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The crucible of the COVIDicene distills critical issues for nursing knowledge as we navigate our dystopian present while unpacking our oppressive past and reimagining a radical future. Using Barbara Carper's patterns of knowing as a jumping-off point, the authors instigate provocations around traditional disciplinary theorizing for how to value, ground, develop, and position knowledge as nurses. The pandemic has presented nurses with opportunities to shift toward creating a more inclusive and just epistemology. Moving forward, we propose an unfettering of the patterns of knowing, centering emancipatory knowing, ultimately resulting in liberating the patterns from siloization, cocreating justice for praxis.

This analysis highlights the evolution of the theory of maternal role attainment. Reva Rubin established the foundation for theory of maternal role attainment in her 1967 article. In 2004, Ramona Mercer made the argument to change the name from maternal role attainment to becoming a mother. In this analysis, recommendations are made to further develop this theory including updated theoretical models. This theory remains relevant to nursing, especially to nurses working with families during this transitionary time.

The theory of planned behavior has been prominently applied in nursing, but no known critique of the theory has been published. Using Fawcett and Desanto-Madeya's framework, we scrutinized and assessed the theory to determine its appropriateness for nursing investigations of behavior. The theory makes explicit assertions regarding human social behavior, incorporating some nursing metaparadigm concepts. Although not derived from the discipline, the theory's scope, content, and context are relevant to nursing, and its significance to nursing research and practice is clear. Studies incorporating all the theory's concepts and relationships are needed to confirm its testability and empirical and pragmatic adequacy.

The assessment of upstream factors is important in population-based nursing practice. The aim of this concept analysis is to enhance understanding of upstream factors and articulate a definition linked to the Conceptual Model for Nursing and Population Health. Upstream factors are thus defined as established conditions related to economic, social, and physical environments that occur outside the health care system, in the communities where people live, and contribute indirectly to the health outcomes for groups of individuals through multiple causal pathways. This concept analysis highlights the need for middle-range theory to guide nursing assessment and contributes to conceptual model evaluation.

This article aimed at describing the development of a theory of the experience of living with cancer. Secondary analysis of data from a series of studies yielded the concepts and propositions of the theory of the omnipresence of cancer. Theory construction was guided by Heidegger's ontology of dasein, whereas Newman's grand theory of health as expanding consciousness guided theory evolution. The theory includes 4 concepts-influencing factors, toward authentic dasein, mapping out the future, and living with cancer-each of which has several dimensions. Based on this theory, nursing interventions can be developed and tested to support persons with cancer.

Over the past few decades, there has been a narrative wave that has advanced and subsided but consistently moved toward acceptance in health care circles. Despite the importance of narrative to nursing practice and research, the discipline has been slow to claim the narrative wave as its own. The purpose of this article is to claim the narrative wave for the discipline of nursing with story theory–guided research and practice and to describe dimensions of the narrative movement in health-related literature. Practical application of story theory is described for both nursing practice and nursing research.

The concept of social capital appears in the literature of multiple disciplines as a social determinant of health, an important aspect of human interaction, and a means to support population health capacity. Little is known about the use of social capital within the context of nursing. This article's aim provides insight into the concept of social capital and nursing. Avant and Walker methodology was used to analyze a sample of 78 articles. Along with a variety of articles and content themes, findings from this concept analysis include critical attributes, an operational definition, and reflections regarding future use.

Nurses published dialogues on wisdom; yet, a conceptual model is unavailable. We present the development process for a theory of wisdom-in-action for clinical nursing developed in 3 phases: (1) a deductively derived model using derivation and synthesis; (2) inductively, a constructivist grounded theory captured the experience of wisdom in nursing practice; and (3) the 2 theories were synthesized into a nascent theory. The theory describes 2 antecedent dimensions, person-related and setting-related factors, and 2 types of wisdom, general and personal. The theory provides a framework for translating wisdom in nursing practice, depicting both the science and art of nursing.

