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Nursing Knowledge:
Science, Practice, and Philosophy

Nursing Knowledge cover

Nursing Knowledge: Science, Practice, and Philosophy is due to be published by Wiley-Blackwell in November 2009. The work takes its point of departure from the theory-practice gap in nursing. It argues that the perceived lack of relevance of nursing research to nursing practice has philosophical origins. In other words, the theory-practice gap arises from a widely held philosophical perspective on nursing knowledge.

What is done by philosophy can be undone by philosophy. This book discusses both historical and contemporary nursing scholarship from the perspective of the philosophy of science. It argues for the importance of the nursing standpoint, a notion which is drawn from feminist standpoint epistemologies. In virtue of their role in contemporary health care, nurses have the unique potential to undersand human health. Unlocking this potential knowledge requires commitment to the values of nursing practice as well as empirical research.

Nursing science is conceived as a broad and methodologically pluralistic enterprise. Since the uniqueness of the nursing discipline is guaranteed by the nursing standpoint, nursing researchers are free to "borrow" theory and draw on other disciplines without fear of dilution. Indeed, the book argues that nursing scholarship gains strength as it links to allied inquiries into human health.

For continuing discussion of these issues and related topics in the philosophy of nursing, see my blog Nursing, Science and Philosophy.

To see descriptions of current research in the philosophy of nursing science, as well as abstracts of and links to published essays, see my nursing research page.

Table of Contents

The chapter outline is reproduced below with links to the Foreword, Preface, and Introductions to each Part. Chapter 1 is available to read on the Wiley-Blackewell website, Wiley.com. All material is subject to copyright. Comments and criticism are appreciated, but please do not cite these pre-production drafts. Hard copy will be available soon. You can pre-order from Wiley.com.

Part I: Nursing Knowledge and the Challenge of Relevance

Introduction to Part I

1. Pre-History of the Problem

The Domain of Nursing
Professionalization and the Translation Gap
Nursing Education Reform in the United States
Nursing Research Begins
A Philosophy of Nursing
What Would a Nursing Science Look Like?
Nursing Theory and Nursing Knowledge
Conclusion: The Relevance Gap Appears

2. Opening the Relevance Gap

Two Conceptions of Nursing Science
The Demise of Practice Theory
The Consensus Emerges
The Relevance Gap
Conclusion: The Relevance Gap Endures

3. Toward a Philosophy of Nursing Science

Philosophical Questions about Nursing
Science, Value, and the Nursing Standpoint
Theory, Science, and Nursing Knowledge
Conclusion: Closing the Gap

Part II: Values and the Nursing Standpoint

Introduction to Part II

4. Practice Values and the Disciplinary Knowledge Base

Dickoff and James' Practice Theory
Values and Theory Testing
Challenges to Dickoff and James' Criteria
Beckstrand's Critique
Carper?s Fact-Value Distinction
Problems with Patterns
Conclusion: Fact and Value in Nursing Knowledge

5. Models of Value-Laden Science

The Johnson Model: Nursing Values as Guides for Theory
Constitutive and Contextual Values
Constitutive Values in Science: Kuhn's Argument
Epistemic and Moral/Political Values
Models of Value-Laden Inquiry
Value-Laden Concepts in Nursing Inquiry
Conclusion: Constitutive Moral and Political Values in Nursing Inquiry

6. Standpoint Epistemology and Nursing Knowledge

Social Role and Epistemic Privilege
Feminist Appropriation of Standpoint Epistemology
Generalizing Standpoints
Knowledge and the Division of Labor in Health Care
Nursing Knowledge and Nursing Roles
Conclusion: Nursing Knowledge as an Epistemic Standpoint

7. The Nursing Standpoint

Top-Down and Bottom-Up Views of Nursing
The Philosophical Questions Revisited
Questions and Concerns
Conclusion: Science and Standpoint

Part III: Nursing Theory and the Philosophy of Science

Introduction to Part III

8. Logical Positivism and Mid-Century Philosophy of Science

Some History and Terminology
Conceptions of Theory in Nursing
Theories and Axiom Systems
Theory Structure: The Received View
Explanation and Confirmation
Conclusion: Logical Positivism and Scientific Knowledge

9. Echoes in Nursing

Did Logical Positivism Influence Nursing?
The Metaparadigm of Nursing
Levels of Theory
Borrowed Theory
Conclusion: The Relevance Gap and the Philosophy of Science

10. Rejecting the Received View

Holistic Confirmation
Failure of the Theory-Observation Distinction
Levels of Theory and Interdisciplinary Research
Conclusion: Rejecting the Received View of Nursing Science

Part IV: The Idea of a Nursing Science

Introduction to Part IV

11. Post-Nursing Theory Inquiry

Passion for Substance
Situation-Specific Theories
Post-Nursing Theory Inquiry
Research Example: Mastectomy
Research Example: Pain Management
Breakthrough Research and Situation-Specific Theory
Conclusion: ReVisioning Nursing Theory

12. The Structure of Theory

Walls and Webs
Questions and Answers
Breakthrough Research Revisited
Borrowed Theory
Conclusion: Piecing the Quilt

13. Models, Mechanisms, and Middle-Range Theory

What is Middle-Range Theory?
An Old, New Definition of Middle-Range Theory
The Semantic Conception and the Received View
Middle-Range Theories as Theoretical Models
Interlevel Models in Nursing Science
Theoretical Models and Explanatory Coherence
Holism, Reductionism, and the Nursing Standpoint
Conclusion: Causal Models and Nursing Science

Part V: Concepts and Theories

Introduction to Part V

14. Consequences of Contextualism

Concepts: Theory-Formed or Theory-Forming?
Public and Personal Concepts
The Priority of Theory
Contextualism and Realism
Concept Analysis and Borrowed Theory
Conclusion: Philosophical Foundations of Multifaceted Concepts

15. Conceptual Models and the Fate of Grand Theory

Models and Theories
The Orientation and Abstraction Pictures
Arguments Against The Abstraction Picture
Advantages of the Orientation Picture
Rereading the Early Theorists
Models of Nursing and Models for Nursing
Conceptual Models as Nursing Philosophy
Philosophical Criticism of Conceptual Models
Conclusion: Science, Practice, and Philosophy

Part VI: Paradigm, Theory, and Method

Introduction to Part VI

16. The Rise of Qualitative Research

Making Space for Qualitative Methodology: Carper, Benner, Watson
The Triangulation Problem
Two Paradigms of Nursing Inquiry
Conclusion: Method, Theory, and Paradigm

17. What is a Paradigm?

Components of a Paradigm
Incommensurability
Pulling Paradigms Apart
Against Paradigms
Conclusion: Nursing Science Without Paradigms

18. Methodological Separatism and Reconciliation

Reality and Realities
Objective and subjective
Deduction and Induction
Reductionism and Value-Freedom
The Unity of Nursing Knowledge
Reconciling Qualitative and Quantitative Research
Conclusion: Local Methodological Decision Making

Part VII: Conclusion

19. Redrawing the Map

Theory
Professional Values and Disciplinary Knowledge
Nursing Knowledge and the Relevance Gap
New Maps, New Directions

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School of Nursing Philosophy Department Emory University