CREDENTIALS AND BACKGROUND OF THE THEORIST

Rosemarie Rizzo Parse, a member of the American Academy of Nursing, is Distinguished Professor Emeritus at Loyola University Chicago. She is founder and editor of Nursing Science Quarterly, and president of Discovery International, which sponsors international nursing theory conferences. Dr. Parse is also founder of the Institute of Humanbecoming, where she teaches the ontological, epistemological, and methodological aspects of the humanbecoming school of thought (Parse, 1981, 1992, 1996, 1998, 2007b). She consults throughout the world with doctoral programs in nursing and with healthcare settings that are utilizing her theory as a guide to research, practice, education, and regulation of standards for quality in practice and education.

Dr. Parse is the author of many articles and books, including Nursing Fundamentals (1974), Man-Living-Health: A Theory of Nursing (1981), Nursing Science: Major Paradigms, Theories and Critiques (1987), Nursing Research: Qualitative Methods (1985) (co-authored), Illuminations: The Human Becoming Theory in Practice and Research (1995), The Human Becoming School of Thought: A Perspective for Nurses and other Health Professionals (1998), Hope: An International Human Becoming Perspective (1999), Qualitative Inquiry: The Path of Sciencing (2001b), and Community: A Human Becoming Perspective (2003a). The Human Becoming School of Thought (1998) was selected for Sigma Theta Tau and Doody Publishing’s “Best Picks” list in the nursing theory book category in 1998. Hope: An International Human Becoming Perspective was selected for the same list in 1999. Many of her works have been translated into Danish, Finnish, French, German, Italian, Japanese, Spanish, Swedish, Taiwanese, Korean, and other languages.

Dr. Parse graduated from Duquesne University in Pittsburgh and received her master’s and doctorate from the University of Pittsburgh. She was a member of the faculty of the University of Pittsburgh, Dean of the Nursing School at Duquesne University, Professor and Coordinator of the Center for Nursing Research at Hunter College of the City University of New York (1983-1993), and Professor and Niehoff Chair at Loyola University Chicago (1993-2006). In 2001, the Unitary Research Section of the Midwest Nursing Research Society recognized Dr. Parse’s contributions to the discipline by presenting her with a Lifetime Achievement Award. She also received the Lifetime Achievement Award from the Asian American Pacific Islander Nurses Association.

Parse’s multiple research projects and interests are focused on lived experiences of health and human becoming. She has developed basic and applied science research methodologies (Parse, 2005) congruent with the ontology of humanbecoming and has conducted and published numerous investigations on a wide variety of phenomena, including laughter, health, aging, quality of life, joy-sorrow, contentment, feeling very tired, respect, and hope. She was principal investigator for the Hope study, which included participants and coinvestigators from nine countries (Parse, 1999). Following that, Parse (2007a) further elaborated understanding of the concept of hope in her humanbecoming hermeneutic study of hope in King’s (1982) “Rita Hayworth and Shawshank Redemption.” Parse’s research methodologies have been used by nurse scholars in Australia, Canada, Denmark, Finland, Greece, Italy, Japan, South Korea, Sweden, Switzerland, the United Kingdom, the United States, and other countries (Doucet & Bournes, 2007). Her theory guides practice in various healthcare settings in Canada, Finland, South Korea, Sweden, Switzerland, the United Kingdom, the United States, and others. Humanbecoming is also used as a guide for education, administration, leadership, change, mentoring, and regulation in several settings on five continents.

THEORETICAL SOURCES

The humanbecoming school of thought is grounded in human science proposed by Dilthey and others over the past century (Cody & Mitchell, 2002; Mitchell & Cody, 1992; Parse, 1981, 1987, 1998, 2007b). The humanbecoming school of thought is “consistent with Martha E. Rogers’ principles and postulates about unitary human beings, and it is consistent with major tenets and concepts from existential-phenomenological thought, but it is a new product, a different conceptual system” (Parse, 1998, p. 4). At the time she was developing her theory, Parse was working at Duquesne University in Pittsburgh. While she was there (during the 1960s and 1970s), Duquesne was regarded as the center of the existential-phenomenological movement in the United States. Dialogues she had with scholars in this school of thought, such as van Kaam and Giorgi, stimulated and focused her thinking on the lived experiences of human beings and their situated freedom and participation in life.

