![The Name of our Discipline is Nursology
Nursology is defined as "knowledge of the phenomena
of interest to nursologists, which are [why, when, where,
and how] nursologists collaborate with other human
beings as they experience wellness, illness, and disease,
within the context of their environments.” (Fawcett, 2019, p.
919)
Nursology is Nursología in Spanish (Suárez-Baquero, 2021)
All members of the discipline are nursologists](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Fawcett Buap may 2021
- 1. Jacqueline Fawcett, RN; PhD; ScD (hon); FAAN; ANEF Professor, Department of Nursing University of Massachusetts Boston 2nd International Videoconference Forum The Epistemology of Nursing Knowledge: Its Importance in Times of Pandemic Benemérita Universidad Autónoma de Puebla May 12, 2021 The Epistemology of Nursology
- 2. The Name of our Discipline is Nursology Nursology is defined as "knowledge of the phenomena of interest to nursologists, which are [why, when, where, and how] nursologists collaborate with other human beings as they experience wellness, illness, and disease, within the context of their environments.” (Fawcett, 2019, p. 919) Nursology is Nursología in Spanish (Suárez-Baquero, 2021) All members of the discipline are nursologists
- 3. The Professional Discipline of Nursology Knowledge Discovery and Dissemination Knowledge Utilization Scholarly Inquiry/ Research Practice Figure. The professional discipline of nursology
- 4. Epistemology of Nursology Epistemology is defined as the theory of knowledge The theory of nursology knowledge “embraces epistemological plurality. In [nursology], there is a commitment to recognizing different ways of knowing to support [the discipline’s] mandate to consider the individual holistically and in context” (Ou et al., 2017, p. 7)
- 5. Epistemology of Nursology Epistemology is concerned with Beliefs about the knowledge The knowledge The truth of the knowledge Justification for the knowledge (Oxford English Dictionary/Oxford Languages, language.oup.com)
- 6. Metaparadigm Conceptual Models Philosophies Theories Methods of Scholarly Inquiry Epistemology of Nursology: Plurality of BELIEFS about the Components of Nursology Knowledge
- 7. Theories Epistemology of Nursology: Plurality of BELIEFS about the Levels of Abstraction of Theories Situation- Specific Theories Middle- Range Theories Grand Theories
- 8. Epistemology of Nursology: Plurality of BELIEFS about the Development of Situation-Specific Theories Multiple Situation- Specific Theories One Middle- Range Theory
- 9. Epistemology of Nursology: Plurality of BELIEFS about the Development of Middle-Range Theories from Situation-Specific Theories A Middle-Range Theory of Functional Status During Childbearing A Situation-Specific Theory of Functional Status During Low-Risk Childbearing A Situation-Specific Theory of Functional Status During High-Risk Childbearing
- 10. Tenacity “We’ve always done it this way; it’s the custom.” “It’s the traditional way to do it here.” Ignores contradictory evidence and opinions No way to decide between conflicting opinions. Unanticipated negative outcomes. Authority “The textbook tells us to do it that way.” “My teacher told me to do it this way.” Authoritative sources are not infallible. No way to decide which authoritative source is correct. A priori method “It seems reasonable. to do this.” One person’s idea of reasonable is not the same as another’s. No way to decide whether reasonableness depends on the current way of thinking or previous education. Practice/Practice Wisdom “My practice has guided me to do this” Theory “The theory guides me to do it.” No way to know the exact source of knowledge other than the individual nursologist Must be developed through rigorous inquiry.and theories can be false. Epistemology of Nursology: The KNOWLEDGE—A Plurality of Ways of Knowing ______________________________________________________________________ Ways of Knowing Limitations ______________________________________________________________________
- 11. Epistemology of Nursology: The KNOWLEDGE--A Plurality of Patterns of Knowing Types of Theories Description Empirical Aesthetic Ethical Personal knowing The science of nursology The art of nursology The ethics of nursology The interpersonal relations of nursology
- 12. Epistemology of Nursology: The KNOWLEDGE--A Plurality of Patterns of Knowing Types of Theories Description Sociopolitical Emancipatory Spiritual The policies and politics of nursology The policies and politics of change The spirituality of nursology
- 13. Epistemology of Nursology: The KNOWLEDGE--A Plurality of Patterns of Knowing Types of Theories Description Unknowing The not explicitly knowing of nursology yet knowing how to be authentically present
- 14. Epistemology of Nursology: The KNOWLEDGE– A Plurality of Patterns of Knowing Accepting eight types of theories is somewhat consistent with Lauden’s (1996) claim that theories are the answers to the problems of science (or to the problems of nursology).
