Secondary Logo

Journal Logo

Original Articles

Properties of Situation-Specific Theories and Neo-pragmatism

Im, Eun-Ok PhD, MPH, RN, CNS, FAAN

Author Information
doi: 10.1097/ANS.0000000000000336
  • Free

Abstract

FOR a long time in human history, scholars believed in the existence of scientific truth and the unity of scientific knowledge, and scientific realism dominated scientific communities across disciplines.1,2 Nowadays, most scholars across disciplines agree with epistemological pluralism as their philosophical basis, which becomes the practical philosophical basis for scientists in general.1 However, it took a while for scholars to come up with a consensus on epistemological pluralism.2 Pragmatism provided a basis for this philosophical evolution in negating dualism and scientific truth.3,4

Nursing has gone through similar changes in its epistemological bases, and now agrees with epistemological pluralism as its philosophical and theoretical basis.5,6 In the early stage of nursing discipline, nursing scholars believed in scientific truth under the huge impact of logical positivism, and tried to develop a universal theoretical basis for nursing discipline by answering questions on nature, mission, and goal of nursing while trying to come up with the unity of nursing knowledge.6–8 From the mid-1980s, nursing began to embrace philosophical thoughts, negating the possibility of developing a universal theoretical basis for nursing knowledge.6 Under the impact of philosophical pluralism in theoretical nursing, a number of mid-range theories have been developed and used.8–11 In 1999, with the assumption of multiple truths based on epistemological pluralism, situation-specific theories were introduced as a new type of theories that could be easily adopted and used in nursing practice and theory.7,12 Here, middle-range theories mean “the theories with a more limited scope and less abstraction that provide organized theoretical frameworks explaining specific nursing phenomena or concepts that cross different nursing fields.”6 Situation-specific theories refer to “the theories that focus on specific nursing phenomena, that reflect clinical practice, and that are limited to specific populations or to particular fields of practice.”7,12

The essential properties of situation-specific theories are: they can incorporate diversities and complexities in nursing phenomenon; they consider sociopolitical, cultural, and historical contexts of nursing encounters; they can be easily applicable to nursing practice; and they intend not to cross time, geographical locations, or socially structured or politically circumscribed situations.7,12 As philosophical bases for situation-specific theories, post-empiricism, critical social theory, feminism, and hermeneutics were proposed.12

Statements of Significance

What is known, or assumed to be true, about this topic:

  • As philosophical bases for situation-specific theories, postempiricism, critical social theory, feminism, and hermeneutics were proposed with an assumption of multiple truths based on epistemological pluralism.
  • The essential properties of situation-specific theories are: they can incorporate diversities and complexities in nursing phenomenon; they consider sociopolitical, cultural, and historical contexts of nursing encounters; they can be easily applicable to nursing practice; and they intend not to transcend time, place, or social or political constraints.

What this article adds:

  • Neo-pragmatism underpins diversities and multiplicities of truths, which subsequently supports high specificity and low level of abstraction in situation-specific theories.
  • As neo-pragmatism supports multiple truths and objects the universal truth and representationalism, it obviously supports the necessity of situation-specific theories because each specific nursing phenomenon would require different conceptualization and theorization based on contextual understanding with the assumption of multiple truths.
  • From a neo-pragmatic perspective, the most important aspect of situation-specific theories would be their linkages to research and practice because neo-pragmatism views theories based on whether the theories serve or do not serve the goals of nursing discipline (research and practice).
  • Neo-pragmatism supports the aim of situation-specific theories to reflect diversities and complexities in nursing phenomenon with limited generalizability because neo-pragmatism does not believe in one unchangeable truth.

The philosophical bases of situation-specific theories may agree with the stance of neo-pragmatism represented by Rorty13 that emphasizes multiple realities. According to neo-pragmatism, the truth is what is approved by the scholars as the truth, which means that the truth is time-dependent and situation-dependent.13 This stance of neo-pragmatism certainly agrees with the philosophical bases of situation-specific theories; situation-specific theories do not cross time, place, or social and/or political contexts.12

The purpose of this article is to discuss whether the properties of existing situation-specific theories are congruent with the philosophical stance of neo-pragmatism. First, neo-pragmatism is concisely reviewed while considering the historical evolution of neo-pragmatism with pragmatism and social critical theory. Then, situation-specific theories' philosophical roots are briefly revisited with an addition of neo-pragmatism. Third, the methods used for the literature review on the properties of existing situation-specific theories are described. Then, the findings of the literature review on the properties of existing situation-specific theories are presented. Finally, the findings on the properties of existing situation-specific theories are discussed in terms of their linkages to the major tenets of neo-pragmatism.

