The Research-Theory-Practice Relationship a Reference for the Discipline of Nursing

Editorial

In the dynamics of the society of knowledge, the discipline of nursing, defined as the study of care of the human health experience [1], is visualized through exercise of the profession; namely, by the development of its praxis from a philosophical approach that invites us to regard nursing as the “reflections and actions of man to impact and change the world” [2]. This reflection-action empowers the contribution research must make to the generation of knowledge, which is a constituent aspect of science.

Science, as an essential factor in culture and contemporary society, requires professionals who, motivated by knowledge, consider not only the scientific method itself, but also their own convictions, aspirations and emotions that make scientific activity an experience where a deep connection with the facets of the person [3] becomes apparent. These characteristics of science are a reference that suggests how nursing research refines, strengthens and increases knowledge of the discipline itself and integrates its underpinnings [4,5], so as to lay the foundation for nursing practice.

A process of continuous feedback between practice and research is generated in this way. It is through practice marked by careful observation, active listening and an open mind, which are particular to the therapeutic relationship, that a variety of health care situations are experienced. These spark constant reflection and interrogatives that translate into questions about good care, ones that demand answers.

The reason for professional nursing practice and, ideally, for all knowledge in the field of nursing should be to solve practical problems. Accordingly, the mission of research that generates, redefines or produces new knowledge is to develop theories that will guide care [1].

As with the attempt to lend meaning to and organize reality, theories are the storehouse for the significance of research findings related to the meta-paradigmatic concepts of nursing, as represented by the person, the surrounding environment, health and care, and the conceptual wealth of nursing, translated into meaningful phenomena particular to the reality of nursing practice. These findings must be tested and backed by theoretical evidence if they are to be of use in solving problems in nursing practice [1,6].

Evidence-based nursing practice is endorsed by research and theory. As such, its orientation is founded on due consideration that is conscientious, explicit and judicious in its decision-making, pursuant to the applicable evidence found in current knowledge. Here, the importance of research is at play not only in the generation of knowledge, but also in its regular consumption, in order to have a solid basis for evaluating practice with a critical eye and adjusting it to the realities that coincide with available scientific evidence [7].

On the other hand, research energizes the structure of nursing knowledge proposed by Fawcett, which is comprised of five components: meta-paradigmatic concepts, philosophical positions, conceptual models, nursing theories and empirical indicators. These elements are positioned harmoniously within the dynamics of abstract and concrete knowledge in the world of nursing [8]. This structure is the reference that makes it possible to describe, explain, predict and prescribe nursing care, bringing innovation to the conceptualization of nursing practice and its performance.

The refinement of nursing knowledge, translated into the generation of theories on care, generates a kind of theoretical practice in which care is provided through evidence-based practice supported by different conceptual perspectives that are the result of the research process [5,6] and respond to the social commitment society demands of nursing as a discipline.

The scenario of nursing practice that is distinguished by good care must be supported by nursing science in which the development and spread of knowledge through research is a two-way street between theory, founded on the concepts and propositions of nursing science, and practice. This course and the aim of closing the gap between the various aspects of knowledge (theory-practice-research) [1] is represented by the Conceptual-Theoretical-Empirical System or CTE (C: meta-paradigm - philosophy (visions) - conceptual model, T: theory of nursing and E: empirical indicator). As suggested by Fawcett, the CTE is a proposal for nursing knowledge to influence nursing practice, with the idea that practice is the way to move nursing science from the world of thoughts to the world of deeds [5,8].

From a supplementary perspective, nursing research based on the epistemological foundations of science will make it possible to consider different methodological and philosophical approaches to achieve, as Bueno suggests, “a rapprochement between abstract thinking and the reality of practice” [9], thereby allowing for synergy between human science and the development of practice.

Consequently, envisioning nursing as a human science [10] implies lending consideration to the necessary relationship between research, theory and practice. This must be done from the ontological perspective of the discipline (to be) and its epistemic perspective (to know), so that being, knowing and doing are part of the process of nursing care and are represented in knowledge, values, principles and skills. This triad, from the standpoint of care, corresponds to the human being, to conceptual development with knowledge that gives meaning to care, and to the process of managing care with the work that gives care certain defining characteristics [11].

An additional aspect that concerns nursing research and, hence, the generation conceptual models and theories on care is the consideration given to research in the process of nursing education, by including it in the curriculum, where it is intended to fulfill a formative function at a personal level and, consequently, at both a professional and social level. Nursing research generates a broad body of knowledge on care, which must be socialized globally, either in writing through the production of articles that are the result not only of research, but also of reflection and review, as well as by oral and visual means, through academic events at local, regional, national and international levels. This must be done in such a way that they are part of the framework for the continuous development of nursing science that supports practice and, therefore, gives it visibility and autonomy with respect to the answers global society demands in terms of nursing care.

An ongoing challenge to the nursing profession is to keep the important relationship between research, theory and practice in force. Practice invariably will spark questions that lead to research ideas, and the answers to those questions will translate into theories that will guide nursing practice based on evidence.

References

1. Duran de Villalobos MM. Marco epistemologico de la enfermeria. Aquichan. 2002; 2: 7-18.
2. Masi AE. concepto de praxis en Paulo Freire. Paulo Freire. Contribuciones para la pedagogia. 2008. 75-72.
3. Vitoria MA. Fuerza y debilidad de la ciencia. Coleccion. Publicaciones D de, editor. Colombia: Universidad de La Sabana. 2014; 139.
4. Gonzalez MA, Castello Badia M, Font CM. The identity of the nursing academic: between education and research. Texto Context - Enferm. 2014; 23: 241-249.
5. Ibarra Mendoza TX, Norena Pena AL, Guillermo Rojas J. Visibilidad de la disciplina enfermera: el factor mediatico de la investigacion. Index de Enfermeria. 2011; 20: 252-256.
6. Fawcett J. Tendencias de investigacion en enfermeria. Aquichan. 2014; 14: 289-293.
7. Barbosa D. Importancia da pesquisa clinica para a pratica na area de saude. Acta Paul Enferm. 2010; 23.
8. Fawcett J, Desanto-Madeya S. Contemporary nursing knowledge: analysis and evaluation of nursing models and theories. F. A. Davis Co; 2013.
9. Bueno Robles LS. Aspectos ontologicos y epistemologicos de las visiones de enfermeria inmersas en el quehacer profesionaL. Cienc y enfermeria. 2011; 17: 37-43.
10. Meleis AI. Theoretical nursing : development and progress. Wolters Kluwer Health/Lippincott Williams & Wilkins. 2011; 672.
11. Cabal E, Eugenia V, Guarnizo TM. Nursing as a discipline. Rev Colomb enfermeria. 2009; 6: 73-81.