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Robinson K, Bender M. The contested status of theory/theorizing and humanism/posthumanism in Olga Petrovskaya's Nursing theory, postmodernism, poststructualism, and Foucault. Nurs Inq 2024; 31:e12566. [PMID: 37232196 DOI: 10.1111/nin.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Keith Robinson
- Department of Philosophy and Interdisciplinary Studies, University of Arkansas at Little Rock, Little Rock, Arkansas, USA
| | - Miriam Bender
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, California, USA
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Clinton M. On Bender's orientation to models: Towards a philosophical debate on covering laws, theory, emergence and mechanisms in nursing science. Nurs Philos 2023; 24:e12439. [PMID: 37070352 DOI: 10.1111/nup.12439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 01/30/2023] [Accepted: 04/05/2023] [Indexed: 04/19/2023]
Abstract
Nursing scholars continuously refine nursing knowledge and the philosophical foundations of nursing practice. They advance nursing knowledge by creating new knowledge and weighing the relevance of developments in cognate sciences. Nurse philosophers go further by providing epistemological and ontological arguments for explanations of nursing phenomena. In this article, I engage with Bender's arguments about why mechanisms should have more primacy as carriers of nursing knowledge. Despite the careful scholarship involved, Bender's arguments need to be more convincing. Accordingly, this article encourages debate about Bender's arguments for reorientating nursing science to mechanisms. I begin by suggesting that the claim that the theory-practice divide can be overcome by reorientating to mechanisms is acceptable only if we accept Bender's depiction of the challenge. Then I question the ontology Bender relies on to justify reorientating nursing science. After that, I argue that mechanisms in models that parallel analytical sociology undermine the kind of nursing science Bender advocates. I illustrate my arguments with a social mechanism thought experiment. Then I explain why Bender's arguments cannot escape the received view of science or inform emancipatory nursing action without theory. Finally, I mention some caveats and implications for nursing science.
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Affiliation(s)
- Michael Clinton
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
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Gasperini G, Renzi E, Longobucco Y, Cianciulli A, Rosso A, Marzuillo C, De Vito C, Villari P, Massimi A. State of the Art on Family and Community Health Nursing International Theories, Models and Frameworks: A Scoping Review. Healthcare (Basel) 2023; 11:2578. [PMID: 37761774 PMCID: PMC10530995 DOI: 10.3390/healthcare11182578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
A Family and Community Health Nursing (FCHN) model was first conceptualized by the WHO approximately 25 years ago in response to the epidemiological transition leading to major changes in the population health needs. To date, no study has comprehensively explored the adherence of current applications of FCHN to the WHO original framework. We carried out a scoping review on PubMed, Scopus and CINAHL with the aim to compare the main features of FCHN models developed at the international level with the WHO's framework. We identified 23 studies: 12 models, six service/program descriptions, four statements and one theoretical model. The FCHN models appear to focus primarily on sick individuals and their family, mainly providing direct care and relying on Interaction, Developmental and Systems Theories. While these features fit the WHO framework, others elements of the original model are poorly represented: the involvement of FCHN in prevention activities is scarce, especially in primary and secondary prevention, and little attention is paid to the health needs of the whole population. In conclusion, current applications of FCHN show a partial adherence to the WHO framework: population approaches should be strengthened in current FCHN models, with a stronger involvement of nurses in primary and secondary prevention.
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Affiliation(s)
- Giulia Gasperini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.C.); (C.M.); (C.D.V.); (P.V.); (A.M.)
- Department of Translational and Precision Medicine, Umberto I Teaching Hospital, 00161 Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Erika Renzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.C.); (C.M.); (C.D.V.); (P.V.); (A.M.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Firenze, Italy;
| | - Angelo Cianciulli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.C.); (C.M.); (C.D.V.); (P.V.); (A.M.)
| | - Annalisa Rosso
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.C.); (C.M.); (C.D.V.); (P.V.); (A.M.)
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.C.); (C.M.); (C.D.V.); (P.V.); (A.M.)
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.C.); (C.M.); (C.D.V.); (P.V.); (A.M.)
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.C.); (C.M.); (C.D.V.); (P.V.); (A.M.)
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Dickinson JK, Juan S, McGuane A, McKenzie-Henry IA. Use of Nursing Concepts in Program and Course Descriptions: An Analysis of Prelicensure Baccalaureate Nursing Programs in the United States. Nurse Educ 2023; 48:1-6. [PMID: 35926129 DOI: 10.1097/nne.0000000000001256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ongoing discussions address how and when to introduce nursing concepts in nursing education. PURPOSE To examine whether baccalaureate nursing programs use 4 nursing concepts in their program and course descriptions. METHODS Researchers explored websites of 300 US bachelor of science in nursing (BSN) programs and assigned scores based on how many of 4 nursing concepts (context, holism, health, and caring) were represented in program and 3 course descriptions. RESULTS Mean program and course scores were 2.51, 0.96, 1.17, and 1.18, respectively. Programs and courses included between 0 and 4 concepts in their descriptions. There was a significant difference in program scores between BSN programs in 4 US regions. The most frequently identified concept was "context" in program descriptions and "holism" in course descriptions. CONCLUSIONS Discipline-specific concepts are missing in many baccalaureate programs and course descriptions, which raises questions about how and when nursing students are learning what nursing is.
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Affiliation(s)
- Jane K Dickinson
- Program Director/Senior Lecturer (Dr Dickinson), Department of Health & Behavior Studies, Teachers College Columbia University, New York, New York; and Student (Mss Juan, McGuane, and McKenzie-Henry), Nursing Education Program, Department of Health & Behavior Studies, Teachers College Columbia University, New York, New York
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Purvis JK. Applying a Foucauldian lens to the Canadian code of ethics for registered nurses as a discursive mechanism for nurses professional identity. Nurs Inq 2022; 30:e12536. [PMID: 36260285 DOI: 10.1111/nin.12536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 11/28/2022]
Abstract
This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline-specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change.
