NCM 100- Theoretical Foundations in Nursing scholarly tools to come up with better results.

In relation to nursing, there

should be also the synthesis and merging of communication. Example is the
LECTURE 1_SCHOLARLINESS IN NURSING ‌ nursing process- the ADPIE (Assessment, Diagnosis, Planning (client care),
Implementation, Evaluation)
On being and becoming a scholar
- A hallmark of the 1990’s because research and theory help explicate major
Scholarliness in Nursing
agreed-on nursing phenomena.
- Norms of scholarliness
*Hallmark is a very significant event in nursing, because this was the time
- Tools of scholarliness
when nursing has achieved the status of scholarly discipline. How? That’s
- Indicators of scholarliness in nursing
because nursing was able to articulate or express its mission- the goal of
Nurses as scholars Revisiting scholarship in the 21st century nursing. Nursing was able to use theoretical terms and scientific data and
nursing has well established organizations in scientific journals. From
Scholarliness in Nursing rigorous research- many changes happened before nursing was able to achieve
Scholarliness- from the word scholar, scholar is a person who pursue academic and the status of scholarly discipline.
intellectual activities particularly those that develop expertise in an area of study.
Indicators of scholarliness in Nursing
Scholarliness in Discipline
- Scholarliness is demonstrated through continuity
- Refers to the degree to which its mission is defined and based on rigorous and
*There should be a continuity of care. Refinement and modification (of
credible research and on well-developed, supported and significant theories.
concepts, researches)- Innovation
*Note: what is our goal or mission in nursing?, do we need to undergo
- Concatenation- condition wherein the distance between the creation of
researches?, do we need to utilize theories?
knowledge, corroboration and translation of knowledge in practice is
diminishing
Scholarliness
*Merging of research theory and practice. Handle clinical problems and
- Combines theory, research, philosophy and in disciplines such as nursing
research problems later on through concatenation.
practice
- Development of the National Institute of Nursing Research
*Note: when we say combines theory, research, philosophy- this is the
*Authorized under the health research act of 1985- significant milestone of
merging or the synthesis and integration between a discipline’s different
nursing
components
- Cumulative work through research and theory
- Characterized by leaps that enhance explanation and understanding of
*Cumulative- ‘tuloy-tuloy’. Example, the health of the environment=health of
phenomena
the patient, environment affect the well-being of the client
*In scholarliness, there should be creativity. We are going to link seemingly
- Development of centers of research that house scholars with expertise, interest
unrelated concepts and variables. We are going to present work or data in a
and research methodologies focused on a particular area for knowledge
creative or unique way. Example is the ‘Apple theory’ by Isaac newton- he
development.
presented his theory in the law of gravity- by the fall and bump of an apple
*There came different categories such as women’s health, vulnerable
into his head while he was sitting under an apple tree in a contemplative
population, disparities in health, and elderly care. Development in the centers
mood. Creativity is a must.-
of research
- A process and state that encompasses the norms and tools of theorizing ang
- Toward valuation and respect accorded to clinical scholars
philosophizing
* Again, achievement of scholarly discipline
*In other words, it includes not only creativity but also in scholarliness there
should be communication of ideas. You can use different theories and
Nurse as Scholars (Nursing Scholars)
- Types of knowers or scholars (Belenky & Colleagues):
a. Silent knowers
- Nurses who tend to accept the voices of authority and thus learn to be silent
- May not be able to articulate what they know through abstract thought for
theoretical development
*In other words, they may not have the language to articulate what they know and
express their analysis or interpretation of a phenomena
b. Received knowers
- Believe others are capable of producing knowledge that they can follow and
reproduce
- They believe in external authorities; abilities to generate knowledge but not in
their own or their peers’ abilities to do the same.
*Depend on and value the expertise of others. Examples are those who use the
work of others because they believe that the work of others are far more superior
c. Subjective knowers
- Depend on their personal experiences.
