizing all pattern information and was initiated after pattern repetition was reached. The researcher then immersed with each pattern profile and identified key short phrases and themes. These themes were named emerging unitary themes of human-environmental pattern manifestations and subsequently used in the second phase of pattern synthesis. Table 2 lists the emerging unitary themes identified in the exemplar pattern profile.
A total of 159 emerging unitary themes of human-environmental pattern manifestations were identified from the 11 pattern profiles. Once all the emerging unitary themes of human-environmental pattern manifestations were identified, the researcher immersed in and dwelled with all 11 pattern profiles, the 159 themes, the mutually shaped pattern profile, and all observational field notes for three months as a means of illuminating the deeper nature of dispiritedness's human-environmental field process.
The 159 emerging themes were sorted and synthesized into common universal unitary themes called resonating unitary themes of human-environmental pattern manifestations. Thus, each resonating unitary theme of human-environmental pattern manifestations reflected a common set of emerging unitary themes of human-environmental pattern manifestations. Table 3 provides one example of how each resonating unitary themes was created from a common set of emerging themes from the 11 pattern profiles. The researcher used imaginative, tacit, intuitive, and contemplative sources of knowledge and insight to discover the nature of the phenomenon and synthesize the themes and essential patterns into one theme. Through synthesis and re-synthesis, ten resonating unitary themes of human-environmental pattern manifestations of dispiritedness emerged. The researcher then dynamically compared the resonating unitary themes across all field pattern profiles and the mutually shaped pattern profile to assure that each resonating theme was present in at least 9 of the 11 pattern profiles. Note that the resonating unitary theme "emerges amidst life's adversity" was present in all 11 pattern profiles. The ten resonating unitary themes of human-environmental pattern manifestations are listed in Table 4. The 10 resonating unitary themes were then synthesized into one unified descriptive unitary portrait of dispiritedness grounded in the experiences, perceptions, and expressions of all participants. The resonating themes were then combined and synthesized into one unified unitary field pattern portrait of dispiritedness. The unitary field pattern portrait of dispiritedness was expressed in the form of an aesthetic rendition of universal patterns that embraces the phenomenon and attempts to portray the nature of dispiritedness (see Table 5).
Theoretical Unitary Field Pattern Portrait Construction
The final phase of the (UFPP) research method was the construction of the theoretical unitary field pattern portrait. To accomplish theoretical unitary field pattern portrait construction, the researcher gathered, immersed in, and dwelled with the unitary field pattern portrait, theoretical field notes, and notes in the reflective journal for an extended period of time in light of Rogers' Science of Unitary Human Beings using creative inductive and deductive pattern synthesis. Creative inductive and deductive pattern synthesis linked the patterns inductively identified in the field pattern portrait to the deductive interpretations guided by the researcher's a priori nursing conceptual system. Interpretation, guided by Rogers' Science of Unitary Human Beings, is termed evolutionary interpretation and involved interpreting the field pattern portrait in light of Rogers' (1988) principles of resonancy, integrality, and helicy, and the postulates of pandimensionality, pattern, openness, and energy fields to create a theoretical unitary field (see Table 6) pattern portrait of dispiritedness. All of Rogers' postulates and principles were used in the creation of theoretical unitary field pattern portrait.
The purpose of constructing the theoretical unitary field pattern portrait was to explicate the theoretical structure of dispiritedness by interpreting the unitary field pattern portrait from the perspective of Rogers' unitary science. Theoretical construction also aids in advancing the evolution of, nursing science by moving the unitary field pattern portrait from description to theory, and is expressed in the language of Rogerian nursing science. Lastly, the theoretical unitary field pattern portrait allowed for creatively positing ideas for further research and nursing practice possibilities. Discussion of the Theoretical Unitary Field Pattern Portrait
A detailed discussion of each of the 10 resonating unitary themes is beyond the scope of this paper but may be found in Butcher 0 994a). Rather, the focus of this paper is on the examination of the theoretical unitary field pattern portrait. The meaning of each of the six theoretical statements is examined in light of Rogers' Science of Unitary Human Beings and relevant literature.
