Contributed by Karen J. Foli
Nursology.net Advisory Team
One of the things I enjoy is learning about phenomenon that helps me process and explain experiences. The truth of this was evident when I read the letter to the editor of Nursing Outlook by Lisa Kelly (2025), who encouraged our nurse scientists to explore the issue of the Matilda Effect in our profession. In brief, the term was coined by Rossiter (1993) who discussed the bias against women scientists and withholding appropriate credit and recognition of their scholarship. A similar pattern was noted by Merton (1968) with the, Matthew Effect, which tends to inflate the contributions of prominent scientists beyond their actual current contributions. It’s easy to grasp how these phenomena merge to create under-credited and under-appreciated contributions of women scientists, and by extension, nursologists. I further extend these biased influences to nursing theory and argue that nursing theory is often discounted because of both the Matthew Effect and Matilda Effect. Last, I discuss the Maya Effect (Mickey et al., 2026), a newly coined term to describe the intersectionality of race and gender in sciences and how nursing theory is positioned given this exclusionary bias.
My first experience with the Matthew/Matilda Effects as a nursologist was early in my academic career when conducting research studies in the area of adoptive families’ mental health. I recall being called into a large conference room with my co-principal investigator, also a woman, and when I opened the door, the cramped room was arm-to-arm with men seated around an oval table. At the time, I was investigating parental postadoption depression (Foli, 2010) and had proudly laid my grant proposal out there for these men to read. I waited for comments and questions and what struck me in its absurdity was the strongest recommendation: I really needed a physician (really a guy) on my team to help explain the biology of it all, the hormonal shifts, like in postpartum depression. And funding was withheld until I obtained such an expert. It wasn’t that I objected to collaborating with a physician. My unvoiced objection was that the science, the proposed study, didn’t need this type of expertise. Such an expert would not contribute to this study; their role didn’t serve any scientific purpose. Clearly, my scholarship, theory, and lived experience didn’t count for much. Undeterred, my colleague and I went on to conduct numerous studies based on my theory of parental postadoption depression, a body of work that has drawn attention from international audiences. And without the presence of a physician/expert on biological endocrine functioning as co-author.
Another area, more disconcerting, is when the Matthew/Matilda Effects are suspected in my role of teaching theory as a nurse educator. My students would gravitate to non-nursing/borrowed theories to describe, explain, and predict phenomenon. The non-nursing theories were somehow more credible, more “evidence-based,” more scientific when compared with nurse-generated theories. They would bypass the nurse theories for what I believe they believed to be more empirically grounded works such as the Health Belief Model of Behavioral Change (Bandura, 1977; Janz & Becker, 1984). I remember Jacqui Fawcett strongly advocating for graduate students to use nursing theories in their work, and if they had to use a borrowed theory, they were required to present the rationale and to link it to a nursing theory. She was so right about so many things.
Perhaps it is the number of nursing theories that are currently in our arsenal of knowledge – dozens on Nursology.net (2026). Rather than pruning these, most nursologists would encourage the creation and dissemination of more nursing theories as the human condition cannot be confined to a limited number of theories. Our epistemological grounding is beyond mere empiricism to embrace all the ways of knowing (Chinn et al., 2025), humanistic approaches to “science,” and adhering to McNamara’s fallacy that not everything can be measured, also known as the quantitative fallacy (Yankelovich, 1971). To explain, Robert McNamara was the U.S. Secretary of Defense during the Vietnam War, and this term emanates from his reliance on quantitative data, leading to the great tragedies and loss of life that ensued during the war. The brilliant nursing theories we have reflect this knowing and while evidence is needed, there is more to our stories as human beings than numbers – or machine learning, large language modeling, or anything else a computer alone spits out (AI).
