Understanding Nursology: Structure and Components of Contemporary Disciplinary Knowledge

1. Overview of the Structure of Contemporary Disciplinary Knowledge Jacqueline Fawcett, RN; PhD; ScD (hon); FAAN; ANEF Professor, Department of Nursing University of Massachusetts Boston Visiting Professor, Faculty of Nursing St. Mary’s College, Kurume, Japan

2. The Name of our Discipline: Nursology • Nursology is the proper name for our discipline • Nursology is defined as: • “the study of nursing aimed towards the development of nursing theory” (Paterson, 1971, p. 143). • “the study of nursing” (Roper, 1976, p. 227) • knowledge of the phenomena of interest to nursologists, which are how, when, and why nursologists collaborate with other human beings as they experience wellness, illness, and disease, within the context of their environments (Fawcett, 2018)

3. The Members of our Discipline • Nursologists • All members of the discipline of nursology • Students • Educators • Practitioners of nursology • Researchers and other scholars • Administrators

4. The Professional Discipline of Nursology Knowledge Discovery and Dissemination Knowledge Utilization Scholarly Inquiry Practice Figure. The professional discipline of nursology

5. Components of Contemporary Nursology • The discipline of nursology is concerned with the discovery, dissemination, and application of discipline specific knowledge in the form of • The metaparadigm • Philosophies • Conceptual models • Grand theories • Middle-range theories • Situation-specific theories • Methods of inquiry

6. The Metaparadigm • A metaparadigm is defined as the global concepts that identify the phenomena of central interest to a discipline, the global propositions that describe the concepts, and the global propositions that state the relations between the concepts • The metaparadigm is the most abstract component of nursology and focuses on the general or global subject matter of interest to our discipline

7. The Metaparadigm • The functions of a metaparadigm are • To summarize the intellectual and social missions of a discipline • To place a boundary on the phenomena of interest to the members of a discipline

8. The Metaparadigm of Nursology • One version of the concepts of the metaparadigm of nursology is: • Human beings • Environment • Health • Nursing processes Fawcett & DeSanto-Madeya, 2013

9. The Metaparadigm of Nursology • Human beings • Refers to the individuals, if individuals are recognized in a culture, as well as to the families, communities, and other groups or aggregates who are participants in nursing

10. The Metaparadigm of Nursology • Environment • Refers to human beings’ significant others and physical surroundings, as well as to the settings in which nursing occur, which range from private homes to health care facilities to communities to society as a whole. The metaparadigm concept environment also refers to all local, regional, national, and worldwide cultural, social, political, and economic conditions that are associated with human beings' health

11. The Metaparadigm of Nursology • Health • Refers to human processes of living and dying

12. The Metaparadigm of Nursology • Nursing processes • Refers to the definition of nursology, the actions taken by nursologists on behalf of or in conjunction with human beings, and the goals or outcomes of nursologists’ actions. Nursologists’ actions are viewed as a mutual process between the participants in nursologists’ actions and the nursologists. The process encompasses activities that are frequently referred to as assessment; labeling, or what some nursologists refer to as diagnosis; planning; intervention; and evaluation

13. The Metaparadigm of Nursology • The relational propositions are: • 1. Nursology is concerned with the principles and laws that govern human processes of living and dying • 2. Nursology is concerned with the patterning of human health experiences within the context of the environment

14. The Metaparadigm of Nursology • The relational propositions are: • 3. Nursology is concerned with the nursing actions or processes that are beneficial to human beings • 4. Nursology is concerned with the human processes of living and dying, recognizing that human beings are in a continuous relationship with their environments

15. Other Versions of the Metaparadigm of Nursology • Client • Environment • Health • Nursing as an action • The nurse interacts with the client and the environment for the purpose of facilitating the health of the client Newman, 1983

16. Other Versions of the Metaparadigm of Nursology • Man • Health • Role • Social systems King, 1984

17. Other Versions of the Metaparadigm of Nursology • Client domain • Client‑nurse domain • Practice domain • Environment domain Kim, 1987, 1997, 2000

18. Other Versions of the Metaparadigm of Nursology • Nursing is the study of caring in the human health experience Newman, Sime, and Corcoran-Perry, 1991

