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20 UNIT I Evolution of Nursing Theories

argued that, in studying behavior, scientists should interaction that emphasize situation, context, and
develop methods and procedures that are dependent the multiple cognitive constructions individuals cre-
on context for meaning rather than eliminate context ate from everyday events (Ford-Gilboe, et al., 1995).
by searching for laws that hold across contexts. This A critical paradigm for knowledge development
critique of the methods and assumptions of research is in nursing also has been described as an emergent,
emerging from phenomenological and ethnomethod- postmodern paradigm that provides the framework
ological theorists who view the scientific process from for inquiring about the interaction between social,
a very different paradigm (Bowers, 1992; Hudson, political, economic, gender, and cultural factors
1972; Mishler, 1979; Pallikkathayil & Morgan, 1991). and the experiences of health and illness (Ford-
Phenomenology is a science that describes how we Gilboe, et al., 1995). A broad conception of post-
experience the objects of the external world and pro- modernism includes the particular philosophies that
vides an explanation of how we construct objects of challenge the “objectification of knowledge,” such
experience. In phenomenology, the investigator posits as phenomenology, hermeneutics, feminism, critical
that all objects exist because people perceive and theory, and poststructuralism (Omery, Kasper, &
construct them as such. Ethnomethodology focuses Page, 1995).
on the world of “social facts” as accomplished or The philosophy of nursing has been developing
co-created through people’s interpretive work. When over a 150-year period. The philosophy of caring,
examining phenomena from this perspective, social naturalism, and holism are themes that can be found
reality and social facts are constructed, produced, and in the literature. Numerous authors have written
organized through the mundane actions and circum- about caring. Caring is the wholeness of the patient’s
stances of everyday life. situation, which implies that nursing care requires
There is neither a single science nor a single scien- interpretation, understanding, and hermeneutic ex-
tific method. There are several sciences, each with perience. The philosophy of caring involves knowl-
unique phenomena and structure and methods for edge, skills, patient trust, and the ability to manage
inquiry (Springagesh & Springagesh, 1986). How- all elements simultaneously in the context of care
ever, the commonality among sciences concerns the (Austgard, 2008).
scientists’ efforts to separate truth from speculation Wholism is another philosophy in understanding
to advance knowledge (Snelbecker, 1974). In ques- the patient (Hennessey, 2011). Wholistic nursing
tions regarding the structure of knowledge in a given views the biophysical, psychological, and sociological
science, the consensus of scientists in the discipline subsystems as related but separate, thus the whole is
decides what is to be regarded as scientific knowl- equal to the sum of the parts. Holistic nursing recog-
edge and the methods of inquiry (Brown, 1977; nizes that multiple subsystems are in continuous
Gale, 1979). interaction and that mind-body relationships do exist
Consensus has emerged in the field of nursing (Kinney & Erickson, 1990).
that the knowledge base for nursing practice is in- Naturalism has a metaphysical component that
complete, and the development of a scientific base implicates that the natural world exists; there is no
for nursing practice is a high priority for the disci- non-natural or supranatural realm. The natural world
pline. The postpositivist and interpretive paradigms is open, because it depends upon what method the
have achieved a degree of acceptance in nursing as enquiry requires. Naturalism insists that knowledge
paradigms to guide knowledge development (Ford- and beliefs are gained by one’s senses guided by
Gilboe, Campbell, & Berman, 1995). Postpositivism reason, and by the various methods of science
focuses on discovering patterns that may describe, (Hussey, 2011). While these philosophies are pro-
explain, and predict phenomena. It rejects the older, posed in the literature, nursing science is in the early
traditional positivist views of an ultimate objective stages of scientific development.
knowledge that is observable only through the senses As the discipline of nursing moves forward, there
(Ford-Gilboe, et al., 1995; Weiss, 1995). The interpre- is abundant evidence that a greater number of nurse
tive paradigm tends to promote understanding by scholars are actively engaged in the advancement
addressing the meanings of the participants’ social of knowledge for the discipline of nursing through