- 15. Epistemology of Nursology: The KNOWLEDGE– Synthesizing a Plurality of Ways of Knowing “[A]cting in the best interests of the people for whom [nursologists] care requires . . . .synthesizing knowledge in a manner that ethically serves clients’ needs” (Zander, 2007, p. 7).
- 16. Epistemology of Nursology: The KNOWLEDGE– Synthesizing a Plurality of Ways of Knowing Synthesis is a substantial challenge that requires nursologists to take into account all five ways of nursology knowing when engaged in scholarly inquiry and practice activities Tenacity Authority A priori Practice Theory
- 17. Epistemology of Nursology: The KNOWLEDGE– Synthesizing a Plurality of Patterns of Knowing Empirical Aesthetic Ethical Personal knowing Sociopolitical Emancipatory Spiritual Unknowing • Synthesis is a substantial challenge that requires nursologists to also take into account all eight types of theories of nursology knowledge when engaged in scholarly inquiry and practice activities
- 18. Epistemology of Nursology: The KNOWLEDGE– Synthesizing a Plurality of Paterns of Knowing Avoid use of only one type of theory, especially in practice, so to prevent that one type of theory from going wild (Chinn & Kramer 2008). Typically, only one type of theory is the focus when nursologists are engaged in scholarly inquiry, although reflection about and analysis of the data may yield more than one type of theory.
- 19. Epistemology of Nursology: The TRUTH About the Knowledge Truth is conditional Knowledge can be false My theory of nursology knowledge could be false Conceptual and theoretical reflection and thinking and new methods can uncover new knowledge that replaces what had been thought to be true Knowledge evolves and may be the result of revolutions
- 20. Epistemology of Nursology: JUSTIFICATION for the Knowledge Accomplished by means of the scholarly methods of inquiry we use to generate and test our descriptions, explanations, and predictions about phenomena of interest to our discipline Determined by individuals or teams of knowledge developers A challenge is to avoid the primacy of method Need a balance of theory and method, with method only for the development of theory
- 21. Epistemology of Nursology: JUSTIFICATION for the Knowledge “[A]cting in the best interests of the people for whom [nursologists] care requires valuing both subjective and objective ways of knowing” (Zander, 2007, p. 7). The nursology scholarly methods of inquiry encompass both the objective and the subjective
- 22. Epistemology of Nursology: JUSTIFICATION for the Knowledge Objective refers to that which is observable and measurable Usually thought of as quantitative Subjective refers to feelings and emotions and perceptions that are non-observable although may be measurable Usually thought of as qualitative
- 23. Epistemology of Nursology: JUSTIFICATION for the Knowledge Both objective and subjective knowledge can be Explicit Explicit knowledge is “the formal information gained from written words, maps, or symbols” (Zander, 2007, p. 8) OR Implicit/Tacit Implicit or Tacit knowledge is “the knowledge gained from experience, interactions, and the acquisition and combination of skills” (Zander , 2007, p. 8)
- 24. Epistemology of Nursology: JUSTIFICATION for the Knowledge Methods for obtaining both objective and subjective knowledge are needed for “multidimensional understanding of the client within the context of situation, family and environment” (Ou et al., 2017, p. 7). Multidimensional understanding is best determined by conduct of scholarly inquiry for the purpose of development of situation-specific theories.
