Nursing theory-guided research

Theory-guided research has a long tradition in nursing that spans at least 50 years. Yet the use of nursing theory with qualitative research approaches continues to raise questions. Grounded theory is selected by nurses as a research methodology to address research questions that are aimed at understanding the nuances of nursing communication processes. Nurse theorist Margaret Newman is recognized in this issue for her theoretical contributions to practice and research, and a Newman scholar is introduced who explains her use of grounded theory research methodology guided by Newman's theory of health as expanding consciousness.     

Partnering of researcher and practicing nurses for transformative nursing

The purpose of this praxis research was to address the process of a researcher's partnering with practicing nurses to incorporate Newman's theory of health as expanding consciousness as a guide for nursing practice. Initially the nurses were bound by their commitment to help clients within a philosophy of cure, but as they began to engage in a caring relationship of pattern recognition with clients, they experienced the clients' transformations in a way that was transformative for them and that pervaded the total realm of their nursing practice. The process illustrates the immediate applicability of Newman's theory.     

Hmong American Women Living With Diabetes

Purpose: To understand how to better care for Hmong women with diabetes using nursing theory praxis.
Design: Qualitative phenomenologic design, specifically community-based collaborative action research based on Margaret Newman's theory of health as expanding consciousness (HEC).
Methods: Five Hmong women with Type 2 diabetes and HgbA1c levels over 7.0 were recruited from a community-health clinic. Audiotaped in-home interviews were conducted and data were analyzed to identify common patterns and then developed into a play by the research team with the help of a female Hmong playwright. Community dialogue about the findings generated meaningful actions for health.
Conclusions: This study indicates the value of nursing praxis rooted in the theory of health as expanding consciousness and the importance of engaging communities to identify meaningful patterns of health and needed actions.
Clinical Relevance: Evidence-based practice is lacking in the care of Hmong women with diabetes. Community-based collaborative action research rooted in the HEC perspective is a new way to envision models of care.     

Expanding the dialogue on praxis in nursing research and practice

The intent of this article is twofold: to expand the dialogue on research as praxis in nursing as articulated by Newman and to support the concept of praxis as a catalyst for extending nursing knowledge. The article revisits the concept of research as praxis through examining critiques by other writers. It explores the notion of praxis as practice within the methodology and research protocol developed by Newman and extended by other researcher-practitioners including the author.     

Awareness of self and expanding consciousness: using nursing theories to prepare nurse-therapists

Psychotherapy is an accepted role of the advanced practice psychiatric nurse. Nursing theorists, notably Hildegard Peplau and Margaret Newman, offer guidance on the psychological and professional development of the nurse. This paper examines Newman's theory of health as expanding consciousness and the concept of awareness of self in Peplau's theory, and suggests that psychiatric advanced practice nursing programs consider the need for nurses to develop self-knowledge to facilitate the nurse-patient relationship and to improve outcomes of patient care in psychotherapy.     

Newman's theory of health applied in family caregiving in Canada

This study was conducted using an innovative mode of heuristic inquiry within the context of Newman's theory of health as expanding consciousness. Twelve caregiving families of persons who were diagnosed with schizophrenia participated in the study. In accordance with Newman's theory of health as praxis, the majority of the participants in the study recognized their patterns of the whole. As a result, they reported understanding and acceptance of their relative's mental illness.     

Health as expanding consciousness: implications for health policy as praxis

The authors of this column explore the implications of Newman's theory of health as expanding consciousness for health policy. One aim is to expand the theory's practice methodology and praxis methods to the development of health policy, an under-represented area in the health as expanding consciousness literature. The second aim is to suggest a framework for policy development, the health as expanding consciousness policy protocol, and explore the possible impact that theory-guided policy may have on community and nursing efforts to transform health and public policy.     

Cardinal John Henry Newman and 'the ideal state and purpose of a university': nurse education, research and practice development for the twenty-first century

Cardinal John Henry Newman's book, The Idea of a University, first published in the mid nineteenth century, is often invoked as the epitome of the liberal Enlightenment University in discussions and debates about the role and purpose of nurse education. In this article I will examine Newman's book in greater detail and with a more critical eye than is generally the case in the writing of nurse academics. In particular, I will focus on the claims that Newman was a champion of the Enlightenment University of the nineteenth century, that he promoted the idea of 'disinterested' universal knowledge for its own sake, that he was an early advocate of the pursuit of knowledge through scientific research, and the supposition that he would have welcomed the discipline of nursing into the University. In each case, I will suggest that these claims are based on an extremely selective reading of Newman's work. I will conclude by employing the example of practice development to propose an alternative way for nursing to find its place in the modern University that does not involve a retreat into what I will argue is an outdated and nostalgic view of the aims and purpose of higher education.     