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Affiliation(s)
- Janet K Purvis
- Rankin School of Nursing, St Francis Xavier University, Antigonish, Canada
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Öhlén J, Bramstång A, Lundin Gurné F, Pihlgren A, Thonander M, Kirkevold M. Complexities in Studying and Practicing Nursing-A Theoretical Elaboration Based on Reflections by Nurses and Nursing Students. ANS Adv Nurs Sci 2021; 44:368-383. [PMID: 34267048 DOI: 10.1097/ans.0000000000000379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to explore nursing students' and clinically active nurses' experiential ideas about nursing to provide a foundation for a critical reflection on the complexities involved in studying and practicing nursing. Using a participatory approach, 9 experiential ideas about nursing as a subject, nursing practice, and being a nurse were identified and reflected upon with a total of 238 participants. This was followed by a theoretical analysis in relation to the clinical gaze in nursing and epistemology, which ends in an argument for a rediscovery of the broader Aristotelian view of knowledge in nursing education and practice.
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Affiliation(s)
- Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy (Drs Öhlén and Kirkevold and Mss Bramstång, Lundin Gurné, and Pihlgren), and Centre for Person-Centred Care, the GPCC (Dr Öhlén), University of Gothenburg, Gothenburg, Sweden; Palliative Centre (Dr Öhlén) and Department for Cardiology (Ms Thonander), Sahlgrenska University Hospital, Gothenburg, Sweden; Department for Nursing Science, University of Oslo, Oslo, Norway (Dr Kirkevold); and Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway (Dr Kirkevold)
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7
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Racine L, Vandenberg H. A philosophical analysis of anti-intellectualism in nursing: Newman's view of a university education. Nurs Philos 2021; 22:e12361. [PMID: 34157208 DOI: 10.1111/nup.12361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 05/07/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti-intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti-intellectualism in nursing education. We use John Henry Newman's view of the purpose of a university education as a heuristic perspective to examine anti-intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency-based curricula and business models rooted in neoliberal financial policies reinforce anti-intellectualism in nursing. Anti-intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti-intellectualism. Counteracting anti-intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti-intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Helen Vandenberg
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
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Abstract
OBJECTIVE For the past 30 years there has been a growing emphasis on evidence as the primary or exclusive basis for nursing practice. METHODS Critical examination of literature related to evidence-based practice from the 1990s to the present. RESULTS This review of the nursing literature from the 1990s to the present reveals that in the midst of the movement to promote evidence-based practice as the gold standard, there have been persistent expressions of concern. These concerns are (a) lack of alignment of evidence-based practice with nursing's disciplinary perspective; (b) wrongful privileging of empirical knowledge over other sources of knowledge; (c) underappreciation of the complexity of practice and practice wisdom;(d) possibilities of evidence-based practice thwarting innovation and creativity;(e) vulnerabilities of empirical evidence to be flawed, inconsistent, and influenced by competing interests; (f) situational realities that limit access to and critical appraisal of evidence that access to and critical appraisal of evidence is not feasible or practical; and (g) lack of relationship of evidence-based practice to theory. CONCLUSIONS We call for a recalibrated practice epistemology that promotes a greater appreciation for the myriad sources of knowledge for nursing practice, and offer recommendations for international change in education, literature, scholarship, and public media.
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Keeping the Nurse in the Nurse Practitioner: Returning to Our Disciplinary Roots of Knowing in Nursing. ANS Adv Nurs Sci 2021; 43:50-61. [PMID: 31922983 DOI: 10.1097/ans.0000000000000301] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Nurse practitioners are a vital and growing body of primary healthcare providers. The ever-changing advancements in science and technology and the increasing complexities in health care delivery are significant factors culminating in the expanding role of nurse practitioner-led care. Nurse educators are striving to develop nurse practitioner curricula to keep pace with the increasingly sophisticated knowledge and competencies nurse practitioners must possess to render safe quality care as independent primary health care providers. However, nursing theory is losing its place as a formative foundation in nurse practitioner curricula. Multiple factors such as content-laden, competency-based, medically focused education have caused a diminishing presence of nursing theory, shrinking the philosophical basis for nursing in nurse practitioner education. The loss of the central unifying focus of the discipline and discipline-specific knowledge (nursology) risks losing the very identity that forms the basis and relevance for nurse practitioner practice. Moreover, the loss of the nurse in the nurse practitioner unmoors nurse practitioner practice from its theoretical and scientific basis, losing discipline-specific attributes that lead to higher levels of patient satisfaction and improved patient outcomes. Keeping the nurse in the nurse practitioner is a moral imperative in nurses' ethical and social contract with society. This article discusses relevant literature and offers recommendations to keep the nurse in the nurse practitioner.
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Sanford S, Schwartz B, Khan Y. The role of tacit knowledge in communication and decision-making during emerging public health incidents. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2020; 50:101681. [PMID: 32834974 PMCID: PMC7247478 DOI: 10.1016/j.ijdrr.2020.101681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
Strong communication systems for knowledge exchange are required to prevent, respond to and mitigate the effects of emerging public health incidents (EPHIs). The objective of this paper is to examine how "tacit knowledge" - implicit knowledge used to guide everyday practice - is employed in professional relationships and communication processes between public health and acute care settings. A qualitative study design was used to explore the experiences of key informants from public health and acute care settings in Ontario, Canada, to examine how specific dimensions of tacit knowledge are employed in communications about EPHIs. Twenty-six in-depth interviews were conducted from 2014 to 2015. The results describe the way in which participants employ discretion and knowledge of local context, and rely on relationships built on trust and credibility, to facilitate decision-making and communication during EPHIs. Given the uncertainty characterizing most EPHIs, communicators rely a great deal on their informal knowledge and networks which allow them to remain flexible and respond quickly to changing situations. The results reveal that communication about public health guidance during emergencies is a complex and active process that draws from past experiences of the individuals involved, and is shaped by the requirements of local circumstances. The broader implications of these findings for building resilient and responsive health systems are considered. In particular, for rethinking the authority of standardized forms of evidence in public health decision-making, and the importance of knowledge which is grounded in the uniqueness of specific local contexts.