- 25. Epistemology of Nursology: CONTEMPORARY CONCERNS The current pandemic has sensitized us to the need to Decolonize nursology knowledge Focus on social justice
- 26. Epistemology of Nursology: CONTEMPORARY CONCERNS The current pandemic has sensitized us to the need to Decolonize nursology knowledge Revise or discard the existing metaparadigm, philosophies, conceptual models, and theories to eliminate the current dominant Euro-centric worldviews of white privilege (Chinn, 2021).
- 27. Epistemology of Nursology: CONTEMPORARY CONCERNS The current pandemic has also sensitized us to the need to Focus on social justice Develop new knowledge of how to increase planetary health equity and reduce or eliminate planetary health disparities Develop new knowledge of how to eliminate structural and systematic racism
- 28. Situation-Specific Theory Conceptual Model Method of Scholarly Inquiry to Study a Nursology Phenomenon Decolonizing Nursology Knowledge Revise or Develop a New Conceptual Model Existing Conceptual Model
- 29. Situation-Specific Theory of High-Risk Childbearing Roy Adaptation Model Stories Told by Women and their Partners about High-Rick Childbearing An Example: Decolonizing Nursology Knowledge Revise or Develop a New Conceptual Model Existing Conceptual Model
- 30. Epistemology of Nursology: CONTEMPORARY CONCERNS Much of the work of decolonizing and social justice can be achieved through an emphasis on development of situation-specific theories by inviting people to tell their stories of their health experiences (Chinn, 2021). Analyze the stories within the context of the situation and the people’s culture Avoid stereotyping of the story-tellers on the basis of their culture
- 31. Epistemology of Nursology: CONTEMPORARY CONCERNS Chinn (2021) maintained that “situation-specific theories are grounded in the actual realm of human experience and the social and political context in which experience is embedded . . . [which leads to] specific social injustices that have [an] overwhelming influence on health” ( p. 34). Uncovering social injustices also uncovers white privilege and facilitates the decolonizing of knowledge (Chinn, 2021).
- 32. Epistemology of Nursology: CONTEMPORARY CONCERNS Decolonizing nursology knowledge and focusing on social justice also can be achieved through Developing knowledge that “is an interchange between [culturally and contextually relevant] theory and practice and [is] guided by [culturally and contextually relevant] philosophy is like a kind of pendulum where all three elements [[culturally and contextually relevant] philosophy, theory, practice] are treated as equals” (Hoeck & Delmar, 2018, p. 1).
- 33. Epistemology of Nursology: CONTEMPORARY CONCERNS In conclusion, I believe it is crucial to the survival of nursology that we think and act on the basis of our five ways of knowing and a synthesis of our eight types of theories always and especially at this time of the pandemic, when so much emphasis is on doing tasks without sufficient attention to the why of the tasks beyond the pragmatic.
- 34. Epistemology of Nursology What else would you like to know about the epistemology of nursology in this time of the pandemic?
- 35. Epistemology of Nursology Muchas gracias.
- 36. References Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23. Chinn, P. L. (2021). Equity and social justice in developing theories. In E-O Im & A. I. Meleis (Eds.), Situation specific theories: Development, utilization, and evaluation in nursing (pp. 29-37). Springer Nature Switzerland. Chinn, P. L., & Kramer, M. K. (2008). Integrated theory and knowledge development in nursing (7th ed.). Mosby Elsevier. Donaldson, S.K., & Crowley, D.M. (1978). The discipline of nursing. Nursing Outlook, 26, 113–120. Fawcett, J. (2019). Nursology revisited and revived [Editorial]. Journal of Advanced Nursing. 75, 919-920. Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing practice. F. A. Davis. Hoeck, B., & Delmar, C. (2018). Theoretical development in the context of nursing—The hidden epistemology of nursing theory. Nursing Philosophy, 19(1), 10 pages. Lauden, L. (1996). Beyond positivism and relativism. Westview Press. Moore, M. (1968). Nursing: A scientific discipline? Nursing Forum, 7, 340.