A process model of healing and personal transformation in persons with chronic skin wounds

Utilizing Newman's research as praxis process, this research examined the patterns of those living with chronic skin wounds. Ten men and 8 women, primarily of retirement age and living with chronic skin wounds for a year or more, reflected upon important relationships and life events during two in-depth interviews and a self-expressive drawing. Emerging from each participant's pattern was the link among human development, expanding consciousness, and processing a serious physical threat. Considering data across participants, five themes emerged from the data with evolution of a process model of wholistic healing that has implications for advanced nursing practice.     

Practice wisdom

A participatory process approach in research and scholarship is proposed in the context of the postmodern movement and a disciplinary emphasis on practice. Two sequential studies are presented to illustrate praxis in nursing in which health is expanding consciousness. A framework of personal practice was developed from the first study and reconceptualized in the second as a process of modeling practice involving partnership, dialogue, pattern recognition, and health as dialectic. This praxis illustrates the merging of theory, practice and research as practice wisdom. Health and caring can be seen as the same process.     

Hermeneutic application research – finding a common understanding and consensus on care and caring

To clinically and contextually implement the theoretical and factual knowledge of care and caring that has been developed in the last 30 years is seen as a great challenge in caring science research. Emphasis has been put on problem‐solving research methodologies and action research in hopes of narrowing the divide between caring theory and clinical practice. Thus, the intention is now to further action research towards a hermeneutic approach and to put emphasis on hermeneutic application where theory and praxis become one through human dialogue. This article highlights hermeneutic application research as an alternative methodology within participatory‐oriented research which presents a new opportunity to unite clinical practice and caring theory. The aim is to contribute to the development of the hermeneutical application research design in its epistemological, ontological and ethical perspective, by articulating and clarifying the central foundations in the application. On the basis of Gadamer's hermeneutical thinking and Levinas ethical thinking, the central foundations in the application research are ethics, creation of a hermeneutical room, dialogue and common understanding and appropriation and action. When theoretical understanding turns into praxis, knowledge also becomes activity and theory and practice become one. Application thus realises the basic idea that praxis and theory are one, and thus, theory of caring can only become evident and implemented in a clinical practice through moments when the participants find a common understanding and consensus on the knowledge of care and caring.     

A concept analysis of personal transformation

A concept analysis of personal transformation Personal transformation, a multidimensional concept, is applicable to nursing practice, education, and research. Using a modified version of Walker and Avant's concept analysis model, personal transformation was analysed relative to Newman's Theory of Health as Expanding Consciousness. By integrating common themes from definitions of several disciplines with Newman's theory, a definition of personal transformation was derived. Personal transformation is a dynamic, uniquely individualized process of expanding consciousness whereby individuals become critically aware of old and new self-views and choose to integrate these views into a new self-definition. A conceptual map depicts the defining attributes, antecedents and consequences of personal transformation. A model case illustrates the applicability of the concept to nursing education. Because the transformation process is revealed through individual patterns, qualitative research for further analysis of the concept is recommended.     

Research testing nursing theory: state of the art

The degree to which investigators have tested nursing theory through empirical research is analyzed. The analysis is based on 62 studies in which the nursing model of Johnson, Roy, Orem, Rogers, and/or Newman was used as a framework for the research. The analysis shows that of these 62 studies, only nine met specified evaluation criteria for the explicit testing of nursing theory. To better understand this finding, impediments and approaches to testing of nursing theory are discussed, as well as implications for nursing theory, research, and practice.     

The Pinwheel Model of Bereavement

The Pinwheel Model of Bereavement is a process-orientated model of grief which recognizes loss as a unique lived experience. The model and relevant nursing response are described using Margaret Newman's nursing theory of health as expanding consciousness. The model is based on research by Carter (1989) and clinical experience. The contextual theme for the model is "personal history." Six core themes are: being stopped, hurting, missing, holding, seeking, and valuing. Three meta themes are change, expectations, and inexpressibility. Capacities for "being with" the bereaved are identified for the practice of nursing     

A holistic exploration of barriers to theory utilization

The nursing profession must frequently grapple with the reluctance of nurses to adopt particular nursing theory/theoretical frameworks as a guide for practice This paper explores some possible perceptions by nurses not previously considered in the literature which may be at the root of their reluctance to use theory Newman's concept of pattern recognition was particularly useful in the identification of these heretofore unidentified perceptions     

Creative movement and transformation to choreography: a mode of research presentation

Creative movement is an expressive technique that can be used to generate knowledge from a unitary perspective. This column will present its use on research based on Newman's theory of health as expanding consciousness and the development of choreography based on participants'creative movements to present research findings.