International Journal of Caring Sciences
May – August 2019 Volume 12 | Issue 2| Page 1225
Special Article
Chaos Theory and Nursing
Muhammet Sait Demir
Nursing Student, Istanbul University-Cerrahpasa Florence Nightingale Faculty of Nursing, Istanbul,
Turkey
Ahmet Karaman, RN, MSc
Research Assistant, Istanbul University-Cerrahpasa Florence Nightingale Faculty of Nursing, Surgical
Nursing Department, Istanbul, Turkey
Seher Deniz Oztekin, RN, MSc, PhD
Professor, Istanbul University-Cerrahpasa Florence Nightingale Faculty of Nursing, Surgical Nursing
Department, Istanbul, Turkey
Correspondence: Ahmet Karaman, RN, MSc, Surgical Nursing Department, Istanbul UniversityCerrahpasa
Florence
Nightingale
e-mail: ahmet.karaman@istanbul.edu.tr
Faculty
of
Nursing,
Sisli,
Istanbul,
Turkey
Abstract
The Chaos Theory, which explains how a complex and unpredictable system behaves, shows that there exists a
system within irregularly visible systems, it has affected all fields of science towards the end of the 20th
century. In the Chaos Theory, it is impossible to understand and predict all of the dynamic system (non-linear
systems), where small changes in a system lead to greater change in the process (sensitive to the initial state),
similar to the smallest part of a whole (fractals). It is stated that behaviors occurring in systems are not random
and that there is an atractor causing the behavior. The complex structure of biological systems studied in life
sciences allows the use of the Chaos Theory in these areas. The focal point of all approaches to complex
structures allows the application of Chaos Theory within the health sciences. In this review, the treatment and
care initiatives for meeting the health needs of nurses, patients or healthy individuals who face most problems
within the health care system are dealt with on the basis of Chaos Theory.
Keywords: Chaos Theory, health sciences, nursing, nursing care
Introduction
Chaos Theory, a combination of conceptual,
mathematical and geometric methods, deals with
nonlinear, complex and dynamic systems
characterized by its fractal structure (Gokmen,
2009; Tuna-Orhan, 2013). The concept of Chaos
Theory dates back to ancient Greek and Chinese
civilizations. Part of the important works that
influenced Chaos Theory was carried out by the
French mathematician , Jules Henri Poincare , in
the 19th century. Poincare, in his study on the
problem of
‘three bodies’, reported that
multidimensional systems were too complex to
be predicted and used the term ’chaos’ for the
first time in technical terms. Bertalanffy defined
the system as a common and complex structure
with a mutual interaction (Diker & Okten, 2009;
Gokmen, 2009).
The beginning of Chaos Theory in the modern
sense is based on the work of Meteorologist
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Edward Norton Lorenz. In 1963, Lorenz wrote
an algorithm to model weather events through his
computer to monitor the behavior of the weather.
This program works on a system of three
differential equations. Lorenz observed the
behavior of this system and how the parameters
changed relative to each other, and in this
modeling he discovered the ‘Atractor’, which
represented the order in complexity described in
Chaos Theory. In addition, when entering data
into the program, in order to save time, he
ignored parts of the numbers after the comma
(for example, 0.506 instead of 0.506127).
However, he pointed out the important
differences that arise in the outputs he obtained
and showed a sensitive commitment to the initial
situation (Figure 1 ) (Gleick, 2005). Over time,
the dynamic system in Chaos Theory is unlikely
to be understood and predicted (non-linear
systems). Small changes in a system, leading to
larger changes in the progressive process.
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(sensitive commitment to the initial state),
fractals-self similarity, the behavior occurring in
the system is not random and it is declared that a
hammer that causes behavior (Rickles, Hawe, &
Shiell, 2007; Samur & İntepeler, 2017; TunaOrhan 2013).
Fractal Structure
Basic Features of Chaos Theory - Sensitive to
The Initial State
In a system according to Chaos Theory, the small
changes that occur in the beginning cause large
changes in the process. ‘‘Sensitive to the initial
state’’ It is possible to explain this property by
the butterfly effect reported in literature. It is
said that a butterfly flapping wings in Beijing
will cause hurricanes in Washington. Of course,
it does not lead to a butterfly hurricane flapping
its wings, but it is important that a butterfly's
wing flap is not neglected in the estimation of a
hurricane (Gleick, 2005; Tuna-Orhan, 2013).
Fractal structure is an expression that refers to
self-reflection or proportional break. A section of
the Manldelbrot cluster found by Benoit
Mandelbrot shows a cross-sectional view of a
whole, similar to the smallest part of a whole
(Figure 2). Likewise, the Koch curve
(Snowflake), defined by Helge von Koch in 1904
(Figure 3), has the characteristic of being present
in the fractal structure. To configure a Koch
Curve, a triangle with a side length of one unit is
drawn. A new triangle is added to the middle of
each edge, one-third the size. Koch snowflakes
are formed when additions are continued. When
a close section of the Koch curve is observed,
fractal structures, one of the main features of the
chaotic structure, are observed (Chaffee &
McNeill, 2007; Varela, Ruiz-Esteban & De Juan,
2010; Samur & İntepeler, 2017).
Figure 1. The diverging two numerical weather prediction graph Reference: Gleick, J. (2005). Chaos, A New
Science Theory. (F. Uccan, Trans.). Ankara, Saner Printing Industry, 13th Edition, 9-10.
Figure 2: Mandelbrot Cluster Reference: Gleick, J. (2005). Chaos, A New Science Theory. (F. Uccan, Trans.).
Ankara, Saner Printing Industry, 13th Edition, 126-127.
