Contents

... Preface ............................................................................ xi1

Authors ............................................................................ xv

Part One The Nursing Discipline and the Development of Nursing Knowledge ........... 1 References ............................................................................ - 4

Chapter 1 Values-Based Practice and Evidence-Based Care: Pursuing Fundamental Questions in Nursing Philosophy and Theory ...................................... 5 William K . Cody. PhD. RN. F A A N

Value-Laden Theory and the Fallacy of Value-Free Science .................................. 6

The Clarion Call for Evidence-Based Practice .............................................. 7

Understanding Praxis ................................................................... 8

Practice as Praxis ...................................................................... - 8

Care .................................................................................. 9

Differentiating Practice and Care ........................................................ 10

Values-Based Practice and Evidence-Based Care ........................................... 11

Suggestions for Further Reflection ....................................................... 12

References ........................................................................... - 1 3

Chapter 2 Structuring Nursing Knowledge: A Priority for Creating Nursing's Future ....... 15 Rozella M . Schlolfeldt. RN. PhD. FAAN

Nursing as a Profession ................................................................ 16

Knowledge of the Discipline ............................................................ 17

References ........................................................................... -20

iii

Contents

Chapter 3 Fundamental Patterns of Knowing in Nursing .................................... 23 Barbara A . Carper. RN. EdD

Identifying Patterns of Knowing ......................................................... 23

Using Patterns of Knowing ............................................................. 31

References ........................................................................... -32

Chapter 4 The State of Nursing Science: Hallmarks of the 20th and 21st Centuries .......... 35 Jacqueline Fawcett. RN. PhD. FAAN

Hallmarks of 20th-Century Nursing ..................................................... 35

Current Trends in Nursing Science ...................................................... 37

The Hallmark of 2lst-Century Nursing: A Prediction ...................................... 39

Conclusion .......................................................................... -42

References ........................................................................... -42

Chapter 5 What Constitutes Nursing Science? ................................................ 43 John R . Phillips. RN. PhD

References ........................................................................... -46

Chapter 6 Nursing Theory-Guided Practice: What It Is and What It Is Not .................. 47 William K . Cody. PhD. RN. FAAN

References ........................................................................... -50

Chapter 7 ........................................ A Practice Discipline That's Here and Now 51

Merian C . Litchfield. RN. PhD and Helga Jdnsdbttir. RN. PhD

Call of the Discipline .................................................................. -52

An Era of Practice .................................................................... -54

A Participatory Paradigm ............................................................... 55

Focus of the Discipline ................................................................. 61

In Action ............................................................................ -63

Conclusion .......................................................................... -65

References ........................................................................... - 65

Contents v

Part Two Conceptualizations of Human Beings. Health. Environment. and Nursing Practice ............................................................. 69

Chapter 8 Nursing: The Ontology of the Discipline .......................................... 73 Pamela G . Reed. RN. PhD. FAAN

............................... Continuing the Dialogue: Nursing as a Process of Well-Being 74

Challenging the Status Quo: Nursing Reconstructed ....................................... 78

Nursing as a Metaparadigm Concept ..................................................... 78

References ........................................................................... -79

Chapter 9 Philosophical Position on Nature of Human Beings Foundational to Orem's Self-care Deficit Nursing Theory ....................................... 81 Barbara E . Banfield. BSN. MSN. PhD

Philosophical Inquiry Process ........................................................... 82

Nature of Human Beings ............................................................... 84

Views of Human Beings ................................................................ 90

Conclusion ........................................................................... 91

References ........................................................................... -92

Chapter 10 Reframing Outcomes: Enhancing Personhood .................................... 95 Anne Boykin. PhD and Savina Schoenhofer. PhD

Nursing as Caring .................................................................... -97

Nursing Situation .................................................................... -99

Knowledge and Skills ................................................................. 10 1

References ..................... : .................................................... -102

Chapter 11 Expressing Health Through Lifestyle Patterns .................................... 105 Nola J . Pender. RN. PhD. FAAN

Person and Health: New Views of Old Concepts .......................................... 106

Health as Pattern .................................................................... -108

Dimensions of the Health Experience ................................................... 109

Con tents

Classifying Expressions of Health ....................................................... 109

Affect ............................................................................... 112

Attitudes ............................................................................ 113

Activity ............................................................................. 114

Aspirations ......................................................................... -115

Accomplishments .................................................................... 116

Concluding Comments ............................................................... 117

References ........................................................................... 117

Chapter 12 Healing as Appreciating Wholeness .............................................. 119 W . Richard Cowling, III. RN. PhD

A Differentiated Healing Conceptualization ............................................. 120

The Appreciating Context ............................................................. 122

The Appreciating Process ............................................................. 123

A Case of Healing as Appreciating Wholeness ............................................ 127

