PHILOSOPHICAL-THEORETICAL FOUNDATIONS IN NURSING

Nursing philosophy

"a statement of foundational and universal assumptions, beliefs and principles about the nature of knowledge and thought (epistemology) and about the nature of the entities represented in the metaparadigm (i.e., nursing practice and human health processes [ontology])."

Nursing epistemology

"the study of the origins of nursing knowledge, its structure and methods, the patterns of knowing of its members, and the criteria for validating its knowledge claims"

Ethics (moral component of nursing)

- refers to the moral code for nursing and is based on obligation to service and respect for human life - occurs as moral dilemmas arise in situations of ambiguity and uncertainty and when consequences are difficult to predict - requires rational and deliberate examination and evaluation of what is good, valuable, and desirable as goals, motives, or characteristics - must address conflicting norms, interests, and principles and provide insight into areas that cannot be tested

Personal knowledge (therapeutic use of self)

- refers to the way in which nurses view themselves and the client - subjective and promotes wholeness and integrity in personal encounters - incorporates experience, knowing, encountering, and actualizing the self within the practice - largely expressed in personality

Esthetic knowledge (art of nursing)

-expressive, subjective, unique, and experiential rather than formal or descriptive. -includes sensing the meaning of a moment. It is evident through actions, conduct, attitudes, and interactions of the nurse in response to another. It is not expressed in language. -relies on perception.

Empiricism

-holds that truth corresponds to observable, reduction, verification, control, and bias-free science. It emphasizes mathematic formulas to explain phenomena and prefers simple dichotomies and classification of concepts. Additionally, everything can be reduced to a scientific formula with little room for interpretation.

Empirical knowledge (science of nursing)

-objective, abstract, generally quantifiable, exemplary, discursively formulated, and verifiable -draws on traditional ideas that can be verified through observation and proved by hypothesis testing -tends to be the most emphasized way of knowing in nursing because there is a need to know how knowledge can be organized into laws and theories for the purpose of describing, explaining, and predicting phenomena of concern to nurses

emancipatory knowing

-refers to human's ability to critically examine the current status quo and to determine why it currently exists -expressed in actions that are directed toward changing existing social structures and establishing practices that are more equitable and favorable to human health and well-being

Logical positivism

-was the dominant empirical philosophy of science between the 1880s and 1950s. -recognized only the logical and empirical bases of science and stressed that there is no room for metaphysics, understanding, or meaning within the realm of science. - maintained that science is value free, independent of the scientist, and obtained using objective methods. The goal of science is to explain, predict, and control. Theories are either true or false, subject to empirical observation, and capable of being reduced to existing scientific theories.

Philosophy of Religion Theology

? is concerned with the study of God, recommending the best religious practises, how our religion should shape our life, and so on. ? is concerned with much the same issues, but where ? uses religious works, like the Bible, as its authority, philosophy likes to use reason as the ultimate authority.

Phenomenology appearance of things understanding experience, values, and perspective each individual's experience is unique many interpretations of reality Perceptions, feelings, values, and the meanings that have come to be attached to things

? is the study of phenomena and emphasizes the ?as opposed to the things themselves. In (lol), ? is the goal of science, with the objective of recognizing the connection between one's ?. It maintains that ?, and there are many interpretations of reality?. Inquiry begins with individuals and their experiences with phenomena. ? and events are the focus.

"a branch of knowledge ordered through the theories and methods evolving from more than one world view of the phenomenon of concern."

A discipline is

Systematic Exploration formulation of hypothesis collection of facts analysis of facts (classification, coding and tabulation) scientific generalisation predication

A scientific research adopts a certain sequential procedure, an organised plan or design of research for collecting and analysis of facts about the problem under study. Generally, this plan includes a few scientific steps—?, ?, ? and ? and ?.

Streubert and Carpenter

According to (2) (2011), it is important to understand the way in which nursing knowledge develops to provide a context in which to judge the appropriateness of nursing knowledge and methods that nurses use to develop that knowledge.

