Towards a philosophic theory of nursing

Abstract Recently, Edwards and Liaschenko questioned the validity of an argument put forward by Dr Søren Holm and Joseph Dunne concerning the impossibility of a theory of nursing. Taking into consideration the premises of the argument, I describe how Maritain's conception of philosophy allows for the possibility of a theory of nursing conceived as a philosophy of nursing art that is both practical and propositional in nature. As well, I identify how the philosophy of nursing art guides nursing art in developing and applying other kinds of artistic practical nursing knowledge: artistic nursing rules and artistic prudential nursing judgements. Finally, the relationship of ethical knowledge to artistic practical nursing knowledge is set down.     

A theory of holism for nursing

In this paper it is argued that nurses should be holists whilst at the same time accepting that ‘holism’ is a contentious concept. One of the problems for a supporter of holism is that of which holism -- an attempt to outline the version of holism advocated is made by identifying only two versions of holism: The Strong theory and the Pragmatic theory of holism. By introducing this device it is hoped to avoid, if only by stipulation, some of the more sophisticated nuances of holism drawn by other commentators. However despite a most judicious use of Ockham's Razor some detailed groundwork remains. In the first part of this paper a simple example is used which aims to articulate what are arguably some of the central issues within the holism debate. These issues are then placed within a wider philosophical context. The second part of the paper will offer definitions of Strong and Pragmatic holism. Drawing on specific examples from the nursing context it will be argued that the Pragmatic theory of holism is the theory of holism most compatible with nursing theory and practice. The methods employed in this paper are philosophical. Since the questions considered are conceptual rather than empirical requiring a discursive approach, utilising thought experiments and case implication to explore the issues. This revised version was published online in July 2006 with corrections to the Cover Date.     

The grounded theory as a methodological alternative for nursing research

This study presents a method of interpretative and systematic research with appliance to the development of studies in nursing called "the grounded theory", whose theoretical support is the symbolic interactionism. The purpose of the paper is to describe the grounded theory as an alternative methodology for the construction of knowledge in nursing. The study highlights four topics: the basic principle, the basic concepts, the trajectory of the method and the process of analysis of the data. We conclude that the systematization of data and its interpretation, based on social actors' experience, constitute strong subsidies to generate theories through this research tool.     

The quest for quality

By adopting six Institute of Medicine goals, the Quest for Quality Prize has put the focus on improving systems of care.     

The quest for normality

Advances in Health Sciences Education - In this editorial, the editor reflects on what ‘going back to normal’ means in the context of health professions education, and she suggests that...     

Popper and nursing theory

Abstract   Science seems to develop by inducing new knowledge from observation. However, it is hard to find a rational justification for induction. Popper offers one attempt to resolve this problem. Nursing theorists have tended to ignore or reject Popper, often on the false belief that he is a logical positivist (and hence hostile to qualitative research). Logical positivism claims that meaningful sentences containing any empirical content should ultimately be reducible to simple, observation statements. Popper refutes positivism by showing that there are no such simple statements. He is not a positivist. For Popper, the scientist begins with problems and puts forward trial solutions. These are subjected to rigorous testing aimed at falsifying them. A new theoretical position is then reached in which the scientist knows either that the trial solutions are false or that they have not yet been falsified. Science is characterized by the fact that it tests its ideas through attempted falsification. Non-science tests its ideas through attempted refutation. Nursing theory is a mixture of science and non-science. Popper's method requires rigorous testing of theory in both realms. As such, some nursing theory should be discarded. Popper's view faces at least two important criticisms. One is that a scientist can always reject an apparent falsification by instead altering some auxiliary hypothesis (e.g. denying the accuracy of the falsifying observation). Popper can deal with this argument by saying that defence of a theory in this way will eventually break down if the theory is false. The second criticism is that Popper's method does ultimately draw upon induction. This criticism is true, but his method can be usefully adapted. An adapted from of Popper's philosophy of science provides a good basis for nursing theory.     

Realism in the quest for polio eradication

Between 1990 and 1994 in Africa, the percentage of children administered 3 doses of oral polio vaccine by 12 months old has fallen to about 80%. Any polio eradication program is successful when circulating oral polio vaccine (OPV) supplants wild polio viruses. Thus, any unimmunized children will grow up without encountering any wild virus. As the pool of unimmunized children grows, the chance of an imported wild virus circulating and causing an epidemic increases, as occurred in the recent epidemics in Holland and Oman. The wild virus is still circulating in Africa (e.g., Namibia in 1993, 53 paralyzed children). Immunization of all children and the reporting of every polio case are needed to achieve polio eradication. Even though 98% of children were immunized with 3 doses of OPV in a town in India, several children still became infected with the polio virus. When 5 doses of OPV were administered, no more cases of polio emerged in the town. In the environs of the town, the intensive polio control program reduced the number of cases from more than 1000 to 36 between 1987 and 1994. The program consists of a network of more than 450 reporting agents based in primary health care centers, hospitals, and clinics (public and private sectors). Despite program staff's hard work, several surveys did not find all reported cases and found several unreported cases, indicating the difficulties encountered by a polio control program. Few studies of polio in Africa are published, yet thousands of polio cases occur annually in Africa. Civil war, famine, and many refugees make it more difficult to control polio in Africa. These situations facilitate the spread of diarrheal diseases. Political commitment, ability, and funds are needed to vaccinate all children and maintain surveillance for at least 10 years in order to eradicate polio. Days of tranquility are needed in conflict zones in Africa to allow workers to distribute OPV.