The first theoretical statement is an interpretation of dispiritedness as experiencing the oscillating rhythm of dissipatting energy expressed as a perception of emptiness and pattern of dwindling vitality, included Rogers' principle of resonancy as well as the postulates of energy field and pattern. Rogers proposed that human beings and the environment are energy fields. Furthermore, energy fields are in continuous motion. According to Rogers (1970), the life process of human beings is a "symphony of rhythmical vibration oscillating at various frequencies" and that human beings experience their environment "as a resonating wave ... rising and falling; now fast, now slow" (p. 101). The principle of resonancy describes the continuous change in wave frequency patterns. The oscillation refers to rhythmical ebb and flow of energy in the human-environmental field mutual process. Rogers (1970) stated "persons may be referred to as magnetic, forceful, moody, withdrawn--observations consistent with a concept of fluctuating field intensities and dimensions" (p. 90). Participants in this study described dispiritedness as having an ebb and flow and as a loss of energy. The term dissipating signified the perception of a loss of energy. Dwindling vitality is a manifestation of field pattern indicating a perception of dissipating energy and emptiness during the experience of dispiritedness.
A perception of emptiness was a universal feature of the experience of dispiritedness and within an energy field perspective, emptiness can be viewed as a loss of energy. While dispiritedness is an awareness of emptiness, it is not the nature of reality in a unitary universe. "Feelings and thought are manifestations of [the] field" (cited in Sarter, 1984, p. 176), rather than a part of a field or the field itself. In a unitary universe, energy fields are an emptiness as well as a plenum, empty because mass is essentially empty space and plenum because there is infinite energy in mass. In other words, what appears as empty space is actually infinitely full of energy and the source of creativity (Bohm, 1986; Capra, 1977). In the quantum world, emptiness has infinite potential as its boundless energy gives rise to transformations of matter. Furthermore, energy is not lost in a unitary universe, but is transformed. Thus, dispiritedness may be viewed as awareness of energy of the human energy field being transformed and subjectively perceived as being lost or dissipating into the environmental field. Hanchett (1992) has drawn similarities between the Madhyamika-Prasangika school of Tibetan Buddhism conceptualization of emptiness and Rogers's concept of energy fields. The Dalai Lama (1986) explained that all changes and transformations are possible because of emptiness. Therefore, the perception of dissipating energy and emptiness creates the possibility of rhythmical transformation between dispiritedness and dspiritedness.
The second theoretical statement was developed to describe the experience of dispiritedness as experiencing dissonant rhythmicity-amidst adversity and uncertainty expressed as feeling out of synchrony with the universe. This theoretical statement also incorporated Rogers' principle of resonancy along with the principle of helicy's concept of uncertainty. When describing the principle of resonancy, Rogers (1970) asserted that "the life process may be likened to cadences--sometimes harmonic, sometimes cacophonous, sometimes dissonant" (p. 101). Dispiritedness was described as emerging from experiencing adversity or difficult times. Adversity is a manifestation of dissonant or dysrhythmic environmental energy field patterns which are experienced by the human energy field. Dissonant rhythms also were manifest in the experience of unpredictability or chaos. Participants described the experience of storms and turbulent events as associated with dispiritedness. Adversity and turbulent storms are inherently chaotic, unpredictable, and transformational (Butcher, 1993). Rogers's (1992) included the idea of unpredictability when discussing the nature of change. Chaos theory is a theory of complex nonlinear systems which describes the turbulent and unpredictable fluctuations in dynamic systems (Butcher, 1993; Phillips, 1991). Experiencing chaos and turbulence was expressed as dissonant environmental rhythms and feeling out of synchrony with the environmental energy field. Expressions such as feeling "out of kilter with the world" and feelings of dysphoria emerging from experiences of adversity in later life are manifestations of the experience of chaotic and dissonant environmental rhythms. Furthermore, "continuous change emerges out of nonequilibrium and exhibits punctualism not gradualism" (Rogers, 1992, p. 32). Experiencing chaos and unpredictability becomes the potential creative source of change (Briggs & Peat, 1989; Butcher, 1993; Prigogine & Strengers, 1984). Therefore, the chaotic and dissonant rhythms of dispiritedness potentially leads to greater creativity, innovativeness, and diversity in human-environmental field patterning.
