Joyce Fitzpatrick and Rhythm Model (Nursing Theory)
Joyce J. Fitzpatrick’s Rhythm Model includes four content concepts and they are: person, health, wellness-illness and metaparadigm. According to experts, the primary purpose of nursing is the promotion and maintenance of an optimal level of wellness. The professional nurse participates in a multi-disciplinary approach to health in assessing, planning, implementing, and evaluating programs in regards to how they affect optimum wellness for patients. When assessing health care needs, the professional nurse incorporates the physical, emotional, social, environmental and spiritual aspects of the profession into her daily routine.
As a direct result of theories such as Joyce Fitzpatrick’s, today some of the best measures of the contribution of an information system to nurses’ clinical decision making have been implemented. Despite disagreements on the classes as well as the language describing the parts of the nursing diagnosis, Fitzpatrick’s approach to taxonomy in nursing has been considered a primary basis for the development of the substantive structure of the discipline.
Classification is a relatively new concept within the realm of the nursing profession. It started out as an effort to develop a language that would define the clinical judgments made by nurses, but it ultimately evolved into a broader range of categories, including the coordination of data set for health statistics, the development of computerized patient records, and advanced education and research. Consequently, Joyce Fitzpatrick’s theory and its major concepts are determinedly applicable.
Though nurses have obviously based their work on knowledge arising from some source, many scholars in nursing have claimed that the nursing profession does not have a strong theoretical basis. They also complain that many of the difficulties experienced in classification development are due to theoretical pluralism in nursing. However, to the extent that the classifications help to better define the concept of the discipline, deriving the theoretical relationships among the concepts in the taxonomies and systematically testing them quickly builds the systematic knowledge that has been sought after for such a long period of time. Even basic structures for knowledge development in nursing had to wait on the introduction of theories and philosophies of nursing until 1950s.
The systematic use of the term “nursing diagnosis” (clinical judgments about individual, family, or community responses to actual or potential health problems and life processes that reflect patient behaviors or patient status and provide the basis for selection of nursing interventions to achieve desired outcomes) along with early attempts to comprehensively list the diagnoses that nurses treat began in 1973. This is when the first classification conference was held, however, research was minimal and substantive literature on concepts of this type were few and far between. Yet as nursing knowledge development increased and diagnostic categories were identified, interest in organizing knowledge for practice, education, and research also increased.
According to Fitzpatrick, the identification and labeling of concepts allows for recognition and communication with others, and the rules for combining those concepts permits thoughts to be shared through language. Thus the concepts within a classification system sanction the organization of ideas. Recognition occurs when what is observed is placed into previously learned classes, or categories, on the basis of observed characteristics. It is therefore important to remember that classification system development parallels knowledge development in a discipline. Moreover, the taxonomies of nursing diagnoses, interventions, and outcomes provide an anchoring framework for nursing knowledge.
The four content concepts that comprise Fitzpatrick’s theory are person, health, wellness-illness and metaparadigm. These concepts are defined as follows:
Person: The term person integrates the concepts of both self and others, and recognizes individuals as having unique biological, psychological, emotional, social, cultural, and spiritual attitudes. They thrive on honor and dignity, self-evaluation and growth and development. Throughout a person’s life, many factors develop within a social setting and interact with a multitude of environments that can significantly influence that person’s health and wellness.
Health: Health is a dynamic state of being that results from the interaction of person and the environment. Optimum health is the actualization of both innate and obtained human potential gleaned from rewarding relationships with others, goal directed behavior, and expert personal care. Adjustments can be made on an “as needed” basis in order to maintain stability and structural integrity. A person’s state of health can vary from wellness to illness, disease, or dysfunction, and it changes continuously throughout the person’s life span.
Wellness-Illness: Professional nursing is rooted in the promotion of wellness practices, the attentive treatment of those who are acutely or chronically ill or dying, and restorative care of people during convalescence and rehabilitation. Other dimensions of professional nursing include the teaching and evaluation of those who perform or are learning to perform nursing functions, the support and conduction of research to extend knowledge and practice, and the management of nursing practice in health care delivery systems. Nursing is a practice discipline and a profession that is based upon a synthesized body of knowledge, which is derived from inquiry and clinical evaluation promoting wellness and diminishing illness. Professional nurses acquire and maintain current knowledge, are willing to participate in peer review and other activities that insure quality of care, and communicate effectively with recipients of care and other health care providers. Thus the nursing practice centers on the application of this body of knowledge in an effort to maintain, restore, or enhance the interactions between people and their environment.
Metaparadigm: Transition is one of the core concepts of nursing theory, derived from and related to the basic metaparadigm concepts of person, environment, health and nursing. While much of the research in nursing has been focused on assisting individuals in their life transitions, whether through phases of growth and development, or experiences with health and illness, the conceptualizations of the nursing profession as focused on transitions has not been adequately researched.
Nursing is both a practice discipline and a profession. A fundamental part of nursing is concerned with concepts, categories, and classification systems. This body of knowledge is continuously developed and refined as an outcome of scientific, historical, philosophical, and ethical inquiry and clinical evaluation. Nursing knowledge is generated about health through behaviors of persons across the life span. Clinical evaluation advances nursing knowledge through the testing and validation of interventions that are used in nursing practice, nursing education, and nursing administration.
Nursing shares, with other health professions, a commitment to the well being of the patient and to a professional practice based on codes of ethics. Over the past two decades, national and international nurses associations have refined their principles to reflect an increasing commitment to human rights and the protection of the patient. However, because of the growing databases of information and the constant advancements of technology, a viable framework for assessments and evaluations must be firmly in place. Joyce Fitzpatrick’s model provides a foundation for these classifications.
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