Positivism

Definition

Positivism is a philosophy of science that states that knowledge comes primarily from sensory
experience, observation, and measurable facts. It emphasizes logic, mathematics, and scientific
evidence as sources of truth.

According to positivists:

 Knowledge must be observable and measurable.

 Facts are more reliable than beliefs or opinions.
 Scientific investigation is the best way to understand reality.

Brown argues that the new epistemology challenged the empiricist view of
perception by acknowledging that theories play a significant role in determining
what the scientist will observe and how it will be interpreted.
--- Scientists do not simply collect facts; their existing knowledge
affects what they notice.

He identified 3 different views of the relationship between theories and

observation:
 o Scientists are merely passive observers of occurrences in the empirical
world. Observable data are objective truth waiting to be discovered.
 o Theories structure what the scientists perceived in the empirical world.
 o Presupposed theories and observable data interact in the process of
scientific investigation

V. Brown's Three Views of Theory and

Observation
1. Scientists as Passive Observers
Definition

Scientists simply observe facts that already exist in the world.

Importance

 Supports objectivity.
  Emphasizes evidence-based observation.

Example

 A nurse records a patient's pulse rate without interpreting its cause.

2. Theories Structure Observation

Definition

Theories influence what scientists pay attention to and how they understand observations.

Importance

 Guides researchers toward relevant information.

 Helps organize scientific investigations.

Example

A nurse who understands diabetes focuses on blood glucose levels and symptoms related to
diabetes.

3. Interaction Between Theory and Observation

Definition

Theory and observation influence each other continuously during research.

Importance

 Reflects modern scientific thinking.

 Improves the development and testing of theories.
 Leads to more comprehensive understanding.

Example

A nurse suspects dehydration, gathers data, and adjusts the diagnosis based on findings.
Emergent Views of Science and Theory in the
Late 20th Century
As science advanced, scholars began to question whether observations are truly objective.

Empiricist View

Definition

Empiricists believe that science remains objective only when data collection and analysis are
independent of theories.

Importance

 Encourages unbiased observation.

 Reduces personal influence during research.
 Promotes accuracy and reliability of findings.

Interdependence Between Theory and

Research
Theory and research depend on one another.

 Theory- Provides explanations.

 Research- Tests whether those explanations are correct-- Research tests and validates
theories

A theory should be judged based on the basis of scientific consensus.

The acceptance of scientific hypothesis through research depends on the

appraisal of the coherence of theory--- Ensures theories are supported by
evidence.

THEORY- A well-substantiated explanation of some aspect of the natural world; an organized

system of accepted knowledge that applies in a variety of situations/hypotheses
Scientific Consensus
Definition

Scientific consensus is the general agreement among experts based on available evidence and
research findings.

Dubin identified when SCIENTIFIC CONSENSUS is necessary:

1. on the boundaries of the theory; the phenomenon it addresses and what it

excludes--- Prevents confusion.

2. on the logic used in constructing the theory to further understanding from a

similar perspective-- A theory must be logically organized and understandable. Makes the
theory easier to apply.

3. that the theory fits the data collected and analyzed though research. A theory
must fit the evidence obtained from research.

Issues in Nursing Philosophy and Science

Development
Nursing has developed its own body of knowledge through philosophy, research, education, and
practice.

Four fundamental patterns of knowledge in Nursing (Carper,

1978)

o Empirical knowledge

o Esthetic knowledge

o Moral knowledge

o Personal knowledge
Carper's Four Fundamental Patterns of
Knowing in Nursing (1978)
Barbara Carper proposed that nursing knowledge is built on four fundamental patterns of
knowing. These patterns help nurses provide holistic, effective, and patient-centered care.

1. Empirical Knowledge (The Science of

Nursing)
Definition

Empirical knowledge is the scientific knowledge of nursing. It is obtained through research,

observation, experimentation, and evidence-based practice. It focuses on facts, theories,
principles, and laws that can be verified and tested.

Importance

 Provides the scientific foundation for nursing practice.

 Helps nurses make evidence-based decisions.
 Promotes safe and effective patient care.
 Supports accurate assessment, diagnosis, and treatment.
 Enhances the quality of healthcare through research findings.

Example

A nurse knows that regular handwashing reduces the spread of infection because scientific
studies have proven it.

2. Aesthetic Knowledge (The Art of Nursing)

Definition

Aesthetic knowledge is the art of nursing. It involves understanding a patient's unique situation
and responding with empathy, creativity, intuition, and compassion. It focuses on the meaning of
a patient's experience rather than just the disease.
Importance

 Helps nurses provide individualized care.

