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临床护理理论的哲学分析

Philosophic analysis of a theory of clinical nursing.

作者信息

Schafer P J

机构信息

Children's Hospital of Pittsburgh, Pennsylvania.

出版信息

Matern Child Nurs J. 1987 Winter;16(4):289-368.

PMID:3450983
Abstract

Knowledge in nursing requires development of theories that address both the science and art of the professional practice discipline. "A Theory of Clinical Nursing" was analyzed to explicate the epistemologic dimensions within an historic perspective. Epistemologic dimensions defined by the philosophy of science--approaches to theory development, sources of knowledge, and methodology--were characterized from two perspectives, scientific inquiry and historicism. The major perspectives in the scientific mode, namely, mechanism, empiricism, logical positivism, and logical empiricism, were analyzed along the three dimensions of theory development, sources of knowledge, and methodology. Trends in theoretical developments in nursing were related to the scientific and historic perspectives and to the epistemologic dimensions. Juxtaposing the diversity of knowledge required for nursing science and practice, and the values systems of the practitioners, revealed the inadequacy of the scientific model. Nursing knowledge explication required several modes of inquiry to articulate the scientific basis of the discipline and the art of delivery of the practice. The historicist approach framed scientific work with the prevailing World View. The Rubin theory was located within the matrix of approaches to inquiry and perspectives in nursing science. Labeled by the theorist as both a nursing research and a nursing care model, "A Theory of Clinical Nursing" represented a transition model of nursing, undergirded by the major conceptualizations and methodologies of field, psychoanalytic, and social behaviorist traditions, but implicitly coalescing the art with the science of nursing. The theory addressed core concepts of person, situation, and nursing care, as well as major process themes of change and interaction. Nursing theories of a more narrow range, such as maternal role attainment and maternal identity, nested within the theory, while subsequent theoretical clarifications and expansions have been constructed by students of the theorist. In the hierarchy of knowledge conceptualizations, Rubin's theory represents a disciplinary matrix: ordering theories, methods, and exemplars; giving direction to the development of theories of nursing that address empirical problems of the discipline; and cohering to the metaparadigm of nursing. Philosophic analysis of theories of nursing can yield an articulated, clearly depicted framework of concepts and their relationships from which new understandings may emerge.

摘要

护理知识需要发展既涉及专业实践学科的科学又涉及艺术的理论。对《临床护理理论》进行了分析,以便从历史角度阐明认识论维度。由科学哲学所界定的认识论维度——理论发展方法、知识来源和方法论——从科学探究和历史主义两个视角进行了刻画。科学模式中的主要视角,即机械论、经验主义、逻辑实证主义和逻辑经验主义,沿着理论发展、知识来源和方法论这三个维度进行了分析。护理理论发展的趋势与科学和历史视角以及认识论维度相关。将护理科学与实践所需知识的多样性以及从业者的价值体系并列,揭示了科学模式的不足。护理知识阐释需要多种探究模式来阐明该学科的科学基础以及实践的艺术。历史主义方法用盛行的世界观构建科学工作。鲁宾理论处于护理科学探究方法和视角的矩阵之中。《临床护理理论》被理论家既标记为护理研究模式又标记为护理照护模式,它代表了一种护理的过渡模式,以田野、精神分析和社会行为主义传统的主要概念化和方法论为基础,但含蓄地将护理艺术与科学结合在一起。该理论涉及人、情境和护理照护的核心概念,以及变化和互动的主要过程主题。范围更窄的护理理论,如母亲角色获得和母亲身份认同,嵌套在该理论之中,而该理论家的学生随后构建了理论阐释和扩展。在知识概念化的层次结构中,鲁宾理论代表了一个学科矩阵:对理论、方法和范例进行排序;为解决该学科实证问题的护理理论发展指明方向;并与护理元范式保持一致。对护理理论的哲学分析可以产生一个清晰阐述、明确描绘的概念框架及其关系,从中可能会产生新的理解。

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