Philosophy of Law Jurisprudence

Also called ?. Study of law attempting to discern what the best laws might be, how laws came into being in the first place, attempting to delimit human laws from natural laws, whether we should always obey the law, and so on. Law isn't often directly dealt with by philosophers, but much of political philosophy obviously has a bearing on it.

Philosophy of Language Plato's Cratylus Locke's Essay Wittgenstein's Tractatus Logico-Philosophicus.

Ancient branch of philosophy which gained prominence in the last century under Wittgenstein. Basically concerned with how our languages affect our thought. Wittgenstein famously asserted that the limits of our languages mark the limits of our thought. Classic works include [3]

ontology, epistemology, and methodology

Approaches to knowledge development have three facets

Practice or applied sciences

Architecture, engineering, medicine, pharmacology, law

An identifiable philosophy At least one conceptual framework (perspective) for delineation of what can be defined as nursing Acceptable methodologic approaches for the pursuit and development of knowledge.

Areas that identify nursing as a distinct discipline are as follows: (3)

Epistemology Metaphysics Logic Ethics Aesthetics (Philosophy of ) Education History Language Law Mathematics Mind Politics Religion Science

Branches of Philosophy [14]

(1) empirics the science of nursing, (2) esthetics the art of nursing, (3) personal knowledge in nursing, and (4) ethics moral knowledge in nursing.

Carper (1978) identified four fundamental patterns for nursing knowledge:

Defined and specialized knowledge base Control and authority over training and education, Credentialing system or registration to ensure competence Altruistic service to society Code of ethics Formal training within institutions of higher education Lengthy socialization to the profession, and Autonomy (control of professional activities)

Characteristic of a profession include (8)

Natural Sciences

Chemistry, physics, biology, physiology geometry, meteorology

Natural Basic or Pure Human or social Practice or applied

Classifications of Science [4]

Philosophy of Politics Plato's Republic Hobbes' Leviathan Locke's Two Treatises J.S. Mill's On Liberty

Closely related to ethics, this is a study of government and nations, particularly how they came about, what makes good governments, what obligations citizens have towards their government, and so on. Classic works include ?, ?, ?, and ?.

Philosophy of Mathematics Principia Mathematica

Concerned with issues such as, the nature of the axioms and symbols (numbers, triangle, operands) of mathematics that we use to understand the world, do perfect mathematical forms exist in the real world, and so on. ? is almost certainly the most important work in this field.

error nobody can ever be wrong about anything

Criticisms of postmodernism have been made and frequently relate to the perceived reluctance to address ? in research. Taken to the extreme as Paley (2005) pointed out, when there is absence of strict control over methodology and interpretation of research, "?" Chinn and Kramer (2011) echoed the concerns by acknowledging that knowledge development should never be "sloppy." Indeed, although application of various methods in research is legitimate and may be advantageous, research must still be carried out carefully and rigorously.

observation, testing, and replication

Empirical knowledge comes from

Francis Bacon John Locke David Hume observation perception by senses experience as sources of knowledge

Empiricism has its roots in the writings of ?, ?, and ?, who valued , ?, and ?

morality moral philosophy

Ethics is a general term for what is often described as the "science (study) of ?". In philosophy, ethical behaviour is that which is "good" or "right". The Western tradition of ethics is sometimes called ?.

constructivist the investigation of the individual's world subjectivity, multiple truths, trends and patterns, discovery, description, and understanding Feminism and critical social theory reality is dynamic social, political, cultural, economic, ethnic, and gender values.

