Discussion: Specific Theories Philosophical Roots

Discussion: Specific Theories Philosophical Roots ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Specific Theories Philosophical Roots Please review the following article (there is an attachment). Here is it’s citation: Discussion: Specific Theories Philosophical Roots Im, E. O., & Meleis, A. I. (1999, December). Situation-specific theories: philosophical roots, properties, and approaches. Advances in Nursing Science, 22(2), 11–24. Read the article, discuss the relevance to your current research agenda/problem. . ( Treating Eating Disorders) Your identifiable problem. What is it? Your proposed nursing theorist that most identifies with your research issue. Whom did you use? Is there a direct correlation? Does the theorist support your research problem? Is there a connection to nursing practice? Does the research offer any diverse support or methodologies? How will you use the outcomes in practice? *- APA 6 th Edition, *- Please include references and intext citations if used. *- A minimum of 300 words required *- Also ,please elaborated two responses with a minimum of 150 words and reference as if it were to respond to two peers based on the above topic. attachment_1 Situation-Specific Theories: Philosophical Roots, Properties, and Approach It is imperative to further develop theoretical bases in nursing, which incorporate diversities and complexities in nursing phenomena, and which consider sociopolitical, cultural, and historic contexts of nursing encounters. Situation-specific theories are proposed in this work as a future direction of such theoretical bases in nursing. Philosophical roots and properties of situation-specific theories are discussed, and an integrative approach to developing this type of theories is suggested. Situation-specific theories could be based on the assumptions of postempiricism, critical social theory and feminism, and or hermeneutics. Six properties of situation-specific theories are presented: (1) low level of abstraction, (2) reflection of specific nursing phenomena, (3) context, (4) connection to research and/or practice, (5) incorporation of diversities, and (6) limits in generalization. The proposed integrative approach to developing situation-specific theories includes (1) a nursing perspective, (2) a linkage among theory, research, and practice, and (3) a conceptual scheme based on internal and external dialogues. Key words: approach, future direction, philosophy, property, situation-specific theories, theory development Eun-Ok Im, RN, MPH, PhD Assistant Professor Department of Health Maintenance, School of Nursing University of Wisconsin Milwaukee, Wisconsin Afaf Ibrahim Meleis, PhD, DrPS (hon), FAAN Professor Department of Community Health Systems University of California San Francisco, California T HEORIES HAVE been defined in different ways, and different levels of theories have been proposed in nursing. 1,2 Generally, theory means an organized, coherent, and systematic articulation of a set of statements related to significant questions in a discipline that are communicated in a meaningful whole to describe or explain a phenomena or a set of phenomenon.1,3 Theories have been categorized into several types in terms of their level of abstraction, goal orientation, scope of explanation, and their components.1 When theories are described in terms of their level of abstraction, they are usually categorized into grand theories and middle-range theories. Grand theories are defined as systematic constructions of the nature of nursing, the mission of nursing, and the goals of nursing care, whereas middle-range theories are defined as theories that have more limited scope and less abstraction, address specific phenomena or concepts, and reflect practice.1 The definitions and the levels of theories reflect different stages in the development of the discipline and the various stages in its Adv Nurs Sci 1999;22(2):11–24 © 1999 Aspen Publishers, Inc. 11 12 ADVANCES IN NURSING SCIENCE/DECEMBER 1999 theoretical sophistication. Early in the history of the development of the discipline, grand theories were articulated to answer questions about the nature, mission, and goals of nursing. Peplau, Henderson, Hall, Johnson, Abdella, King, Wiedenbach, and Rogers proposed coherent and well-articulated vision of the nature, goals, and boundaries of nursing care.1 These visions have been instrumental in creating theoretical debates and in helping to develop the theoretical foundations of nursing knowledge. These theories focused the discussions among nurse scholars on defining and developing central concepts in nursing, on connecting theory to practice, on developing theory-based research, and on the dialectical relationship between theory, research, and practice. Progress in theoretical thinking was initiated by these theories. From the end of 1960s, metatheorists such as Ellis,4 Walker,5 Jacox,6 Fawcett,51 Duffey and Muhlenkamp,7 Hardy,8 and Chinn9 addressed metatheoretical concerns that focused on types of theories and content of theories. The debates were more on the form rather than the substance of nursing. Dialogues and discussions included what is meant by theory, what are the major components of theory, and ways to analyze and critique theories.4–8 Then, from the middle of the 1980s, there was an increase in writing related to concept development, which is about more practiceoriented, integrative, and substance-related questions.9–11 Furthermore, from the beginning of the 1990s, there was a considerable progress in theory development in nursing manifested by the development of numerous middle-range theories. 