- Believe and depend on their own inner voices and feelings (naniniwala sa
sariling kakayahan)
-Knowledge is personal, private, subjectively known and intuited
-Truth is an intuitive reaction- something experienced, not thought out
*Have wisdom that holistically looks and explains complete situation
d. Procedural knowers
-Depend on careful observations and procedures
-They communicate procedures, rules and regulations
*Rationalist, communicate procedures, rules and regulations suited for developing
empirical or procedural theories
e. Constructed knowers
-Knowledge as contextual
-They experience themselves as creators of knowledge and value both subjective
and objective strategies of knowing
*Integrate the different twist of knowing, believe that it is a never-ending process
of knowledge development
Scholarship of integration (summary)
- Our discipline is scholarly if it engages in the development of knowledge that
has some significance (or will bring benefit) to humanity and to human beings
- Scholarliness in the discipline means flexibility regarding to its theoretical
base (refinement and modification)
- Scholarliness in nursing includes the collaborative efforts of all the resources
within nursing to work together to develop critical and reflective thinking in
students, academicians and clinicians (interdisciplinary team, collaboration of
efforts of all resources within nursing)
- Scholarliness necessitates the use of local models of excellence and the
promotion of sponsorship of novices by experts or mentors and mentorees as
essential (Example just by doing the lecture without demonstration, will it be
effective? No, especially if skill is needed, skill development. Just by merely
using lecture without working relationship between the mentor and the
mentoree, it may not be tangible. There should be a return demonstration;
goal: same characteristics as the mentor or possible development
The Scholarly Tool-tools used to enhance a student’s expertise especially in research
1. Google Scholar-no. 1 academic search engine, lets you find research paper
for all academic disciplines for free. It provides links to full text pdf files
2. Microsoft Academic- the answer of Microsoft to google scholar, it takes a
different approach, generate for each paper index an overview page that
allows to easily explore top citing articles and its references
3. Trello- a useful and dynamic visual aid that can be accessed by every member
of the team. Certain task can be optimized, staffing changes can be accounted
for and everybody on the team can see where the project is going as a whole
4. Mendeley- a must-have in scientific research. Helps manage references and
import papers from other research tools, create bibliography and citations.
5. Scrivener- originally intended as a tool for screenwriters and novelist
6. Scanmarker- a portable, digital Optical Character Recognition (OCR) reader;
a device that can read a page of printed text and convert It into a usable data
On becoming a scholar…
o Passion- feeling of intense enthusiasm or desire for something. Example are
scientist who desires to study things
o Confidence- feeling of self-assurance
o Composure- in control
o Ability to be a team player- flexible enough, and accept that every now and
then there are changes to be made
o Analytical skills
 o Foresight- futuristic, ability to predict what will happen or what things will be knowledge that enable those in the profession to explain what they do for their
needed in the future patients and the reason for their action.

LECTURE_2 AND 3 2. Definitions – convey the general meaning of the concepts

 Fundamentals of Theoretical Nursing *Explanation of the meaning of the concept, a word or a phrase
Theoretical Foundations in Nursing
Concepts 3. Assumptions – statements that describe concepts
Statements *Assume to describe a concept even without a proof. Examples: Cultural
Theories competence is an important component of nursing, illness and wellness are
Assumptions shaped by various factors including perception and coping skills of the client
Framework or Models
Paradigms 4. Propositions – statements that describe relationships between concepts.
Phenomenon/ Phenomena *Relationships meaning relate the different theories to one another. Example
 History of Theory Development the theory of Jim Watson, of Newman and of Orlando, analyze these theories
and find similarities. From there, a proposition can be created, relating, or
What is a Theory? stating or describing the relationship between concepts.
- A theory is a group of related concepts that propose action that guide practice.
*Group of related concepts meaning it is a system of ideas intended to exploit 5. Phenomenon – aspect of reality that can be consciously sensed or experienced
something may it be a fact or an event. (Meleis, 1997).
- A set of concepts, models, definitions, and assumptions that project a *A fact, a situation that is observed to exist or happen. Example are
systematic view of a phenomenon phenomenon such as: Gravity and tides, meteor shower, eruptions, in nursing
*Components of a theory are caring, self-care or a patient’s response to stress
- It may consist of one or more relatively specific and concrete concepts and
propositions that purport to account for, or organize some phenomenon 6. Models – are representations of the interaction among and between the
(Barnum, 1988). concepts showing patterns.
* organize some phenomenon meaning they can be tested that is to provide *serves as frameworks
support to challenge another theory or a work. To sum it up, a theory is a well
substantiated explanation of an aspect and that can incorporate laws, Types of Concepts
hypotheses and facts 1. Empirical concepts – can be observed or experienced through the senses
*Can be gained through experience, abstract thoughts contained in an object.
What are the Components of a Theory? Example: Beauty, Justice
1. Concepts – ideas and mental images that help to describe phenomena 2. Abstract concepts – are not observable (caring, hope, etc.)
(Alligood and Marriner- Tomey, 2002) *Can be understood but has no physical form. Example: Love, Success and
*A general notion, a thought, an abstract idea that occur in the mind, speech Freedom
and thought. These are fundamental building blocks of thoughts and beliefs.