- 37. References Munhall, P. L. (1993). “Unknowing.” Toward another pattern of knowing in nursing. Nursing Outlook, (3), 126-129. Ou, C. H. K., Hall, W. A., & Thorne, S. E. (2017). Can nursing epistemology embrace p-values? Nursing Philosophy, 18(4), 9 pages Smith. M. C., Chinn, P. L., & Nicoll, L. H. (2021). Knowledge for nursing practice: Beyond evidence alone. Research and Theory for Nursing Practice, 35(1), 7-23. Suárez-Baquero, D. (2021, April 21). Guest Post: Decolonizing the language of nursology. nursology.net. https://nursology.net/2021/04/20/guest-post-decolonizing-the-language-of-nursology White, J. (1995). Patterns of knowing: Review, critique, and update. Advances in Nursing Science, 17(4), 73-86. Willis, D. G., & Leone-Sheehan, D. M. (2019). Spiritual knowing; Another pattern of knowing in the discipline. Advances in Nursing Science, 42(1), 58-68. Zander, P. E. (2007). Ways of knowing in nursing. The historical evolution of a concept. Journal of Theory Construction and Testing, 11(1), 7-11
Hinweis der Redaktion
- Referring to the discipline as Nusology and to ourselves as Nursologists immediately places us on the same “playing field” as members of other widely known disciplines, such as biology, psychology, and sociology, and indicates a “legitimate” place in universities. Nursología ”embraces the notion of nursing as the science of caring comprehensively.” (Suárez-Baquero & Walker, cited in Suarez-Baquero, 2021)
- Along with Donaldson and Crowley (1978), I consider contemporary nursology to be a professional discipline, which means that nursologists have a globally agreed on mission to discover and disseminate knowledge, as do the members of all academic disciplines, and also to utilize that knowledge in service to others. (A profession uses specialized knowledge for service to society. The double-headed arrows in the diagram indicate that there is a reciprocal relation between discovery and dissemination of the knowledge of nursology and utilization of that knowledge, which is actualized in the reciprocal relation between scholarly inquiry and practice, such that the knowledge discovered through scholarly inquiry is then disseminated in journal articles, books and book chapters, and presentations, and subsequently is used in practice. The results of utilization of that knowledge in practice are used to advance the scholarly injury that is required for further discovery and dissemination of knowledge. Furthermore, I agree with Moore (1968) and Donaldson and Crowley (1978) that scholarly inquiry governs practice. Thus, although practical problems may serve as a stimulus for scholarly inquiry, the starting point for the reciprocal relation between scholarly inquiry and practice always is scholarly inquiry.
- The word, epistemology, is derived from the Greek words, episteme and legos Episteme means knowledge Legos means study of or theory of (Zander, 2007)
- This is what I and at least some other nursologists believe constitutes the epistemology of nursology – our theory of the theory of knowledge in our discipline I acknowledge multiple versions of the metaparadigm; my version is human beings, environment, health, and nursologists’ activities Multiple philosophies, conceptual models, theories, and methods of scholarly inquiry are recognized as valid knowledge about our discipline Some nursologists refer to conceptual models as grand theories or even as philosophies. I regard conceptual models as paradigms I believe that the findings of every instance of scholarly inquiry constitute a theory Methods of scholarly inquiry encompass historical, philosophical, and empirical methods, all of which can include qualitative (subjective) and quantitative (objective) approaches
- Theories encompass three levels of abstraction – grand theories, middle-range theories, and situation-specific theories Grand theories are the most abstract and are applicable to the entire population that is the focus of scholarly inquiry Middle-range theories are generalizable to the entire population that is the focus of scholarly inquiry Situation-specific theories are about a particular group of persons who are experiencing a particular health condition and are not generalizable or transferable beyond these people and this health condition
- Note that a series of related situation-specific theories can be combined or integrated to form a middle-range theory.
- For example, a situation-specific theory of functional status during low risk childbearing Could be combined with A situation specific theory of functional status during high risk childbearing To develop a middle-range theory of functional status during childbearing Could eventually have a middle-range theory of functional status during serious illness and normal life transitions from a series of situation-specific theories of functional status during low-risk childbearing, during high-risk childbearing, cancer, dialysis, and parents of children in a body cast.