12–14 Middlerange theories have provided a conceptual focus and a mental image that reflect the discipline’s domain, but they did not provide the much-needed guidelines that may connect theory to research and practice.15 Theory, research, and practice continue to be somewhat disconnected. There might be several reasons for the seeming disconnection among theory, research, and practice. One of the reasons could be the tension between theoretical vision and clinical wisdom.16 Although proponents of theoretical vision emphasize the importance of theories as a framework for practice, proponents of clinical wisdom as the framework for practice argue that clinical work is based on the experiences of the clinicians and the wisdom they develop from their daily practice.17,18 The clinical wisdom advocates remind us that the humanity of the nursing encounters cannot be well articulated theoretically.19 However, there are arguments that nurses tend to focus on empirical phenomenon such as blood pressure, pulse, blood test results, and X-rays in their clinical settings, and they at times may not have the time to deal with contextual factors that may be influencing their clients’ health. Even the nature of nursing phenomenon may be conceptualized differently by those who advocate for theoretical wisdom and by those who advocate for practical wisdom.19,20 Furthermore, as Roy21 asserted, the nature of knowledge for nursing practice can emerge from examining how the philosophical basis and the derived practice theories address such issues as the phenomena of the discipline, environment, teleology, and nursing theoretical frameworks. Without ways by which the humanity in nursing encounters can be articulated and conveyed, the connection among theory, research, and practice may continue to be elu- Situation-Specific Theories sive.1,16 Phenomena related to patient care are becoming more complex, and are complicated by multiple factors, including increased patient diversity.22 Nurses are working more and more with culturally diverse groups, and an important goal for our discipline becomes to develop knowledge that reflects the nature and the consequences of diversities on responses to health and illness.22,23 Nursing scholars22,23 assert that theoretical development must take into consideration the diversity of nursing philosophies as well as the diverse populations served by nurses. However, traditional approaches to knowledge development that depend on the assumptions of homogeneity, normality, and statistical reliability rather than coherent reflections of diverse human experiences have limitations in generating competent models of care.24 Without incorporating the diversities, complexities, and contextual complexities, theoretical foundations of nursing discipline cannot achieve the connections for which its members have been striving.22 How, then, can we connect theory, research, and practice while incorporating the diversity, complexity, and context? Perhaps the answer is not in grand theories, middle range theories, or concept development. Grand theories and middle-range theories rarely incorporate the diversities in nursing phenomenon, and have limitations in describing, explaining, and providing understanding of the diversities in clients’ experiences and responses to specific phenomenon. The theories also do not consider the diverse ways that nurses may interpret these phenomena. They also have limitations in guiding nursing care for the increasing diverse clients in health care systems. Middle-range theories also tend to assume a wide range of general- 13 ization and universalization; although far less so than grand theories.12,24,25 However, this generalization may be incongruent with the nature of a human science. Furthermore, grand theories and middle range theories rarely consider sociopolitical, cultural, and/or historic contexts inherent in each client-nurse encounter.12,24,25 For example, Orem’s self care theory, when to guide nursing practice with Korean patients, may not allow an understanding of this population’s assumptions and cultural attitude toward the relinquishment of self care responsibilities to the extended family care. In their traditional culture, patients expect to and are entitled to be cared for by their caregivers, and they do not expect to be their own self-care agencies. 