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Affiliation(s)
- S Sanford
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
| | - B Schwartz
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
| | - Y Khan
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
- Department of Medicine, University of Toronto, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada
- University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada
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Lundin Gurné F, Lidén E, Jakobsson Ung E, Kirkevold M, Öhlén J, Jakobsson S. Striving to be in close proximity to the patient: An interpretive descriptive study of nursing practice from the perspectives of clinically experienced registered nurses. Nurs Inq 2020; 28:e12387. [PMID: 33108693 PMCID: PMC8244039 DOI: 10.1111/nin.12387] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 01/14/2023]
Abstract
This paper explores essential characteristics of current nursing practice from the perspectives of clinically experienced registered nurses in various fields of health care in Sweden. Nursing practice has been the subject of much debate in the past and because of its complexity as well as continuous changes in society it is important to continue the debate. A qualitative study, including 16 group interviews with altogether 74 participants, was conducted. Nursing practice was viewed as a multifaceted field. The participants struggled to define nursing but were able to describe it using concrete examples. The analysis, using interpretive description, identified current practice as essentially consisting of: ‘A practice pervaded by comprehensive responsibility’, ‘A practice that recognises a patient's unique needs’, ‘A practice based on multifaceted knowledge’ and ‘A practice that mediates between traditional values and changing demands’. Current nursing practice can be understood as striving to be in close proximity to the patient, but in tension with pervasive requirements and societal changes. Going forward, it is necessary to continue to reflect on and discuss the nature of nursing practice in an interprofessional context. Studies from primary and home care are also needed to broaden the understanding of nursing practice.
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Affiliation(s)
- Frida Lundin Gurné
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Lidén
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Jakobsson Ung
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Marit Kirkevold
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Joakim Öhlén
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital, Västra Götaland Region, Gothenburg, Sweden
| | - Sofie Jakobsson
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Delaney KR, McIntosh D. Exploring the thinking, reasoning and clinical approach of expert child psychiatric nurses. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 34:41-49. [PMID: 32697417 DOI: 10.1111/jcap.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/23/2020] [Accepted: 07/14/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Expert nurses are characterized by their deep knowledge of patient situations and understanding of patients in the context of their total situation. We know of no studies that have focused on the expert practice of child/adolescent (C/A) psychiatric mental health (PMH) advanced practice nurse. OBJECTIVE The purpose of this study was to gather information on how expert C/A advanced practice psychiatric nurses (APPNs) view their role and assess/treat children and adolescents with complex mental health issues. METHOD Expert C/A APPNs were interviewed by one of the two investigators using a semi-structured interview guide. All interviews were audiotaped and transcribed. This was a qualitative descriptive study and in line with that method, interview content was open-coded and examined for themes that were collapsed into categories. RESULTS Fifteen C/A PMH APPNs were interviewed. Initial categories that were distilled included descriptions of their commitment to the population, development of families as partners, an expanded approach to medication management, and how they demonstrate expertise. CONCLUSION Expert nurses adopt an invaluable approach to children and families-inherently patient and family-centered. They view the child/teen in terms of the multiple contexts of their lives.
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Affiliation(s)
- Kathleen R Delaney
- Department of Community, Systems and Mental Health, Rush College of Nursing, Chicago, Illinois, USA
| | - Diana McIntosh
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
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Abstract
A theme of this article is the theory-research link and its essential role in advancing nursing science and practice. Concern is expressed over the current status of nursing theory relative to the advances in research and practice. Soon-to-be and current theoreticians and scientists are encouraged to champion not just nursing theory proper but scientific nursing theories that have explanatory power. The role of the precision health movement in facilitating development of scientific theory is explored.
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Affiliation(s)
- Pamela G Reed
- College of Nursing, The University of Arizona, Tucson, AZ, USA
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14
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Truant TLO, Varcoe C, Gotay CC, Thorne S. Les soins aux survivants du cancer : vers une grande qualité, en toute équité. Can Oncol Nurs J 2020; 29:163-169. [PMID: 31966016 DOI: 10.5737/23688076293163169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Tracy L O Truant
- Directrice ancienne, Recherche, Éducation et Innovation, BC Cancer, Vancouver BC,
| | - Colleen Varcoe
- Professeure, École des sciences infirmières, University of British Columbia,
| | - Carolyn C Gotay
- Professeure émérite, School of Population and Public Health, University of British Columbia,
| | - Sally Thorne
- Professeure, École des sciences infirmières, University of British Columbia,
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Porter S. Commentary: A qualitative examination of the perceived impact of bureaucratic managerialism on evidence-based practice implementation in Nigeria: a collective case study. J Res Nurs 2019; 24:647-648. [DOI: 10.1177/1744987119883695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sam Porter
- Professor of Nursing Sociology, Head of Department of Social Sciences and Social Work, Bournemouth University, UK
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Bergdahl E. Is meta-aggregation a viable method for qualitative evidence synthesis? A reply to the commentary by Lockwood et al. Nurs Inq 2019; 26:e12325. [PMID: 31637804 DOI: 10.1111/nin.12325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Elisabeth Bergdahl
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Abstract
Nursing actions in support of equitable health and social relations have always been central to the work of our discipline. The mandate for social justice advocacy is identified in many of our professional and ethical frameworks, with systems-level advocacy situated as a core competency for advanced practice nurses. And yet, the sociopolitical processes that generate health inequities are not always readily understood by nurses. Emancipatory knowing provides an accessible lens to reveal how social injustice occurs while delineating a practical structure through which reflective action can be undertaken toward social change, otherwise known as nursing praxis.
