RESEARCH ON THE BARRETT THEORY OF POWER

There has been over 25 years of research and more than 80 qualitative or quantitative studies using either Barrett’s theory of power and/or the Power as Knowing Participation in Change Tool called the PKPCT.   Information on the tool is published various places (Barrett, E.A.M. (2003).  O.L. Strickland & C. Dilorio (Eds.). Vol. 4. Measurement of Nursing Outcomes:Focus on patient/client outcomes (pp. 21-39).  New York: Springer).  As principal investigator, I have studied over 2000 people in several quantitative and qualitative studies.  An important premise of the theory is that power is a natural human capacity of all people regardless of gender, race, ethnicity, socioeconomic class, language, or country.  The studies of this view of power have now occurred in seven countries and, indeed, there is evidence that people, simply by definition of being human, have the power to participate knowingly in change, and this capacity can be enhanced using certain approaches such as guided imagery, Therapeutic Touch, exercise, and meditation.  It is also well established that power as knowing participation in change is correlated with other qualities that tend to enhance or diminish it.

As co-investigator, I have also participated in several studies with colleagues.  Two of the most interesting involved using guided imagery with adults who had asthma.  Together with Gerald N. Epstein, MD, and other colleagues and funded by the Office of Alternative Medicine of the National Institutes of Health, we discovered that by using imagery as a treatment for their asthma, people felt more powerful (p = 0.04), and particularly in relation to having more choices  (p = 0.03) (1994).  Many in the experimental group were also able to decrease or eliminate their medications without  deterioration in pulmonary function as measured in the pulmonary laboratory (p = 0.05) (2004).  We then conducted a qualitative study with members of the experimental group to learn more about their experience of using imagery.  Participants told us that having another tool (guided imagery) diminished their fears, such as dreading that they would forget their inhaler and die from a sudden onset of an asthma attack. Interestingly, all of their comments could be related to one of the four dimensions of power (awareness, choices, freedom to act intentionally, and involvement in creating change).  This finding provided further validation for the power as knowing participation in change theory (1997).

Cynthia Caroselli, RN; PhD, and I published a 15 year review of 39 completed studies in which researchers had used the power theory and/or the power as knowing participation in change measurement instrument in either a quantitative, qualitative, or triangulated approach (1998). Tae Sook Kim, RN; PhD, has submitted for publication a follow-up survey of researchers who have used the theory or tool since the earlier survey conducted in 1995. 

Caroselli and I reported that in the quantitative studies, approximately one-third used samples of nurses, one-third looked at healthy adult populations, and one-third studied groups of participants with particular conditions.  All but three of these studies were conducted within the view of Rogers’ science.  The majority used descriptive correlational designs; some used descriptive comparative designs.  A few designs were experimental.

Positive significant correlations were demonstrated in various studies between power or a power subscale and human field motion, life satisfaction, purpose in life, feminism, well-being, spirituality, transformational leadership style, perspective taking, imagination, empathy, perceived health and socioeconomic status.

By way of contrast, statistically significant inverse/negative relationships were demonstrated between power and personal distress, chronic pain, environmental factors, anxiety, previous recent crisis, injury severity, creativity, hopelessness, and transactional leadership style.

In the experimental or comparative studies higher power scores were found:

  1. In persons who reduced smoking following guided imagery versus persons in the control group who did not reduce smoking (Wynd, 1992);
  2. In persons with no chronic pain as compared with persons with chronic pain (Matas Rapacz, 1992);
  3. In diabetics receiving education versus diabetics who did not receive education (Roznowski, 1995);
  4. In Swedes and Finns as compared to Japanese and South Koreans (Winstead-Fry, Paletta, Barrett, Krause, Lee, Nojima, & Olsson, 1996);
  5. In persons with asthma who used guided imagery as compared to persons with asthma in the control group (Epstein, Barrett, Halper, Seriff, Phillips, & Lowenstein, 1997);
  6. In non-depressed women compared with depressed women (Malinski, 1997).
  7. And in men and women with lung cancer who exercised compared with those who didn’t exercise (Wall, 2000).

In contrast, there were no differences in power scores:

  1. In postmenopausal women with and without coronary artery disease (Gloss & Crowe, 1993);
  2. In polio survivors and those with no comparable disease (D.W. Smith, 1995).
  3. And in dyspneic patients pre and post education (Krause, 1991).

Six qualitative studies were identified that used the power theory in some way.  The
power theory and/or tool have also been used as a pedagogical device in research and
measurement courses.  In addition, they have also been used in practice or demonstration
projects such as providing a theory and evaluation tool for group therapy with
adolescents who have attempted suicide  (Caroselli & Barrett, 1998), and a psychiatric
unit in Canada has used the theory and tool to conduct research and to guide practice since 1999. (Personal Communication, December18, 2007).

Dr. Kim’s publication will tell us about many exciting research studies that have
taken place in recent years.  Although I am familiar with quite a few of these studies, I
am eagerly awaiting the published review.

References

  • Barrett, E.A.M. (2003).  A measure of power as knowing participation in change.  In O. Strickland & C. Dilorio, Measurement of nursing outcomes, 2nd ed., vol 3 (pp. 21-39).  New York: Springer.
  • Caroselli, C. & Barrett, E.A.M. (1998).  A review of the power as knowing participation in change literature.  Nursing Science Quarterly, 11, 9-16.
  • Epstein, G.N., Halper, J.P., Barrett, E.A.M., Birdsall, C., McGee, M., Baron, K. & Lowenstein, S. (2004).  A pilot study of mind-body changes in adults with asthma who practice mental imagery.  Alternative Therapies in Health and Medicine, 10, 66-71.
  • Epstein, G.N., Barrett, E.A.M., Halper, J.P., Seriff, N., Phillips, K., & Lowenstein, S. (1997).  Alleviating asthma with mental imagery: A phenomenological approach, Alternative and Complementary Therapies, 3, (1), 42-52.