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- Nursing Science
- Nursing Knowledge: Science, Practice, and Philosophy
- Nursing Knowledge in the 21st Century: Domain-Derived and Basic Science Practice-Shaped
- Mark Risjord, Nursing knowledge, science, practice and philosophy
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By clicking register, I agree to your terms. All rights reserved. Design by w3layouts. Full Text Original article doi: Early work on the nature of theories in nursing was strongly influenced by logical empiricism, and this influence remains even long after nurse scholars have come to reject logical empiricism as an adequate philosophy of science. Philosophers of science have also rejected many of the central tenets of logical empiricism, including its focus on the logical justification of theories and the idea that science is, or should be, unified.
Instead, there has been an increasing focus on the practice of science, which in turn has led to a pluralist understanding of science that emphasizes the construction of scientific models that are appropriate for certain purposes or in certain contexts.
I suggest that this approach to philosophy of science may provide better resources for nursing science. Keywords: epistemology, philosophy of science, positivism. Introduction Although the discipline of nursing dates back at least to the work of Florence Nightingale in the midth century, the idea of nursing as a science emerged only in the middle of the 20th century.
Because professions are identified in part by a specific body of knowledge that its members are Correspondence: Dr Robyn L. In working through what such a nursing science should look like, they looked to then current work in philosophy of science, specifically to logical empiricism. The turn to logical empiricism, however, led nursing scholars to adopt a view of scientific theories that conflicted with the need to specify the scope of nursing as a profession. In particular, two features drawn from logical empiricism contributed to this tension.
This meant that the topdown and bottom-up approaches had to somehow be fit into a unified nursing science. Thus, while drawing on logical empiricism for the development of nursing science did have clear advantages, it also gave rise to debates within nursing science that are still being dealt with today. Yet even as nursing scholars developed their own philosophy of science by drawing on logical empiricism, this philosophical approach was beginning to lose its status as the predominant view in philosophy.
Now, many philosophers of science have come to view science from a pluralist perspective, one that emphasizes disunity. This paper traces the influence of logical empiricism on nursing theory and shows that contemporary philosophy of science provides a better philosophical framework for nursing theorists.
This consensus, known as logical empiricism, is the form of philosophy of science that influenced nursing scholarship during the late s and the s. Other aspects of logical empiricism, however, are importantly different from nursing theory. One of these is that logical empiricism focused on the products of science, specifically on scientific theories, rather than on the process of doing science.
This distinction is made explicit by Rudolph Carnap, who viewed the former as the concern of logic and philosophy; the latter, by contrast, was the domain of sociologists and historians. Hans Reichenbach builds on this idea: Epistemology does not regard the processes of thinking in their actual occurrence; this task is entirely left to psychology. What epistemology intends is to construct thinking processes in a way in which they ought to occur if they are to be ranged in a consistent system; or to construct justifiable sets of operations which can be intercalated between the starting-point and the issue of thought-processes, replacing the real intermediate link.
Epistemology thus considers a logical substitute rather than real processes. Reichen- bach, , p. In the s, a small group of philosophers and scientists known as the Vienna Circle met regularly to discuss issues in logic and philosophy of science. Although there was some important diversity in views among this group, their general approach to philosophy of science came to be known as logical positivism.
The Vienna Circle also maintained ties with similarly oriented groups throughout Europe and the rest of the world, and with the worsening political situation in Europe throughout the s, a number of the European philosophers emigrated to the UK and the USA, where they further developed positivist themes in philosophy of science.
The syntax of theories consisted of a set of statements that expressed relationships between the concepts that were relevant to a particular science. Objects were identified and individuated in terms of these observable properties and then the relationships among these objects were expressed logically, resulting in generalizations that were held to reflect laws of nature.
Another important characteristic of logical empiricism is its view of the relationships among sciences and scientific theories. In particular, science was considered to be unified. There are various ways to understand the idea of a unified science. Alternatively, science can also be considered to be unified because all of the sciences follow a single method.
