Advancing development of nursing theory: an innovative approach

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Finfgeld-Connett’s (2008) paper in this issue of JAN presents an innovative approach to the creation of a new theoretical framework of nursing practice. I found her paper particularly compelling due to my long-standing interest in advancing nursing knowledge through the use of nursing discipline-specific conceptual models, grand theories and middle-range theories.

Finfgeld-Connett selected three concepts that are commanding considerable attention in the contemporary nursing literature and has incorporated them into a new theoretical framework for the practice of our discipline. Art of nursing, presence and caring have become virtual nursing mantras in the past few years, although these certainly are timeless concepts. Yet most scholarly work has treated each concept as an isolated silo. Finfgeld-Connett’s convergence methodology offers a logical way to bring the concepts together. The methodology also offers an approach that may facilitate the synthesis of concepts emanating from empirical and non-empirical ways of knowing. A special feature of the methodology is the use of refutational hypotheses, which is similar to negative case analysis used with some qualitative research designs, to explore alternative results of convergence work.

Finfgeld-Connett’s methodology is particularly intriguing because it extends methodologies that focus on integration of qualitative research findings, such as metasynthesis and metasummary, and those that focus on integration of quantitative research findings, such as meta-analysis. Those methodologies are limited to integrating the findings of research addressing a single phenomenon. An example is Finfgeld-Connett’s (2006) metasynthesis of presence. Convergence methodology, in contrast, extends to integration of two or more concepts through examination of similarities between the concepts. A question that remains is whether the result of convergence work is an entirely new unitary phenomenon or a simpler sum of the concepts.

I wonder how many other concepts could be candidates for convergence and what the advantages of convergence work might be. Specifically, how many other concepts that have heretofore been regarded as silos could be brought together using convergence methodology? Would nurses be more willing to use distinctive nursing knowledge to guide their research and practice if more concepts were brought together? Would programmes of nursing research be more common if the research was directed towards generation and testing of middle-range theories made up of a convergence of concepts? Would the outcome of a nursing intervention guided by a convergence of concepts be more beneficial for patients than if the intervention were guided by a single concept? Would patient and nurse satisfaction with nursing practice guided by a convergence of concepts be higher than practice guided by a single concept?

I have spent a great deal of time and much effort during the past 40 years of my nursing career analysing and evaluating the content and use of existing nursing conceptual models and theories as guides for research, practice, education and administration of nursing services. I look forward to tracking the use of Finfgeld-Connett’s new theoretical framework in the years to come. And, I encourage readers to share their ideas in JAN Forum and to undertake their own convergence work using Finfgeld-Connett’s methodology.

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