Despair: a unitary appreciative inquiry

The World of Women's Despair: An Unfolding Unitary Conceptual Journey

In looking back over 3 decades since the development of his interest in developing a unitary conceptualization of despair, nurse scholar W. Richard Cowling, III, had new insights and revelations. The purpose of this dialogue article is to re-envision this journey as one of unfolding, seen with the gift of new eyes. Revisiting this journey allowed him to understand and appreciate it anew. Horizons of possibilities of this conceptual journey are explained in terms of conceptual-theoretical development, inquiry, and the advancement of discipline-specific knowledge, and improving the lives of women in despair. It is his sincere hope, as with all meaningful scholarly endeavors, that a wider discourse occurs with the persistent inclusion of women's voices and experiences.

Identifying Holistic Nursing Research Priorities for 2023-2026

The primary goal of holistic nursing research is to develop and expand the knowledge base of holism and healing for nursing praxis. This article provides an overview of the process used to identify the research priorities for holistic nursing research over the next 3 to 5 years. A mixed method design using Appreciative Inquiry and surveys revealed five research priorities and the holistic philosophical foundation for these priorities. Additionally, new challenges in the environment, person, health, and nursing will undoubtedly emerge, requiring nurses to discern the research needs beyond 2026. This work seeks to inspire holistic nurses to consider research related to the American Holistic Nurses Association's five key research priorities.

Unitary Appreciative Nursing Praxis

The purposes of this article encompass describing the development of unitary appreciative nursing praxis since the conception of a unitary pattern-based nursing practice over 30 years ago; explicating unitary appreciative nursing praxis in its current state; and clarifying the elements and dimensions of a unitary appreciative nursing praxis model. The body of this work is linked to a greater call for nursing care that transcends the fragmentation and medicalization of the human experience and advocates for nursing that liberates rather than manipulates those who are most vulnerable. Further exploration of praxiological knowing and refinement in conceptual-theoretical development is advocated.

A Unitary Healing Praxis Model for Women in Despair

The evolution of a unitary healing praxis model derived from three unitary appreciative inquiries of despair is described. Explication of unitary appreciative inquiry and how it informed and contributed to the development of the model is provided. The model is based on a conceptualization of healing as appreciating the inherent wholeness of life and provides knowledge specific to the individual lives of women in despair. The process of generative theorizing that led to the creation of the model is explicated. Unitary, appreciative, and participatory responses to despair are integrated in the model, praxis modalities are delineated, key concerns and perspectives of women in despair are addressed, and potentialities for healing are illustrated.

Moving Beyond Dwelling in Suffering

The authors present an explanation of the development of a situation-specific theory of men’s healing from maltreatment during childhood. Development of the theory was guided by Rogers’ science of unitary human beings (SUHB). The four multidimensional concepts of the theory are interpreted within the context of the SUHB from themes discovered from the findings of a hermeneutic phenomenological study of men who had been exposed to childhood maltreatment, including neglect and abuse. The concepts are: moving beyond suffering, desiring release from suffering, dwelling in suffering, and experiencing wellbeing. Moving beyond suffering is the process of healing from childhood maltreatment. Desiring release from suffering is the facilitator of men’s life experiences that speeds up the rate of evolution from moving beyond suffering to experiencing healing. Dwelling in suffering is the barrier in men’s life experiences that slows down the rate of evolution from moving beyond suffering to experiencing wellbeing.

Wholeness and life patterning: unitary foundations for a healing praxis

Unitary appreciative nursing is a healing praxis that is grounded in an evolving theory of wholeness and life patterning. The theory regards people as having the potential for transforming their health through participating knowingly in change focused on appreciating their wholeness and life patterning. In unitary appreciative nursing, people generate their own knowledge through appreciation and participation in the wholeness of life patterning. This knowledge facilitates and advances their flourishing and well-being in a healing praxis. The conceptual presuppositions and theoretical propositions that were generated or affirmed arising from a healing praxis are clarified and explicated with women who have experienced abuse and despair.