Still, other approaches make stronger claims about the unity of science; one possibility is that there is unity in the concepts used in various sciences where the concepts themselves are based on combinations of observation terms , and another is the even stronger claim that the laws discovered by the various sciences will eventually provide a unified theory. In this view, the claims and theories of the various sciences will be translatable directly into each other, rather than all being related only by being translatable into a basic observation language.
The overall picture of science that was developed by logical empiricism is thus one of a monolith of scientific knowledge, composed of hierarchical levels of theories, which in turn consisted of statements expressing law-like relationships between the concepts of the theory. The whole structure rested on a foundation of observations, which were expressed in statements describing basic observable properties.
The next section shows how, and why, this picture was adopted and adapted by nursing scholars. This can be seen in a number of papers that were published during this time.
Similarly, Faye Abdellah emphasized the need for a nursing science — both in order to solve the specific problems that nurses needed solved as opposed to the problems that were of concern to other sciences and in order to provide a solid grounding for nursing practice. Both Johnson and Abdellah, then, accept that theories are central to nursing science. But there is also an important difference between the philosophy of science that was developed within nursing and the logical empiricist view that inspired it.
Recall that the logical empiricists explicitly focused on scientific theories as the products of scientific activity, while the latter were interested in how to actually develop theories. Because the logical empiricists were concerned only with rational reconstructions, i. Two papers published in , by Ada Jacox and by Margaret E.
Hardy, provide detailed accounts of how to build theories that fit the logical empiricist view. Jacox and Hardy also follow logical empiricism in their view of the relationships among theories. Some theories are relatively concrete, and their concepts pick out observable properties or objects.
Other theories, and the concepts in them, are more abstract. Abstract concepts are defined in terms of other, more concrete concepts. This means that there is, as in logical empiricism, a hierarchy of theories, with more abstract theories at the top and more concrete theories at the bottom. But both their interpretation of this philosophy and the way that their work was taken up by other nursing scholars were influenced by the needs of nursing and the professional context within which they were working.
In this section, I briefly review this context and show how it interacted with the ideas being brought in from logical empiricism to form a distinctive philosophy of nursing science. I then show how tensions within this philosophy have shaped two central debates in nursing: the acceptability of using borrowed theory and the appropriate relationship between theory and practice. At this time, both nursing education and the occupational role of nurses within health care were changing see Risjord, Nurses were increasingly receiving their training in academic nursing programmes, as opposed to the earlier hospital-based apprenticeships, which in turn meant that there had to be nursing faculty and a nursing curriculum for them to teach.
There were also changes within the profession as nurses increasingly took on managerial responsibilities and direct care was coming to be provided by people who did not have nursing training.
These changes led to questions about what nursing actually should be and how to understand the nature of nursing knowledge. During the s and s, several scholars, including Virginia Henderson and Hildegard Peplau, began to address this issue by writing systematic overviews of the practice of nursing.
They did so by breaking down that process of nursing into stages and articulating the unique role of nurses in health care. These works therefore exemplify what I Robyn L. Around the same time that Jacox and Hardy were writing, the first nursing theories were being developed with the aims of clarifying the unique character of nursing work and of setting it apart from medicine McKenna, But these were not theories in the logical empiricist sense; they were more abstract and were not firmly rooted in an observational basis, and therefore they were not open to direct empirical testing.
They further note that the two movements proceeded largely separately, at least during the early and mids. It is not clear that proponents of the use of conceptual models to guide nursing science mean that theories should be derived from conceptual models in the strict logical sense, but the top-down view clearly does regard theories as being shaped by conceptual models.
This indicates that theories are not to be built bottom up from a foundation of concrete concepts, but should come from higher level, conceptual models. There is, therefore a tension between the top-down and the bottom-up approaches to theory building because they view theories as arising from different sources. One way to defuse this tension might have been to establish a sort of peaceful coexistence between the approaches, on which scholars could pursue either approach without reference to the other.
