“Nursing Philosophy and Theory in Japan: Current Trends and Challenges” (Sakashita et al. 2025) has rapidly emerged as a notable work that provides a very important advancement in decolonizing nursology knowledge.
Evolution of Nursology Knowledge in Japanese Doctoral Nursing Programs
The authors are commended for their systematic, scholarly approach to tracing the evolution of nursing philosophy and theory in Japanese doctoral nursing programs, as documented in course syllabi. They reported that only 22 (17.2%) of the currently existing 128 (as of 2024) Japanese doctoral nursing programs include courses that focus on philosophy and/or theory.
The authors mentioned that Florence Nightingale’s work was most frequently discussed in Japanese nursing literature. This is not surprising given that Western nurses came to Japan to establish nursing education programs and that Japanese nursologists came to Western countries for graduate studies when Florence Nightingale is regarded as having founded modern nursing (see, for example, https://nursology.net/2022/05/13/nightingale-2020-2021-a-symposium-commemorating-the-bicentennial-of-florence-nightingales-birth/).
Decolonizing Nursology Knowledge: From a Western Perspective to a Distinctive Japanese Perspective
Decolonizing knowledge means that
Actions and process [are] implemented to acknowledge the history and contributions of Black, Indigenous and other people of color to expose, resist, challenge, transform, and dismantle the structures, policies, concepts and systems built from colonized, Eurocentric values and priorities and to create new policies, concepts, and systems that honor and reflect perspectives, values, and priorities built from the traditions and perspectives of Indigenous and other people of color Decolonization is shifting the power [from White privilege to those of other races and ethnicities]. (Chinn et al., 2026, p. 263)
Most important for decolonizing our disciplinary knowledge is the recent development of middle-range and especially situation-specific theories of phenomena of particular concern to the people of Japan and their health conditions. This contribution to decolonized nursology knowledge followed after many years of use of conceptual models and theories developed by Western nurses, especially those from the United States.
Sakashita et al. (2025) explained,
In nursing, Western theories introduced by the United States have faced criticism for their cultural misalignment, reliance on unfamiliar abstract Western concepts and terminology, and insufficient focus on practical techniques. For instance, while patients’ decision-making in the United States is largely based on their individual autonomy, Japanese patients would prioritize harmony with their family members and the broader social context. Nursing philosophy in the United States is rooted in the cultural and intellectual history of Western philosophy. Conversely, with its unique cultural heritage, Japan cannot achieve a truly authentic nursing philosophy by merely adopting Western frameworks without critical reflections (p. 198).
Theories Developed by Japanese Nursologists
Sakashita et al.’s (2025) review of publications by Japanese nursologists revealed 11 papers about theories, which are listed here:
- Scientific Nursing Theory
- Kanal Original Modern Innovation Theory
- Concentric Sphere Family Environment Theory
- Family Care/Caring Theory
- Family Belief Systems Theory for Transcultural Family Health Care Nursing
- Middle Range Theory on Women’s Leadership in Asian Culture
- Middle Range Theory on Asian Women’s Leadership in Nursing
- Child Self-Care Nursing Theory in Japan
- SST [situation-specific theory] of Dining Supports for Life Enhancement at Welfare
- Facilities for Seniors in Japan
- Community Caring for Public Health Nursing theory
- SST of Transition for Stroke Survivors with Dysphagia
The Next Stage of Evolution of Japanese Nursology Knowledge
The next stage of evolution can take at least two approaches to decolonizing nursology knowledge.
Chinn et al. (2026) advocated for these two approaches:
One [approach] is to replace or start anew with perspective derived from the knowledge perspectives developed by and for people of color. Another is to revise colonial knowledge structures in such a way that [people of color’s] perspectives are integrated with existing structures. Both approaches require, and depend on, shifts that respect, honor, and give primary space for the insights and wisdom that derive from people of of color and their cultural heritages (p. 4).
My idea of approaches is similar. One approach is to derive decolonized knowledge from Western perspectives. For example, according to Sakashita et al. (2025), Florence Nightingale (see https://nursology.net/nurse-theories/florence-nightingales-perspective-of-nursology/) is the basis for these two theories developed by Japanese scholars–Scientific Nursing Theory and Kanal Original Modern Innovation Theory. In addition, the Child Self-Care Nursing Theory is based on Orem’s Self-Care Framework (see https://nursology.net/nurse-theories/orems-self-care/).
Moreover, Roy’s Model (RAM; 2009) has been used for many years by faculty and learners at St. Mary’s College School of Nursing in Kurume, Japan. RAM guides the curriculum within the undergraduate and graduate programs. RAM also guides research, which is organized within college’s Roy Academia Nursology Research Center
Examples of a distinctively Japanese perspective of nursology based on RAM are these nursology.net blogs:
- What is Real Nursing and Who are Real Nurses? Perspectives from Japan
- The Definition of Health: Thoughts from Japan.
- Decolonizing Nursology Knowledge-Japan
The second approach is for Japanese nursologists to continue to develop distinctive nursology theories based on explicit Japanese nursology perspectives This approach requires that Japanese nursology scholars develop distinctive nursology conceptual models as the explicit starting point for nursology middle-range and situation-specific theories.
References
Chinn, P. L., Canty, L. , & Mkandawire-Valhmu, L. (2026). Knowledge development in nursing. Theory and process (12th ed.). Elsevier. ISBN: 978-0-443-12711-3
Sakashita, R., Awamura, K., & Ono, H. (2025). International Section. Nursing Philosophy and Theory in Japan: Current Trends and Challenges. Advances in Nursing Science, 48(2), 189–201. https://doi.org/10.1097/ANS.0000000000000561