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Analysis of Integration in Nursing Science and Practice


  • Robin Whittemore

    1. Robin Whittemore, PhD, APRN, Mu, Associate Research Scientist, Lecturer, Yale School of Nursing, New Haven, CT. The author acknowledges Kathleen A. Knafl, PhD, for reviewing an early draft of this manuscript. Correspondence to Dr. Whittemore, Yale School of Nursing, 100 Church Street, P.O. Box 9740, New Haven, CT 06536–0740. E-mail:
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Purpose:To clarify the definition of integration and to identify universal aspects of the experience of integration related to healing, health, and nursing care.

Design:An integrative review concept analysis method was used. Relevant reports were identified by a computer-assisted search using the keyword integration in CINAHL from 1966 to 2004 and by reviewing the reference lists of retrieved reports. The final sample included 56 reports; 36 were empirical and 20 were theoretical.

Methods:Data were extracted from primary sources on the definition of integration, aspects of the process, antecedents, consequences, and facilitators. Data display matrices were used and were iteratively compared to derive a process model of integration related to health.

Findings:A wide range of primary sources indicated that integration is an important aspect of healing or recovery from illness. Integration is defined as a complex person-environment interaction whereby new life experiences (i.e., illness) are assimilated into the self and activities of daily living, thereby contributing to overall life balance.

Conclusions:Results of this analysis indicate the importance of the concept of integration to the science and practice of nursing. The process of integration appears to be a significant phase that occurs between a diagnosis of illness and subsequent physical and emotional healing.