With regards to mental representation, they are conceived in the mind. Conceptual Model and Framework
Example is a tree, a chair or a table, in nursing are health, wellness, illness, 0 Conceptual Model
stress and health promotion. Importance in nursing: provides the foundational
 - Is made up of concepts and propositions which state the relationship between
concepts that are generally abstract and not readily observable in the empirical
world.
- Symbolic representation of a theory, shown through diagrams or mathematical
notations.
- Very broad ideas that form the fabric of the theory
* Provide coherent, unified and orderly way of envisioning related events or
processes, some are physical objects, examples are models such as dummies
assembled and may be made to work like the object it represents such as in IV
insertions, we use hands to be practiced
0 Conceptual Framework
- Structure that links concepts together, representing a unified whole.
- Explains the relationships between concepts in a logical manner, but rather
than being based on one theory, links concepts selected from several theories,
research results, or from experiences.
- Provide a focus, a rationale, and a tool for the integration and interpretation of
information.
- Usually expressed abstractly through word models, a conceptual framework is
the conceptual basis for many theories.
*Set of concepts and assumptions, used to make conceptual distinctions and
organize ideas. Several theories, concepts and research results, from that are
linked through arrows. Express key relationships between elements.
Facilitates understanding on a network of ideas
Nursing Theory
- a conceptualization of some aspect of reality that pertains to nursing. The
concept is articulated for the purpose of describing, explaining, predicting, or
prescribing nursing care (Meleis as cited in George, 2002).
- Nursing theories are "attempts to describe or explain the phenomenon
(process, occurrence and event) called nursing" (Barnum,1998)
- Nursing theories are the creative products of nurses who seek to thoughtfully
describe relationships and interactions that exist within nursing practice.
Theories address the many questions that confront nurses daily.
*guide of nurse, theories are needed or vital as they guide and give meaning to
what we see applied in nursing practice
Purposes of Nursing Theory
*Theories- explain person, environment… (4 metaparadigms of nursing), gives a
perspective for assessing patients, situations and organizing data and methods for
analyzing and interpreting information. Example is theory of Orem which is the
theory of Self-Care, where if used this theory of practice we are going to assess and
interpret data to determine patient’s self-care needs/deficits/abilities to manage the
disease or situation of client. Guide nurses the design to design patient centered
nursing interventions. Application of a nursing theory in practice depends on the
knowledge of nursing in other theoretical models, how they relate to one another and
their use in designing nursing interventions. We need theoretical base to demonstrate
knowledge through the use of knowledge. Helps to identify the focus the means/goals
of practice. Enhance communication Increase autonomy and accountability for care to
the patients.
a. Defines nursing
b. Describes what nurses do (nursing practice)
c. Provides goals or outcomes of care
d. Enables nurses to know WHY they are doing WHAT they are doing
Development of theories
3 stages of theory development
1. SPECULATIVE- Attempts to explain what is happening
2. DESCRIPTIVE- Gathers descriptive data to describe what is really happening
(evidence based to describe what is really happening)
3. CONSTRUCTIVE-revises old theories and develop new ones based on continuing
research (use another theory to develop new ones)
Theory Development Process
1. THEORY-PRACTICE-THEORY: Take existing theory, apply, develop a new
theory.
2. PRACTICE- RESEARCH-THEORY: See what is happening, submit to
research (curiosity), develop theory from results
3. THEORY-THEORY- RESEARCH/PRACTICE: Build on an initial theory to
develop a second theory, then apply and test it
There have been three reasons for the interest in theory:
 1. Theory development contributes to knowledge building and is seen as a
means of establishing nursing as a profession
2. The growth and enrichment of theory in and of itself is an important goal of
nursing, as a scholarly discipline (refined, modified, and flexible)
3. Theory helps practicing nurses categorize and understand what is going on in
nursing practice; it helps them to predict client's response to nursing services
and is helpful in clinical decision making.
*Primary purpose: to improve practice by positively influencing the quality of
life of patients, reciprocal/mutual/binding of theory and practice, should not
stand alone (theory put into practice, and in practice there exists the guide
which is the theory.
History of theory development
- The history of professional nursing began with Florence Nightingale. She
envisioned nurses as a body of educated women at a time when women were
neither educated nor employed in public service. century (Kalisch & Kalisch,
2003)
*Florence- mother of modern nursing, known as the lady with the lamp during
the Crimean war. They see nursing as a house job and not a noble profession
for those who were not educates as it involves only caring. Following her
service of organizing and caring for the wounded at Scutari during the
Crimean war, her vision and establishment of a school of nursing at St.
