Rosemarie Rizzo Parse's Human Becoming Theory Of Nursing

Rosemarie Rizzo Parse first developed the Human Becoming Theory of Nursing in 1981, as a human science nursing theory. The human becoming theory is a simultaneous paradigm of human being rooted in a mutual process of the human-universe relationship as cause and effect (Parse, 1992). Foundations of the theory draw beliefs about human wholeness, the human-universe relationship, pattern recognition, and the nature of health (Parse, 1992). The overall goal of nursing practice under the theory of human becoming is to provide quality of life through true presence in respect to autonomy of the patient or family unit (Parse, 1992, 2010).

Parse’s human becoming theory is structured by philosophical assumptions borrowed from the philosophies outlined

The study population was a community-based sample of 4,394 subjects from the Health and Retirement Study cohort, surveyed biannually since 1992 with healthcare proxy interviews completed with 24 months with cohort member death. Defined outcome quality metrics were obtained from Medicare data and included, a high proportion of deaths outside of the hospital, a low number of hospital and intensive care unit days at end of life, and a high rate of hospice enrollment more than 72 hours before death. Primary predictors included whether subjects engaged in ACP, document preferences in an advanced directive, or assigned a designated power of attorney. Secondary predictors assessed healthcare utilization of preferences according to advanced directives, categorized as all care possible, some limits, and comfort care. Covariates including demographic characteristics, comorbidities, and functional limitations were also measured. Quality outcome were measured by bivariate analysis and differences in care related to confounding was measured with multivariable Poisson regression analysis.

Of the study subjects, 76% engaged in advanced care planning with 92% who completed advanced directives prioritized comfort care measures over life prolonging interventions (Bischoff et al., 2013). Adjusted association between ACP and quality of end of life care found subjects who engaged in ACP were less likely to die in a hospital (aRR=0.87, 95% CI 0.80-0.94, P<0.01) (Bischoff et al., 2013). No significant difference in rate of hospitalizations, intensive care admission, or frequency of emergency department visits were found in the last month of life (Bischoff et al.,