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Ben Hassine A, Souli I, Braiki R, Chouigui R, Amira A, Laaroussi H, Mejri B, Ladib M, Hidoussi A. La qualité de vie à la suite à d’une cystoprostatectomie totale chez les hommes: perception des patients tunisiens. Can Oncol Nurs J 2019; 29:219-225. [PMID: 31966005 PMCID: PMC6970011 DOI: 10.5737/23688076294219225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Introduction La cystoprostatectomie totale (CPT) entraîne souvent des changements dans la qualité de vie postopératoire et, par le fait même, des répercussions psychologiques, physiques, sociales et sexuelles difficiles à assumer. La présente étude vise à décrire la qualité de vie postopératoire d’hommes tunisiens âgés ayant subi une CPT à cause d’un cancer de la vessie. Méthodologie Il s’agit d’une étude descriptive quantitative, menée auprès de 40 hommes cystoprostatectomisés. Les instruments de mesure utilisés sont: le questionnaire Stoma-Qualité de vie (Stoma-QOL) de Prieto, Thorsen et Juul (2005) , traduit et validé en arabe, ainsi que la version arabe du questionnaire de l’index international de la fonction érectile (IIEF5), validée par Shamloul, Ghanem et Abou-Zeid (2004) . Résultats 77,5 % des participants obtiennent un score de qualité de vie médiocre. Toutes les dimensions de la qualité de vie sont touchées, à savoir l’image corporelle, physique et psychologique, la vie familiale et sociale, et enfin, la sexualité. En outre, tous les participants ont souffert d’impuissance sexuelle grave après l’intervention. Conclusion Le counseling pré et postopératoire s’avère nécessaire pour faciliter la transition après l’opération et assurer aux hommes ayant subi une CPT à cause d’un cancer de la vessie une meilleure qualité de vie liée à la santé.
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Affiliation(s)
- Asma Ben Hassine
- Faculté des sciences infirmières de l'Université Laval, Québec, QC, , Tel: +1 418-264-3424
| | - Intissar Souli
- Faculté des sciences de la santé de l'Université d'Ottawa, Ottawa,
| | - Raoua Braiki
- Faculté des sciences infirmières de l'Université Laval, Québec, QC,
| | - Rabeb Chouigui
- professeur principal paramédical, Université de Tunis, École supérieure des sciences et techniques de Tunis, TUNISIE,
| | - Abbessi Amira
- professeur principal paramédical, Université de Tunis, Institut supérieur des sciences infirmières de Tunis, TUNISIE,
| | - Hatem Laaroussi
- Faculté des sciences infirmières de l'Université Laval, Québec, QC,
| | - Boutheina Mejri
- Faculté des sciences infirmières de l'Université Laval, Québec, QC,
| | - Mohamed Ladib
- Faculté de médecine de l'Université de Sousse, TUNISIE,
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Truant TLO, Varcoe C, Gotay CC, Thorne S. Toward equitably high-quality cancer survivorship care. Can Oncol Nurs J 2019; 29:156-162. [PMID: 31966022 DOI: 10.5737/23688076293156162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Although models of cancer survivorship care are rapidly evolving, there is increasing evidence of health disparities among cancer survivors. In the current context, Canada's survivorship care systems privilege some and not others to receive high-quality care and optimize their health outcomes. The aim of this study was to improve survivorship care systems by helping clinicians and decision makers to a better understanding of how various psychosocial/political factors, survivors' health experiences and health management strategies might shape the development of and access to high-quality survivorship care for Canadians with cancer. Using a nursing epistemological approach informed by critical and intersectional perspectives, we conducted a three-phased Interpretive Description study. We engaged in critical textual analysis of documentary sources, a secondary analysis of interview transcripts from an existing database, and qualitative interviews with 34 survivors and 12 system stakeholders. On the basis of these data, we identified individual, group, and system factors that contributed to gaps between survivors' expected and actual survivorship care experiences. By understanding what shapes survivorship care systems and resources, we help illuminate and unravel the complex nature of the issue, supporting clinicians and decision makers to find multi-layered approaches for equitably high-quality survivorship care.
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Affiliation(s)
- Tracy L O Truant
- Former Director, Research, Education and Innovation, BC Cancer, Vancouver BC,
| | - Colleen Varcoe
- Professor, School of Nursing, University of British Columbia,
| | - Carolyn C Gotay
- Professor Emeritus, School of Population and Public Health, University of British Columbia,
| | - Sally Thorne
- Professor, School of Nursing, University of British Columbia,
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Abstract
BACKGROUND In 2005, Pearson et al. presented a developmental framework of evidence-based practice that sought to situate healthcare evidence and its role and use within the complexity of practice settings globally. A decade later, it was deemed timely to re-examine the Model and its component parts to determine whether they remain relevant and a true and accurate reflection of where the evidence-based movement is today. METHODS A two-phase process was employed for this project. Phase 1 involved a citation analysis, conducted using the index citation of the original source article on the Joanna Briggs Institute (JBI) Model by Pearson et al. The databases searched were Web of Science and Google Scholar from year of publication (2005) to July 2015. Duplicates and articles in languages other than English were removed, and all results were imported and combined in an Excel spreadsheet for review, coding and interpretation. Phase 2 (model revision) occurred in two parts. Part 1 involved revision of the Model by an internal working group. This revised version of the Model was then subjected to a process of focus group discussion (Part 2) that engaged staff of the Joanna Briggs Collaboration during the 2015 annual general meeting. These data were recorded then transcribed for review and consideration. RESULTS The citation analysis revealed that the Model was primarily utilized to conceptualize evidence and evidence-based healthcare, but that language used in relation to concepts within the Model was variable. Equally, the working group and focus group feedback confirmed that there was a need to ensure the language utilized in the Model was internationally appropriate and in line with current international trends. This feedback and analysis informed the revised version of the JBI Model. CONCLUSION Based on the citation analysis, working group and focus group feedback the new JBI Model for Evidence Based Healthcare attempts to utilize more internationally appropriate language to detail the intricacies of the relationships between systems and individuals across different settings and the need for contextual localization to enable policy makers and practitioners to make evidence-based decisions at the point of care.