This research study shows how race becomes ascribed through nursing theory and day-to-day workplace socialization processes. We show how public health nurses supporting and promoting breastfeeding for new mothers learn about and reproduce racialized stereotypes, which shape the care they provide. Even when nurses attempt to actively resist racialized stereotypes, most participate in essentialized nursing practice by using racialized institutional practices. Nursing theory needs to expand to help the nurse navigate and understand both the nurses' and client's local histories as well as individual-to-systems level constraints and supports that may impede, or promote, a mother's ability to breastfeed.

Military to civilian reintegration is a complex, multidimensional phenomenon warranting holistic perspectives. Complex phenomena require theory to understand and interpret relationships among concepts. Despite the need for theory-driven research, recent nursing reports often lack a theoretical structure. We extracted relevant concepts from the Neuman's Systems Model (stressors, environment, and person) and the Transactional Model of Stress and Coping (primary and secondary appraisal, coping, and adaptation) to form a Conceptual-Theoretical-Empirical model. Exemplar empirical instruments are presented, along with their conceptual and theoretical dimensions. An integrated System Theory of Stress, Resilience, and Reintegration is presented with its utility demonstrated through a research application.

Doctorally prepared nurses must be able to represent the unique nursing perspective within interdisciplinary teams to address contemporary health challenges. This article provides a student exemplar applying the unifying focus of facilitating humanization as described by Willis, Grace, and Roy to science on nature and health. As scientific knowledge becomes more complex, nurses must be skilled in translating information through the nursing lens to support individuals in realizing meaning, choice, quality of life, and healing in living and dying. In order for doctoral students to shepherd the discipline, they must first integrate nursing's philosophical underpinnings into their practice.

The purpose of this article is to present an analysis on the theory development strategies that have been used to develop middle-range theories through an integrated literature review and to provide directions for future theoretical development in nursing. First, theory development strategies that have been suggested and used in nursing are briefly discussed. Second, the methods used for the analysis are described. Then, 4 themes reflecting the theory development strategies that have been used to develop middle-range theories are discussed. Finally, suggestions for future theoretical development in nursing are made on the basis of the findings.

In today's era of nursing, the role of a unique disciplinary knowledge that is grounded in philosophy is essential to inform nursing practice, fill knowledge gaps, improve the quality of nursing education, and guide the theoretical development of nursing. Realism and relativism have contributed to the development of the nursing discipline by providing the basis of evidence-based nursing practice, nursing research, nursing education, and theoretical construction. This article explores the role of realism and relativism in the development of the discipline of nursing and presents their contributions to the work of nurse clinicians, nurse researchers, nurse educators, and nurse theorists.

This article describes the Lee Geropalliative Caring Model (GCM), a situation-specific theory that guides geropalliative care, defined as the care of older adults in the last 2 years of life. Underpinned by the theory of human caring, the GCM offers a framework for achieving the person/family outcome of well-being by suggesting caring interventions within 4 priority domains: aligning care, keeping safe, comforting body/mind/spirit, and facilitating transitions to persons with late-stage illness, including frailty and dementia. The GCM can be used to inform practice, policy, education, and research.

The American Association of Colleges of Nursing specifies that all nurses must be prepared to deliver high-quality palliative care upon entry into practice. To achieve this aim, a clear understanding of palliative care nursing is needed. The Walker and Avant model for concept analysis was used to review and analyze relevant literature from 2000 to 2016. The authors utilized findings of this extensive review to develop a concept model and other practical resources for guiding nurses, educators, and researchers in applying and evaluating competence in the delivery of high-quality palliative nursing care.

In 1994, the concept of marginalization was explored in an article in Advances in Nursing Science. This is a revisitation of the concept incorporating new scholarship. This update is founded on feminism, postcolonialism, critical race theory, and discourse deconstruction, all viewpoints that have been explicated in nursing. The purpose of this analysis is to look at new scholarship and concepts useful to applying marginalization in nursing knowledge development from the standpoint of Bourdieu's macro, meso, and micro levels. New scholarship includes globalization, intersectionality, privilege, microaggressions, and implicit bias. Implications for decreasing health disparities through this new scholarship are discussed.

