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Nursing philosophy: what is nursing philosophy, 2 nursing philosophies, what is a paradigm, 2 paradigms
- All research is built upon philosophical beliefs &
- assumptions (worldviews or paradigms) about the world.
: system of motivating values, concepts, principles, and the nature of human knowledge of an individual, group, or culture
is a Greek word that means pattern. This word has been applied to science to describe the way people in society think about the world
- Two nursing philosophies
- -ontology: study of being, existence, & its relationship to non-existence
- ie: An example is a tree. Such a thing for me exists
- -epistomology: knowledge/what is truth or reality
How do I know a tree is?
I see it, feel its trunk & leaves, smell its flowers, have seen it before, people tell me about it, & I read about it. I have knowledge of what something is to be a tree.
- Two paradigms
- Paradigm: a model that explains the linkages of science, philosophy, and theory accepted and applied by a
- The two paradigms positivism & constructivism each determines a researchers actions & research methodology.
Definition: the "received view" in quantitative research; a philosphical approach that recognizes only observable data
Ontology: Reality exists (but no absolute truth) & it can be measured, observed & known as fact. Reality is driven by natural laws.
Epistemology: Objectivism is valued as phenomena can be observed & measured.
Quantitative or deductive research. Deductive is starting with the general picture. This could be starting with 2 or more concepts (a theory) & suggest relationships.
Deductive reasoning = logical thought process in which hypotheses are derived from theory; reasoning moves from general to the particular
Definition: basis for naturalistic (qualitative) research, which developed from writers such as Immanuel Kant, who sought alternative ways of thinking about the world
Ontology: Reality is not fixed but is a construction of what people perceive it to be. Many realities exist that are influenced by culture & the environment.
Epistemology: Multiple truths that are determined by the individual or group of individuals. No ultimate truth. Subjectivism is valued.
Qualitative or inductive or naturalistic research. Inductive is figuring out what there is there. Starts with particulars & moves to a general picture.
Inductive reasoning = logical thought process in which generalizations are developed from specific observations; reasoning moves from particular to the general
Know how a researcher chooses a research process in light of the paradigms: p. 29
starts with what kind of paradigm
Mixed method or triangulation
Useful when little is known about the phenomena
Definition: (used in social sciences) as research in which the investigator collects and analyzes data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or a program of inquiry. Is a form of triangulation - in which the researcher uses more than 1 research strategy in a single study
Both the quantitative & qualitative methods can be used in a single study if mixing matches the research goals
- -If you were studying the influence of leadership on the
- intent of nurses to stay in their jobs to aid in the development of a leadership training program you could use a combination of methods.
- -You could do a focus group to identify what leader’s
- qualities/skills influence a front line nurse’s job satisfaction & intent to stay. A survey can then be done using the major themes identified from the focus group. After statistical testing, significant results can be used to develop a teaching program.
-In essence the subjective data is being quantified or measured.
-This type of research is becoming more popular by researchers.
Approaches to Science: step by step, what do you start with first
1. The aims of inquiry or goal of research vary with the paradigm a researcher chooses.
2. Dependent upon the research goal an approach is chosen: inductive or deductive.
3. Remember we reviewed that some of the aims of research were identification, description, exploration, explanation, prediction or control. (PURPOSE OF RESEARCH: IDEEPC)
- Inductive reasoning: Start with details
- of experience and move to a general picture. This would be used if the aim was to explore, explain, describe.
: Start with a general picture and move to a specific direction; uses two or more concepts. This would be used if a researchers aim was to identify differences, predict or control.
Framework: ladder of abstraction
Framework: research requires a framework to help visualize research
researchers use a ladder of abstraction which is a visual way of placing thinking about the philosophies, theories, methods and measurements of their research.
A researcher usually does this when planning out research but rarely states it in their research article.
It is often an assumption that the article reader must catch.
As a novice research consumer this is a good place to start to understand research.
A. Worldview: highest rung on the ladder
Definition: paradigm or assumption about person, health, environment, & nursing
- 1. Person
- Recipient of care, including physical, spiritual,
- psychological, and sociocultural components.
Individual, family, or community
- 2. Environment
- All internal and external conditions, circumstances, and
- influences affecting the person
- 3. Health
- Degree of wellness or illness experienced by the person
- 4. Nursing
- Actions, characteristics and attributes of person giving
B. Middle rung on the ladder: framework (2) & theories (3)
framework: 2 kinds, how to evaluate a framework
theories: grand, middle, micro
: gives structure to the research, clarifies concepts, identifies & states underlying assumptions of a study, specifies relationship among and between concepts
- Two kinds of framework
- 1. Theoretical framework: based on a specific theory. Structure of concepts exists (and has been tested) & is a ready-made map for a study
How to evaluate a framework:
- 2. Conceptual framework: in studies rooted in a conceptual model
- -conceptual model/map series of interrelated concepts of rational scheme by virtue of their relevance to a common theme. It's not based in a specific theory
- 1. Is the framework clearly identified?