By synthesizing the science of unitary human beings, developed by Martha E. Rogers (1970, 1992), with the fundamental tenets from existentialphenomenological thought, as articulated by Heidegger, Sartre, and Merleau-Ponty, Parse secured nursing as a human science. She contends that humans cannot be reduced to component systems or parts and still be understood. Persons are living beings who are more than and different from any schemata that divide them. Parse challenges the traditional medical view of nursing and distinguishes the discipline of nursing as a unique, basic science focused on human lived experience. Parse supports the notion that nurses require a unique knowledge base that informs their practice and research, and this knowledge (of the humanuniverse process) is essential for nurses to fulfill their commitment to humankind (Parse, 1981, 1987, 1993, 2007b).

In developing her theory, Parse was especially influenced by Rogers’ principles of helicy, integrality, and resonancy and by her postulates (energy field, openness, pattern, and pandimensionality) (Parse, 1981; Rogers, 1970, 1992). These ideas underpin Parse’s notions about persons as open beings who relate with the universe illimitably, that is, “with indivisible, unbounded knowing extended to infinity” (Parse, 2007b, p. 308), and who are indivisible, unpredictable, everchanging, and recognized by patterns (Parse, 1981, 1998, 2007b).

From existential-phenomenological thought, Parse drew on the tenets of intentionality and human subjectivity and the corresponding concepts of coconstitution, coexistence, and situated freedom (Parse, 1981, 1998). Parse uses the prefix co on many of her words to denote the participative nature of persons. Co means together with, and for Parse, humans can never be separated from their relationships with the universe. Relationships with the universe include all the linkages humans have with other people and with ideas, projects, predecessors, history, and culture (Parse, 1981, 1998).

From Parse’s perspective, humans are intentional beings. By this she means that human beings have an open and meaningful stance with the universe and the people, projects, and ideas that constitute lived experience. Human beings are intentional in that their involvements are not random but are chosen for reasons known and not known. Parse says that being human is being intentional and present, open, and knowing with the world. Intentionality is also about purpose and how persons choose direction and ways of thinking and acting toward projects and people. People choose attitudes and next actions from a realm of possibilities (Parse, 1981, Parse, 1998).

The basic tenet, human subjectivity, means viewing human beings not as things or objects but as beings that are indivisible, unpredictable, and everchanging (Parse, 1998), and as beings that are a mystery of being with nonbeing. Human beings live what was, is, and will be in the now moments of their intersubjective relationships with the universe. Parse posits that the human’s presence in and relationship with the world are personal, and humans assign meaning to their lives and to their projects in the process of becoming who they are. As people choose meanings and projects, according to their value priorities, they coparticipate with the world in indivisible, unbounded ways (Parse, 1981, 1998, 2007b). Every person, although inseparable from the world and from others, crafts a unique relationship with the universe. Human beings have a personal relationship with the universe that is open to new possibilities and directions. The personal relationship is the person’s becoming, and becoming is complex and full of explicit-implicit meanings (Parse, 1981, 1998).

Coconstitution is the idea that the meaning of any moment or situation is linked with the particulars that contribute to the moment or situation (Parse, 1981, 1998). Human beings choose meaning as they choose to see and evaluate the particular constituents of day-to-day life. Life happens, events unfold in expected and unexpected ways, and the human being coconstitutes personal meaning and significance. Coconstitution surfaces with opportunities and limitations for human beings as they live their presence with the world, and as they make choices about what things mean and how to proceed. The term coconstitution also links to the ways people create different meanings from the same situations. People change and are changed through their personal interpretations of life situations. Various ways of thinking and acting unite familiar patterns with newly emerging ones as people proceed with crafting their unique realities.

The term coexistence means “the human is not alone in any dimension of becoming” (Parse, 1998, p. 17). Human beings are always with the world of things, ideas, language, unfolding events, and cherished traditions, and they also are always with others—not only contemporaries, but also predecessors and successors. There is no individual in Parse’s humanbecoming theory. There is only community that one has been cocreated with (Parse, 2003a). There is the personal and there is the intersubjective, and even the way one knows self as a human being is linked intimately to the ways others think and act around persons. Indeed, Parse posits that “without others, one would not know that one is a being” (Parse, 1998, p. 17). Persons think about themselves in relation to how they are with others and how they might be with their plans and dreams. Coexistence links with the notion of mutual process and the unity of lived experience. No objective-subjective dualities or cause-effect relationships can represent humanbecoming. Linked to the assumption of freedom, Parse describes an abiding respect for human change and possibility.

Finally, situated freedom means that human beings emerge in the context of a time and history, a culture and language, physicality, and potentiality. Parse suggests that human freedom means “reflectively and prereflectively one participates in choosing the situations in which one finds oneself as well as one’s attitude toward the situations” (Parse, 1998, p. 17). Humans are always choosing. Persons decide what is important in their lives. They decide how to approach situations and what projects and people to pay attention to. Day-to-day living represents people choosing and acting on their value priorities, and value priorities shift as life unfolds. Sometimes being able to act on beliefs is as important as achieving the desired outcome. Personal integrity is linked intimately to the notion of situated freedom.