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Bender M, Holmes D. Reconciling nursing's art and science dualism: Toward a processual logic of nursing. Nurs Inq 2019; 26:e12293. [DOI: 10.1111/nin.12293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/09/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Miriam Bender
- Sue & Bill Gross School of NursingUniversity of California, Irvine Irvine California
| | - Dave Holmes
- Sue & Bill Gross School of NursingUniversity of California, Irvine Irvine California
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Chinn PL, Falk-Rafael A. Embracing the Focus of the Discipline of Nursing: Critical Caring Pedagogy. J Nurs Scholarsh 2018; 50:687-694. [PMID: 30230200 DOI: 10.1111/jnu.12426] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE To present a theoretical model that grounds teaching and learning in nursing in the focus, values, and ideals of nursing as a discipline. ORGANIZING CONSTRUCTS The critical caring pedagogy model was formed by integrating Falk-Rafael's theory of critical caring in public health nursing, Noddings' philosophy of caring education, and Chinn's theory of peace and power. METHODS The model of critical caring pedagogy was developed by logical analysis of the three organizing constructs and the conceptual relationships between and among these constructs. The analysis was informed by the authors' experiences implementing the theoretical constructs in teaching and learning. CONCLUSIONS When nurse educators ground teaching and learning practice in nursing's own theoretical and philosophic foundation, they teach nursing in powerful ways that show nursing values and ideals through action, revealing deeper meanings of the words that form texts, lectures, and objectives set forth in a curriculum outline. CLINICAL RELEVANCE Nursing students who experience education that is grounded in nursing's own disciplinary focus acquire an appreciation of nursing's disciplinary knowledge grounded in experience, paving the way for grounding their eventual practice in nursing theoretical perspectives.
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Affiliation(s)
- Peggy L Chinn
- Mu, Professor Emerita, University of Connecticut, School of Nursing, Storrs, CT, USA
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24
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Greenhalgh T, Thorne S, Malterud K. Time to challenge the spurious hierarchy of systematic over narrative reviews? Eur J Clin Invest 2018; 48:e12931. [PMID: 29578574 PMCID: PMC6001568 DOI: 10.1111/eci.12931] [Citation(s) in RCA: 288] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/20/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Trisha Greenhalgh
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sally Thorne
- School of Nursing, University of British Colombia, Vancouver, Canada
| | - Kirsti Malterud
- Research Unit for General Practice, Uni Research Health, Bergen, Norway
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25
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Reorienting Esthetic Knowing as an Appropriate "Object" of Scientific Inquiry to Advance Understanding of a Critical Pattern of Nursing Knowledge in Practice. ANS Adv Nurs Sci 2018; 40:24-36. [PMID: 27798436 DOI: 10.1097/ans.0000000000000160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The esthetic pattern of knowing is critical for nursing practice, yet remains weakly defined and understood. This gap has arguably relegated esthetic knowing to an "ineffable" creativity that resists transparency and understanding, which is a barrier to articulating its value for nursing and its importance in producing beneficial health outcomes. Current philosophy of science developments are synthesized to argue that esthetic knowing is an appropriate "object" of scientific inquiry. Examples of empirical scholarship that can be conceived as scientific inquiry into manifestations of esthetic knowing are highlighted. A program of research is outlined to advance a science of esthetic knowing.
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Abstract
The discipline of nursing has long maintained that is has a unique contribution to make within the health care arena. This assertion of uniqueness lies in great part in the discipline's claim to a distinct body of knowledge. Nursing knowledge is characterized by diverse and multiple forms of knowing and underpins the work of all nurses, regardless of field of practice. Unfortunately, it has been challenging for the discipline to take full ownership of its epistemological diversity, largely due to factors such as competing worldviews, and ideological and binary positioning. A philosophical middle ground stance is proposed as a way for the discipline to contemplate, discuss and develop nursing knowledge; a middle space that provides the freedom to consider competing worldviews while still allowing for the discipline to fully express itself in all of its epistemological diversity. In being able to enact its multiple forms of knowledge in a creative and open space that is open to different ideas and worldviews, not only can nursing take full ownership of its practice and its unique knowledge, it can also demonstrate how best to navigate an increasingly polarized world. In a world that is increasingly fixated on binary solutions and dualistic points of view, it is time for nursing to celebrate its epistemological diversity.
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Guinane J, Hutchinson AM, Bucknall TK. Patient perceptions of deterioration and patient and family activated escalation systems—A qualitative study. J Clin Nurs 2018; 27:1621-1631. [DOI: 10.1111/jocn.14202] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Jessica Guinane
- School of Nursing & Midwifery Deakin University Geelong Vic. Australia
| | - Alison M Hutchinson
- Monash Health Melbourne Vic. Australia
- Centre for Quality and Patient Safety Research (QPS) School of Nursing and Midwifery Deakin University Geelong Vic. Australia
| | - Tracey K Bucknall
- School of Nursing & Midwifery Deakin University Geelong Vic. Australia
- Centre for Quality and Patient Safety Research (QPS) School of Nursing and Midwifery Deakin University Geelong Vic. Australia
- Alfred Health Melbourne Vic. Australia
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Turkel M, Fawcett J, Chinn PL, Eustace R, Hansell PS, Smith MC, Watson J, Zahourek R. Thoughts About Advancement of the Discipline: Dark Clouds and Bright Lights. Nurs Sci Q 2018; 31:82-85. [PMID: 29235950 DOI: 10.1177/0894318417741121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In this essay, several nurse scholars who are particularly concerned about the contemporary state of nursing science present their specific concerns (dark clouds) about the advancement of our discipline and the ways in which the concerns have been addressed (bright lights). This essay is the first of two essays that were catalyzed by Barrett's paper, "Again, What Is Nursing Science?" The second essay will be published in the next issue Nursing Science Quarterly.