The notion that creativity can emerge from the experience of difficult situations or adversity is also consistent with Bugental's (1980; 1987) conceptualization of dispiritedness. In describing the "other side of dispiritedness," Bugental (1980, p. 61-67) described how dispiritedness can lead to greater personal awareness and harmony. "When they [feelings of low spirited times] are accepted and understood, when they are incorporated
into our total being and worked through, they free us to live more fully, to experience the good times more thoroughly, to know our total natures more authentically" (p. 65).
The third theoretical statement, integrality experienced as fractured expressed as disengaging from life's flow, describes dispiritedness in relation to Rogers's principle of integrality. In Rogers' (1970) early work, she stated that "deviations in the rhythmical relationship between man[5k] and environment may be postulated to manifest themselves in disruption and reorganization in human field and the environmental field directed toward evolving a new rhythmical relationship between man[5k] and environment" (p. 188). Reinterpreted to be more consistent with the current understanding of Rogerian science, changes in the mutual process of human-environmental mutual field process may be postulated to manifest themselves as increasing innovative and diverse human-environmental field patterning. The principle of integrality describes the continuous mutual human and environmental field process (Rogers, 1992). The human and environmental energy field are continuously open to each other and, therefore, inseparable. Mutual process signifies the dynamic interconnectedness of everything. While the nature of unitary universe is a seamless unbroken flow of human-environmental field patterning, persons experiencing dispiritedness perceive a disruption in integrality. Descriptions of feeling separated from life's flow, alone, isolated, detached, not involved, out of touch, and disconnected were expressions of feeling disengaged from the flow of human-environmental field patterning. Feelings and thoughts of integrality as being fractured are a manifestation of experiencing adverse turbulent, dissonant, and chaotic human-environmental field patterning and are, therefore, not a reflection of the true integral nature of human and environmental fields.
The fourth theoretical statement included in the theoretical unitary field pattern portrait, openness and pandimensionality perceived as collapsing expressed as increasing restrictiveness and uncertain future, incorporated the postulates of openness and pandimensionality to describe the experience of dispiritedness in later life. Rogers (1970, 1988, 1992) asserted that the universe is an open system. "Energy fields are open, not a little bit, but continuously ... A universe of open systems explains the infinite nature of energy fields" (Rogers, 1992, p. 30). Therefore, energy fields are without boundaries. Within Rogers' nursing science, all reality is postulated to be pandimensional. Pandimensionality provides for an infinite domain without limit and is defined as a nonlinear domain without spatial or temporal attributes (Rogers, 1992). Nonlinearity means that reality spreads all over; it is not a line; it represents an infinite transcendent domain. Nonspatial means reality cannot be bound in spatial geometry, and nontemporal refers to the relativity of time and to the relative present for any individual (Sarter, 1988).
The pandimensional human energy field is characterized as having imaginary fluctuating boundaries. Persons who are experiencing dispiritedness perceived their field boundaries as being restricted, limited, contained, and contracted, rather than open and infinite. Expressions of feeling trapped, powerless, restricted, not as active, experiencing barriers, disconnected, and cut off, were pattern manifestations of dispiritedness reflecting perceived imaginary boundaries of the infinite pandimensional human energy field to be restricted or collapsing. Furthermore, participants in this study described a future filled with apprehension and uncertainty. Descriptions of a "dense fog," the "future looking fuzzy," "cloudiness," "darkness," "bleakness," "world looking like it is ending," feeling in "limbo," "little to look forward to," fear of being useless, and fearing a storm looming on the horizon, all conveyed a sense of apprehension and ambiguity about the future. The infinite domain of unlimited possibilities and potentials of a pandimensional reality seems restricted to a person experiencing dispiritedness. The future does not seem present in the infinite now. In dispiritedness, the pandimensional reality seems like it is shrinking and collapsing as choices seem limited and restricted.