"An existential place of pain": the essence of despair in women

While there is a substantive body of knowledge on depression, little is known about the experience of despair. Though the terms depression and despair are often used interchangeably, studies of despair suggest that it is distinguishable from depression as experienced by women. This study explored women's experience of despair through qualitative interviews with 14 women ages 28 to 55 (M = 45) who self-identified as experiencing despair. Three themes emerged: "Crippling and Debilitating," "There's Nothing You Can Do," and ''It'll Never End." The findings lend support to the notion that despair is distinguishable from depression, but this warrants further study. The findings also suggest that while there are common elements of despair among women, there are also unique experiences of despair. While there is a substantive body of knowledge on depression, little is known about the experience of despair. This phenomenological study explored women's experience of despair through qualitative interviews with 14 women ages 28 to 55 (M = 45) who self-identified as experiencing despair. Three themes emerged: "Crippling and Debilitating," "There's Nothing You Can Do," and "It'll Never End." The findings suggest that women desire to have their experiences recognized and validated while simultaneously receiving acknowledgment of their ability to overcome the past and to shape their own destinies.

My life: my encounters with insanity

Evocative memories of an early career in mental health nursing contextualize an alienation from traditional psychiatric practices. These memories tell tales that center on exploring a personal rejection of mental health nursing practices that were based on a reductive-pharmacological approach. In its place, it is suggested, should be the adoption of more holistic ideology that places the person at the very center of mental health nursing as a holistic, human-centered activity. This process may be guided by, for example, the adoption of the principles of the Tidal Model.

Unitary appreciative inquiry: evolution and refinement

Unitary appreciative inquiry (UAI), developed over the past 20 years, provides an orientation and process for uncovering human wholeness and discovering life patterning in individuals and groups. Refinements and a description of studies using UAI are presented. Assumptions and conceptual underpinnings of the method distinguishing its contributions from other methods are reported. Data generation strategies that capture human wholeness and elucidate life patterning are proposed. Data synopsis as an alternative to analysis is clarified and explicated. Standards that suggest enhancing the legitimacy of knowledge and credibility of research are specified. Potential expansions of UAI offer possibilities for extending epistemologies, aesthetic integration, and theory development.

Science of Unitary Human Beings

The purpose of this column is to review the published studies conducted within Rogers' science of unitary human beings from 2004 to 2007. The findings from a critical review of 24 research studies (15 quantitative and 9 qualitative) are presented.

An essay on women, despair, and healing: a personal narrative

Much of my career has focused on knowing and understanding human wholeness, developing praxis approaches for life patterning and healing, and inquiring into the lives of the women who have been abused as children and live with despair. Sensing the desire of people to share their stories to understand their despair and being discontented with fragmenting and dehumanizing approaches to practice and research, I sought an alternative path. This article describes the personal and professional journey that led me into the lives of women, the discoveries and revelations that emerged, and an appreciation of unimagined potentials for healing. It also confirmed the need for nursing to examine its underlying assumptions of healing.

Home as place for healing

Although environment is a core concept in nursing, it has had little theoretical or empirical attention, especially related to healing. This article explores the following aspects of the meaning of healing as they relate to environment as place: (a) healing is grounded in suffering; (b) healing is active and requires presence of the patient and the nurse; and (c) healing is private, spiritual, and profound. Home is explored as a place for healing. The article explores implications for the study of meaning of home, when home is not a place for healing, and future directions for theory and research.

Research Paradigms and Methods for Investigating Holistic Nursing Concerns

Holistic nursing is a discipline focused on healing the whole person and dedicated to understanding and supporting the premise of holistic health of the patient and promoting healing in practitioners, patients, families, social groups, and communities. An explication of knowledge related to caring and healing in the human health experience and in holistic nursing is informed by the individual nurse's paradigmatic stance. Holistic nursing research is complex and focuses on healing, particularly healing of self, others, systems, and communities at large. This article discusses the competing paradigmatic perspectives, theoretic perspectives supporting holistic research, fundamental patterns of knowing and knowledge generation, a framework for holistic research, and the challenges of conducting holistic research. Recommendations for future research agenda are presented.

Despairing women and healing outcomes: a unitary appreciative nursing perspective

The purpose of this article is to explicate unitary appreciative nursing and the emergence of healing outcomes associated with despairing women. Unitary appreciative nursing was derived from the science of unitary human beings, informed by the participatory worldview of cooperative inquiry, and shaped by the voices and perspectives of despairing women. It integrates 3 strands of responsiveness (unitary, appreciative, and participatory) to the chosen focus of practice. Healing outcomes for despairing women reflect a conceptualization of healing that involves realizing, knowing, and appreciating the wholeness of life, clarifying understandings of life patterning, and elucidating potentials and opportunities for the betterment of life-a journey toward human flourishing.