Thomas’ hospital in London marked the birth of modern nursing. Nightingale
pioneering activities in nursing practice and subsequent writings describing
nursing education became a guide for establishing nursing schools in United
States at the beginning of the twentieth.
- 1950’s- Nursing profession leaders began a serious discussion of the need to
develop nursing knowledge apart from medical knowledge. Still, nursing as a
vocation rather than a profession.
CURRICULUM ERA
- The curriculum era addressed the question of what prospective nurses
should study to learn how to be a nurse. (focus: course selection and
content)
- Emphasis was on what courses nursing students should take, with the goal of
arriving at a standardized curriculum (Alligood, 2006a)
- By the mid-1930s, a standardized curriculum had been published.
However, it was also in this era that the idea of moving nursing
education from hospital-based diploma programs into colleges and
universities emerged.
*A vocation is generally a job that requires a particular set of skills
acquired through experience or training but not necessarily dependent
on a college degree. A profession refers to the career that one opts for,
getting extensive training and acquiring special skills to become
eligible for a job in it. Undergo series of trainings and also dependent
on a college degree.
RESEARCH EMPHASIS ERA (1970’s)
- This era came about as more and more nurses embraced higher education and
arrived at a common understanding of the scientific age, that is, that research
is the path to new nursing knowledge. Nurses began to participate in research,
and research courses began to be included in the nursing curricula of many
developing graduate programs (Alligood, 2006a).
GRADUATE EDUCATION ERA
- Master’s degree programs in nursing emerged to meet the public need for
nurses with specialized clinical nursing education
- Most nursing master’s programs began to include courses in concept
development or nursing models that introduced students to early nursing
theorists and the knowledge development process (Alligood, 2006a).
THEORY ERA/ THEORY UTILIZATION ERA (1980’s)
- was a natural outgrowth of the research and graduate education eras.
- Research without theory produced isolated information, and that it was
research and theory together that produced nursing science (Batey, 1977;
Fawcett, 1978; Hardy, 1978)
*Theories are utilized/applied in nursing practice
Nursing Philosophy
- describes personal beliefs or a worldview
- defines Nursing or discusses Nursing in a general sense
- A nurse uses his or her philosophy of nursing to explain what he or she
believes nursing is, the role nursing plays in the health care field, and how he
or she interacts with patients.
 - Examples of Nursing Philosophy:
0 Florence Nightingale's Definition of Nursing
0 Virginia Hendersons's Definition of Nursing Health Person
0 Ernestine Widenbach's Helping Art of Clinical Nursing
0 Jean Watson's Theory of Human/Transpersonal Caring
0 Patricia Benner’s Philosophy of Caring, Clinical Wisdom and Ethics in *4 concepts under the nursing paradigm by Jacqueline Fawcette (1984)
Nursing Practice

LECTURE_4

Nursing Metaparadigm 4 key concepts in Nursing 1. Nursing

-Person - “... the protection, promotion, and optimization of health and abilities (3 levels of
-Health care), prevention of illness and injury, alleviation of suffering through the diagnosis
-Environment and treatment of human response, and advocacy in the care of individuals, families,
-Nursing communities, and populations (American Nurses Association).
-Caring
- Caring: Human caring as the moral ideal of nursing is the central focus of
Nursing Metaparadigm professional practice.
*Allows us to understand and explain what nursing is, what nursing does and why *Involves concern and empathy, the commitment to the clients live experience of
nurses do what they do. human health and the relationship among wellness illness and disease. Involve human
- [met″ah-par´ah-dīm] a set of concepts and propositions that sets forth the person or nurse engaged in an active partner with human care transactions with clients
phenomena with which a discipline is concerned. across lifespan
*Term was first introduced in the late 1970s appeared on 2 papers of Margaret
Hardy
- Hardy defined a metaparadigm as “a gestalt or total world view... that serves 2. Person
as way of organizing perceptions.” - the recipient of nursing care (including individual patients, groups, cultures,
*Gestalt- putting many information into one to have a total perspective or total families, and communities) (American Nurses Association)
understanding or a whole understanding of the concept being organized *Receiver are taken care of, they could be in a collective manner

3. Health
Jacqueline M Fawcett, PhD, FAAN, RN - the condition of being sound in body, mind, or spirit; especially: freedom from
Professor Emerita of Nursing physical disease or pain (Merriam Webster)
- Dr. Fawcett received her BS from Boston University, and her MSN and PhD *Interaction and interconnectedness of body mind and spirit; Encompasses whole
degrees from New York University. aspect of individual
*Persona the reason to be behind nursing metaparadigm, she persisted,
explained and was firm that there is a unified nursing discipline in terms of - Health is the absence of any disease or impairment. (Sartorius N., 2006)
knowledge development
- Health is a state that allows the individual to adequately cope with all demands of
Nursing Environment daily life (implying also the absence of disease and impairment). (Sartorius N.)