The theoretical underpinnings of continuing to participate knowingly in change while wanting to relinquish the will to live are derived from Barrett's (1984, 1989, 1990) theory of power as knowing participation in change. Barrett's theory of power incorporates all of Rogers' postulates and principles. Within Barrett's Rogerian theory of power, power is defined as the capacity to participate knowingly in the nature of change characterizing the continuous patterning of human and environmental fields as manifest by awareness, choices, freedom to act intentionally, and involvement in creating changes. Participants in the present study described dispiritedness as an awareness, but an awareness of limited choices, increasing restrictiveness, and feeling detached. Interpreted within Barrett's (1989) theory of power, dispiritedness is an experience of low frequency power in human-environmental field patterning manifested by low frequency choices, low frequency in acting intentionally, and low frequency involvement in creating changes. In experiencing low frequency power participants described feelings of "wanting to give up" and of "losing the will to live," yet and at the same time felt they could not give up. Instead, when dispirited, participants would continue to "push" themselves; "not allowing myself to give up;" "become industrious;" continue to work; "get out of bed anyway;" or continue to care for a loved one. Thus, while one's sense of knowing participation in change is "challenged" while dispirited, participants would not "give up" during adversity. Rather, dispiritedness was characterized by continuing forward motion toward an uncertain future. Thus, dispiritedness is characterized by low frequency power while persons continued to exercise their relative power by enduring and not giving up. Interestingly, a number of participants stated that the difference between depression and dispiritedness was that depression is when you do give up. Dispirited persons in later life continued to participate in the human-environmental field mutual process despite experiencing low frequency power.
The final theoretical statement further illustrated participants' continued involvement in their own life process in later life. The statement is a description of the evolutionary potential of the continuous rhythmical oscillation of dispiritedness with inspiritedness. The theoretical understanding of dispiritedness as a continuous rhythm with inspiritedness accelerating movement toward patterns of greater diversity manifested by visioning infinite potentials and creating innovative ways of actively participating in the life process was best described within Rogers' principle of helicy and Barrett's (1988, 1989) theory of power as knowing participation in change. The principle of helicy describes the change process as the continuous, innovative, unpredictable, increasing diversity of human-environmental wave frequency patterns (Rogers, 1988).
All participants in this study who were asked to describe their experiences, perceptions, and expressions of dispirited ness in later life also included descriptions of how they dealt with feelings of dispiritedness. Participants described multiple, creative, diverse, and innovative ways of staying connected, actively involved, and infusing hope in the later life process. Rogers' principle of helicy describes this continuous rhythmical movement toward patterns of increasing diversity. The continuous dispiritedness-inspiritedness rhythmicity created new potentials for knowing participation in change in the later life process. Participants spoke of becoming "industrious" and "getting energy from friends." Another participant stated "sometimes when I'm dispirited, before I go to sleep, I day-dream, and think about what I have to do next, and that somehow energizes me." Using the imagination and envisioning future potentials is an example of pandimensional modes of awareness that facilitate knowing participation in change. Several participants mentioned that their spirit was "nourished by harmonic music;" or they would "listen to old time hymns;" music "soothes me and makes me happy and content."
Perhaps Participant 4 stated it best:
I respirit myself by engaging in activities that water and replant the earth. Even though events associated with aging can lower my spirits, I can create a sense of balance of spirits through my faith in God, and engagement in my family and my work.
The intent of this researcher was to investigate dispiritedness in later life using the (UFPP) research method to: expand nursing science; contribute to the development of Rogers' Science of Unitary Human Beings; and to expand Rogers' nursing science for guiding practice by enhancing an understanding of dispiritedness in later life.
