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18 UNIT I Evolution of Nursing Theories

If the thesis is accepted that objective truth does to a normal science, then to a crisis, then to a revolu-
not exist and science is an interactive process between tion, and then to a new normal science. Once normal
invented theories and empirical observations, how are science develops, the process begins again when a
scientists to determine truth and scientific knowledge? crisis erupts and leads to revolution, and a new normal
In the new epistemology, science is viewed as an science emerges once again (Kuhn, 1970; Nyatanga,
ongoing process. Much importance is given to the idea 2005). This is what Kuhn refers to as paradigm shift in
of consensus among scientists. As Brown (1977) con- the scientific development within a discipline. For
cluded, it is a myth that science can establish final example, recent research supports that early mobiliza-
truths. Tentative consensus based on reasoned judg- tion of critically ill patients shows better patient out-
ments about the available evidence is what can be comes (Schweickert & Kress, 2011). Theory-based
expected. In this view, scientific knowledge is what nursing practice has demonstrated the capacity to
the consensus of scientists in any given historical era restructure professional care, improving outcomes
regard as scientific knowledge. At any point in time, and satisfaction (Alligood, 2011).
the current consensus among scientists determines the
truth of a given theoretical statement by concluding Interdependence of Theory
whether or not it presents a plausible description of
reality (Brown, 1977). This consensus is possible and Research
through the collaboration of many scientists as they Traditionally, theory building and research have been
make their work available for public review and debate presented to students in separate courses. Often, this
and as they build upon previous scientific discoveries separation has caused problems for students in under-
(Randall, 1964). standing the nature of theories and in comprehending
In any given era and in any given discipline, science the relevance of research efforts (Winston, 1974). The
is structured by an accepted set of presuppositions that acceptance of the positivist view of science may have
define the phenomena for study and define the appro- influenced the sharp distinction between theory and
priate methods for data collection and interpretation research methods (Gale, 1979). Although theory and
(Brown, 1977; Foucault, 1973; Kuhn, 1962). These pre- research can be viewed as distinct operations, they
suppositions set the boundaries for the scientific enter- are regarded more appropriately as interdependent
prise in a particular field. In Brown’s view of the trans- components of the scientific process (Dubin, 1978). In
actions between theory and empirical observation: constructing a theory, the theorist must be knowledge-
able about available empirical findings and be able
“Theory determines what observations are worth to take these into account because theory is, in part,
making and how they are to be understood, concerned with organizing and formalizing available
and observation provides challenges to accepted knowledge of a given phenomenon. The theory is sub-
theoretical structures. The continuing attempt to ject to revision if hypotheses fail to correspond with
produce a coherently organized body of theory empirical findings, or the theory may be abandoned
and observation is the driving force of research, in favor of an alternative explanation that accounts
and the prolonged failure of specific research for the new information (Brown, 1977; Dubin, 1978;
projects leads to scientific revolutions.” Kuhn, 1962).
(Brown 1977, p. 167)
In contemporary theories of science, the scientific
The presentation and acceptance of a revolution- enterprise has been described as a series of phases
ary theory may alter the existing presuppositions and with an emphasis on the discovery and verification (or
theories, thereby creating a different set of boundaries acceptance) phases (Gale, 1979; Giere, 1979). These
and procedures. The result is a new set of problems or phases are concerned primarily with the presentation
a new way to interpret observations; that is, a new and testing of new ideas. New ways of thinking about
picture of the world (Kuhn, 1962). In this view of phenomena or new data are introduced to the scien-
science, the emphasis must be placed on ongoing tific community during the discovery phase. During
research rather than established findings. According this time, the focus is on presenting a persuasive argu-
to Kuhn, science progresses from a pre-science, then ment to show that the new conceptions represent an