- The third definition states that health is a state of balance, an equilibrium that an
individual has established within himself and between himself and his social and
physical environment. (Sartorius N.)
-Health is a state of complete physical, mental and social well- being and not merely
the absence of disease or infirmity. (world health organization)
*All aspects in good condition
4. Environment
-Environment is the circumstances, objects, or conditions by which one is surrounded.
(Merriam Webster)
-the setting or conditions in which a particular activity is carried on (Oxford
Dictionary)
*Setting: Community, clinical, intoxicated, rural area or in the city work activities
take place
-Technical Definition: the surroundings or conditions in which a person, animal, or
plant lives or operates. (Oxford Dictionary)
- Environment/situation includes all possible condition affecting patients and the
settings where they go for their health care. (Fundamentals of Nursing Practice)
Summary -Jacqueline Fawcett has named PERSON, HEALTH, NURSING, and
ENVIRONMENT as the nursing metaparadigm. (Fundamentals of Nursing Practice)
*Person is the recipient or receiver of care. Health the complete physical and mental
wellbeing not only the absence of disease. Nursing is the practice of caring.
Environment is a situation or the setting that may influence the being of an individual.
4 major concepts of metaparadigm by Jacqueline Fawcett
LECTURE_5
Concept analysis in Nursing
- Definition
- Relevance of Concept analysis in Education, Research, and Clinical Practice.
- Purposes of Concept analysis in Nursing.
- Purposes and usefulness of theories in Nursing Research and Practice
- Theoretical and knowledge development in Nursing, theory-based nursing practice,
evidence-based practice research.
CONCEPT ANALYSIS IN NURSING
- Definition: Concept analysis is a formal linguistic exercise to determine
certain defining attributes. (Chon SJ. Kanho Hakhoe Chi. 1989;19(1):92-98.
doi:10.4040/jnas.1989.19.1.92)
*Formal linguistics-linguistics that favors the use of precise definitions for
grammar, semantic and in other concepts. Treats language as if it were
composed of well-defined patterns of symbols.
- According to Walker (1983) as cited by Chon (1989), the basic purpose of
concept analysis is to clarify ambiguous concepts in a theory, and to propose a
precise operational definition which reflects its theoretical base.
*Eg. One concept is unclear or vaguely explained, it has to be understood to
the conduct of CA. Concept analysis attempts to provide a simpler and more
comprehensive definition based on the theory that is being reviewed
- a concept analysis can provide guidance when a concept of interest does not
have sufficient literature, is vaguely defined, or is not understood clearly or
when literature and research do not match
*When the situation/circumstance that a literature and research do not match it
has to be reviewed and analyzed, and concept analysis can be defined as a
dissection of a concept into a simpler element, meaning it has to be presented
in a simpler manner, in smaller particles promotion of clarity, providing
mutual understanding in nursing so that everybody involved in the nursing
practice/profession have a clearer view/understanding of what the concept
means
- Stages by Aarabi, Akram & Rafii, Forough & Cheraghi, Mohammad &
Ghyasvandian, Shahrzad. (2014). Nurses’ policy influence: A concept
analysis. Iranian journal of nursing and midwifery research. 19. 315-22.
*Attributes- quality or features of a certain concept
*Antecedent- case or events that have existed before or that has been logically
precedes another, so it is existing already.
*Referents- thing, word or phrase that describes, denotes or stands for.
 *Last stage- there is already a meaning provided.
Concept analysis dissect vague concepts and theories
Nursing Theories are developed to improve the quality of life of care rendered
by nurses to their clients/patients
*Since concept analysis would try to dissect big concepts in theories, let us talk about
the nursing theories which are primarily the concerned theory in our profession. NT
tries or engages in activities and knowledge development so the quality of life and
provision of care be improved and enhanced
Theory-Based Nursing Practice
- Theory provides nurses with a perspective with which to view client situations, a
way to organize the hundreds of data bits encountered in the day-to- day care of
clients, and a way to analyze and interpret the information.
*Theoretical perspective allows a nurse to plan and implement care purposefully and
reactively for the benefit of the patients taken care of.
