The Epistemology of Nursology: One Perspective

On May 12, 2021, I was honored to present the keynote address for the 2nd International Videoconference Forum, “The Epistemology of Nursing Knowledge: Its Importance in Times of Pandemic,” sponsored by the Benemérita Universidad Autónoma de Puebla, in Puebla, México. The topic I had been asked to address was the epistemology of our discipline. Although I certainly do not consider myself an epistemologist, I accepted the challenge of articulating my version of the epistemology of nursology.

The complete presentation is available below. A summary of the presentation is given here.

Inasmuch as epistemology refers to a theory of knowledge (Zander, 2007), I described the theory of nursology knowledge as embracing and “epistemological plurality . . . [that reflects] . . . a commitment to recognizing different ways of knowing to support [nursology’s disciplinary] mandate to consider the individual holistically and in context” (Ou et al., 2017, p. 7).
Epistemology is concerned with

  • Beliefs about the knowledge
  • The knowledge
  • The truth of the knowledge
  • Justification for the knowledge

My Beliefs about the Knowledge of Nursology

I and at least some other nursologists believe the epistemology of nursology includes a metaparadigm, philosophies, conceptual models, theories, and methods of scholarly inquiry. I acknowledge multiple versions of the metaparadigm; my version is human beings, environment, health, and nursologists’ activities. I believe that multiple philosophies, conceptual models, theories (grand theories, middle-range theories, situation-specific theories), and methods of scholarly inquiry are recognized as valid knowledge about our discipline. I also believe that the findings of every instance of scholarly inquiry constitute a theory, and that methods of scholarly inquiry encompass historical, philosophical, and empirical methods, all of which can include qualitative (subjective) and quantitative (objective) approaches.

The Knowledge

My understanding of the knowledge of nursology encompasses five ways of knowing – tenacity, authority, a priori, practice/practice wisdom, and theory—as well as eight fundamental patterns of knowing in nursing—empirical, aesthetic, ethical, personal, sociopolitical, emancipatory, spiritual, and unknowing.

The Truth of the Knowledge

My understanding of the truth of nursology knowledge is that “acting in the best interests of the people for whom [nursologists] care requires valuing both subjective and objective ways of knowing” (Zander, 2007, p. 7), and that the nursology scholarly methods of inquiry encompass both the objective (quantitative) and the subjective (qualitative). Both objective and subjective knowledge can be explicit or implicit/tacit.

Justification for the Knowledge

I maintain that methods for obtaining both objective and subjective knowledge are needed for “multidimensional understanding of the client within the context of situation, family and environment” (Ou et al., 2017, p. 7), which is best determined by conduct of scholarly inquiry for the purpose of development of situation-specific theories. In keeping with the conference theme, my presentation also included content about decolonizing nursology knowledge, which may be accomplished by revising or discarding the existing metaparadigm, philosophies, conceptual models, and theories to eliminate the current dominant Euro-centric worldviews of white privilege (Chinn, 2021).

Additional Comments

My presentation also included these suggestions for attaining social justice.

  • Develop new knowledge of how to increase planetary health equity and reduce or eliminate planetary health disparities
  • Develop new knowledge of how to eliminate structural and systematic racism

I agree with Chinn (2021) that much of the work of decolonizing and social justice can be achieved through an emphasis on development of situation-specific theories by inviting people to tell their stories of their health experiences. The stories than can be analyzed within the context of the situation and the people’s culture, with attention to avoiding stereotyping of the story-tellers on the basis of their culture. Decolonizing nursology knowledge and focusing on social justice also can be achieved through developing knowledge that “is an interchange between [culturally and contextually relevant] theory and practice and [is] guided by [culturally and contextually relevant] philosophy is like a kind of pendulum where all three elements [[culturally and contextually relevant] philosophy, theory, practice] are treated as equals” (Hoeck & Delmar, 2018, p. 1).

Conclusion

I believe it is crucial to the survival of nursology that we think and act on the basis of our five ways of knowing and a synthesis of our eight types of theories always and especially at this time of the pandemic, when so much emphasis is on doing tasks without sufficient attention to the why of the tasks beyond the pragmatic.

References

Chinn, P. L. (2021). Equity and social justice in developing theories. In E-O Im & A. I. Meleis (Eds.), Situation specific theories: Development, utilization, and evaluation in nursing (pp. 29-37). Springer Nature Switzerland.

Epistemology (2021, June 13). https://en.wikipedia.org/wiki/Epistemology
Hoeck, B., & Delmar, C. (2018). Theoretical development in the context of nursing—The hidden epistemology of nursing theory. Nursing Philosophy, 19(1), 10 pages. https://doi.org/10.1111/nup.12196

Ou, C. H. K., Hall, W. A., & Thorne, S. E. (2017). Can nursing epistemology embrace p-values? Nursing Philosophy, 18(4), 9 pages. https://doi.or/10.1111/nup12173

Zander, P. E. (2007). Ways of knowing in nursing. The historical evolution of a concept. Journal of Theory Construction and Testing, 11(1), 7-11.

The slides can also be viewed here

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