Although nursing leaders call for theory utilization in research, use remains low within the discipline. The purpose of this article is to explore the application of interdisciplinary integration of models and theories to nursing research. An example of theory integration for the purposes of guiding a study relevant to school nursing is described. A conceptual-theoretical-empirical structure based on the Neuman's systems model, a nursing theory, integrated with the social communication model of pain, a psychology model, was developed to guide the study to examine pain assessment for schoolchildren with intellectual and developmental disabilities.

Based on a retheorized epistemology for knowledge translation (KT) that problematizes the "know-do gap" and conceptualizes the knower, knowledge, and action as inseparable, this paper describes the application of the Knowledge-As-Action Framework. When applied as a heuristic device to support an inquiry process, the framework with the metaphor of a kite facilitates a responsiveness to the complexities that characterize KT. Examples from a KT demonstration project on the integration of a palliative approach at 3 clinical sites illustrate the interrelatedness of 6 dimensions-the local context, processes, people, knowledge, fluctuating realities, and values.

Substantial public health efforts have been activated to reduce health disparities and ensure health equity for patients through the provision of culturally and linguistically appropriate services; yet associated policies and standards are sluggishly translating into practice. Little attention and resources have been dedicated to translation of public health policies into practice settings. Dissemination and implementation is presented as an active, strategic approach to enhance uptake of public health standards; reviews dissemination and implementation concepts; poses a systematic model to adoption, implementation, and dissemination; and concludes with recommendations for hospital-based implementation teams and complementary interprofessional collaboration.

Approaches to knowledge translation (KT) have undergone substantial transformation in an effort to find more effective strategies to ensure the best available knowledge informs nursing practice. However, the fundamental epistemology underpinning KT itself has gone largely unquestioned. Of particular concern is the inadequacy of current representational models to depict the complex, social process of KT. To address the limitations of representational models we propose an inquiry heuristic that conceptualizes KT as a knowledge-as-action process. Developed through a series of KT research projects, the heuristic is intended to guide the KT process and support effective navigation in the complexities of contemporary health care milieus.

This article presents an explication of spiritual healing situated within 3 nursing conceptual models (Neuman's systems model, Rogers' science of unitary human beings, and Roy's adaptation model) and 1 middle-range theory (Watson's theory of human caring), all of which include a focus on spirituality. These models and the theory are the vehicle for translation of themes of spiritual healing extracted from data provided by 30 adult male survivors of childhood maltreatment into nursing practice. This discipline-specific translational scholarship advances the profession of nursing.

Critical theories such as postcolonial feminism and intersectionality can provide new and vital perspectives on the interplay between social justice, religion, spirituality, health, and nursing. Criticality prompts us to examine taken-for-granted assumptions, such as the neutrality and universality of spirituality, while analyzing social relations of power, including the racialization of religion and religious patriarchy, that may result in oppressive conditions and social exclusion. The argument is made that when refracted through critical, intersectional lenses, religious and spiritual traditions can be rich sources of theoretical foundations and practical services that could inform nursing's recent re/turn toward social justice.

Nursing is grounded in care of the body. This article examines nursing as bodywork, as experienced intersubjectively by nurses together with patients and collectively as a body within the health care labor force. The relation of nurses to the body generates conflicting and contradictory social meanings from intimate and sacred work to dirty work. Such meanings have contributed to stigmatizing the work and the worker within the labor force as well contributing to an ongoing stratification in the labor force as nurses have shifted bodywork "to lower level" or ancillary workers.

Praxis is a concept that is both vague and overused in nursing science. Hence, a more stringent use of the concept praxis could help clarify the connections between theory and practice. The purpose of this theoretical article was to highlight the advantages of developing praxis in nursing education. By using praxis as a dialectic concept, nurse educators can make significant contributions to clinical practice by clarifying that theory and practice are perceived as 2 sides of same coin, leading to a move from “being in praxis” to “being of praxis,” a way to develop the profession's autonomy.