- 2. Is the framework appropriate for the topic?
- 3. Are the concepts and variables clearly and appropriately
- 4. Is the basis for the hypothesis(es) clear and consistent?
- as a "set of two or more interrelated concepts that present a systematic view of a phenomenon that helps to explain it and make predictions about the phenomenon”
- Nursing theory:
- set of concepts, definitions, relationships, & assumptions or propositions derived from nursing models or from other disciplines & project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, & /or prescribing. As this is the aim of inquiry for much research theory makes effective grounding for studies.
- Theory Levels
- 1. Grand theory: all-inclusive conceptual structure that tends to include the metaparadigm views on person, health, environment to create a perspective for nursing.
- Ie. Orems' theory of self-care deficit, Parse's theory of human becoming
- 2. Midrange: synthesizes practice and research
- Ie. typically addresses a particular pt experience or problem; their range of applicability is relatively narrow but hte narrow range allows them to be developed to address specific issues encountered in clinical practice
- 3. Microrange: provides specific directions for practice. Linkage of concrete concepts into a statement that can be examined. Also called practice or narrow theory. Situation specific, lacks generalizability.
- Ie. Daily routine of a nurse with contact with patients, hypothesis
C. Lowest rung on the ladder: concepts & variables
concept: conceptual & operational
- A concept: is an abstraction based on observations of – or inferences from- behaviors or characteristics.
- Examples: pain, stress, caregiver burden, grief, self-efficacy, knowledge sharing.
A conceptual definition
: is the abstract or theoretical meaning of the concepts being studied. It defines a concept as it is rooted in the theoretical literature
. Comparable to a dictionary definition.
- −A operational definition: is the definition
- of a concept or variable in terms of the procedures by which it is to be measured. It specifies how the concept will be measured. What instruments will be used to capture a variable.
Dependent variable (DV)
- A variable is a defined concept or properties that take on different values and are studied by the quantitative method.
: in experimental studies, the presumed effect of the independent variable or experimental variable on the outcome. usually the outcome or measureable variable
Independent variable (IV)
: the variable that has the presumed effect on the dependent variable. is usually the concept of interest or the treatment variable
: a prediction
about the relationship between one or two variables.
Review of the ladder of abstraction
Epistemology: branch of philosophy that deals with what we know as truth or knowlege and includes its origins, limits, and nature
Ontology: branch of philosophy that studies the nature of being or existence
Context: place where something occurs which can include physical place, cultureal beliefs, and life experience
Paradigm: how a person or a group of people think about the world ("pattern")
Constructivism: basis for naturalistic (qualitative) research, a world view that's guided by an ontological perspective and suggests that many realities exist rather than only a single reality
Postpositivism: philosophy that holds that truth is sought through replicable observations and based on the premise that a single reality exists
Quantitative vs Qualitative
- based on the belief that we can best understand humans and their behaviour by taking humans apart, studying specific characteristics one at a time and measuring each one in the hope that we can understand each characteristic in a clear and context-free manner. Once we clearly understand all of the pieces, we can put them together and understand the whole. Quantitative studies rely much more heavily on preselected instruments, collect lots of data, and answer questions through the analysis of numbers that represent those characterictics
- uses naturalistic approaches to learn about human phenomena and is an accepted way of gaining knowledge. It's grounded in the social sciences and gives nurses ways to better understand the lived experience and human processes that surround health and illness
Inductive vs. Deductive
Inductive: moves from particular to the general (or conclusions developed from specific observations)
Deductive: moves from general to particular (or predictions developed from known relationships)
Examples of a concept
"...stress and empowerment were used to guide this study."
clinical decision making
Examples of an operational definition
"fatigue symptoms were measured using the Modified Fatigue Symptoms Checklist (MFSC), a liist of 30 symptoms of fatigue. Scores range from zero (no fatigue symptoms) to 30 symptoms (maximum fatigue)."
Older (i.e., more than 35 years of age) first-time mothers
Examples of a conceptual definition
"Serenity is viewed as a learned, positive emotion of inner peace that can be sustained...that decreases perceived stress and improves phsical and emotional health."
"Acute confusion is a transient syndrome characterized primarily by abnormalities in attention and cognition, but disordered psychomotor behavior, sleep-wake distrubance, and autonomic nervous system distrubances are not uncommon."