Expansion of Nursing Science
A direct contribution to the expansion of nursing science was the construction of a theoretical description of the experience of dispiritedness grounded in a theoretical system specific to the nursing discipline. The theoretical description of dispiritedness is a conceptualization of the experiences, perceptions, and expression of dispiritedness which may serve to increase understanding of dispiritedness in the language of nursing science. Current conceptualizations of dispiritedness by Jourard (1971) and Bugental and Bugental (1984) are not specific to nursing and are incongruent with Rogers' unitary perspective (Butcher, 1994a). Dispiritedness was conceptualized as a unitary, irreducible energy field pattern manifestation emerging out of the human-environmental mutual field process. All the postulates and principles that constitute Rogers' nursing science were included in the theoretical description of dispiritedness. The theoretical unitary field pattern portrait of dispiritedness in later life provides a new, evolutionary, and unitary conceptualization of dispiritedness specific to nursing science, thereby advancing the development of nursing theory.
Expansion of Roger,' Nursing Science
The results of this study expanded Rogers' nursing science in two major ways. The research methodology used in this study was the first application of the (UFPP) research method. The method is specific to Rogers' nursing science. The research methodology led to the development of a unitary conceptualization of a phenomenon specific to the well-being of human beings. Thus, the UFPP may be used to investigate other phenomena central to nursing's concern as a means to develop concepts specific to Rogers' Science of Unitary Human Beings.
Secondly, the unitary conceptualization of dispiritedness expanded understanding of Rogers' nursing science. The theoretical description of dispiritedness in later life as perceiving integrality as fractured, openness and pandimensionality as collapsing, energy as dissipating, and resonancy as dissonant are new ways of using the principles and postulates in the Rogerian system to conceptualize the unique personal experiences of unitary human beings. For example, ebb and flow of the dispiritedness-inspiritedness rhythm in the life process creates the potential for personal transformation as new and innovative potentials for participating knowingly in the later life process emerge. All participants described new ways of inspiration by staying connected to the environment, creating hope, and being actively involved in the later life process.
Expansion of Unitary Pattern-Based Practice
The findings of this study contribute to the enhancement of knowledge guiding unitary pattern-based practice. Dispiritedness was found to be a common, universal human experience in later life relevant to understanding the nature of well-being. Unitary pattern-based practice focuses on the experiences, perceptions, and expressions of unitary human beings (Cowling, 1990). The unitary field pattern portrait provides a vivid description of the experiences, perceptions, and expressions of dispiritedness in later life. The portrait may enhance nurses' ability to recognize and appreciate the human-environmental pattern manifestations which characterize the experience of dispiritedness in later life.
Nurses guided by Rogers' nursing science can use the process of pattern profile construction to assist clients in describing their own unique patterns of dispiritedness. Sharing the pattern profile of dispiritedness with clients enhances their awareness of their own life process and potentially facilitates their knowing participation in change. The knowledge of the rhythmical nature of dispiritedness-inspiritedness may enhance the nurse in mutual process with clients experiencing dispiritedness to create opportunities to facilitate inspiritedness. For example, when caring for persons in later life, nurses can explore and create opportunities that (1) enhance ability to remain actively involved in their later life process; (2) intensify connectedness to the nature, family, and friends; and (3) facilitate a sense of hope for a future manifest with kaleidoscopic and symphonic potentials.
Received January, 1996
Accepted March, 1996
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Howard K. Butcher, RN; PhD, CS Assistant Professor
Pacific Lutheran University School of Nursing
Tacoma, Washington 98447-0003 206-535-8489
The author extends his deepest appreciation to W. Richard Cowling [I], RN; PhD, CS, chairperson of this dissertation research.