This article is a presentation of a method of concept analysis designed to assist in understanding the unique manner in which various disciplines use the same word or group of words to describe differing conceptual ideas. Nurse researchers often borrow research instruments developed in other disciplines. However, research instruments are developed in accordance with the philosophical underpinnings of a specific discipline with the intent to contribute to the knowledge base of that discipline. Therefore, it is uncertain whether research instruments borrowed from other disciplines actually measure the conceptual phenomenon from a nursing perspective.

The timing of the literature review in grounded theory has been debated for decades, with previous recommendations to delay the review now under question. Mounting evidence suggests that a preliminary review can enhance theoretical sensitivity and rigor and may lead to innovative insights. However, researchers must acknowledge the influence of prior knowledge during data analysis and theory development to avoid bias. This article critically examines the ongoing debate and recommends that we should not seek to avoid preconceptions but ensure that they are well grounded in evidence and always subject to further investigation, revision, and refutation. If used reflexively, a preliminary literature review may well enhance grounded theory research. Refereed/Peer-reviewed

Researchers and practitioners can use inductively derived theory to direct their research and practice. This article describes the ongoing development of a theory that can assist in explaining experiences of young women with breast cancer who have genetic testing for the BRCA mutation. Seventeen BRCA-negative women with breast cancer from a larger grounded theory study were interviewed. While receiving a negative BRCA mutation test result subsequent to a breast cancer diagnosis was described as a relief, the information was also confusing. The author's published Theory of Genetic Vulnerability is expanded to incorporate the outcomes of this analysis.

The growing number of individuals with comorbidities experiencing care transitions represents a challenge to the current health care system. A qualitative study of empirical literature, using the Dimensional Analysis approach, was conducted to elucidate the theoretical underpinnings of the phenomenon of individuals with comorbidities undergoing care transitions. The findings were arranged in a novel schematic demonstrating that the relationship among individual attributes, comorbidities, and care processes informed the individual's risk for adverse outcomes. This schematic is useful for future nursing research studies evaluating innovative programs implemented to improve health outcomes among vulnerable populations undergoing care transitions.

The purpose of this article was to critique and synthesize the trajectory of the work of Dr Jane Georges in Advances in Nursing Science over the past decade in the development of an emancipatory theory of compassion, with implications for contemporary nursing. Specifically, this article (1) summarizes and critiques the work in each stage of its development, describing missing elements at each stage and subsequent development of ideas built upon previous work, and (2) proposes future directions for the work, including the proposal of a theory of compassion within the emancipatory paradigm to guide further scholarly inquiry in nursing.

Critical caring is a midrange theory proposed as a framework to guide public health nursing practice. This article reports findings of a study that examined the relevance of the theory to the practice of expert public health nurses (PHNs). Twenty-six PHNs participated in this study: 10 in interviews and 16 in 2 focus groups. Findings support the relevance of critical caring to PHN practice, explicated, and further refined the theory through the richness of participants' practice accounts As such, it has potential as a tool of resistance to forces that limit PHNs working to their full scope of practice.

This article is focused on the primary finding of the 2010 Institute of Medicine report asserting that nurses practice to the full extent of their education and training. An evolving theoretical perspective for hospital nursing practice is proposed as a basis for reaching this goal. This article describes the background and current factors influencing professional hospital nursing practice, presents a theoretical model for future research designed to optimize the power of hospital nursing practice, using a newly evolved concept of "nurse force," and discusses the implications of nurse force theory on perspectives of hospital nurse fatigue and patient harm.

Race is a social environmental element in many nursing knowledge contexts. We explore how race and racism have been conceptualized in nursing research and theory, situating these issues in the debate between Critical Race Theory and postracialism. Contemporarily, racism is more subtle than overt. Subtle racism takes the form of microaggressions in everyday discourse and practices by whites toward African Americans. This occurs with little to no awareness on the part of whites. Using this concept, practice and education are explored. We hold that microaggressions contribute to stress for the target person, which may partly account for racial health disparities.

