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CHAP TER

The Structure of Specialized

Nursing Knowledge

Martha Raile Alligood

his chapter presents the structure for specialized TABLE 4-1 Knowledge Structure Levels
Tnursing knowledge used for the organization of with Examples
the units of this text. As presented in Chapter 1, the
requirement for a body of specialized knowledge for Structure Level Example
recognition of nursing as a profession was a driving Metaparadigm Person, environment, health, and nursing
force in the twentieth century. Because of the impor-
tance of nurses to the nation’s health, early in the Philosophy Nightingale
twentieth century, studies of nursing were legislated Conceptual Neuman’s systems model
and conducted by sociologists who recommended that models
nursing be developed as a profession. The criteria for a Theory Neuman’s theory of optimal client stability
profession provided guidance in this process (Bixler & Middle-range Maintaining optimal client stability with
Bixler, 1959; Kalish & Kalish, 2003). The criterion that theory structured activity (body recall) in a
called for specialized nursing knowledge and knowl- community setting for healthy aging
edge structure was a particularly important driving Modified from Alligood, M. R. (2010). Nursing theory: Utilization & applica-
force in recognition of nursing as a profession (Bixler tion (4th ed.). St. Louis: Mosby; and Fawcett, J. (2005). Contemporary
& Bixler, 1959). The criterion reads: nursing knowledge: Conceptual models of nursing and nursing theories
(2nd ed.). Philadelphia: F. A. Davis.
Utilizes in its practice a well-defined and well-
organized body of specialized knowledge [that] logical presentation. Early works that predate the
is on the intellectual level of the higher learning nursing theory era, such as Nightingale (1969/1859),
(p. 1143).
contributed to knowledge development by providing
The types of knowledge, levels, and examples of direction or a basis for subsequent developments.
each are included in Table 4-1. The theoretical works Later works reflect contemporary human science and
presented in Chapters 6 to 36 are nursing frameworks its methods (Alligood, 2010a; Chinn & Kramer, 2011;
organized into four types. Box 4-1 lists the theorists Meleis, 2007). Selected works classified as nursing
included in each type. The placement of works within philosophies are presented in Unit II, Chapters 6 to 11.
the four types reflects a level of abstraction or the A second type, nursing conceptual models, comprises
preference of the theorist. nursing works by theorists referred to by some as pio-
The first type is nursing philosophy. Philosophy is neers in nursing (Chinn & Kramer, 2011; Fawcett, 2005;
the most abstract type and sets forth the meaning of Meleis, 2007). Fawcett (2005) explains, “A conceptual
nursing phenomena through analysis, reasoning, and model provides a distinct frame of reference for its

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