Presentation for Advanced Nursing Theory Class for FNP Degree

1. Chapter 22- Multiple Paradigms
of Nursing Science
Carmen Saunders
Advanced Nursing Theory
College of Mount Saint Vincent

2. Multiple Paradigms of Nursing
Science
• Paradigm- “a pattern,example,or model” and
secondarily as”an overall concept accepted by
most people in an intellectual community, as a
science, because of its effectiveness in explaining
a complex process,idea,or set of data”
(Webster's,1988)
• An abstract view or perspective of a discipline, a
set of systematic beliefs, a worldwide view, and a
theory (Kuhn, 1970).A disciplinary matrix that
includes symbolic generalizations, shared beliefs,
and shared values

3. Metaparadigm
• Describes from a global perspective, the concepts and
themes chosen as the focus of a discipline and those that
differentiate it from others (Fawcett, 1989).In nursing the
metaparadigm concepts are agreed to be
person,environment,nursing,and health.
• Disagreement on defining a single defenition of the
term,however,a discipline must have a predominant
paradigm in order to demonstrate progress as a legitimate
science
• 20 years debate on which science should guide nursing
science

4. What do paradigms do in nursing
science?
• Paradigms infer methods that scientists apply to solve
problems regardless of their philosophy and perspective or
lens through which phenomena can be viewed
• Answer questions to the disciplines most important
answers and shape the way resolving problems,conducting
research,and deriving theories and laws.For nursing
scientists,paradigms direct the perspectives from which
research questions are asked,problems are
investigated,research is designed as well as what methods
are used and data are collected, analyzed, and interpreted
(Newman,1991).

5. 2 Predominant Paradigms
• Empiricist-based on the assumption that what is
known can be verified through the senses ( Chin &
Cramer,1995).Theories depicting reality are
reduced into components that can be either
validated or disproved empirically in order to
justify the relationships set forth.
• Empiricism has its roots in the logical positivist
school of philosophy. Positivists disavowed
religious and metaphysical explanations reality
and analyzed theories for logical patterns of
reasoning that could be verified through reality.

6. Empiricism
• The scientific method is associated with empiricism and observation is
the preferred method of data collection
• Necessary to substantiate claims regarding nursing care and the
responses of persons in health and illness situations,provide
explanatory models, and test and generate theory
(Gortner,1990;Weiss,1995).
• Some nursing scientists criticize positivism because it doesn’t
recognize other forms of knowing besides that that can be verified.
• Didn’t reflect the values and beliefs of nursing nor the disciplines
focus on holism, person-centered care, and understanding of human
experiences in health and disease.
CAN YOU THINK OF AN EXAMPLE IN YOUR PRACTICE WHERE
EMPIRICISM HAS BEEN USED POSITIVELY OR NEGATIVELY
GIVING NURSING CARE?

7. Interpretative Paradigm
• Reality is complex, holistic, and content dependent (Boyd,1993). The focus of
investigation is on human experience:thus subjectivity rather than objectivity is
emphasized(Hard,1997).
• Common features of these research traditions are a a holistic approach to questioning, a
focus on human experience, purposive sampling,sustained contact with participants,the
involvement of the researcher in the process,emergent design, negotiated outcomes, and
special criteria for trustworthiness ( Lincoln & Guba,1985).
• Broadly grouped under the term qualitative research
• Emphasizes humanistic approaches but ignores reality of physiological problems that
are an integral part of of a discipline that deals with health and disease
• Nursing science must address the complex problems that nurses are deal with
daily.Relying solely on interpretation and gaining understanding are not amenable to
testing theory ( Gortner,1990).
• HOW DO YOU FEEL ABOUT INTERPRATIVE VS EMPIRICISM PARADIGM SO
FAR? WHICH ONE CAN YOU IDENTIFY MORE WITH?

8. Is Nursing Science a Mature
Science?
• Kuhn- predominant paradigm is the most important criterion. Using
paradigms are extant. He emphasizes facts, experimentation,
empiricism, and natural; science. This positivist perspective is
inappropriate and too narrow for for a human science such as nursing
that confronts a variety of problems (Fry,1995;Meleis,1997).
• Meleis-Diversity, theory development,competition, creativity,
innovation Kuhns criteria nursing science is at a preparadigamatic
stage because several, openness, flexibility , and change are
characteristics of a mature discipline according to Meleis. She states
that nursing has achieved disciplinary status when evaluated by these
criteria.

9. Single or Multiple Paradigms?
• Single Paradigm
• The advantage of one paradigm lies in its simplicity as
there are fewer concepts and relationships to be examined (
Silva & Rothbart, 1997). Hardy (1997) suggests that one
possible reason for adopting a predominant is to define the
boundaries.
• Disadvantage of theoretical unification is the narrowness
of vision afforded by such a perspective. Not examining
new phenomena ; rather, the aim of normal sciences to
articulate the phenomena and theories that the paradigm
already supplies( Kuhn, 1970).

10. Single or Multiple Paradigms?
• Multiple
• Indicative of a “healthy” scientific community because they encourage
creativity, stimulate the debate and the exchange of ideas,provide
diversity of views (Kim,1997;Ramos,1997), promote productivity
(Donaldson & Crowley,1997), and keep open avenues of inquiry
(Ramos,1997).
• Multiple paradigms encourage “thinking outside the box”rather than in
the box like theoretical unification
• Different pragmatic views may increase productivity instead of relying
on one perspective limiting scientists to repeatedly investigating the
same problem from the same approach in different populations.
• Disadvantage- Practitioners and may become confused and divided
over the conflicting claims if different viewpoints (Reed,1995).
• DO YOU FEEL WE SHOULD HAVE ONE SINGLE PARADIGM
OR MULTIPLE PARADIGMS GUIDING OUR PRACTICE?

11. Implications for Nursing Science
• Need a perspective that emphasizes inquiry rather than
paradigmatic supremacy or u unification is more
advantageous to nursing as a discipline
• Collaboration toward solving problems is more beneficial
for the discipline than competition over which tradition is
more useful ( Silva & Rothbart, 1997).
• Integration of quantitative and qualitative methods have
been suggested to advance nursing science.Research
traditions from the empirical and interpretative paradigms
are complementary as each represents a different approach
( Poole & Jones, 1996).
• DO YOU THINK ONE CAN SURVIVE WITHOUT THE
OTHER? EMPIRICISM VS INTERPRATIVE

12. Implications
• Qualitative- can describe phenomena of interest and generate theories
that propose relationships between identified concepts.
• Quantitative- test relationships of qualitatively developed theory and
suggest whether the theory should be accepted or revised.
• Clinician readily understand that there are many ways to accomplish
the same goal and that nurses use whatever method they are most
comfortable with that works best in a particular situation.
• Presenting research as a system of inquiry that can be accomplished
several ways may improve the palatability of research in educational
programs.
• If differing perspectives can generate and test theories that provide
faithful representations of practice and are useful in practice settings ,
they will flourish
• DO YOU AGREE WITH THE AUTHOR THAT
MULTIPARADIGISM IS THE BEST APPROACH?