26,27 Consequently, although self care theory provides useful and productive guidelines for nursing practice in general, it does not provide adequate guidelines for phenomenon within diverse contexts and situations, and it limits the consideration of patients and their dynamic historic and sociocultural context. Therefore, the question is: Are other types of theories to develop that may overcome the limitations inherent in the nature of grand and middle-range theories? Meleis and Meleis and Im1,22,28 defined situation-specific theories as theories that focus on specific nursing phenomena that reflect clinical practice and that are limited to specific populations or to particular fields of practice. Situation-specific theories are put in social and historical context and they are not developed to transcend time, a socially constraining structure, or a politically limiting situation.1,10,22,28 They are theories that are more clinically specific, that reflect a particular context, and that may include blueprints for action.1,10,22,28 We propose 14 ADVANCES IN NURSING SCIENCE/DECEMBER 1999 that situation-specific theories could be the discipline of nursing. Situation-specific theories can incorporate diversities and complexities of nursing phenomena, and emphasize contextual factors surrounding nursing. Situation-specific theories may provide integrative frameworks and or guidelines for nursing practice and research. The purpose of this article is to argue that situation-specific theories are more congruent with the future goals of our discipline. It is also to clarify what philosophical base situation-specific theories have, what their properties are, and how to develop them. PHILOSOPHICAL ROOTS OF SITUATION-SPECIFIC THEORIES Philosophical bases of the substance and the syntax of nursing knowledge have been debated by many nursing scholars.23,29–32 There are debates on the relationship among philosophies, theories, research, and practice.32–34 The debates can be roughly categorized into three positions:34 (1) the purist bona-fide position that philosophical viewpoints should guide and direct theory development, research strategy, and clinical practice; (2) the nonpurist position about philosophical, theoretical, and methodological pluralism; and (3) the radical separationist position, which argues that a discipline’s theory and research are distinct entities and do not necessarily have to be congruent philosophically and methodologically. We assume the need for philosophical, theoretical, and methodological plurality, and we further assert that such pluralism is more congruent with the nature and goals of nursing and those of situation-specific theories. Three major philosophical roots that could drive the development of situationspecific theories might be (1) postempiricism, (2) critical social theory and feminism, and (3) hermeneutics. Each of these could provide the assumptions and the framework for situation-specific theories. Postempiricism One of the philosophical roots compatible with situation-specific theories is postempiricism. Until recently, empiricism has been equated with positivism, especially logical positivism and the Vienna Circle,34 and the equation brought hot criticisms about empiricism. Consequently, nursing scholars tend to abandon the traditional realist approach to the care of patients, and nursing theory is currently beset by the problems of scientific and moral relativism and philosophical incoherence.35 Contemporary empiricist views—so called postempiricism— are somewhat different from positivism, especially logical positivism. A contemporary empiricist view continues belief in observables and in careful scientific strategies that bear results that can be corroborated if not confirmed.36 Yet, no common pattern is rigidly viewed as having relevance for every individual or situation, and no universal laws governing all of health are believed to exist by contemporary empiricists. Rather, the empiricists assume that reasonable predictions are possible and that these predictions can provide nurses with estimates of expected human responses under certain conditions of health and illness as well as how nursing care may serve to influence these responses in beneficial ways. Empiricists are concerned with complex phenomenon, some of which can be reduced and partitioned for study and some of which Situation-Specific Theories cannot.34 Some of extant theory is used generally, but generative theory is not ruled out. The empiricists believe that the phenomena under study can be modeled or “objectified.”36 Furthermore, contemporary empiricism is regarded as having the capacity for explanation that is so necessary for clinical practice because it provides the linkage between the observables such as vital signs and laboratory findings and the unobservables, and between those normal and abnormal physiologic and psychological processes, which suggest causal factors and subsequent treatment.34 Situation-specific theories can be developed using the assumptions and the methodology of contemporary empiricism because they aim at modeling the linkages between the observables and the unobservables, and between those normal and abnormal processes influencing human beings’ responses toward health and illness, especially a particular group of people in a specific situation. Furthermore, the theories have a goal of predicting experiences and responses of a particular group of human beings under certain conditions of health and illness. Critical social theory and feminism Another main philosophical root could be critical social theory and feminism. Critical social theory and feminism provide the rationale for respecting diversities and sociopolitical and historical contexts of situationspecific theories. Feminist assumptions, goals, and values, as well as critical theories that emphasize the consideration of values imbedded in societies, challenge scientists and scholars in a number of fields who subscribed to traditional epistemology.29,31,37 Feminists and critical theorists emphasize the subjective and social construction of re- 15 ality; sociopolitical and economic influences on science; and the prevalence of racism, classism, and sexism in scientific and social activities in many fields, including nursing. 