But in practice, the solution was not this easy. This is because nursing scholars also accepted a second basic tenet of logical empiricism — the belief in the unity of science.
If nursing science was to be unified, it had to be possible to reconcile the more abstract, top-down approach with the theories that were developed from the bottom up.
Because of this commitment to the unity of science, it is still very common in nursing textbooks to present nursing theories as forming a hierarchy, with abstract conceptual models nearer to the top and more concrete theories at the bottom.
It should be noted, though, that as with the logical empiricist discussion of theories, the understanding of the unity of science was also adapted to meet the specific concerns of nursing scholars.
In the logical empiricist view, the unity of science means that, ultimately, all of the sciences will form a single hierarchy, with everything else reducing to physics, the foundational science. In summary, 1 nursing scholars developed a view of theories inspired by logical empiricism, which committed them to both the unity of nursing science and to a bottom-up view of theory construction, and 2 the need to establish overarching goals for nursing that would distinguish it from other health science professions and show why nursing care could not simply be provided by people who lacked nursing training required a top-down specification of the goals and nature of nursing, which, because nursing science was seen as unified, needed to be integrated with the bottom-up approach.
Moreover, because nursing science was seen as unified, these two approaches needed to be integrated. Another is in discussions about the relationship between theory and practice. The debate over borrowed theory reflects the commitment to a unified nursing theory, but also comes from the need to establish and maintain the autonomy and uniqueness of nursing science. This means that there are two aspects to the borrowed theory debates.
Although his list differs from the issues I identify, I think that our analyses are compatible. Johnson takes an optimistic approach to the use of borrowed theory.
Other scholars are willing to accept that nursing can use theory borrowed from other sciences, but argue that it cannot simply be incorporated into nursing theory without alteration. Theory derivation involves selecting parts of the theory for adaptation and eliminating parts of the theory that do not seem to apply in the nursing context. Presumably, the new theory would also undergo some sort of empirical validation of the sort demanded by Riehl and Roy in order to determine whether it successfully meets the needs of nurses.
Other scholars see the problem differently and Robyn L. Bluhm argue against the use of borrowed theory on the grounds that it threatens the autonomy of nursing as a discipline.
This viewpoint reflects the top-down approach discussed above regarding the establishment of nursing as an autonomous profession, supported by its own scientific knowledge. Although this problem dates back to the s, it is still an issue for many contemporary scholars. This view is echoed in a paper by William Cody, which argues against the reliance of middle-range theories on borrowed theory. Theory and practice Another issue debated by nursing theorists during this time was the question of the appropriate relationship between theory and practice.
This issue was also related to questions about the scope and legitimacy of nursing and nursing science. One problem was that while other sciences could easily be identified in terms of their object of study, nursing itself was not clearly defined. One way to identify the subject matter of nursing science is to look at the goals of nursing. Yet clearly nursing science is in some way related to the basic sciences; this is what gave rise to the problem of borrowed theory. One of the most influential discussions in this regard occurs in a paper published in by James Dickoff and Patricia James.
Central to their discussion is that all theories must be judged in terms of how well they meet their goals and that, in the case of nursing and other professional and applied sciences, the goal of theories must be to help practitioners to achieve certain outcomes.
Nursing Knowledge: Science, Practice, and Philosophy
Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Preface Foreword. Introduction to Part I. Nursing knowledge. Two kinds of theory practice gap. Philosophy of nursing science.
Nurses when assisting a patient in an emergency situation, or in any other circumstances, act putting into action, learned knowledge and experienced, personal skills such as intuition and scientific principles resulting from the research. They do it, according to the person, the situation and the context, considering the best way to do this and the possibility of implementation within an ethical perspective. When these nurses find solutions to problems that arise in a process of reflection in an action and reflection on the action, are acquiring own nursing knowledge that when systematized - in a process of reflection on the reflection in an action - shared and validated by their peers turns into nursing science. Nursing being a human science, is a discipline oriented to the practice, established on the development of a care relationship between nurses and users, in a perspective of health and wellness 1. A practical human science with a practical-reflexive rationality distinguished from a technical rationality , within an epistemology of practice as distinct from a classical epistemology , whose specific knowledge turns into hermeneutical spiral processes 2. Recursive processes, between theory and practice, which are developed in a context of high complexity, the environments where the nursing action takes place, the relationship established between caregivers and users, and the characteristics of these interventions.