For social scientists, the ? approaches of the perceived view focus on understanding the actions of, and meaning to, individuals. What exists depends on what individuals perceive to exist. Knowledge is subjective and created by individuals. Thus, research methodology entails ?. There is an emphasis on ? [6]. ? may also be considered to be perceived view. These philosophical schools of thought recognize the influence of gender, culture, society, and shared history as being essential components of science. Critical social theorists contend that ? and shaped by ? [6]

scientists hope to create new knowledge to provide understanding and interpretation of phenomena

In human sciences,

rationalism, empiricism, human science/phenomenology

In the period of modern science, three philosophies of science (paradigms or worldviews) dominate

Conceptual knowledge

It incorporates curiosity, imagination, persistence, and commitment in the accumulation of facts and reliable generalizations that pertain to the discipline of nursing.

Philosophy of Science Hume's Treatise on Human Nature Kripke's Naming and Necessity Kuhn's Structure of Scientific Revolutions

It is the Study of science concerned with whether scientific knowledge can be said to be certain, how we obtain it, can science really explain everything, does causation really exist, can every event in the universe be described in terms of physics and so on. Also popular in recent times, classic works include ?, ?, ?.

Ethical Neutrality

It only seeks knowledge. How this knowledge is to be used, is determined by societal values. It here only means that he must not allow his values to distort the design and conduct of his research.

Encourage the use of different types of knowledge in practice, education, theory development, and research Encourage the use of different methodologies in practice and research Make nursing education more relevant for nurses with different educational backgrounds Accommodate nurses at different levels of clinical competence Ultimately promote high-quality client care and client satisfaction.

Kidd and Morrison (1988) state that in nursing, synthesis of theories derived from different sources of knowledge will:

reductionism empirical validation hypothesis testing

Kidd and Morrison (1988) state that in their haste to prove the credibility of nursing as a profession, nursing scholars have emphasized ? and ? through quantitative methodologies, emphasizing ?.

deconstruction postcolonialism feminist philosophies feminism and critical theory

Knowledge development moves from emphasis on identifying a truth or fact in research to discovering practical significance and relevance of research findings. Similar or related constructs and worldviews found in the nursing literature include "?," "?," and at times, ?. In nursing, the postcolonial worldview can be connected to both ?, particularly when considering nursing's historical reliance on medicine.

logos what is spoken thought or reason arguments correct reasoning to advance an account of valid and fallacious inference to allow one to distinguish

Logic (from Classical Greek λόγος (?), originally meaning the word, or ?, but coming to mean ?) is most often said to be the study of ?. Logic is the study of ?. However, the subject is grounded, the task of the logician is the same: ?.

Basic or pure sciences

Mathematics, logic, chemistry, physic, English (language)

initiate life-saving measures, improve and promote the health and well-being of the planet, and ease pain, suffering, and loss.

Nurses use their specialized knowledge, experience, and skill set to (3)

understand truth to describe nursing to examine prediction and causality to critically relate theories, models, and scientific system to explore determinism and free will.

Philosophy of science in nursing seeks to (4)

1960s positivistic logic strictly controlled experimentation in artificial settings over fragmentation in knowledge and theory development analysing the logically ideal artificial discovery contexts scientific inquiry explanation and prediction of complex phenomena contextual variables

Positivism came under criticism in the ? when ? was deemed faulty. An overreliance on ?. Produced results that indicated that much significant knowledge or information was missed. In recent years, scholars have determined that the positivist view of science is outdated and misleading in that it contributes to ?. It has been observed that positivistic analysis of theories is fundamentally defective due to insistence on ?, which results in findings that have little to do with reality. It was maintained that the context of discovery was ? and that theories and explanations can be understood only within their ?. Also, ? is inherently value laden, as even choosing what to investigate and/or what techniques to employ will reflect the values of the researcher. The current generation of postpositivists accept the subjective nature of inquiry but still support rigor and objective study through quantitative research methods. Indeed, it has been observed that modern empiricists or postpositivists are concerned with ? , recognizing ?.

multiple methods for development of scientific understanding synthesis of both research methods

Postmodernism has loosened the notions of what counts as knowledge development that have persisted among supporters of qualitative and quantitative research methods. Rather than focusing on a single research methodology, postmodernism promotes use of ? and incorporation of different ways to improve understanding of human nature. Increasingly, in postmodernism, there is a consensus that ? can be used at different times to serve different purposes.