 Strengthens the nurse-patient relationship.
 Promotes empathy and compassion.
 Allows nurses to respond appropriately to patients' emotional and psychological needs.
 Enhances patient comfort and satisfaction.

Example

A nurse notices that a patient is anxious before surgery and provides reassurance and emotional
support even without the patient expressing fear directly.

3. Moral Knowledge (The Ethics of Nursing)

Definition

Moral knowledge refers to the ethical and moral aspects of nursing practice. It involves
understanding what is right and wrong and making decisions based on ethical principles,
professional values, and patient rights.

Importance

 Guides ethical decision-making.

 Protects patient dignity and rights.
 Promotes fairness, honesty, and accountability.
 Helps nurses handle ethical dilemmas.
 Ensures professional and responsible nursing practice.

Example

A nurse maintains patient confidentiality and does not disclose private health information
without the patient's consent.

4. Personal Knowledge (Knowing Self and

Others)
Definition
Personal knowledge is the understanding of oneself and one's relationship with others. It
involves self-awareness, self-reflection, and recognizing personal beliefs, values, strengths,
weaknesses, and biases.

Importance

 Helps build trust and therapeutic relationships with patients.

 Improves communication skills.
 Encourages self-growth and professional development.
 Prevents personal biases from affecting patient care.
 Promotes genuine and authentic interactions.

Example

A nurse recognizes personal feelings about a patient's lifestyle choices and ensures those feelings
do not influence the quality of care provided.

Development of Nursing Science and Theory

1. 1952s: Beginning of Nursing Theory Development
Hildegard Peplau's Contribution (1952)

Hildegard Peplau developed the first theory of nursing practice through her book:

Interpersonal Relations in Nursing

Definition

Peplau emphasized the importance of the nurse-patient relationship as the foundation of

nursing care. She believed that effective communication and interaction between the nurse and
patient promote healing and recovery.

Importance

 Established nursing as a professional discipline with its own body of knowledge.

 Highlighted therapeutic communication.
 Became the foundation for many later nursing theories.
 Improved understanding of patient-centered care.

 Journal of Nursing Research (1952)

2.1960s–1970s: Analysis and Debate on Nursing
Theories
 Definition
 This period focused on examining and evaluating nursing theories and their philosophical
foundations, known as metatheoretical issues.
 Metatheory means "theory about theories."

3. 1980s: Acceptance of Nursing Theory

Definition

During the 1980s, nursing theories became widely accepted and were incorporated into nursing
education and practice.

4. 1990s: Nursing as a Science

During the 1990s, scholars debated the nature of nursing.

Progress in the Discipline of Nursing (Meleis)

According to Afaf Ibrahim Meleis, the nursing profession has progressed and developed through
four major areas: Practice, Education and Administration, Research, and Development of
Nursing Theory. These areas work together to strengthen nursing as a profession and improve
patient care.

1. Practice

Definition

Practice refers to the actual delivery of nursing care to patients, families, and communities. It is
where nursing knowledge, skills, and theories are applied to real-life situations.

2. Education and Administration

 Education involves preparing future nurses through teaching, training, and professional
development.

 Administration- Administration refers to the management and leadership of nursing

services, personnel, and healthcare resources.
Example : A nurse manager creates staff schedules, supervises nurses, and ensures adequate
staffing in a hospital unit.

[Link]

Research is the systematic process of investigating nursing questions and problems to generate
new knowledge and improve practice.

4. Development of Nursing Theory

Definition

The development of nursing theory involves creating and refining concepts, models, and
theories that explain nursing phenomena and guide nursing practice.

Modern Philosophical Paradigms in Nursing

A paradigm is a way of viewing, understanding, and studying reality.

1. Postpositivism
Definition

Postpositivism is a philosophical approach that believes reality exists, but humans can never
know it with complete certainty. Instead, researchers gather evidence to find patterns,
relationships, and the most probable explanation for a phenomenon.

2. Interpretive Paradigm
Definition

The interpretive paradigm focuses on understanding people's experiences, feelings, beliefs, and
meanings rather than measuring facts or numbers.

3. Critical Paradigm
Definition

The critical paradigm examines how social, political, economic, cultural, and gender-related
factors affect health and healthcare.

Paradigm Main Focus Key Question Example

Scientific patterns"What factors cause this Studying risk factors for
Postpositivism
and evidence problem?" hypertension
"What does this
Interpretive Human experiences Understanding how patients
experience mean to the
Paradigm and meanings cope with cancer
person?"
Critical Social justice and "How does society Studying healthcare access
Paradigm inequality influence health?" among poor communities