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Affiliation(s)
- Marian Turkel
- 1 Associate Professor, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Jacqueline Fawcett
- 2 Professor, Department of Nursing, University of Massachusetts Boston, Boston, MA, USA
| | - Peggy L Chinn
- 3 Professor Emerita, University of Connecticut, and Editor, Advances in Nursing Science, Oakland, CA, USA
| | - Rosemary Eustace
- 4 Associate Professor, College of Nursing and Health, Wright State University, Dayton, OH, USA
| | | | - Marlaine C Smith
- 6 Dean and Helen K. Persson Eminent Scholar, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Jean Watson
- 7 Founder/Director, Watson Caring Science Institute, and Distinguished Professor and Dean Emerita, University of Colorado Denver, Boulder, CO, USA
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Abstract
In an environment in which evidence-based practice is the espoused norm, nurses have understandably sought to frame the knowledge they deem relevant to practice decisions, including the findings of their qualitative studies, as a form of evidence. However, since cancer patients face a significant challenge interpreting various evidence claims, it is important to recognize that the results of our qualitative studies reflect a different form of knowledge from that which an evidence-based practice definition of evidence presumes. Thus, we need to rethink our relationship to what qualitative studies offer to the evidentiary dialog. An approach to qualitative inquiry that derives from a nursing disciplinary logic model is, therefore, presented as an alternative means by which to generate the kinds of knowledge nurses need to practice and to gain expertise in clinical wisdom. Drawing on cancer communications research as an example, a nursing angle of vision on how best to use qualitative approaches to interpret evidence and inform practice emerges.
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Affiliation(s)
- Sally Thorne
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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MacKinnon K, Butcher DL, Bruce A. Working to Full Scope: The Reorganization of Nursing Work in Two Canadian Community Hospitals. Glob Qual Nurs Res 2018; 5:2333393617753905. [PMID: 29410976 PMCID: PMC5794041 DOI: 10.1177/2333393617753905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/29/2017] [Accepted: 12/04/2017] [Indexed: 11/21/2022] Open
Abstract
Work relationships between registered nurses (RNs) and practical nurses (LPNs) are changing as new models of nursing care delivery are introduced to create more flexibility for employers. In Canada, a team-based, hospital nursing care delivery model, known as Care Delivery Model Redesign (CDMR), redesigned a predominantly RN-based staffing model to a functional team consisting of fewer RNs and more LPNs. The scope of practice for LPNs was expanded, and unregulated health care assistants introduced. This study began from the standpoint of RNs and LPNs to understand their experiences working on redesigned teams by focusing on discourses activated in social settings. Guided by institutional ethnography, the conceptual and textual resources nurses are drawing on to understand these changing work relationships are explicated. We show how the institutional goals embedded in CDMR not only mediate how nurses work together, but how they subordinate holistic standards of nursing toward fragmented, task-oriented, divisions of care.
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Affiliation(s)
| | | | - Anne Bruce
- University of Victoria, Victoria, British Columbia, Canada
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31
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From the Editor. ANS Adv Nurs Sci 2018; 41:1. [PMID: 29389724 DOI: 10.1097/ans.0000000000000199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hoeck B, Delmar C. Theoretical development in the context of nursing-The hidden epistemology of nursing theory. Nurs Philos 2017; 19. [DOI: 10.1111/nup.12196] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Bente Hoeck
- User Perspectives; Department of Public Health; University of Southern Denmark; Odense C Denmark
| | - Charlotte Delmar
- Section for Nursing; Department of Public Health; Aarhus University; Aarhus C Denmark
- Faculty of Medicine; Aalborg University; Aalborg Denmark
- Diakonova University College; Oslo Norway
- Health and Caring Science; The Arctic University of Norway; Tromsoe Norway
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Bender M. Models versus theories as a primary carrier of nursing knowledge: A philosophical argument. Nurs Philos 2017; 19. [PMID: 29057563 DOI: 10.1111/nup.12198] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Theories and models are not equivalent. I argue that an orientation towards models as a primary carrier of nursing knowledge overcomes many ongoing challenges in philosophy of nursing science, including the theory-practice divide and the paradoxical pursuit of predictive theories in a discipline that is defined by process and a commitment to the non-reducibility of the health/care experience. Scientific models describe and explain the dynamics of specific phenomenon. This is distinct from theory, which is traditionally defined as propositions that explain and/or predict the world. The philosophical case has been made against theoretical universalism, showing that a theory can be true in its domain, but that no domain is universal. Subsequently, philosophers focused on scientific models argued that they do the work of defining the boundary conditions-the domain(s)-of a theory. Further analysis has shown the ways models can be constructed and function independent of theory, meaning models can comprise distinct, autonomous "carriers of scientific knowledge." Models are viewed as representations of the active dynamics, or mechanisms, of a phenomenon. Mechanisms are entities and activities organized such that they are productive of regular changes. Importantly, mechanisms are by definition not static: change may alter the mechanism and thereby alter or create entirely new phenomena. Orienting away from theory, and towards models, focuses scholarly activity on dynamics and change. This makes models arguably critical to nursing science, enabling the production of actionable knowledge about the dynamics of process and change in health/care. I briefly explore the implications for nursing-and health/care-knowledge and practice.