Currently, per capita health care expenditures in the United States are more than 20% higher than any other country in the world and more than twice the average expenditure for European countries, yet the United States ranks 37th in life expectancy. Clearly, the health care system is not succeeding in improving the health of the US population with its focus on illness care for individuals. A new theoretical approach, critical interactionism, combines symbolic interactionism and critical social theory to provide a guide for addressing health care problems from both an upstream and downstream approach. Concepts of meaning from symbolic interactionism and emancipation from critical perspective move across system levels to inform and reform health care for individuals, organizations, and societies. This provides a powerful approach for health care reform, moving back and forth between the micro and macro levels. Areas of application to nursing practice with several examples (patients with obesity; patients who are lesbian, gay, bisexual, and transgender; workplace bullying and errors), nursing education, and research are also discussed.

This article uses an exemplar of phenomenological research of middle school boys, experiences of being bullied as applied philosophy and science to illuminate the intersection of the moral and scientific realms for theory-oriented research and practice. As a consequence, a clear foundation for advancing nursing science and envisioning innovative nursing practice with boys who experience being bullied is provided. Included is a weaving together of phenomenological perspective for research and practice, Roger's (nursing) Science of Unitary Human Beings (SUHB), and SUHB-derived middle range theories of self-transcendence and power.

Unitary appreciative nursing is a healing praxis that is grounded in an evolving theory of wholeness and life patterning. The theory regards people as having the potential for transforming their health through participating knowingly in change focused on appreciating their wholeness and life patterning. In unitary appreciative nursing, people generate their own knowledge through appreciation and participation in the wholeness of life patterning. This knowledge facilitates and advances their flourishing and well-being in a healing praxis. The conceptual presuppositions and theoretical propositions that were generated or affirmed arising from a healing praxis are clarified and explicated with women who have experienced abuse and despair.

This article answers a call, recently published in Advances in Nursing Science, to more fully explore the use of Italian political philosopher Giorgio Agamben's theory of biopower in nursing research and scholarship. Giorgio Agamben argues that biopower is not a modern phenomenon, and critical analysis of the historical origins of Western political practice shows how humanist discourse has been complicit in a long tradition of marginalization and violence, accomplished in each era by designating certain classes of human beings as "bare life." I discuss how I have used Agamben's theory to frame my own research, and the challenges of applying this theory in emancipatory work.

This article provides a critique and theoretical extension of a work that sought to describe the contribution of nurses to stroke rehabilitation. At the time, the role of nursing was considered important but therapeutically nonspecific. Stroke nursing research has increased significantly and so has research focusing on the patient experiences of the adjustment and rehabilitation processes following a stroke. These developments provide significant new insights that may refine and extend the original understanding of the role of nursing in stroke rehabilitation. This article proposes an extended theoretical framework of the role of nursing in stroke recovery and rehabilitation.

Late entry to prenatal care is a complex problem disproportionately affecting immigrant and refugee women living in Western-style countries. Improving the health and well-being of these women and their children is a critical need. Utilizing Newman's praxis research approach, this study explored engaging 6 Cambodian American women living with pregnancy in the process of finding meaning. Dialoguing on important events and relationship from childhood to present day, patterns of health emerged. Considering data across participants, 3 preliminary themes were illuminated. Study provides new knowledge about environmental disruptions and promoting health.

Nursing is at a critical juncture in creating data repositories that support nursing research and theory development, as health systems adopt and design electronic health records. This article discusses how informatics theory can be used to guide designing nursing documentation screens and analyzing the resulting data sets, while highlighting methods to maximize reliability and validity and to address measurement issues. Examples will be applied to spiritual care, a required dimension of care. These examples present methods to capture and study "soft" areas of nursing that have not traditionally been documented or measured.