In 2007, Parse published important conceptual refinements for the humanbecoming school of thought. First, she changed human becoming and human-universe to humanbecoming and humanuniverse. These changes, according to Parse (2007b), further specify her commitment to the indivisibility of cocreation. Parse’s new concepts of humanbecoming and humanuniverse demonstrate through language that there is no space for thinking that humans can be separated from becoming or the universe—these notions are irreducible.

In addition to her new conceptualizations of humanbecoming and humanuniverse, Parse (2007b) specified four postulates that permeate all principles of humanbecoming. The four postulates are illimitability, paradox, freedom, and mystery. The four postulates further specify ideas already embedded within Parse’s school of thought. Illimitability better represents Parse’s thinking about the indivisible, unpredictable, everchanging nature of humanbecoming. Parse (2007b) stated, “Illimitability is the ‘unbounded knowing extended to infinity, the all-at-once remembering and prospecting with the moment’” (p. 308). Indivisible, unbounded knowing “is a privileged knowing accessible only to the individual living the life” (Parse, 2008b, p. 46). Paradox has always been affiliated with humanbecoming, and Parse’s bringing it forth as a postulate that permeates all theoretical principles emphasizes the importance of paradox in human cocreation. She stated, “paradoxes are not opposites to be reconciled or dilemmas to be overcome but, rather, are lived rhythms…expressed as a pattern preference” (p. 309), “incarnating an individual’s choices in day-to-day living” (Parse, 2008b, p. 46). Humans make choices about how they will be with paradoxical experiences and continuously make choices about where to focus their attention. For example, all humans live paradoxical rhythms of certainty-uncertainty, joy-sorrow, and others, and they move with the rhythm of their paradoxical experiences—at times focusing on certainty or joy, for instance, yet always having an awareness of living the uncertainty or sorrow inherent in situations. Likewise, freedom, although a cornerstone of Parse’s early thinking, is positioned in a new light in her most recent thinking. Here, she (Parse, 2007b) stated that freedom is “contextually construed liberation” (p. 309). People have freedom with their situations to choose ways of being. Finally, mystery, the fourth postulate, is presented in a more specific way as something special that transcends the conceivable and as the unfathomable and unknowable that always accompanies the “indivisible, unpredictable, everchanging humanuniverse” (p. 309). Based on her latest thinking, Parse (2007b) also refined the wording of the three principles of her theory as indicated in the following.

USE OF EMPIRICAL EVIDENCE

Research guided by the humanbecoming theory is meant to enhance understanding of the theoretical foundation, or the knowledge contained in the principles and concepts of the humanbecoming theory. Research is not used to test Parse’s theory. Nurses do not set out to test if people have unique meanings of life situations; or if persons have situated freedom; or if humans are indivisible, unpredictable, everchanging beings; or if persons relate with others and the universe in paradoxical patterns. To test these beliefs would be comparable to testing the assumption that humans are spiritual beings or that people are composed of complex systems. These statements are abstract beliefs based on experience, observation, and beliefs about the nature of reality. The foundational or ontological statements are value laden, and, as noted earlier, a nurse either has an attraction and commitment to these foundational beliefs or not. The idea of a human being who is indivisible, unpredictable, everchanging and freely choosing meaning is an assumption that is either believable or not. Assumptions about human beings are theoretical, not factual. A student or a nurse relates to one notion of human being or another. According to Parse, this is why there is a need for multiple views; the discipline of nursing can and does accommodate different views and different theories about the phenomenon of concern to nursing—the human-universe-health process. In agreement with Hall, Parse (1993) stated the following when discussing the issue of testing the humanbecoming theory:

Research with Parse’s theory expands understanding about humanly lived experiences and builds new knowledge about humanbecoming. Knowledge of humanbecoming contributes to the substantive knowledge of the nursing discipline. Disciplinary knowledge is different from the practical or technical knowledge that nurses use in various healthcare settings. Disciplinary knowledge is theoretical and identifies the phenomenon of concern for nurses—for Parse (1998, 2007b), humanbecoming. According to Parse (1998), “Scholarly research is formal inquiry leading to the discovery of new knowledge with the enhancement of theory” (p. 59). This idea of new knowledge with enhancement of theory requires additional attention to clarify the distinctions among different ways of thinking.