19. Other Versions of the Metaparadigm of Nursology • Care is the essence of nursing and the central, dominant, and unifying focus of nursing Leininger 1991

20. Other Versions of the Metaparadigm of Nursology • Nursing is the study and practice of caring within contexts of the human health experience Malloch, Martinez, Nelson, Predeger, Speakman, Steinbinder, and Tracy, 1992

21. Other Versions of the Metaparadigm of Nursology • The core focus of nursing, the metaparadigm, is the human-universe-health process Parse, 1997

22. Other Versions of the Metaparadigm of Nursology • Nursing is the study of human health and illness processes. • Nursing practice is facilitating, supporting and assisting individuals, families, communities, and/or societies to enhance, maintain and recover health, and to reduce and ameliorate the effects of illness. • Nursing’s relational practice and science are directed toward the explicit outcome of health related quality of life within the immediate and larger environmental contexts Thorne, Canam, Dahinten, Hall, Henderson, and Kirkham, 1998

23. Other Versions of the Metaparadigm of Nursology • The central phenomenon of nursing is not health or some sort of restoration of holistic balance and harmony but respect of human dignity Jacobs, 2001

24. Other Versions of the Metaparadigm of Nursology • Nursing client • Transitions • Interaction • Nursing process • Environment • Nursing therapeutics • Health Meleis, 2007

25. Other Versions of the Metaparadigm of Nursology • Human beings • Environment • Quality of life • Nursing Plummer and Molzahn, 2009

26. Philosophy • A philosophy is defined as a statement encompassing • Ontological claims about the phenomena of central interest to a discipline, evident in the question, “What is real?” • Epistemic claims about how those phenomena come to be known, evident in the question, “What is knowable?” • Ethical claims about what the members of a discipline value, evident in the question, “Is this just?”

27. Philosophy • The function of a philosophy is to communicate to members of disciplines and the general public • What the members of a particular discipline believe to be true in relation to the phenomena of interest to that discipline • What they believe about the development of knowledge about those phenomena • What they value with regard to their actions and practices

28. Conceptual Model • A conceptual model of nursology is defined as a set of relatively abstract and general concepts and propositions about human beings, their environments, their health, and nursing processes

29. Conceptual Model • The function of a conceptual model is to • Provide a particular way to view the subject matter of the discipline • No one conceptual model is better than another

30. Grand Theory • A grand theory is defined as a set of somewhat abstract and general concepts and propositions about one, two, or three of the phenomena of interest to nursologists (human beings, environment, health, nursing processes) • A grand theory sometimes is used in place of a conceptual model

31. Middle-Range Theory • A middle-range theory is defined as one or more relatively concrete and specific concepts and propositions about a phenomenon identified by a conceptual model

32. Situation-Specific Theory • A situation-specific theory is defined as one or more very concrete and specific concepts and propositions about a phenomenon identified by a conceptual model and focused on a particular population with a particular health condition

33. Theories • The function of a theory is • To narrow and more fully specify the phenomena contained in a conceptual model • To provide a relatively concrete and specific structure for the interpretation of initially puzzling behaviors, situations, and events

34. Methods of Scholarly Inquiry • Empirical research • Qualitative research (data are words) • Quantitative research (data are numbers) • Mixed methods research (data are words and numbers that are combined, merged, or integrated) • Descriptive research – Qualitative or quantitative data • Correlational research – Quantitative data • Experimental research – Quantitative data

35. Types of Research and Types of Middle-Range or Situation-Specific Theories • Descriptive theories • Explanatory theories • Predictive theories • Descriptive research • Correlational research • Experimental research

36. Empirical Research Methods • The methods used to generate or test the middle-range or situation-specific theory • Research design • Sample • Instruments and experimental conditions • Procedures for collecting data and protecting participants • Data analysis techniques

37. Methods of Scholarly Inquiry • Empirical Indicators • The function of an empirical indicator is to provide the means by which middle‑range theories or situation-specific theories are generated or tested • Empirical indicators that are instruments yield word data that can be sorted into qualitative categories (interview guides) or number data that can be calculated as quantitative scores (questionnaires) • Empirical indicators that are experimental conditions or procedures that tell the researcher or practitioner exactly what to do; interventions.

