A Theory of the Structure of Nursing Knowledge

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A Theory of the Structure of Nursing Knowledge

• Jacqueline Fawcett, PhD, RN, FAAN
• Professor
• College of Nursing and Health Sciences
• University of Massachusetts Boston
• USA

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Nursing Knowledge Yes or No?

• Does nursing have a unique or distinctive body of
  knowledge?
• Mason and Whitehead, in the preface to their
  book, Thinking Nursing, said No.

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Nursing Knowledge Yes or No?

• Will you join me in rejecting Mason and
  Whiteheads claim?

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Celebrate the Growth of Nursing Knowledge

• Will you join me in celebrating the growth of
  distinctive nursing knowledge?

5
Embrace the Use of Nursing Knowledge

• Will you join me in embracing the use of nursing
  discipline-specific knowledge?

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Tell Nursings Story to Everyone

• A magnificent epic of service to humankind
• A mission to translate nursing knowledge into
• human service

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Telling Nursings Story as a Theory

• The holarchy of contemporary nursing knowledge
• An epistemological theory

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The Holarchy of Contemporary Nursing Knowledge

• Holarchy refers to components that are whole
  within themselves but also part of a larger whole
• The larger whole is contemporary nursing
  knowledge

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The Holarchy of Contemporary Nursing Knowledge

• Five components
• Each component of the holarchy is a complete
  whole but also is a part of a larger whole

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The Holarchy of Contemporary Nursing
KnowledgeFive Components

• Metaparadigm
• Philosophies
• Conceptual Models
• Theories
• Methodologies for inquiry and practice

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The Holarchy of Contemporary Nursing
KnowledgeMetaparadigm

• A global statement identifying the phenomena of
  interest to members of a discipline
• Delineates the subject matter and boundaries of a
  discipline

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The Holarchy of Contemporary Nursing
KnowledgeMetaparadigm of Nursing

• Human beings
• Environment
• Health
• Nursing

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The Holarchy of Contemporary Nursing
KnowledgeMetaparadigm of Nursing

• Principles and laws governing human processes of
  living and dying
• Patterning of human health experiences within the
  environment

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The Holarchy of Contemporary Nursing
KnowledgeMetaparadigm of Nursing

• Nursing actions or processes that are beneficial
  to human beings
• Human processes of living and dying, recognizing
  that human beings are in continuous relationship
  with their environments

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The Holarchy of Contemporary Nursing
KnowledgePhilosophies

• Stipulate philosophical claims about phenomena of
  interest to a discipline
• Communicate what the members of a discipline
  believe to be true about phenomena, what they
  believe about the development of knowledge about
  those phenomena, and what they value with regard
  to their actions and practices

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The Holarchy of Contemporary Nursing
KnowledgePhilosophies of Nursing

• Worldviews
• Reaction
• Reciprocal interaction
• Simultaneous action

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The Holarchy of Contemporary Nursing
KnowledgeConceptual Models

• A set of relatively abstract and general concepts
  that address the phenomena of central interest to
  a discipline, the propositions that broadly
  describe those concepts, and the propositions
  that state relatively abstract and general
  relations between two or more of the concepts
• Each conceptual model provides a distinctive
  focus of phenomena of interest to a discipline

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The Holarchy of Contemporary Nursing
KnowledgeConceptual Models of Nursing

• Neuman Systems Model
• Orem Self-Care Framework
• Roper-Logan-Tierney Model of Nursing
• Roy Adaptation Model
• Many more nursing conceptual models

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The Holarchy of Contemporary Nursing
KnowledgeTheories

• One or more relatively concrete and specific
  concepts that are derived from a conceptual
  model, the propositions that narrowly describe
  those concepts, and the propositions that state
  relatively concrete and specific relations
  between two or more of the concepts
• Narrows and more fully specifies the phenomena
  identified by the conceptual model

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The Holarchy of Contemporary Nursing
KnowledgeTheories

• Grand theories
• Middle-range theories

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The Holarchy of Contemporary Nursing
KnowledgeNursing Theories

• Nursing Grand Theories
• Leiningers theory of culture care diversity and
  universality
• Newmans theory of health as expanding
  consciousness
• Parses theory of human becoming

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The Holarchy of Contemporary Nursing
KnowledgeNursing Theories

• Nursing Middle-Range Theories
• Orlandos theory of the deliberative nursing
  process
• Peplaus theory of interpersonal relations
• Watsons theory of human caring
• Many, many more nursing middle-range theories

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The Holarchy of Contemporary Nursing Knowledge
Types of Nursing Middle-Range Theories

• Empirical theories
• Aesthetic theories
• Ethical theories
• Theories of personal knowing
• Sociopolitical theories

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The Holarchy of Contemporary Nursing Knowledge
Methodologies

• Legitimate participants in nursing research and
  practice
• Research instruments and practice tools
• Designs for inquiry and interventions
• Protocols for collection, analysis, and
  interpretation of data or practice information

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The Holarchy of Contemporary Nursing Knowledge
Most abstract
Metaparadigm
Philosophies
Conceptual Models
Theories
Methodologies
Most concrete
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The Holarchy of Contemporary Nursing Knowledge
Translated for Empirical Nursing Research
Study participants Settings Health
conditions Research process
Metaparadigm
Philosophies
Ethical conduct of research Approaches to
knowledge development
Research guidelines
Conceptual Models
Theories
Research questions Study variables
Research designs Samples Instruments Data
analysis techniques
Empirical Research Methods
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The Holarchy of Contemporary Nursing Knowledge
Translated for Nursing Practice
Metaparadigm
Nursing participants Significant others Practice
settings Health conditions Nursing process
Philosophies
Code of ethics Patients Rights Philosophy of
nursing practice
Conceptual Models
Professional nursing perspective Practice
guidelines
Theories
Evidence
Standards for Practice Practice
ToolsIntervention protocols
Practice Methodologies
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Tell the Story of Nursing Knowledge Development

• Celebrate the fantastic growth of distinctive
• nursing knowledge!

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Tell the Story of Use of Nursing Knowledge

• Celebrate the use of distinctive nursing
  knowledge in service to humankind!