Characteristics of a Useful Theory [Robert T. Croyle (2005)
- A useful theory makes assumptions about a behavior, health problem, target
population, or environment that are:
- Logical
- Consistent with everyday observations
- Similar to those used in previous successful programs and
- Supported by past research in the same area or related ideas.
*You can’t come about a new information unless you are given an idea from a
previous information based from previous researches or related ideas
Importance of Nursing Theories
- Nursing theory aims to describe, predict and explain the phenomenon of
nursing
- It should provide the foundations of nursing practice, help to generate further
knowledge and indicate in which direction nursing should develop in the
future. Theory is important because it helps us to decide what we know and
what we need to know
- It helps to distinguish what should form the basis of practice by explicitly
describing nursing. The benefits of having a defined body of theory in nursing
include better patient care, enhanced professional status for nurses, improved
communication between nurses, and guidance for research and education
- The main exponent of nursing – caring – cannot be measured, it is vital to
have the theory to analyze and explain what nurses do
- As medicine tries to make a move towards adopting a more multidisciplinary
approach to health care, nursing continues to strive to establish a unique body
of knowledge
- This can be seen as an attempt by the nursing profession to maintain its
professional boundaries
*Purpose of theory in practice, General purposes.
To understand what is caring it must be embedded in a theory
Knowing the history of nursing we were under the umbrella of the medical field
Able to establish own profession
Identified as a profession must be sustained, improved, maintain the standards that we
have been practicing, enhance areas where we would see ourselves to be weak,
practice our profession without going beyond the scope
Purpose of Nursing Theories in Practice, Education and Research
PRACTICE
- Assist nurses to describe, explain, and predict everyday experiences.
- Serve to guide assessment, interventions, and evaluation of nursing care.
- Provide a rationale for collecting reliable and valid data about the health status
of clients, which are essential for effective decision making and
implementation.
 - Help to describe criteria to measure the quality of nursing care.
- Help build a common nursing terminology to use in communicating with other
health professionals.
- Ideas are developed and words are defined.
- Enhance autonomy (independence and self-governance) of nursing through
defining its own independent functions.
*One way to give meaning to a phenomena, give idea; Nursing process, guides ang
give us idea to take care of patients; How to measure quality-based by the
effectiveness of the intervention that was promoted/provided to the patient and the
like; Since we are part of the health care team it there should be an established good
communication/relationship, that’s why there are terminologies by which the health
care profession are comprehensive or can understand what terms mean-good
communication; Concept analysis-define vaguely expressed or explained, ability to
define words, ideas are being developed; Autonomy-ability of the group to decide for
itself, independence, self governance, in control/ manage of our own profession.
Without order by others. Can perform nursing profession by ourselves
EDUCATION
- Provide a general focus for curriculum design
- Guide curricular decision making.
*Different models were able to come up with unique terms; Primarily Prepare student
for practice as members of the professional community; Before proceeding to clinical
practice, preparation is needed (exposed to community and clinical area, and in
different setting where we would be delivering, providing and practicing our
profession
RESEARCH
- Offer a framework for generating knowledge and new ideas.
- Assist in discovering knowledge gaps in the specific field of study.
- Offer a systematic approach to identify questions for study; select variables,
interpret findings, and validate nursing interventions.
- Approaches to developing nursing theory
- Borrowing conceptual frameworks from other disciplines.
- Inductively looking at nursing practice to discover theories/concepts to explain
phenomena.
- Deductively looking for the compatibility of a general nursing theory with nursing
practice.
- Questions from practicing Nurse about using Nursing theory
* Generate knowledge by basing it from a previous idea
Research look for answers, we can identify lapses
Generate knowledge through research, possible formulate and develop new nursing
theory from results
Some conceptual frameworks are non nursing, applicable in profession conceptual
model by Abraham Maslow Hierarchy of needs
Inductively- specific to general knowledge
Deductively- general to specific
Allows us to examine ourselves
NOTE: 3 fields are interdependent, mutually reliant on each other. Relationship in
between Helps in building nursing knowledge

*1955 nursing scholars engaged in researches that generated knowledge we are
utilizing today, how nursing theory developed; Late 1980 rest period
Theory-Based Nursing Practice Evidence-Based Practice Research
*Theory development in nursing we have this
The principal objective of research around which all of the other goals revolve is
primarily to produce new knowledge and add to the existing body of knowledge in
specific area of science. Knowledge that could be directly applicable for practice or
knowledge that needs further verification before application. In the sense of evidence
base practice research promotes the quality of care that is being demonstrated to be
effective. There is a problem-solving approach here, testing theories based on the
most reliable evidence in clinical expertise and patients’ preferences to answer the
question. There are 6 characteristics of characteristic of quality healthcare that
reinforce the aspects of EBP client centered, scientifically based, population outcome
based, individualized to client needs, system policies and resources. EBP involve
accurate and thoughtful decision making about health care delivery for clients based
on the results of the most relevant and support evidence derived from research
TBP: generate new body of knowledge
EBP: discover new effective ideas or modality by which we can improve or promote
the quality of care that we are providing for our patients. Practice founded can reach
the gap of nursing and practice or nursing practice and research to provide bases for
nurses to transition or to transform research into quality care.