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Affiliation(s)
- Miriam Bender
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA
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34
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Chiffi D, Zanotti R. Fear of knowledge: Clinical hypotheses in diagnostic and prognostic reasoning. J Eval Clin Pract 2017; 23:928-934. [PMID: 27882636 DOI: 10.1111/jep.12664] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/01/2016] [Accepted: 10/03/2016] [Indexed: 01/25/2023]
Abstract
Patients are interested in receiving accurate diagnostic and prognostic information. Models and reasoning about diagnoses have been extensively investigated from a foundational perspective; however, for all its importance, prognosis has yet to receive a comparable degree of philosophical and methodological attention, and this may be due to the difficulties inherent in accurate prognostics. In the light of these considerations, we discuss a considerable body of critical thinking on the topic of prognostication and its strict relations with diagnostic reasoning, pointing out the distinction between nosographic and pathophysiological types of diagnosis and prognosis, underlying the importance of the explication and explanation processes. We then distinguish between various forms of hypothetical reasoning applied to reach diagnostic and prognostic judgments, comparing them with specific forms of abductive reasoning. The main thesis is that creative abduction regarding clinical hypotheses in diagnostic process is very unlikely to occur, whereas this seems to be often the case for prognostic judgments. The reasons behind this distinction are due to the different types of uncertainty involved in diagnostic and prognostic judgments.
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Affiliation(s)
- Daniele Chiffi
- Ragnar Nurkse School of Innovation and Governance, Tallinn University of Technology, Tallinn, Estonia.,Molecular Medicine, University of Padova, Padova, Italy
| | - Renzo Zanotti
- Molecular Medicine, University of Padova, Padova, Italy
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35
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van Wijngaarden E, Meide HVD, Dahlberg K. Researching Health Care as a Meaningful Practice: Toward a Nondualistic View on Evidence for Qualitative Research. QUALITATIVE HEALTH RESEARCH 2017; 27:1738-1747. [PMID: 28799478 DOI: 10.1177/1049732317711133] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Being able to describe how research findings become evidence is crucial in providing a justification for all kinds of research findings. However, qualitative researchers in health care, including those who conduct phenomenological research, are usually fairly modest when it comes qualifying their research findings as such. We advocate a view of evidence for phenomenological research, an approach that is rooted in philosophy of science, including perspectives of ontology, epistemology, and methodology. We suggest that phenomenology can become an exemplar for how qualitative research can make convincing arguments and thus can be better appreciated. In this article, we present a philosophical foundation for phenomenological evidence by exploring the notions of objectivity, validity, and generalizability in terms of openness, meaning, and essence.
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Affiliation(s)
| | | | - Karin Dahlberg
- 2 Linnaeus University, Växjö, Sweden
- 3 Independent researcher
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Bliss S, Baltzly D, Bull R, Dalton L, Jones J. A role for virtue in unifying the 'knowledge' and 'caring' discourses in nursing theory. Nurs Inq 2017; 24. [PMID: 28247531 DOI: 10.1111/nin.12191] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 11/27/2022]
Abstract
A critical examination of contemporary nursing theory suggests that two distinct discourses coexist within this field. On the one hand, proponents of the 'knowledge discourse' argue that nurses should drop the 'virtue script' and focus on the scientific and technical aspects of their work. On the other hand, proponents of the 'caring discourse' promote a view of nursing that embodies humanistic qualities such as compassion, empathy and mutuality. In view of this, we suggest a way to reconcile both discourses despite the fact that they appear to be at odds theoretically and practically. To that end, we argue that nursing theory must give a prominent role to the Aristotelian conception of virtue, and we offer an account that includes both character and intellectual virtues. This account allows for a focus on moral competence but also accommodates the demands for discipline-specific knowledge. Our account incorporates the caring discourse by suggesting a way for individuals to cultivate the conditions within themselves that make 'caring in nursing' possible, while the knowledge discourse is accommodated via the acquisition of the intellectual virtues. The process for achieving both these ends is the same: an intention to consistently develop, hone and exercise certain character traits over time.
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Affiliation(s)
- Suzanne Bliss
- School of Humanities, University of Tasmania, Launceston, TAS, Australia
| | - Dirk Baltzly
- School of Humanities, University of Tasmania, Hobart, TAS, Australia
| | - Rosalind Bull
- School of Health Sciences, University of Tasmania, Launceston, TAS, Australia
| | - Lisa Dalton
- School of Health Sciences, University of Tasmania, Launceston, TAS, Australia
| | - Jo Jones
- School of Health Sciences, University of Tasmania, Hobart, TAS, Australia
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Affiliation(s)
| | - Wendy A. Hall
- School of Nursing; University of British Columbia; Vancouver BC Canada
| | - Sally E. Thorne
- School of Nursing; University of British Columbia; Vancouver BC Canada
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Sawatzky R, Porterfield P, Roberts D, Lee J, Liang L, Reimer-Kirkham S, Pesut B, Schalkwyk T, Stajduhar K, Tayler C, Baumbusch J, Thorne S. Embedding a Palliative Approach in Nursing Care Delivery: An Integrated Knowledge Synthesis. ANS Adv Nurs Sci 2016; 40:261-277. [PMID: 27930401 PMCID: PMC5555976 DOI: 10.1097/ans.0000000000000163] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A palliative approach involves adapting and integrating principles and values from palliative care into the care of persons who have life-limiting conditions throughout their illness trajectories. The aim of this research was to determine what approaches to nursing care delivery support the integration of a palliative approach in hospital, residential, and home care settings. The findings substantiate the importance of embedding the values and tenets of a palliative approach into nursing care delivery, the roles that nurses have in working with interdisciplinary teams to integrate a palliative approach, and the need for practice supports to facilitate that embedding and integration.