NEO-PRAGMATISM

Neo-pragmatism is a postmodern version of pragmatism that reintroduces many concepts of pragmatism, but that centers on language.14 Because of its roots in pragmatism, it is necessary to understand pragmatism to discuss neo-pragmatism.14 Pragmatism was originated from the American philosophy founded by Peirce.3 Pragmatism has 2 basic assumptions.3 First, truth cannot be contained in some correspondence to external reality, which agrees with Kant's position.3 Second, both process and progress are crucial characteristics of the nature of human knowledge, which agrees with Hegel's position.3 Pierce tried to replace “truth” by “method.”15 In other words, Pierce's position is that truth is whatever is ultimately delivered to the group of inquirers who go after a certain resolution in a certain manner and truth is correspondence to a “mind-independent reality” (objective idealism).15 According to his position, if we could have a method that self-stabilizes internally, accepts indefinite fallibility, and concurrently settles down, then we would identify a better way to adjust our beliefs.15 Also, he believed that, if we could adequately continue our inquiries, then we would have a stabilized view about a problem that could be addressed.15 Thus, in his stance, the truths are the stabilized agreements made by the end of continuous inquiries.

James,4 who advocated pragmatism, had a little bit different position on the truth. His position is: truth is whatever answers to our current inquiries and needs, or at least those inquiries and needs that we are having.4 Dewey's stance was similar to James; truth is justified acceptability within a social construct of inquirers.15 With this stance, all dualisms are negated, and instrumentalism is supported.15 In other words, from his perspective, things that we make are just instruments that help put our experiences into thoughts and that help make our actions fit with our goals.15 Subsequently, from his perspective, theories and laws have no truth in themselves.15 Rather, theories and laws are just instruments. Basically, the stance of James and Dewey was different from that of Pierce.15 They did not care what we would stabilize by the end of continuous inquiries.15 Rather, they posited that reason is whatever goes in the inquiries during our days and rationality is extrinsic to this. In other words, rationality is just what we agree on.15

Later, Rorty further developed pragmatism to neo-pragmatism, sometimes called linguistic pragmatism.13 Basically, neo-pragmatism agrees with the ideas of James and Dewey, and is based on most concepts of pragmatism.14 According to the Blackwell Dictionary of Western Philosophy,14 neo-pragmatism is “a postmodern version of pragmatism developed by the American philosopher Richard Rorty and drawing inspiration from authors such as John Dewey, Martin Heidegger, Wilfrid Sellars, Willard Van Orman Quine, and Jacques Derrida.” Neo-pragmatism negates “universal truth,” “epistemological foundationalism,” “representationalism,” and “epistemic objectivity.”14 While traditional pragmatism by Pierce, James, and Dewey is based on experience, neo-pragmatism by Rorty is based on language.13 From a neo-pragmatic perspective, language depends on use, subsequently producing meanings by using words in “familiar manners.”13 Rorty's definition of truth is similar to James' and Dewey's; he supported that “there is little to be said about truth, and philosophers should explicitly and self-consciously confine themselves to justification.”13 His basic position was: there exists no truth about the world that is waiting to be discovered; truth results from “free and open discussion”; and knowledge is just “consensus.”16 Subsequently, this stance supports that there does not exist one way that the world exists and no one method that the world can be accurately represented.13

Although Rorty seldom mentioned the words of subjectivity or objectivity,17 he asserted that neo-pragmatism would basically agree with the notion of multiple truths.13 Also, from this perspective, there would be no need for further discussion on the linkage of the word to the world once the justification for accepting or rejecting a word is made based on its functionality to meet social necessity.16 Thus, from a neo-pragmatic perspective, it would be difficult to determine how the world could make a perspective superior to another or how the world could choose one over another.16 In other words, there does not exist one unchangeable truth about the nature (essence) of reality.16 Therefore, from a neo-pragmatic perspective, it is important to view nursing theories based on if they serve or do not serve the goals of nursing discipline and if they consider multiple truths about the nature (essence) of reality.

The linguistic focus of neo-pragmatism could also invite a critical analysis of the sociopolitical, cultural, and historic contexts of nurses' dialogical engagement with patients, political leaders, employers, and the public. Indeed, neo-pragmatism supports intersubjectivity, community, and solidarity,18 subsequently emphasizing nurses' dialogical communication and engagement with nursing clients. Thus, this language-focused form of pragmatism could directly influence reality and offer a self-correcting development of knowledge through fallible progress of inquiries.18

Finally, neo-pragmatism has similarities with critical social theory.3,19 Critical social theory rejects the necessity of an objective/scientific basis of criticism that is also negated by neo-pragmatism. Certainly, the necessity of an objective/scientific basis of criticism does not agree with social criticism that is toward particular target populations at specific time points with their own necessity for liberation/emancipation. Subsequently, as neo-pragmatism does, critical social theory objects seeking a single universal theory, but supporting multiples theories in various situations.3,19 Despite diverse thoughts within critical social theory, most of critical social theorists support that only practical inquiries could overcome the challenges (epistemic and normative) of social criticism, subsequently providing a basis for accomplishing the goals of critical theory.3,19 Critical social theorists including Habermas claimed “technocratic” as any inquiries that could generate optimal strategies for problem-solving based on objective knowledge on the unbiased results from all actions.20 This conception of practical knowledge could be applied to nurses' roles, who selects the best/optimal solution for a problem of nursing care. This technocratic model of nurses as impartial observer always requires to be contextualized, as it accounts for the practical knowledge that could be distributed socially. This position is also shared by neo-pragmatism.