To close, there is one more “M” effect I’d like to draw your attention to: the Maya Effect (Mickey et al., 2026). Coined by Mickey and colleagues (2026), this phenomenon extends beyond the Matthew/Matilda Effects to draw attention to the intersection of gender and race. Named after the esteemed poet and writer, Maya Angelou, this effect adds the intersectionality of race and gender in science and how credit is disproportionately withheld to women of color. Mickey et al. (2026) go on to describe how collaborative efforts are also different for women of color in science:
The Maya Effect shows how both race and gender together affect how credit is shared in research teams. Women of color often face unique challenges in collaborations, such as having their contributions ignored, being excluded from important decisions, or having to constant prove their value. Unlike older theories that focus mostly on status or gender, the Maya Effect highlights how racial and gender inequalities work together (p.387).
The Maya Effect led me to the Nursology.net Theory/Model Author Gallery (2026) and scrolling through the various photos and models/theories. I hadn’t reviewed this gallery for some time, and it seems to me that we are showing strong signs of moving toward diversity in nursing theorists. There appears to be an increased number of men and people of color, a diversity of thought as well. I am proud to be part of this representation and hope that this multiplicity in theoretical works and theorists continues to increase. Despite the three “M Effects,” nursing theory is alive, growing, and reflects diversity in representation and in thought.
References
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215.
Chinn, P. L., Canty, L., & Mkandawire-Valhmu. (2025). Knowledge development in nursing: Theory and process. Elsevier.
Foli, K.J. (2010). Depression in adoptive parents: A model of understanding through grounded
theory. Western Journal of Nursing Research, 32, 379-400. doi:
10.1177/0193945909351299
Janz, N. K., & Becker, M. H. (1984). The Health Belief Model: A decade later. Health Education Quarterly, 11(1), 1-47.
Kelly, L. (2025). Letter to the editor: Naming the Matilda effect in nursing Nursing Outlook, 73(6), Issue 6, 102554
Merton, R. K. (1968). The Matthew Effect in Science: The reward and communication systems of science are considered. Science, 159(3810), 56–63. https://doi.org/10.1126/science.159.3810.56
Mickey, E., Misra, J., Smith-Doerr, L., & Kane-Lee, E. S. (2026). The Maya Effect: Theorizing beyond Matthew and Matilda Effects to an intersectional understanding of collaboration. Gender & Society, 40(3), 386–415. https://doi.org/10.1177/08912432261449277
Nursology.net. (2026). Theory/model author gallery. https://airtable.com/appwl1cDmac36YQTu/shrNEpT7s2qsPgT7c/tblbCTW4IIcC8TqB8
Rossiter, M. W. (1993). The Matthew Matilda effect in science. Social Studies of Science, 23(2), 325–341. https://doi.org/10.1177/030631293023002004
Yankelovich, D. (October 15, 1971). The New Odds (Speech). Marketing Strategy Conference of the Sales Executives Club of New York. https://ryanmadden.net/pdf/the_new_odds.pdf
About Karen Foli
Karen J. Foli, PhD, RN, ANEF, FAAN, is Professor and Louise Herrington Endowed Chair for Mental Health Nursing, Baylor University. Over the past 20 years, Dr. Foli has connected nursing research to theory and practice, resulting in international impact for those struggling with mental health. With an interdisciplinary team, Dr. Foli led the testing of her first theory, the middle-range theory of parental postadoption depression, and has since become internationally known for her research in nursing, social work, and medicine, especially in the United Kingdom. Her second theory, the middle-range theory of nurses’ psychological trauma, has reverberated across the United States and globe, and was prophetic to nurses’ traumatic experiences during the COVID-19 pandemic. In July 2026, Dr. Foli was inducted into the Sigma Theta Tau International Nurse Researcher Hall of Fame, a highly competitive award and in 2026, bestowed upon only 26 individuals from across the globe. She has also been recognized as one of the “Top 2% Most Cited Researchers in the World – 2024” (Elsevier Data Repository). Dr. Foli is both a Fellow in the American Academy of Nursing and the Academy of Nursing Education through the National League for Nursing.