Summary .......................................................................... -136

References .......................................................................... -137

Chapter 13 Thinking Upstream: Nurturing a Conceptual Understanding of the Societal Context of Health Behavior ....................................... 139 Patricia G . Butte6eld. RN. MS

Nursing's Role in Pushing Upstream .................................................... 140

The Downstream View: The Individual as the Locus of Change ............................. 141

The Upstream View: Society as the Locus of Change ...................................... 142

The Need for Alternative Perspectives ................................................... 145

References .......................................................................... -146

Chapter 14 Environmental Paradigms: Moving Toward an Ecocentric Perspective .......... 149 Dorothy Klefel. RN. MPH. DNSc

Egocentric Approach ................................................................. 150

Homocentric Approach ............................................................... 151

Ecocentric Approach ................................................................. 152

Ecocentrism in the World's Traditions .................................................. 153

Contents vii

Implementing the Ecocentric Paradigm ................................................. 157

References .......................................................................... -158

Chapter 15 Nursing Science: The Transformation of Practice ........ Rosemarie Rizzo Parse. RN. PhD. FAAN

Introduction ........................................................................ -161

Ethical Considerations ................................................................ 166

Challenges and Opportunities ......................................................... 167

Recommendations ................................................................... 168

References .......................................................................... -168

Chapter 16 A Dialectical Examination of Nursing Art ........................................ 171 Joy L . Johnson. RN. PhD

Method ............................................................................ -172

Distinct Conceptualizations of Nursing Art .............................................. 173

Ability to Skillfully Perform Nursing Activities ........................................... 177

Conclusion ......................................................................... -182

References ........................................................................... 183

Chapter 17 A Conceptual Framework for Person-Centered Practice with Older People ..... 187 Brendan McComack. DPhil(0xon). BScNsg(Hons). PGCEA. RGN. RMN

Introduction ......................................................................... 187

Person Centeredness .................................................................. 188

Autonomy and Person-Centeredness: A Hermeneutic Study ............................... 188

Person-Centeredness as Authentic Consciousness ........................................ 189

Imperfect Duties .................................................................... -190

The Nurse as a Facilitator of Authentic Consciousness .................................... 192

The Patient's Values .................................................................. 193

The Nurse's Values and Expertise ...................................................... 194

The Context of Care .................................................................. 194

A Composite Example ................................................................ 194

Conclusions ......................................................................... 195

References ...................... ... ................................................ -196

viii Contents

Chapter 18 Relational Practice and Nursing Obligations ..................................... 201 Gweneth H . Doane. RN. PhD and Colleen Varcoe. RN. PhD

Connecting Relationships. Ethics. and Nursing Effectiveness ............................... 202

Relationships. Ethics. and Nursing Obligations ........................................... 206

Obligations as External Entities ........................................................ 206

Reframing Obligation ................................................................. 208

Bringing a Relational Inquiry Lens to Relationships ....................................... 209

Relational Inquiry and Nursing Obligations ............................................. 211

Conclusion ......................................................................... -216

References .......................................................................... -216

Part Three Contemporary Perspectives on Nursing ........................................ 221 References .......................................................................... -222

Chapter 19 Nursing Knowledge and Human Science: Ontological and Epistemological Considerations ............................. Gail I . Mitchell, RN. PhD and William K Cody. PhD. RN. F A A N

Defining Human Science .............................................................. 224

Significance of Human Science for Nursing .............................................. 227

Analysis of the Nursing Frameworks .................................................... 227

Incorporating Diverging Beliefs ........................................................ 228

Extending Essential Beliefs ............................................................ 231

Parse's Theory of Human Becoming .................................................... 233

Critique of the Theory of Human Becoming ............................................. 234

Conclusion ......................................................................... -236

References .......................................................................... -236

Chapter 20 Professionalism and the Evolution of Nursing as a Discipline: A Feminist Perspective ........................................................... 239 Judith Wuest. RN. MN

Feminist Theoretical Perspectives ...................................................... 239

Feminism. Professionalism. and Nursing ................................................ 240

Contents ix

Knowledge Development .............................................................. 245

Feminism: Looking to the Future for Nursing ............................................ 248

Conclusion ......................................................................... -252

References .......................................................................... -253

Chapter 2 1 .............................. Rapture and Suffering with Technology in Nursing 257

Rozzano C . Locsin. RN. PhD. FAAN and Marguerite J . Purnell. RN. PhD. AHN-BC

Person or Object of Care? ............................................................. 258

Influence of Technology on Practice .................................................... 259 Human-Technology Interface in Nursing: Source or Resource? ............................ 260

Theory-Based Practice ................................................................ 262

Practice of Nursing as Knowing Persons ................................................. 263

Artificial Emotions and Evocative Objects ............................................... 265

