Playle J F
Manchester College of Midwifery and Nursing, Stockport, Cheshire, England.
J Adv Nurs. 1995 Nov;22(5):979-84. doi: 10.1111/j.1365-2648.1995.tb02651.x.
Nursing and nurse education have been influenced by a shift towards a broadly humanistic philosophy as a basis for practice. At the same time, in attempts to develop a knowledge base and credibility as a profession, the vital importance of research has been acknowledge. Both these aspects of nursing are increasingly forming the basis for all nursing courses. However, in this paper, it is argued that the implicit adoption of notions of science based in a positivistic paradigm gives rise to conflicts with a humanistic philosophy. It is contended that nursing has inherited a 'legacy of positivism', which promotes objectivity and reductionism and which excludes subjective meaning and the personal from the research process. In part this has been due to the powerful influence of medical hegemony, which has defined the nature of legitimate knowledge and controlled nursing research through the gatekeeping function of doctors. If nursing is to make progress in the development of a knowledge base, the contradictions between humanism and positivism must be acknowledged as a barrier to an integration of the art and science of nursing. This paper suggests that what is required is a paradigm shift, a redefinition of nursing science, which not only rehumanizes the nature of research, but also refutes and challenges the notion of objectivity and the objective attitude.
护理及护理教育受到了向一种广义人文主义哲学转变的影响，这种哲学作为实践的基础。与此同时，为了发展专业的知识基础并提升可信度，研究的至关重要性已得到认可。护理的这两个方面正日益成为所有护理课程的基础。然而，本文认为，基于实证主义范式对科学概念的隐性采用引发了与人文主义哲学的冲突。有人认为，护理继承了“实证主义遗产”，这种遗产促进客观性和还原论，将主观意义和个人因素排除在研究过程之外。部分原因在于医学霸权的强大影响，它界定了合法知识的性质，并通过医生的把关功能控制着护理研究。如果护理要在知识基础的发展上取得进步，就必须承认人文主义与实证主义之间的矛盾是护理艺术与科学融合的障碍。本文认为，需要的是一种范式转变，即对护理科学的重新定义，这不仅要使研究的性质重新人性化，还要反驳和挑战客观性的概念及客观态度。