1,29,37 Critical theory holds that all research and theory are sociopolitical constructions, that human societies are inherently oppressive, and that all interpretations including mythical, religious, scientific, practical, and political interpretations are open to criticism.37,38 Critical theorists believe that all theories reflect underlying ideologies, and critical theory provides a multidimensional lens for scholarship. However, the critical theory lacks modeling.1,37 Critical theory disagrees with classical social and economic theories, which consequently limits its empirical application. Thus, it is difficult to say that situation-specific theory is based on critical theory, but it would be true that critical theory tremendously influences its philosophical roots because situation-specific theories emphasize sociopolitical and historic contexts surrounding a phenomenon. The use of liberal, cultural, and radical feminist thoughts in nursing theory and research is increasing. It is particularly meaningful for nursing as a predominantly female profession.39,40 Indeed, feminist thought has had tremendous influence on theoretical debates in nursing discipline, and has provided an important perspective on nursing phenomenon. Despite diverse perspectives within feminism, all feminists share the view that it is important to center on problems that reflect the diversity of women’s situations.39–42 Feminism emphasizes the world of women in a male-dominated society, and shares with hermeneutics the belief in lived experience and history as the basis of knowing, generating, and using lan- 16 ADVANCES IN NURSING SCIENCE/DECEMBER 1999 Feminist thought has had tremendous influence on theoretical debates in nursing discipline, and has provided an important perspective on nursing phenomenon. guage for documentation and analyses.34 In this regard, situation-specific theories are congruent with feminist thinking and assumptions. Hermeneutics A third philosophical root could be hermeneutics. Hermeneutics can influence the development of situation-specific theories through emphasizing historical consciousness and the value of humanistic and historical knowledge in understanding human existence. Hermeneutics appreciate the human state or essence as supreme; emphasize the interactive circle—“hermeneutic circle”—between patient and nurse or subject and scientist; share meanings and embedded meaning, and self reflection; and regard understanding as the basis of knowing.34,43 However, because hermeneutic philosophers negate objectifying the human state or negate the modeling of the human state except the objective, validation hermeneutics it may be difficult to justify the development of a situation-specific theory with hermeneutics. Nursing theories increasingly address biology, behavior, and culture, and they depict associations among factors and suggest explanatory variables for human health and illness. Therefore, they require reduction, objectification, and specification of relationships between the variables. These goals may not be accom- modated by a hermeneutic or phenomenologic perspective.34,43 PROPERTIES OF SITUATIONSPECIFIC THEORIES Situation-specific theories may emerge from synthesizing and integrating research findings and clinical exemplars about a specific situation or population with the intent of developing a framework or blueprint to understand the particular situation of a group of clients. Even though researchers or authors may not have identified models and/or theories that they developed through research and/or practice as situation-specific theories, there are some examples of socalled situation-specific theories. When compared with grand theories and middlerange theories, situation-specific theories can be characterized by (1) a lower level of abstraction, (2) reflection of specific nursing phenomenon, (3) context, (4) readily accessible connection to nursing research and practice, (5) reflection of diversities in nursing phenomena, and (6) limitation of generalization. A comparison of the properties of grand theories, middle-range theories, and situation-specific theories is provided in Table 1. Some examples of each type of theories are also presented in Table 1. Low level of abstraction Changes in theory development from grand theories to middle-range theories may be considered significant milestones marking a considerable progress in nursing knowledge development.1,12 Because nursing phenomena require a focus on specific phenomena that reflect and emerge from nursing practice and clinical process, there was an increasing need for a shift from Situation-Specific Theories 17 Table 1. Properties and examples of grand, middle-range, and situation-specific theories Properties … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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