Perform well in providing care for patients by following and performing based on the
theories had in the profession as basis for our interventions and provision of care for
our patient and it is highly possible as well to be theorist providing new knowledge.
LECTURE_6
Patterns of knowing
*Consider that there has to be sources of how we are going to perform
duties/procedures expected of us
 4 Patterns of Knowing in Nursing
- Empirical
- Ethical
- Aesthetic
- Personal
- 5th pattern of knowing the unknown
Barbara A. Carper (April 24, 1931- May 9, 2002)
- Dr. Carper earned her bachelor’s degree in nursing at Texas Woman’s
University in 1959, one of the earliest 4-year nursing programs in Texas.
- She earned a nurse Anesthetist certificate at the University of Michigan
Medical School in Ann Arbor.
- After several years of practice as a Nurse Anesthetist, she went to Teacher’s
College Columbia for a Masters, and then an EdD degree, where she
completed the research that resulted in the conceptualization of nursing’s
fundamental Patterns of knowing. She held faculty positions in Texas, Maine
and North Carolina until her retirement in 1999.
*Responsible in coining, developing or conceptualizing patterns of knowing.
Originally 4, but as time goes by with the works of scholars with their
research/analysis, they were able developed and formulate and conceptualize
other patterns sources and ways of knowing.
She is a scholar that has greatly contributed in nursing
Fundamental Patterns of Knowing
1. EMPIRICAL KNOWING- The SCIENCE of Nursing.
*Science-knowledge from the careful study of structure, and behavior of the physical
world especially by watching, measuring, and doing experiments, and the
development of theories that describe the results of these activities.
There is knowledge from activities or behaviors involving the use of senses, involving
practicality, and testing with measurement, experiment and development of theories.
2. PERSONAL KNOWING- The PERSONAL Knowledge
3. AESTHETIC KNOWING- The ARTS of Nursing.
*Aesthetic- decorations, ornamentals, graceful, elegant, beautiful, attractive, pleasing
4. ETHICAL KNOWING- The MORAL Component.
*Moral component-good and evil, involve judgement of right and wrong doing in
relation to intention, reason and attribute of individuals and situations.
Ethical knowing- requires knowledge of different philosophical positions regarding
what is good and right and making moral action and decisions particularly in the
theoretical and clinical components of nursing
Empirical knowing
*Late 1950s the term nursing science was barely used in literature but there is a sense
of urgency, because when you try to practice
Empirical- objective described as based on testing and experience, when we try to
describe something there has to be an evidence/testing/experienced especially when
talking about a phenomena and other circumstances. You can’t explain something
without valid information, or facts to be presented. Principal form of relating factual
and descriptive knowing in the expansion of abstract and theoretical explanation.
Example: knowledge obtained from textbooks, lectures, journals, and online
resources. When you try to explain something, you have to research or to look into
evidence to expand explanation or to dig deeper to how you are going to express and
describe what is expected from you. Engagement in research activities, as there is a
scientific method to produce a desired study result, to find out/discover something.
Being able to practice/experience/perform interventions based on EBP (involvement
of accurate and thoughtful decision making about health care delivery of our client
since it has been tested or proven and based on experience, effective in terms of
intervening the condition of the patient) or based from acceptable clinical practices
(tested, with evidence why it is good to apply)
- … sense of urgency
- There seem to be general agreement that there is a critical need for knowledge
about the empirical world, knowledge that is systematically organized into
general laws and theories for the purpose of describing, explaining and
predicting phenomena of special concern to the discipline of nursing.
Personal knowing
- Personal Knowledge as a fundamental pattern of knowing in nursing is the
most problematic, the most difficult to master and to teach.
*Every individual is unique, hence there is something exemplary or makes
identity different from the others.
