Theoretical thinking in nursing: problems and prospects

The foregoing exposition suggests a global approach to evaluate theoretical thinking in nursing. Several issues have come to light in examining the current status of nursing's theoretical work within the proposed framework. In most of the theoretical pieces of work in nursing, major threads of theoretical thinking are difficult to identify. It seems that even if it were to be an afterthought, any major theoretical work should be committed to certain positions at the four higher levels so that it becomes obvious for the kind of theory that gets developed. As has been stated by many nursing scholars, the so-called grand nursing theories or conceptual frameworks require further specification to be called theories. There seems to be two ways these frameworks could be developed further: 1. They may be developed into paradigms of nursing by specifying advocated assumptions about the nature of human beings and nursing, theory-building strategy or strategies assumed to appropriate for the perspective, an image of nursing practice the perspective holds, and types of theoretical statements that are possible within the perspective; or 2. They may be developed as bona-fide theories by rigorously following the criteria at the fifth level. It seems that the time is ripe for nursing scholars working within similar theoretical perspectives to come together in order to formulate integrative nursing theories covering concepts from different domains of nursing. For example, much work in nursing within the symbolic interactionist tradition may be ready to be assimilated into a nursing theory of 'self-identity'. Similarly, much of the theoretical and empirical work dealing with how people develop competence in living with chronic illness, for example, cancer, can also be integrated into one nursing theory for further testing. The community of nursing scholars at large has not dealt with the meaning of prescriptive theories for nursing science and nursing practice. There should be more rigorous debates regarding the normative nature of prescriptive theories and their effects on the development of nursing science and application to nursing practice in the context of philosophy of science, nursing philosophy, and praxiology. The beliefs that praxiology follows naturally from prescriptive theories and that prescriptive theories are naturally the goal of nursing science are both naive and dangerous. Certainly, we are becoming increasingly sensitive and competent to carve out those requiring scientific explanation in the nursing perspective. And in doing so, we have created world views of nursing that seem both socially and epistemologically relevant to pursue.(ABSTRACT TRUNCATED AT 400 WORDS)