DEVELOPMENT PROCESS OF

THEORY IN NURSING
“Why should nurses be interested in the history and
philosophy of science? The history and philosophy of
science is important as a foundation for exploring
whether scientific results are actually truth. As nurses
our practice should be based upon truth and we need
the ability to interpret the results of science. Nursing
science provides us with knowledge to describe, explain
and predict outcomes. The legitimacy of any profession
is built on its ability to generate and apply theory.”
(McCrae, 2011, p. 222)
“ Philosophy in its broadest sense is wondering and being curios
about the BIG or FUNDAMENTAL QUESTIONS that humans
have grappled with throughout history. Questions about :
WHAT IS REAL? , (Ontology) ,
WHAT IS KNOWABLE? (Epistemology) ,
IS THIS JUST? (Ethics) and
IS THERE AN ART OF CARING? (Aesthetics) are considered
indispensable reflections in nursing practice.”
(Bruce, Rietze and Lim , 2014,p.65)
 HISTORICAL VIEWS OF THE NATURE OF SCIENCE
 Why is science important? Science is a method for describing , explaining ,
and predicting causes or outcomes of interventions.
 Scientific activity has helped to established the evidence we use to guide
practice in the delivery of nursing care.
 We desire to know the unknown , and identify the cause , the effect, and
the significance difference that an intervention can make to increase the
longevity of life. ( Bronowski, 1979 ; Gale ,1979 ; Piaget,1970).
 Since 1960s, nursing leaders have strategized for nursing to be
considered a scientific discipline. Being a scientific discipline means
identifying nursing’s unique knowledge for the care of patients, families ,
and communities and populations.
 To formalize the science of nursing , basic questions must be considered ,
such as: What is science , knowledge , and truth? What methods produce
scientific knowledge? The answers to these questions are influenced by
one’s philosophy.
HISTORICAL VIEWS OF THE NATURE OF SCIENCE
(CONTINUATION)
 The particular philosophical perspective selected to answer the questions will
influence how researchers perform scientific activities, how they interpret
outcomes , and even what they regard as science and knowledge (Brown,1977 ;
Foucalt,1973)
 Two competing philosophical perspectives used in science are RATIONALISM &
EMPIRICISM. Each is a type of epistemology that is a theory of knowledge for
understanding how to uncover the answer to a question.
 Nursing science has been characterized by two branching philosophies of
knowledge as the discipline developed. Various terms are used to describe
these 2 stances:
1. Empiricist , mechanistic quantitative and deductive AND
2. Interpretive , holistic, qualitative, and inductive forms of science.
 Understanding the nature of these different philosophical stances facilitates
appreciation for what each form contribute to nursing knowledge.
 RATIONALISM
 Is the epistemological view that “ regards REASON as the
chief sources and test of knowledge” OR any view appealing
to reason as a source of knowledge or justification. It is a
methodology or a theory “ in which the criterion of truth is not
sensory but intellectual and deductive”.
 Rationalist epistemology (scope of knowledge) emphasizes
the importance of a priori reasoning as the appropriate method
for advancing knowledge.
 A priori reasoning uses deductive logic by reasoning from
cause and effect or from a generalization to a particular
instance.
EMPIRICISM
 Is the theory that the origin of all knowledge is sensory
experience ( seeing ,feeding , hearing facts , etc )
 It emphasizes the role of experience and evidence, especially
sensory perception in the formation of ideas , and argues that
the only knowledge humans can have is a posteriori (based on
experience).
 Empiricist view that , to build a more complex body of
knowledge from these direct observation, induction or inductive
reasoning (making generalizations based on individual
instances) must be used.
 RATIONALISM & EMPIRICISM
Rationalism
 Reason is the source of all
knowledge
 Mind contains innate ideas
 Knowledge can be gained a
priori(deductive logic)
 Knowledge can be certain
 Senses are easily fooled
 Uses theory-then-research
strategy
Empiricism
 The senses are the source of all
knowledge
 Mind is a “tabular rasa” (for clean
state)
 Biology is a model for knowledge
 Knowledge is only gained a
posteriori (inductive method)
 Knowledge can ever be probable
 Reasons only can give us access to
uninformative tautologies
 Uses research-then-theory strategy
 VIEWS OF SCIENCE & THEORY
IN THE EARLY 20TH CENTURY :
• POSITIVISM which supports that that empirical research and logical
analyses (deductive & inductive) were two approaches that would
produce scientific knowledge (Brown, 1977)
• The logical empiricists argued that theoretical propositions must be
tested through observation and experimentation (Brown ,1977)
• This perspective rooted in the idea that empirical facts exist
independently of theories and offer the only basis for the objectivity in
science.
• In this view, objective truth exists independently of the researcher , and
the task of science is to discover it, which is an inductive method.
• Philosophers focused on the analysis of theory structure,
whereas scientist focused on empirical research.
• Positivism (imposed on the mind by experience) is the
philosophy of science that information is derived from logical
and mathematical treatments and reports of sensory
experience is the exclusive source of all authoritative
knowledge.
• The logical positivist believed that, empirical research and
logical analysis would produce scientific knowledge.
• Logical empiricist argued that theoretical propositions must
be tested through observation and experimentation.
• Empiricists argue that for science to maintain its objectivity,
data collection and analysis must be independent of a
theory.
 VIEWS OF SCIENCE & THEORY
IN THE LATE 20TH CENTURY :
• A new perspective in science emerged as several authors presented analyses,
challenging the positivist position.
• Foucault presented his major thesis which believes that empirical knowledge
was arranged in different patterns at a given time and in a given culture and that
humans were emerging as objects of study.
• In 1977, Brown argued for an intellectual revolution in philosophy that
emphasized the history of science was replacing formal logic as the major
analytical tool in the philosophy of science.
• One of the major perspectives in the new philosophy emphasized that science
was a process of continuously building research rather than a products of
findings.
• Brown (1977) proposed that theories play a significant role in determining what
the scientist observes and how it is interpreted.
• Nurses use evidence-based science to support the intervention performed in the
care of patients.
• Foucault (1973) published his analysis of the epistemology (knowledge) of
human sciences from the seventeenth to the nineteenth century.
• In The Phenomenology of the Social World, Schutz (1967) argued that
scientists seeking to understand the social world could not cognitively
know an external world that is independent of their own life experiences.
• Phenomenology, set forth by Edmund Husserl (1859 to 1938) proposed
that the objectivism of science could not provide an adequate
apprehension of the world (Husserl 1931, 1970).
• Empiricists view phenomena objectively, collect data, and analyze it to
inductively proposed theory (Brown, 1977).
• Brown (1977) set forth a new epistemology challenging the empiricist view
proposing that theories play a significant role in determining what the
scientist observes and how it is interpreted.
 THE FOLLOWING STORY ILLUSTRATES
BROWN’S PREMISE THAT OBSERVATIONS
ARE CONCEPT LADEN:

“An elderly patient has been in a trauma and appears to be

crying. The nurse on admission observes that the patient has
marks on her body and believes that she has been abused; the
orthopedist has viewed an x-ray and believes that the crying
patient is in pain due to a fractured femur that will not require
surgery only a closed reduction; the chaplain observes the
patient crying and believes the patient needs spiritual support.
Each observation is concept laden.”