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May – August 2019 Volume 12 | Issue 2| Page 1227
Figure 3. Development stages of Koch Curve (fractal) Reference: Gleick, J. (2005). Chaos, A New Science
Theory. (F. Uccan, Trans.). Ankara, Saner Printing Industry, 13th Edition,114-115.
Atractors
One difference is the particularization of Caos
Theory is the atractor. When the mathematical
reflections are put on a graphic, the places which
are intense are called attractors. It is pointed out
that the behaviours seen in the caotic systems are
not random and it is asserted there are some
attractors that cause those behaviours. For
example, the most intensive region in Turkey is
Marmara Region. Because of its Economy,
transportation and the service sectors are
advanced it helps the region attract attention. In
this context, Marmara region is the most
prominent attractor of Turkey (Altun, 2001;
Rickles, Hawe, & Shiell, 2007; Tekel, 2006;
Tuna-Orhan, 2013).
Nonlinear Systems
The systems we see around can be described by
some different features. Linearity or nonlinearity
are some of its features. Linear systems are the
ones who are easy to predict. For example, when
we think of a machine which utilizes 10 raw
materials and with those materials it produces 5
products, this machine would produce 10
products by using 20 raw materials. Hence the
nonlinear systems are the ones who are
unpredictable which depend first conditions. For
example, when we think of a nonlinear machine,
by using 10 raw materials it may produce 1,2,3
and 10 products or nothing which depend on its
first conditions. Nonlinear sytems are the basic
feautures of Chaotic sytems (Higgins, 2002;
Yıldız, Fidancı, Konukbay & Suluhan, 2016).
Chaos Theory –Human
The biological, psychological, social and cultural
aspects of human beings are complex and
predictable up to a certain point, allowing us to
implement Chaos Theory. The coincidental,
irregular and irreversible distribution of useful
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energy in any physical or chemical event is
defined as entropy. Entropy states that everything
in the universe is moving towards disorder, and
there is an irregularity in the order. For example,
the emergence of a star, the continuous loss of
heat over time and the path towards the disorder
and its disappearance are typical examples of this
situation. Typical examples include the release of
glucose in the human body, of glucose in the
mitochondria, of adenosine triphosphate, of death
of millions of cells and of the formation of new
cells. The fact that there is homeostasis (inner
balance) against the existing entropy in the
human body and that it continues until death
shows the order that exists in our body. This
situation is an express and open example of
regularity inside irregularity as per this Chaos
Theory (Janecka, 2007).
Looking at the human body, which is the
cornerstone of complex structures, each organ
has its own unique microstructure and unique
chemistry. Examining the samples of chaos in
the human body; In the heart of the ventricle
fibrillation, electrocardiogram strips, lung
bronchial branching, and the exchange of
information are observed to follow the chaotic
rules of information exchange. When the
electroencephalography images are analyzed, it
is seen that there is an order in the human brain
in irregular pullers (chaotic properties). The
condition of this disorder, which expresses
chaotic structure, causes disease.
Chaos Theory and Nursing
The Chaos Theory, which explains how a
complex and unpredictable system behaves, by
the end of the twentieth century, it influenced all
fields of science. The complex and unpredictable
biological, psychological and socio-cultural
structure of human beings, who have an
important place among the basic concepts of
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May – August 2019 Volume 12 | Issue 2| Page 1228
nursing, allow the application of Chaos Theory
in nursing science (Haigh, 2008; Samur &
İntepeler, 2017).
Theory is in parallel with the individualized care
understanding that is of importance in treatment
and care (Janecka, 2007; Lett, 2001).
As previously stated, Small changes in a system
in Chaos Theory are known to lead to greater
changes in the process. ‘‘Sensitive to the initial
state(butterfly effect)’’ is expressed as, especially
in the intensive care unit, bronchospasm due to
endotracheal aspiration and a decrease in oxygen
saturation, sample can be given. In cases where
necessary nursing care interventions are not
performed, impairment of general condition
related to deterioration in all other hemodynamic
parameters, described in the theory of chaos
‘‘Sensitive to the initial state (butterfly effect)’’
can be explained by. In this context, a decision
on a patient or a healthy individual can lead to a
large and unforeseeable outcome for the patient
or healthy individual in the course of the process.
With this approach, it can be determined by
examining the onset of the disease development
process and new approaches can be revealed in
the early diagnosis of diseases (Janecka, 2007;
Lett, 2001).
Conclusion
It is stated that behaviors occurring in chaotic
systems are not random and that there is a
attractor
which causes this behavior. For
example, the lack of water in the desert causes
the desert ecosystem (plants and animals) to
collect around water resources altogether. The
serious importance of water in the desert
ecosystem makes it attractive. The patient or
healthy person in which the treatment and care
interventions are applied and the focus of health
care professionals can be given as examples of
attractors expressed in Chaos Theory (TunaOrhan, 2013).
Another feature of Chaos Theory is the similarity
of the parts that make up the whole and the parts
that make it up, and the fractal structures that
indicate that no part of a whole can be thought
apart. Fractal structures are similar to the holistic
approach that advocates the need to address all
dimensions of the individual in the planning and
implementation of nursing care (Haigh, 2008).
Non-linear systems are unpredictable systems
depending on initial conditions. Despite the same
treatment and care protocol for two individuals
with the same clinical features, clinical course
may vary. Different initiatives can be applied to
individuals in the treatment and care process.
Therefore, individuality is at the forefront in all
stages of nursing care. This feature in Chaos
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The nurse, who seeks solutions to complex
problems in the health care system, can meet the
needs of the patient or healthy individual, taking
into account the characteristics of complex
events described in Chaos Theory.
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