Nursing process results in change The nature of change ineludes alternatives of cognitive repatterning (using new information to increase understanding), affective adjustment (using the relationship to become aware of, accept, and express feelings), and synthesis of cognitions and feelings in interpersonal repatterning (using the relationahip to learn to interact with others in the social system) The direction of change can be toward health enhancement or deterioration. Obvioualy, the nurse wants to direct change toward health.