ACKNOWLEDGING THEORETICAL, PHILOSOPHIC, AND EMPIRIC LINKAGES
This issue of Advances in Nursing Science (ANS), focused on “Palliative Care,” was planned to provide an opportunity for ANS to respond to a call for nursing journals to participate in “The Conversation Project” (http://theconversationproject.org; see also https://nursingeditors.com/inane-initiatives/conversation-project). The Conversation Project is an initiative encouraging people in all walks of life to engage in conversations about palliative and end-of-life care with their loved ones and especially with their health care providers. Despite the widely recognized need to have these kinds of conversations, they are difficult conversations, even in the context of health care relationships. Nurses, in particular, are in key roles to encourage and facilitate these conversations, and nursing scholarship can contribute significantly to the resources that support not only conversations but also the practices that occur in palliative care and end-of-life situations.
It is notable that the articles in this issue, taken together, demonstrate a fundamental fact of science—the necessity of theory, philosophy, and empirics in developing disciplinary knowledge. The imperative of each of these dimensions of knowledge development remains largely unacknowledged. The focus remains on empirical evidence without adequate scrutiny of the underlying meanings of mental constructs and world views that shape what is taken to be empirical evidence. Perhaps the real-life situations that call for palliative care draw attention to these underlying meanings. These situations demand something more than empirical knowledge alone. These situations are complex, fraught with uncertainty, mystery, and a sense of urgency for remedies and for human caring—caring that embraces the deeper challenges of finding meaning in life, in suffering and in death.
The nature of nursing as a discipline places nursing at the center in providing palliative care, and at the center of the larger enterprise of exploring and finding effective ways of responding to the physical, emotional, and spiritual suffering of patients and their loved ones. This enterprise calls for empiric evidence that informs decisions that guide effective practice. But empiric evidence alone does not suffice as adequate knowledge when deeper issues such as personal and cultural meaning, the purpose of life, and spirituality are so central. Philosophic perspectives provide the foundation from which all scientific endeavors emerge. Theoretical knowledge provides a frame of reference, a road map, and conceptual relevance that guides the development of empiric evidence and that prompts emerging possibilities for developing ever-growing relevance in the search for understanding.
The articles in this issue of ANS collectively address the vital dimensions of palliative care and the interrelated realities of social and cultural justice, family dynamics, sacred, and spiritual meanings. As these articles illustrate, the interfaces between theory, research, and practice are vital if we are to develop knowledge, understanding, and appreciation of the human health experience.
—Peggy L. Chinn, PhD, RN, FAAN