Predictability

Predictions can be made about the subject and can be tested

Human or social sciences

Psychology, anthropology, sociology, economics, political science, history, religion

received view

Rationalism and empiricism are often termed

clinical, conceptual, and empirical

Schultz and Meleis (1988) three patterns of knowledge in nursing:

Abstractness

Science is not interested in giving a realistic picture.

Verifiability

Science rests upon sense data, i.e., data gathered through our senses—eye, ear, nose, tongue and touch. Scientific knowledge is based on verifiable evidence (concrete factual observations) so that other observers can observe, weigh or measure the same phenomena and check out observation for accuracy.

6 5-3 2-0

Science-has all ?characteristics. Pseudoscience-has ? of the characteristics. Nonscience-has ? of the characteristics.

Reliability

Scientific knowledge must occur under the prescribed circumstances not once but repeatedly. It is reproducible under the circumstances stated anywhere and anytime. Conclusions based on casual recollec¬tions are not very reliable.

Tentativeness

Scientific theories are subject to change because of technology

Predictability

Scientists do not merely describe the phenomena being studied, but also attempt to explain and predict as well. It is typical of social sciences that they have a far lower predictability compared to natural sciences. The most obvious reasons are the complexity of the subject matter and inadequacy at control etc.

Consistency

Several scientists can repeat an experiment and the results are the same.

Consistency Observability Natural Predictability Testability Tentativeness

Six Characteristics of Science

Philosophy of Mind Plato's Republic Wittgenstein's Philosophical Investigations

Study of the mind, attempting to ascertain exactly what the mind is, how it interacts with our body, do other minds exist, how does it work, and so on. Probably the most popular branch of philosophy right now, it has expanded to include issues of AI. Classic works include ? and ?, although every major philosopher has had some opinion at least on what the mind is and how it works.

Testability

Subject can be tested using a controlled experiment

perceived view of science interpretive view phenomenology constructivism historicism the pursuit of knowledge and truth is naturally historical, contextual, and value laden no single truth if it withstands practical tests of utility and reason

The ?, which may also be referred to as the ?, Includes ?, ?, and ?. The (lol) recognizes that the perceptions of both the subject being studied and the researcher tend to de-emphasize reliance on strict control and experimentation in laboratory settings The (lol) centers on descriptions that are derived from collectively lived experiences, interrelatedness, human interpretation, and learned reality, as opposed to artificially invented (i.e., laboratory-based) reality. It is argued that ?. Thus, there is ?. Rather, knowledge is deemed true ?.

attainment of knowledge

The goal of basic science is the

represent the nature of nursing—(to understand it, to explain it, and to use it for the benefit of humankind.)

The goal of nursing science is to

Objectivity Verifiability Ethical Neutrality Systematic Exploration Reliability Precision Accuracy Abstractness Predictability

The nine main characteristics of science are as follows:

produce descriptions and interpretations to help understand the nature of human experience

The purpose of research in human science is to

Observability

The results or subject of an experiment can be observed by using the five senses or extensions of them

observation, verifiability, experience

The scientific approach to understanding reality is characterized by (3)

nursing philosophy, nursing science, philosophy of science in nursing

The terms [3] are sometimes used interchangeably. The differences, however, in the general meaning of these concepts are important to recognize.

social sciences

The tradition of using qualitative methods to study human phenomena is grounded in the

improve nursing practice

The ultimate purpose of knowledge development is to

truth or knowledge

Traditionally, only what stands the test of repeated measures constitutes ?