By clicking register, I agree to your terms. All rights reserved. Design by w3layouts. Full Text Original article doi: Early work on the nature of theories in nursing was strongly influenced by logical empiricism, and this influence remains even long after nurse scholars have come to reject logical empiricism as an adequate philosophy of science. Philosophers of science have also rejected many of the central tenets of logical empiricism, including its focus on the logical justification of theories and the idea that science is, or should be, unified. Instead, there has been an increasing focus on the practice of science, which in turn has led to a pluralist understanding of science that emphasizes the construction of scientific models that are appropriate for certain purposes or in certain contexts.
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Nursing Knowledge in the 21st Century: Domain-Derived and Basic Science Practice-Shaped
Too often we dismiss philosophy as something obscure that has nothing to do with our practice. It is true that much contemporary academic philosophy is criticised for being very technical, narrowly focused and detached from human concerns Norris But this is not how we understand philosophy in Careful Nursing. Our aim is to think philosophically about nursing ideas and how we practice. Implicitly, we think philosophically about nursing every day without realising it, for example, every time we reflect on our practice, question our practice or wonder what components of our practice actually mean.
Mark Risjord, Nursing knowledge, science, practice and philosophy
Она поставила машину на зарезервированное за ней место и выключила двигатель. Миновав похожую на сад террасу и войдя в главное здание, она прошла проверку еще на двух внутренних контрольных пунктах и наконец оказалась в туннеле без окон, который вел в новое крыло. Вскоре путь ей преградила кабина голосового сканирования, табличка на которой гласила: АГЕНТСТВО НАЦИОНАЛЬНОЙ БЕЗОПАСНОСТИ (АНБ) ОТДЕЛЕНИЕ КРИПТОГРАФИИ ТОЛЬКО ДЛЯ СОТРУДНИКОВ С ДОПУСКОМ Вооруженный охранник поднял голову: - Добрый день, мисс Флетчер. - Привет, Джон.
Стояла полная тишина, и он внимательно прислушался. Ничего. Вроде бы на нижней ступеньке никого. Может, ему просто показалось. Какая разница, Стратмор никогда не решится выстрелить, пока он прикрыт Сьюзан. Но когда он начал подниматься на следующую ступеньку, не выпуская Сьюзан из рук, произошло нечто неожиданное.
- Обычно травматическая капсула не убивает так. Иногда даже, если жертва внушительной комплекции, она не убивает вовсе. - У него было больное сердце, - сказал Фонтейн. Смит поднял брови. - Выходит, выбор оружия был идеальным. Сьюзан смотрела, как Танкадо повалился на бок и, наконец, на спину. Он лежал, устремив глаза к небу и продолжая прижимать руку к груди.
Mark Risjord, Nursing knowledge, science, practice and philosophy. Wiley-Blackwell, Chichester, , pp., $(paper), ISBN:
Он усмехнулся. Просто надо уметь задавать вопросы… Минуту спустя незаметная фигура проследовала за Беккером по калле Делисиас в сгущающейся темноте андалузской ночи. ГЛАВА 29 Все еще нервничая из-за столкновения с Хейлом, Сьюзан вглядывалась в стеклянную стену Третьего узла. В шифровалке не было ни души. Хейл замолк, уставившись в свой компьютер.
Предупредить. Он же вас ненавидит. - Он позвонил и предупредил, что заканчивает работу над алгоритмом, создающим абсолютно стойкие шифры. Я ему не поверил.