- NURSING is considered as an interpersonal process. THERAPEUTIC USE
OF SELF
*Interpersonal process- knowing of self, identify strengths, weakness,
shortcomings, what is best from you and best that you can give. Kilalanin ang
sarili bago ang iba through self-awareness. Extensive acknowledgement of
self. Necessary as it make you know when you’re ready. Self-awareness to
deliver well care to patients later on. Therapeutic use of self- ability to use
your own personality, insights, perceptions or judgement as part of the
therapeutic process. Example: you’re a jolly person, you use it in taking care
of patients, and it may be good for your patients perhaps. Describes an
individual’s plan of using his/her personality/insight/perceptions/judgement as
part of the therapeutic process.
- PERSONAL KNOWLEDGE is concerned with the knowing, encountering
and actualizing the concrete, individual self.
Aesthetic knowing
*AK- make you say “ganito pala ang gagawin ko dapat”
Uncover something on the long run be creative, artistic, able to discover something in
experience
- “ART” - manual or technical skills involved in nursing practice
- APPRENTICE SYSTEM imitative learning style and the acquisition of
knowledge by accumulation of unrationalized experiences.
- An aesthetic experience involves the creation and/or appreciation of a
singular, particular, subjective expression of imagined possibilities or
equivalent realities that “resist projection into the discursive form of
language”
*Related to understanding what is significant to particular patients such as
feelings, attitudes, POVs, according to Carper. Manifestation if creative and
expressive styles of the nurse.
Art of nursing- how you perform or put into practice the creative form of your
new discoveries. Giving appropriate nursing care to understand the uniqueness
of every patients (personal knowing).
In designing activities or nursing case, it should be individualistic, per
person/patient
- Empathy: an important mode in the aesthetic pattern of knowing.
*Empathy- capacity for participating in vicariously experiencing another’s
feeling. Putting yourself in the shoes of others to imagine the feelings and
experiences of the patients, understanding what is going on with the patient.
 Compassion, mercy and understanding to others. Example: patient asking person about it, so we have to understand the background of the patient to know
about condition, realized the patient is illiterate, by being creative explain what influenced the care of patient, there should be an exploration/exposure of
patient condition through asking others, explanation of medical terms making alternative means of health to patient. To enable care to all people
the patient understand. Creative and appreciate the person (artistic) …Social political knowing consists of two levels, firstly the social political
context of the person (nurse and the patient) and secondly, the social political
Ethical knowing context as a practice profession.
*Requires an understanding of how to connect and motivate people where they
- Ethics: Ethos - Greek word; a system of moral principles:
are. Understanding of what messages would be most effective in pushing
*Ethics-things dealing with values relating to human conduct with respect to
someone’s matter or eliciting a strong emotional response.
the rightness and wrongness of certain actions and to the goodness and
badness of the motives in ends of such actions Emancipatory knowing (Chinn and Kramer)
- Obligations or What ought to be done …foundational to developing reflexivity in clinical practice.
*Purpose of us nurses, guided with the moral code that guides us with the *Root: Emancipate- freeing yourself from the string or control or power of another.
ethical conduct of nurses that is based on the primary principle of obligation
embodied in the concepts of service to people and of course respect to human Reflexivity- fact that one is able to examine his/her feelings, reactions, and motives.
life. It is deeply rooted on the concepts of human dignity, service and respect “Bakit ko ba ginagawa to? Ano ba ang ginagawa ko? Why am I doing this and what is
for life. Inclusion of deliberate nursing actions involving and under the his reaction in terms of the daily counteractive?
jurisdiction of ethics and professionalism. Know what we should do in the
nursing practice Patterns of knowledge- where we are able to derive or obtain our knowledge thus
facilitate us in performing well in involving ourselves in the provision of care to our
Unknowing (toward another pattern of knowing in nursing Patricia Munhall, patients. Contribute to the future articulation and development of nursing
1993)
…Unknowing is a condition of openness
…This pattern of unknowing focused herein on the intersubjective whole between
patient and nurse is applicable as well to learning in a more formal sense.
*Unknowing-lack of awareness or knowledge. Art of unknowing enables a nurse
to understand with empathy, the actual essence of meaning and experience has for
patient. Improve and enhance nursing care procedure/plan to your patient.
Intersubjective-coined by a philosopher, concept used to describe the space of
shared understanding or common ground between persons where in people as
individual subjects collaboratively create and share meaning.
“ah ganun pala, yun pala yun”. Know what is unknown; Openness- I never
thought about it that way; wonderment of coming upon an unknown
Socio-Political knowing (Jill White, 1995)
…Sociopolitical Knowing is a core strength of professional nursing.
*Essential to an understanding of all the others. Example-taking care of patient
from a far flung area, with no understanding as there is no knowledge by that