Empirics Personal knowledge Intuitive knowledge Somatic knowledge Metaphysical (spiritual) knowledge Esthetics Moral or ethical knowledge

Ways of Knowing (7)

knowledge episteme logos nature, origin, scope and possibility of knowledge objective attack and defend

[Epistemology] The theory of ?, from the Greek words ?(knowledge) and ?(word/speech), is the branch of philosophy that deals with the ?. Dealing with nature, is one of the branches of philosophy. But before anything is done, the meaning of philosophy should be understood. A philosopher of religion must be ?. Anyone who is ready to study philosophy should be able to ?. It is not attacking other religions and defending his own.

meta & physika after physics Aristotle First Philosophy first principles being ontology most general aspects of reality, pertaining to subjects such as substance, identity, the nature of the mind, and free will nature and the nature of the world in which humans live

[Metaphysics] Metaphysics however (derived from the Greek words " ? ") - meaning '?'. It was the way students referred to a specific book in the works of ?, and it was a book on ?. (The assumption that the word means "beyond physics" is misleading) Metaphysics is the branch of philosophy concerned with the study of "?" and "?" (?). In other words, Metaphysics is the study of the ?. In other words it is a study of ?.

Plato's Republic Locke's Thoughts Concerning Education Rousseau's Emile

[Philosophy of Education] Classic works include [3]

Vico's New Science Hegel and Marx's works

[Philosophy of History] Classic works include [2-ish]

Accuracy

[correctness] A physician, like a common man, will not say that the patient has slight temperature or having very high temperature but after measuring with the help of thermometer, he will pronounce that the patient is having 101.2 F temperature. simply means truth or correctness of a statement or describing things in exact words as they are without jumping to unwarranted conclusions

Precision

[presentation] It is not vague like some literary writing. Tennyson wrote, "Every moment dies a man; every moment one is born", is good literature but not science. To be a good science, it should be written as: "In India, according to the 2001 census, every 10th second, on the average, dies a man; every 4th second, on the average, an infant is born." Precision requires giving exact number or measurement. Instead of saying "most of the people are against love marriages," a scientific researcher says, "Ninety per cent people are against love marriages".

Profession

a learned vocation or occupation that has a status of superiority and precedence within a division of work

Conceptual knowledge

abstracted and generalized beyond personal experience

basic science

analytical and the ultimate function is to analyze a conclusion backward to its proper principles

Personal maturity and freedom

are components of personal knowledge

hypothesis testing experimentation

are considered scientific methods (2)

Disciplines

are distinctions between bodies of knowledge found in academic settings.

concepts

are drafted and relational statements are formulated

Instrumentation, reliability, and validity

are stressed in empirical research methodologies

Postmodernism

began in Europe in the 1960s as a social movement centered on a philosophy that rejects the notion of a single "truth." Although it recognizes the value of science and scientific methods, ? allows for multiple meanings of reality and multiple ways of knowing and interpreting reality. In ? , knowledge is viewed as uncertain, contextual, and relative.

Aesthetics critical analysis and reflection

branch of philosophy that explores the creation and appreciation of beauty through critical analysis and reflection

received view or received knowledge

denotes that individuals learn by being told or receiving knowledge

praxis of nursing

emancipatory knowing "—what they designate as the

Empirical knowledge

evaluated through systematic review and critique of published research and conference presentations

Intuition introspection reasoning

examples of philosophical methodologies.

Conceptual knowledge

explicates patterns revealed in multiple client experiences, which occur in multiple situations, and articulates them as models or theories

qualitative research

findings answer questions centered on social experience and give meaning to human life.

Empiricism

focuses on understanding the parts of the whole in an attempt to understand the whole. It strives to explain nature through testing of hypotheses and development of theories. Theories are made to describe, explain, and predict phenomena in nature and to provide understanding of relationships between phenomena.

nursing science

gives direction to the future generation of substantive nursing knowledge, and it is this that provides the knowledge for all aspects of nursing.

Empiricism

has its roots in the writings of Francis Bacon, John Locke, and David Hume, who valued observation, perception by senses, and experience as sources of knowledge -founded on the belief that what is experienced is what exists, and its knowledge base requires that these experiences be verified through scientific methodology -This knowledge is then passed on to others in the discipline and subsequently built on.