38. Methods of Scholarly Inquiry • Some other methods of scholarly inquiry used by nursologists • Philosophic inquiry • Historical inquiry

39. Research and Theory • The function of research is to develop theory • Research findings ARE theory

40. Send your questions about the components of contemporary nursology to • jacqueline.fawcett@umb.edu

41. References • Donaldson, S. K., & Crowley, D. M. (1978). The discipline of nursing. Nursing Outlook, 26, 113-120. • Fawcett, J. (2018, December). Analysis and evaluation of conceptual models and theories of nursology and status of contemporary models and theories. Videoconference lecture for faculty and PhD program students, Universidad Autonoma de Neuvo Leon, Facultad de Enfermeria, Monterrey, Mexico. • Fawcett, J., & DeSanto-Madeya, S. (2013). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (3rd ed.). Philadelphia, PA: F. A. Davis. • Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing practice. Philadelphia, PA: F. A. Davis. • Fitzpatrick, J. J. (2014). The discipline of nursing. In J. J. Fitzpatrick & G. McCarthy (Eds.), Theories guiding nursing research and practice: Making nursing knowledge development explicit (pp. 3-13). New York:, NY Springer. • Jacobs, B. B. (2001). Respect for human dignity: A central phenomenon to philosophically unite nursing theory and practice through consilience of knowledge. Advances in Nursing Science, 24(1), 17-35.

42. References • Kim, H. S. (1987). Structuring the nursing knowledge system: A typology of four domains. Scholarly Inquiry for Nursing Practice, 1, 99–110. • Kim, H. S. (1997). Terminology in structuring and developing nursing knowledge. In I. M. King & J. Fawcett (Eds.), The language of nursing theory and metatheory (pp. 27–36). Indianapolis, IN: Sigma Theta Tau International Center Nursing Press. • Kim, H. S. (2000). The nature of theoretical thinking in nursing (2nd ed.). New York, NY: Springer. • King, I. M. (1984). Philosophy of nursing education: A national survey. Western Journal of Nursing Research, 6, 387–406. • Leininger, M. M. (1991). The theory of culture care diversity and universality. In M. M. Leininger (Ed.), Culture care diversity and universality: A theory of nursing (pp. 5–65). New York, NY: National League for Nursing. • Malloch, K., Martinez, R., Nelson, L., Predeger, B., Speakman, L., Steinbinder, A., & Tracy, J. (1992). To the editor [Letter]. Advances in Nursing Science, 15(2), vi–vii.

43. References • Meleis, A. I. (2007). Theoretical nursing: Development and progress (4th ed.). Philadelphia, PA: Lippincott Williams and Wilkins. • Moore, M. (1968). Nursing: A scientific discipline? Nursing Forum, 7, 340. • O’Toole, M. (Ed.) (2013). Mosby’s medical dictionary (9th ed.). St. Louis, MO: Mosby. • Newman, M. A. (1983). The continuing revolution: A history of nursing science. In N.L. Chaska (Ed.), The nursing profession: A time to speak (pp. 385– 393). New York: McGraw‑Hill. • Newman, M. A., Sime, A. M., & Corcoran‑Perry, S. A. (1991). The focus of the discipline of nursing. Advances in Nursing Science, 14(1), 1–6. • Parse, R. R. (1997). The language of nursing knowledge: Saying what we mean. In I.M. King & J. Fawcett (Eds.), The language of nursing theory and metatheory (pp. 73–77). Indianapolis: Sigma Theta Tau International Center Nursing Press. • Paterson, J. G. (1971). From a philosophy of clinical nursing to amethod of nursology. Nursing Research, 20, 143-146.

44. References • Plummer, M., & Molzahn, A.E. (2009). Quality of life in contemporary nursing theory. Nursing Science Quarterly, 22, 134-140. • Roper, N. (1976). A model for nursing and nursology. Journal ofAdvanced Nursing, 1, 219-227. • Thorne, S., Canam, C., Dahinten, S., Hall, W., Henderson, A., & Kirkham, S. (1998). Nursing’s metaparadigm concepts: Disimpacting the debates. Journal of Advanced Nursing, 27, 1257-1268.