Table 1 Exemplar Pattern Profile Pattern Profile of Participant 4 Dispiritedness is a lack of an inner life that seems to have an ebb and flow and rhythm. Spirit to me has a religious connotation and is a life force that gives me meaning and significance. Dispiritedness has varying degrees of intensity and I have experienced both high and low spirits. The greatest intensity of low spirits was during a very difficult struggle. When I'm in low spirits, I may not feel like jumping out of bed but I get out of bed anyway. The life force seems like it is missing leaving a sense of emptiness. When I've been dispirited I have felt discouraged, dismayed, frustrated, dissatisfied with myself, and perceive no joy in this day. When I've created barriers between me and my environment, I become detached from the aliveness of the world. When I was most dispirited, I was empty inside and I lost my sense of identity and self worth. Dispiritedness is an empty and isolated person in a burnt-out environment, where trees are bent, broken, burned, and charred. There is no sun, no water, and no growth. With nothing inside, I have no energy, little desire, and my hope is diminished. But in the soil there is always potential, and I respirit myself by engaging in activities that water and replant the earth. Even though events associated with aging can lower my spirits, I can create a sense of balance of spirits through my faith in God, and engagement with my family and my work. Table 2. Emerging Unitary Themes of Human-Environmental Pattern Manifestations from Exemplar Pattern Profile A rhythmical ebb and flow Missing the life force Meaning and significance is missing leaving emptiness Getting up anyway Detached from the liveliness of the world Surrounded by a burnt-out, charred, environment Loneliness and isolation Being engaged with the environment and having faith balances ebb and flow of energy Emerged during a very difficult struggle Creating barriers Loss of identity from not being valued A sense of emptiness Feeling joyless and discouraged No energy Diminishing desire and hope Table 3. Emerging Unitary Themes reflecting the Resonating Unitary Theme Emerging Amidst Life's Adversity Feeling down admist sadness and Everything is against you (1) loss (1) Effort seems useless (2) Going down hill (2) A desperate life (2) No longer feeling needed while becoming older (3) Loss of identity from not being Emerged during a difficult valued (4) struggle (4) Comes out of a time when life is From being over the hill and there meaningless (5) is not much time left (5) Discouraged while no longer Fearing uselessness and feeling valued or having dependency (6) purpose (5) No longer feeling needed while Comes with adversity (7) becoming older (3) Not being able to function (7) Everything is against you (7) When life becomes restricted it Let down by adversity (9) pulls one down (8) Feeling useless and unable to No peace (10) work (9) When going through a difficult Being down in the dumps amidst time (10) adversity (11) Note. The number after each emerging unitary themes signifies the associated pattern profile Table 4 Resonating Unitary Themes Dispiritedness in Later Life A resonating integral human experience in later life Experiencing the ebb and flow of dissipating energy Perception of an abyss of emptiness Emerges amidst life's adversity Feeling adrift in swirling chaos while out of rhythm with the world Enduring adversity while wanting to relinquish the will to live Moving aimlessly and apprehensively through a dense fog with uncertainty Feeling detached, alone, and disconnected from the flow of life Expressed as dwindling vitality and liveliness Active involvement, connectedness, and maintaining hope propels inspiritedness. Table 5 The Unitary Field Pattern Portrait of Dispiritedness in Later Life Dispiritedness is experiencing the resonating ebb and flow of dissipating energy while perceiving of an abyss of emptiness amidst enduring adversity in later life. Dispiritedness embraces loneliness, disconnectedness, and feeling of being adrift in swirling chaos while out of rhythm with life's flow. Dispiritedness is expressing dwindling vitality, liveliness, and wanting to relinquish the will to live, yet, moving aimlessly and apprehensively through a dense fog with uncertainty. Active involvement, connectedness, and maintaining hope propels inspiritedness Table 6 Theoretical Unitary Field Patter, Portrait. Dispiritedness is: experiencing the oscillating rhythm of dissipating energy expressed as a perception of emptiness and patterns of dwindling vitality; experiencing dissonant rhythmicity amidst adversity and uncertainty expressed as feeling out of synchrony with the universe; integrality experienced as fractured expressed as disengaging from life's flow; openness and pandimensionality perceived as collapsing expressed as increasing restrictiveness, ambiguity, and apprehension; continuing to participate knowingly in change while wanting to relinquish the will to live; in a continuous rhythm with inspiritedness accelerating movement toward patterns of greater diversity manifested by visioning infinite potentials and creating innovative ways of actively participating in the later life process.
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|Author:||Butcher, Howard Karl|
|Publication:||Visions: The Journal of Rogerian Nursing Science|
|Article Type:||Clinical report|
|Date:||Jan 1, 1996|
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