Research guided by the humanbecoming theory explores universal lived experiences with people as they live them in day-to-day life. Parse contends that there are universal human experiences, such as hope, joy, sorrow, grief, anticipation, fear, confidence, and contemplation. Further, persons experience what was, what is, and what will be—all at once. This means that research guided by the humanbecoming theory explores lived experiences as people live them. People live in the moment, and what is remembered and what is hoped for are always viewed within the reality of the now. Further, universal experiences cannot be reduced to linear time frames because lived experiences are cocreated with “indivisible, unbounded knowing” (Parse, 2007b, p. 308). A nurse researcher conducting a Parse method study invites persons to speak about a particular universal experience. For instance, a researcher might invite a participant to talk about his or her experience of grieving (Cody, 1995a, 2000; Pilkington, 1993). The researcher would not ask the participant to speak about grieving while in the hospital, for example, because lived experiences are not compartmentalized. The researcher guided by humanbecoming knows that the person’s reality encompasses what is remembered and what is imagined or hoped for as it is appearing in the moment (Parse, 2007b). The researcher also assumes that the person knows his or her experience and can offer an account of the experience as he or she lives and knows it. What is shared about the experience under study is what Parse (2008b) called “truth for the moment” (p. 46). Truth for the moment is the person’s description of his or her reality, an expression of “personal wisdom” (Parse, 2008b, p. 46) about the phenomenon under study in light of what is happening and known in that instant. Truth, from this perspective, is “unfolding evidence, testimony to everchanging knowing, as new insights shift meaning and truth for the moment” (Parse, 2008b, p. 46). Thus, all research evidence is “truth for the moment.”

In 1987, Parse first developed a specific research method consistent with the humanbecoming theory; since then, her humanbecoming hermeneutic method has been articulated (Cody, 1995c; Parse, 1998, 2001b, 2005, 2007a). A third method, an applied science method (qualitative descriptive preproject-process-postproject) has also been articulated (Parse, 1998, 2001b). For details of all these methods, please see The Human Becoming School of Thought: A Perspective for Nurses and Other Health Professionals (Parse, 1998) and Qualitative Inquiry: The Path of Sciencing (Parse, 2001b). The Parse research method records accounts of personal experiences and systematically examines those accounts to identify the aspects of lived experiences that are shared across participants. The core concepts, or ideas shared across all participants, form a structure of the phenomenon under study. The structure as defined by Parse (2007c) is the “paradoxical living the now of remembering and prospecting allat-once.” New knowledge is embedded in the core concepts, and, once discovered, the new knowledge enhances theory and understanding in ways that go beyond the particular study. The weaving of the new knowledge with the theoretical concepts expands understanding of the content of the humanbecoming theory, and that is how the new knowledge develops disciplinary and interdisciplinary thinking and dialogue.

A metaphor of panning for gold may help describe the Parse method. The researcher gathers descriptions from participants like a person panning for gold gathers up the earth. The extraction-synthesis processes of the Parse method can be imagined to be like the gathering, sifting, swirling, seeking, and separating as when panning for gold. Researchers following the Parse method work to separate particular context from core ideas. The gathering and discovering happen over and over as context and earth are separated from the core ideas or nuggets that eventually stand out from the surrounding context or earth. Panning for gold is thought of as back-breaking work, and Parse’s research method is also arduous. Both processes include excitement and anticipation of what is to be discovered. The extraction-synthesis processes of the Parse method separate the core ideas that are present in all participant descriptions. The core ideas, like gold nuggets, can be isolated but are not yet refined to a form that will make them meaningful in the world at large. Gold nuggets get refined into coins or jewelry. Core ideas are refined by being abstracted to the language of humanbecoming and nursing science, so that other nurses can see not only the gold nuggets, which are the newly discovered ideas, but also the meaningfulness of the ideas in light of a language of nursing science. Because all research is theory driven, research findings require interpretation in light of the guiding frame of reference in order to advance disciplinary knowledge.

MAJOR ASSUMPTIONS

Parse (1998) synthesized “principles, tenets, and concepts from Rogers, Heidegger, Merleau-Ponty, and Sartre…in the creation of the assumptions about the human and becoming, underpinning a view of nursing grounded in the human sciences. Each assumption is unique and represents a synthesis of three of the postulates and concepts drawn from Rogers’ work and from existential phenomenology” (p. 19). This underscores just how firmly Parse’s theoretical sources underpin her development of the humanbecoming school of thought. Parse draws upon the work of other theorists to build a solid foundation for a new nursing science. Accordingly, the assumptions underpinning the humanbecoming theory focus on beliefs about humans and about their becoming, which is health. Parse does not specify separate assumptions about the universe, because her belief is that the universe is illimitable and cocreated with humans—rather than separate from humans. This is evident in Parse’s (1998, 2007d) assumptions about humans and becoming:

Parse (1998, 2007d) synthesized the original nine assumptions about humans and becoming into three assumptions about humanbecoming, as follows:

Three themes arise from the assumptions of the humanbecoming theory. These include (1) meaning, (2) rhythmicity, and (3) transcendence (Parse, 1998). The postulate’s illimitability, paradox, freedom, and mystery (Parse, 2007b) permeate the three themes. Meaning is borne in the messages that persons give and take with others in speaking, moving, silence, and stillness (Parse, 1998). Meaning indicates the significance of something and is chosen by people. Outsiders cannot decide the meaning or significance of something for another person. Nurses cannot know what it will mean for a family to hear news of an unexpected illness or change in health until they learn the meaning it holds from the family’s perspective. Sometimes people may not know the significance of something until meaning is explored and possibilities examined. Personal meanings are shared with others when people express their views, concerns, hopes, and dreams. According to Parse (1998), meaning is linked with moments of day-to-day living, as well as with the meaning or purpose of life itself.

Rhythmicity is about patterns and possibility. Parse (1981) suggests that people live unrepeatable patterns of relating with others, ideas, objects, and situations. Their patterns of relating incarnate their priorities, and these patterns are changing constantly as they integrate new experiences and ideas. For Parse, people are recognized by their unique patterns. People change their patterns when they integrate new priorities, ideas, and dreams, and when they show consistent patterns that continue like threads of familiarity and sameness throughout life.

Transcendence is the third major theme of the humanbecoming school of thought. Transcendence is about change and possibility, the infinite possibility that is humanbecoming. “The possibilities arise with…[humanuniverse]…as options from which to choose personal ways of becoming” (Parse, 1998, p. 30). To believe one thing or another, to go in one direction or another, to be persistent or let go, to struggle or acquiesce, to be certain or uncertain, to hope or despair—all these options surface in dayto-day living. Considering and choosing from these options is cotranscending with the possibles.

THEORETICAL ASSERTIONS

Parse’s (1981, 1998) principles are the assertions of the humanbecoming theory. Each principle interrelates the following nine concepts of humanbecoming: (1) imaging, (2) valuing, (3) languaging, (4) revealing-concealing, (5) enabling-limiting, (6) connecting-separating, (7) powering, (8) originating, and (9) transforming (Figure 24-1). Research projects generate structures that further specify relationships among the theoretical concepts. For example, Wang (1999) studied hope for persons living with leprosy in Taiwan, and she presented the following theoretical structure: The lived experience of hope is imaging the connecting-separating in originating valuing. Theoretical structures can be used to enhance understanding of specific phenomena as readers consider the detailed participant descriptions that are linked to the concepts of humanbecoming theory. For more information about humanbecoming research, refer to the comprehensive overview of studies compiled by Doucet and Bournes (2007).

LOGICAL FORM

The inductive-deductive process was central to the creation of the humanbecoming theory. The theory originated from Parse’s personal experiences with her readings and in nursing practice. She deductively-inductively crafted major components of humanbecoming from the science of unitary human beings and existential-phenomenological thought. With her intuitive sense, Parse methodically derived the assumptions, concepts, principles, and practice and research methodologies of the humanbecoming school of thought. Figure 24-1 shows how the principles, concepts, and theoretical structures can be linked. The figure shows the most abstract view of humanbecoming—the simplicity and the complexity of the theory are evident. Abstraction and complexity create possibility for growth, scholarship, and sustainability.

The following bibliography demonstrates the broad scope of acceptance by the nursing community. A strong and influential group of nurse scholars is advancing humanbecoming in practice, research, and education. The theory has made a difference to nurses and to persons (patients) who experience humanbecoming practice. The theory informs nurses who work with older persons and with children. The theory guides practice for nurses who work with families and with persons in hospital settings, clinics, and community settings. A community-based health action model, for instance, has been developed and is receiving support from the local community and other funding agencies (Crane, Josephson, & Letcher, 1999). The theory of humanbecoming has also helped to generate controversy and scholarly dialogue about nursing as an evolving discipline and a distinct human science. It is interesting to note that the theory of humanbecoming provides a set of beliefs that can be lived by nurses who have opportunities to be with human beings. It is not a question of whether or not the theory works in any particular setting. The theory has been lived by nurses in the operating theater, in parishes, in shelters, in acute care hospitals, and in other long-term and community settings. A more important question for nurses may be, What settings consistently provide opportunities for nurses to have relationships with persons and families?