- (Fawcett & Garity, 2009)
- These theories are considered four of the eight fundamental patterns of knowing in nursology (Carper, 1978) Empirical theory is the science of nursology. This type of theory is expressed in the form of empirical theories, statements of fact, or formalized descriptions and interpretations of empirical events or objects. Empirical refers to that which is accessible to sensory perception, either directly or indirectly. Aesthetic theory is the art of nursology. This type of theory allows one to move beyond the surface to sense the meaning of the moment and to connect with human experiences that are unique for each person: sickness, suffering, recovery, birth, and death. Aesthetic knowing in practice is expressed through the actions, bearing, conduct, attitudes, narrative, and interactions of the nursologist in relation to others. Ethical theory is the ethics of nursology. This type of theory focuses on matters of obligation and what ought to be done, as well as the norms or the ethical codes of conduct. It involves making moment-to-moment judgments about what ought to be done, what is good and right, and what is responsible. Personal knowing theory is the interpersonal relations of nursology. This type of theory concerned with the nursologist’s inner experience of becoming a whole, aware, genuine and authentic self. Personal knowing encompasses knowing one’s own self well as the self in relation to others.
- These theories are considered three other of the eight fundamental patterns of knowing in nursology (Chinn & Kramer, 2008; White, 1995; Willis & Leone-Sheahan, 2019) Sociopolitical theory is the policies and politics of nursology. This type of theory focuses on seeking freedom from institutional and institutionalized social and political contexts that sustain advantage for some and disadvantage for others. Emancipatory theory is the policies and politics of change In nursology.. This type of theory focuses on changing social determinants and practices that harm people and on developing an awareness of social problems and taking action to create social change. Spiritual theory is the spirituality of nursology. This type of theory is about the spiritual qualities and experiences that provide meaning and purpose, awareness of a greater reality, and. uplifting of the human spirit. Spiritual emphasizes a contemporary focus on multi-disciplinarity and perception and appreciation of nonmaterial aspects of life.
- This theory is considered one more of the eight fundamental patterns of knowing in nursology (Munhall, 1993) “Unknowing, paradoxically, is another pattern[of knowing. Knowing that one does not know something, that one does not understand someone, that once does not understand someone who stands before” (Munhall, 1993, p.125). Although Munhall (1993) denies that unknowing is similar to other patterns (i.e., theories) of knowing, her description of unknowing is especially similar to personal knowing theory, which focuses on knowing how to be authentic.
- Lauden wrote that "the aim of science is to secure theories with a high problem-solving effectiveness” and that scientific progress is possible when empirical data [are] diminished. Indeed, . . . it is possible that a change from an empirically well-supported theory to a less well-supported one could be progressive, provided that the latter resolved significant conceptual difficulties confronting the former. Finally, the better theory solves more conceptual problems while minimizing empirical anomalies.” (Laudan, 1996, pp. 77-87 from https://en.wikipedia.org/wiki/Larry_Laudan)
- Knowledge evolves slowly through successive programs of scholarly inquiry Or Rapidly though revolutions when reflection and scholarly inquiry uncovers innovations in thinking, such as unpacking black boxes of knowledge
- Tacit knowledge is similar to the practice way of knowing
- The starting point for decolonizing nursology knowledge and focusing on social justice is an existing conceptual model to identify – at an abstract level – a phenomenon of interest to the discipline. The phenomenon of interest is the topic for a situation-specific theory The situation-specific theory can be used to support or revise the conceptual model or develop a new conceptual model
- Example Use the Roy Adaptation Model to guide a study with a group of women and their partners to tell their stories of their experiences of high-risk childbearing. Findings of analysis of the stories is a situation-specific theory The theory now can be used to determine whether the Roy Adaptation Model needs to be revised or a new model of adaptation or other phenomenon needs to be developed. The study would take the Roy Adaptation Model (RAM) cultural assumptions into account. Experiences within a specific culture will influence how each element of the RAM is expressed (Roy, 2009, p. 31). Cultural expressions of the elements of the RAM may lead to changes in practice activities such as nursing assessment (Roy, 2009, p. 31).