Reconciliation or Rift-Technology and Caring in Nursing ................................. 265

References .......................................................................... -266

Chapter 22 Exploring an Alternative Metaphor for Nursing: Relinquishing Military Images and Language .................................... 267 Gail J . Mitchell. RN. PhD. Mary Ferguson.Par-6. RN. PhD. CHE. and Joy Richards. RN. PhD

Military Metaphor and Its Integration in Nursing ........................................ 270

Military Language and Beliefs in Nursing ................................................ 271

Exploring the Frontier: A New Metaphor for Nursing ..................................... 273

References .......................................................................... -276

Commentary ........................................................................ 277

Barbara Paterson. RN. PhD

References .......................................................................... -278

Chapter 23 Nursing Science in the Global Community ...................................... 279 Shakt! Kett$an. RN. EdD. F A A N and Richard W . Redman. RN. PhD

Perspectives ........................................................................ -280

References .......................................................................... -288

x Contents

Chapter 24 Nursing Practice with Aboriginal Communities: Expanding World Views ...... 291 Othmar F . Arnold. RN. BScN and Anne Bruce. RN. PhD

Differing World Views ................................................................ 292

Aboriginal Health .................................................................... 292

Aboriginal Health Belief Systems ....................................................... 293

Bridging Intercultural Gaps ............................................................ 297

Conclusion ......................................................................... -299

References ........................................................................... 299

Part Four Interrelationships Among Nursing Theory. Research. and Practice ........... 301

Chapter 25 Optimizing Nursing Care by Integrating Theory-Driven Evidence-Based Practice .......................................................... 303 Teri Britt Pipe. RN. PhD

Setting ............................................................................. -304

Application of the Rosswurm and Larrabee Model ........................................ 304

Lessons Learned ..................................................................... -307

Conclusion ......................................................................... -308

References .......................................................................... -308

Chapter 26 On Nursing Theories and Evidence .............................................. 311 Jacqueline Fawcett. RN. PhD. FAAN. Jean Watson. PhD. FAAN. Beny Neuman. PhD. FAAN. Patricia Hinton Walker. PhD. FAAN. and Joyce J . Fitzpatrick, PhD. FAAN

On Nursing Theories ................................................................. 312

Conclusions ......................................................................... 317

References ........................................................................... 318

Chapter 27 Evidence-Based Practice: Critique and Alternative View ......................... 321 Gail J . Mitchell. RN. PhD

Specific Issues of Concern ............................................................. 323

Where Is the Evidence? ................................................................ 323

Contents xi

Obscuring the Theory-Practice Link .................................................... 324

Self-serving or Other Serving .......................................................... 325

The Misrepresentation of Evidence ..................................................... 327

References .......................................................................... -329

Part Five The Future of Advanced Nursing Practice ...................................... 331

Chapter 28 ....................................... Theory-Based Advanced Nursing Practice 333

Janet W . Kenney. RN. PhD

Relevance of Theory-Based Practice in Nursing .......................................... 334

Structure of Nursing Knowledge and Perspective Transformation .......................... 337

............................. Models and Theories Applicable in Advanced Nursing Practice 339

Selection of Relevant Models and Theories .............................................. 344

Guidelines for Selecting Models and Theories for Nursing Practice ......................... 346

........................................... Application of Theory-Based Nursing Practice 348

Summary .......................................................................... -349

References .......................................................................... -350

Chapter 29 What Will Count as Evidence in the Year 2050? .................................. 353 France2yn M . Reeder. RN. PhD

What and Why Now? ................................................................. 353

Contributions from Human Sciences and from the Discipline of Nursing .................... 355

References ......................................................................... -358

Chapter 30 An Ontological View of Advanced Practice Nursing ............................. 361 Cynthia Arslanian.Engoren, RN. PhD. Frank D . Hicks. RN. PhD. Ann L . Whall. RN. PhD. FAAN. FGSA. and Donna L . Algase. RN. PhD. FAAN. FGSA

Case for a Disciplinary Focus .......................................................... 362

Advanced Practice Nurses and Knowledge Development .................................. 362

Developing a World View: Philosophy. Science. and Nursing Science ....................... 363

A New View: Nursing Processes ........................................................ 364

xii Contents

Application to Advanced Practice Nursing ............................................... 366

Conclusion ......................................................................... -367

References ........................................................................... 368

Chapter 3 1 The Nurse Scholar of the 2 1st Century ........................................... 369 Sandra Schimdt Bunkers. RN. PhD. FAAN

Nursing: A Call to Scholarship ......................................................... 369

Framing Nursing Knowledge .......................................................... 372

Foundational Tenets in Guiding the Framing of Nursing Knowledge ........................ 373

Conclusion .......................................................................... 381

References .......................................................................... -382

Index .............................................................................. -385