Philosophy of science in nursing

helps to establish the meaning of science through an understanding and examination of nursing concepts, theories, laws, and aims as they relate to nursing practice.

perceived view

human science/phenomenology and related worldviews (i.e., historicism) are considered

Intuitive knowledge

includes feelings and hunches is not guessing but relies on nonconscious pattern recognition and experience

emancipatory knowing

inn and Kramer (2011) also expanded on Carper's patterns of knowing to include

basic research

investigator is interested in understanding the problem and produces knowledge for knowledge's sake

Ethics

is a general term for what is often described as the "science (study) of morality".

Occupation

is a job or a career

Science

is concerned with causality (cause and effect)

Philosophy

is concerned with the purpose of human life, the nature of being and reality, and the theory and limits of knowledge

Somatic knowledge

knowledge of the body in relation to physical movement includes experiential use of muscles and balance to perform a physical task.

Moral or ethical knowledge

knowledge of what is right and wrong

Esthetics

knowledge related to beauty, harmony, and expression. ?knowledge incorporates art, creativity, and values

human sciences

knowledge takes the form of descriptive theories regarding the structures, processes, relationships, and traditions that underlie psychological, social, and cultural aspects of reality.

Philosophy of Education

mainly concerned with what is the correct way to educate a person

Clinical knowledge

manifested in the acts of practicing nurses and results from combining personal knowledge and empirical knowledge

Clinical knowledge

may also involve intuitive and subjective knowing communicated retrospectively through publication in journals

Most would agree then that nursing is increasingly recognized as a

multiparadigm discipline

Natural (cause)

must be used to explain why or how the naturally occurring result or experimental subject happens. Supernatural can't be used

Positivism

often equated with empiricism. Like empiricism, positivism supports mechanistic, reductionist principles, where the complex can be best understood in terms of its basic components.

applied science

one that uses the knowledge of basic sciences for some practical end

Personal knowledge

pertains to knowledge gained from thought alone.

Philosophy of History

philosophical study of history, particularly concerned with the question whether history (i.e. the universe and/or humankind) is progressing towards a specific end?

Nursing philosophy

refers to the belief system or worldview of the profession and provides perspectives for practice, scholarship, and research.

Clinical knowledge

refers to the individual nurse's personal knowledge

Ontology

refers to the study of being: what is or what exists

Epistemology

refers to the study of knowledge or ways of knowing

practice sciences

research is largely clinical and action oriented

Empirical knowledge

results from experimental, historical, or phenomenologic research and is used to justify actions and procedures in practice

Clinical knowledge

results from using multiple ways of knowing while solving problems during client care provision

Metaphysical (spiritual) knowledge

seeking the presence of a higher power. Aspects of spiritual knowing include magic, miracles, psychokinesis, extrasensory perception, and near-death experiences.

Objectivity

simple means the ability to see and accept facts as they are, not as one might wish them to be.

Fawcett, Watson, Neuman, Walkers, and Fitzpatrick

stress that integration of all patterns of knowing is essential for professional nursing practice and that no one pattern should be used in isolation from others.

human science

study human life by valuing the lived experience of persons and seek to understand life in its matrix of patterns of meaning and values.

Propositional statements

supported by empirical or anecdotal evidence or defended by logical reasoning

Intuition

the ability to understand something immediately, without the need for conscious reasoning

introspection

the examination or observation of one's own mental and emotional processes

applied research

the investigator works toward solving problems and producing solutions for the problem

Methodology

the means of acquiring knowledge

Empirics

the scientific form of knowing.

Logic

the study of correct reasoning

Metaphysics

the study of the most general aspects of reality, pertaining to subjects such as substance, identity, the nature of the mind, and free will

nursing science

the substantive, discipline-specific knowledge that focuses on the human-universe-health process articulated in the nursing frameworks and theories"

Wilhelm Dilthey

the term human science is traced to philosopher

Epistemology

theory of knowledge