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Affiliation(s)
- Richard Sawatzky
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Pat Porterfield
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Della Roberts
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Joyce Lee
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Leah Liang
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Sheryl Reimer-Kirkham
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Barb Pesut
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Tilly Schalkwyk
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Kelli Stajduhar
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Carolyn Tayler
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Jennifer Baumbusch
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
| | - Sally Thorne
- School of Nursing, Trinity Western University, Langley (Drs Sawatzky, Lee, and Reimer-Kirkham and Ms Liang), School of Nursing, University of British Columbia, Vancouver (Ms Porterfield and Drs Baumbusch and Thorne), Fraser Health Authority, Surrey (Mss Roberts and Tayler), School of Nursing, University of British Columbia–Okanagan Campus (Dr Pesut), Providence Health Care (Ms Schalkwyk), and School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, Victoria (Dr Stajduhar), British Columbia, Canada
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Thorne S. Making our nursing research matter. Rev Bras Enferm 2016; 69:813-814. [PMID: 27783721 DOI: 10.1590/0034-7167-2015-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Sally Thorne
- University of British Columbia, Faculdade de Ciências Aplicadas, Escola de Enfermagem. British Columbia, Canada
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Affiliation(s)
- Renzo Zanotti
- Department of Molecular Medicine; Laboratory of Evidence Based and Nursing Studies; University of Padova; Padova Italy
| | - Daniele Chiffi
- Department of Molecular Medicine; Laboratory of Evidence Based and Nursing Studies; University of Padova; Padova Italy
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Finfgeld-Connett D. The Future of Theory-Generating Meta-Synthesis Research. QUALITATIVE HEALTH RESEARCH 2016; 26:291-293. [PMID: 26612890 DOI: 10.1177/1049732315616628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Thorne S, Stephens J, Truant T. Building qualitative study design using nursing's disciplinary epistemology. J Adv Nurs 2015; 72:451-60. [PMID: 26412414 DOI: 10.1111/jan.12822] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2015] [Indexed: 11/28/2022]
Abstract
AIM To discuss the implications of drawing on core nursing knowledge as theoretical scaffolding for qualitative nursing enquiry. BACKGROUND Although nurse scholars have been using qualitative methods for decades, much of their methodological direction derives from conventional approaches developed for answering questions in the social sciences. The quality of available knowledge to inform practice can be enhanced through the selection of study design options informed by an appreciation for the nature of nursing knowledge. DESIGN Discussion paper. DATA SOURCES Drawing on the body of extant literature dealing with nursing's theoretical and qualitative research traditions, we consider contextual factors that have shaped the application of qualitative research approaches in nursing, including prior attempts to align method with the structure and form of disciplinary knowledge. On this basis, we critically reflect on design considerations that would follow logically from core features associated with a nursing epistemology. IMPLICATIONS FOR NURSING The substantive knowledge used by nurses to inform their practice includes both aspects developed at the level of the general and also that which pertains to application in the unique context of the particular. It must be contextually relevant to a fluid and dynamic healthcare environment and adaptable to distinctive patient conditions. Finally, it must align with nursing's moral mandate and action imperative. CONCLUSION Qualitative research design components informed by nursing's disciplinary epistemology will help ensure a logical line of reasoning in our enquiries that remains true to the nature and structure of practice knowledge.
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Affiliation(s)
- Sally Thorne
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.,Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Stephens
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tracy Truant
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
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Finfgeld-Connett D. Intimate Partner Violence and Its Resolution Among African American Women. Glob Qual Nurs Res 2015; 2:2333393614565182. [PMID: 28462296 PMCID: PMC5342865 DOI: 10.1177/2333393614565182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 10/03/2014] [Accepted: 10/28/2014] [Indexed: 12/23/2022] Open
Abstract
Intimate partner violence (IPV) is a significant problem that is difficult to overcome within African American communities. Thus, the purpose of this qualitative systematic review was to synthesize isolated qualitative findings relating to IPV among African American women to make them more meaningful and generalizable. A framework of IPV among African American women resulted from this work, and key elements include the following: ubiquitous and perpetual oppression and abuse contribute to the emergence of IPV, and personal and interpersonal forms of inspiration and support are generally inadequate to prevent or resolve it. Moreover, ambivalence of others, fear, mental health problems, and negative perceptions of helping services are barriers to change. Resolution of IPV is an emergent process that is enhanced by holistic Afrocentric services. Outcomes are safety with strings attached and personal growth for mothers and children. Research hypotheses are inferred from this framework along with implications for clinical practice.
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Finfgeld-Connett D. Qualitative Systematic Review of Intimate Partner Violence among Native Americans. Issues Ment Health Nurs 2015; 36:754-60. [PMID: 26514253 DOI: 10.3109/01612840.2015.1047072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The incidence of intimate partner violence (IPV) among Native Americans is high, and a full understanding of how to prevent it is unclear. Based on this qualitative systematic review of 13 research reports, a model of IPV among Native Americans was developed. IPV appears to be grounded within a history of upheaval and loss, and is entrenched and repressed within families. Victims are reluctant to seek assistance, and when they do, they often experience barriers within the service system. To prevent and resolve IPV, service providers are urged to establish trust with individuals who seek assistance and to leverage cultural strengths. They also are encouraged to adapt theoretical models to optimize care.
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Rehg E, SmithBattle L. On to the ‘rough ground’: introducing doctoral students to philosophical perspectives on knowledge. Nurs Philos 2014; 16:98-109. [DOI: 10.1111/nup.12077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Ellen Rehg
- School of Nursing; Saint Louis University; St. Louis MO USA
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Abstract
When appraising research papers, how much understanding is enough? More specifically, in deciding whether research results can inform practice, do appraisers need to substantively understand how findings are derived or is it sufficient simply to grasp that suitable analytic techniques were chosen and used by researchers? The degree or depth of understanding that research appraisers need to attain before findings can legitimately/sensibly inform practice is underexplored. In this paper it is argued that, where knowledge/justified beliefs derived from research evidence prompt actions that materially affect patient care, appraisers have an epistemic duty to demand high (maximal) rather than low (minimal) levels of understanding regards finding derivation (i.e. appraisers have a duty to seek a superior epistemic situation). If this argument holds assumptions about appraiser competence/ability and the feasibility of current UK conceptions of evidence based practice are destabilized.
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Affiliation(s)
- Martin Lipscomb
- Faculty of Health and Life Sciences, University of the West of England, Gloucester, UK
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