PHILOSOPHICAL ROOTS OF SITUATION-SPECIFIC THEORIES AND NEO-PRAGMATISM

As mentioned earlier, Im and Meleis12 proposed a new type of nursing theories, situation-specific theories, as the “ready to wear” theories for nursing practice and research. At that time, they proposed postempiricism, critical social theory and feminism, and hermeneutics as the philosophical roots of situation-specific theories.12 While differentiating postempiricism from well-established logical positivism, they emphasized that nursing scholars tended to give up traditional realist approach to nursing care, and nursing theory had been affected by problems/issues from “scientific and moral relativism” and “philosophical incoherence.”12 According to them,12 a current empiricist view still believes in observables and rigorous scientific approaches, and supports that results can be supported if not confirmed. Yet, contemporary empiricists have an assumption that reasonable predictions are possible and that these predictions can allow nurses to estimate the consequences under certain health/illness conditions and to approximate positive results of nursing care.21 According to Im and Meleis,12 contemporary empiricists understand that some phenomenon can be reduced, but others cannot while accepting the complexity of nursing phenomenon. Their basic position is: situation-specific theories have their philosophical roots on contemporary empiricism and can be developed based on contemporary empiricism. Indeed, nursing practice in clinical settings is mainly based on the observables (eg, laboratory values) and physiologic and psychological processes that generally suggest etiologies of patients' conditions and subsequent treatments, which are based on empiricism.12 Through contemporary empiricist approaches, situation-specific theories can aim at modeling the relationships among the observables and the unobservables and among normal and abnormal processes affecting the responses of a particular group to health/illness in a specific situation.12 Also, situation-specific theories can aim at predicting experiences and responses of a particular group of people in certain health/illness conditions.12

As another main philosophical root of situation-specific theories, Im and Meleis12 proposed critical social theory and feminism. They viewed that critical social theory and feminism could provide the grounds for respecting diversities and considering sociopolitical and historical contexts of nursing phenomenon.12 They thought situation-specific theories were congruent with feminist assumptions, goals, and values, as well as those of critical theories.12 Feminists and critical social theorists are well known about their emphasis on the subjective and social construction of reality, the impacts on science by sociopolitical and economic contexts, and the influences on science (including nursing) by racism, classism, and sexism.22 Yet, as they claimed, situation-specific theory could not be based on critical theories because critical theories lack modeling.12 Rather, situation-specific theories have its philosophical roots in critical theory because they assume it influences sociopolitical and historic contexts on nursing phenomena. In terms of feminism, situation-specific theories have their certain philosophical links. Throughout nursing history, feminism has influenced theoretical debates and provided an important and critical view on nursing phenomenon.23 With various different thoughts within feminism, all feminists believe that we need to center on women's diverse problems and/or situations and raise questions on women's daily life in a male-dominated society,22 which is congruent with the views of situation-specific theories.

Finally, Im and Meleis12 also proposed hermeneutics as a philosophical root of situation-specific theories. Hermeneutics are consistent with the philosophical positions of situation-specific theories.23 Hermeneutics put an emphasis on historical consciousness and humanistic and historical knowledge and place the human state or essence as supreme.24 Furthermore, hermeneutics place an emphasis on “hermeneutic circle” between subject and scientist (nurse), shared and embedded meanings, and self-reflection and understanding as the basis of knowing.24 However, because nursing theories need some degrees of reduction, objectification, and specification of relationships between the variables, hermeneutic or phenomenological perspective might not accommodate all the views of situation-specific theories.12

In addition to these philosophical roots of situation-specific theories, neo-pragmatism could provide an important philosophical root for situation-specific theories because of its support for multiple truths and pragmatic views. Although the previously proposed philosophical roots of situation-specific theories could somewhat explain multiple truths, none of them could adequately explain the explicit pragmatic views and multiple truths embedded in situation-specific theories. As mentioned previously, neo-pragmatism rejects the ideas of “universal truth,” “epistemological foundationalism,” “representationalism,” and “epistemic objectivity,”14 which is consistent with the philosophical stance of situation-specific theories. Furthermore, as described earlier, the basic tenets of neo-pragmatism are: (a) “there is no truth about the world that is waiting to be discovered”; (b) “there does not exist one way that the world exists”; and (c) “no one method that the world can be accurately represented.”16 These positions of neo-pragmatism support the notion of multiple truths, which is congruent with the philosophical stance of situation-specific theories. Again, neo-pragmatic perspective does not support superiority or inferiority of a perspective to another though.16 More importantly, neo-pragmatism views nursing theories from a pragmatic perspective on whether the theories could contribute to achieving the goals of nursing, which is congruent with the inherent nature of situation-specific theories. Situation-specific theories basically aim to provide theoretical bases that work best for specific populations in particular situations and to provide “blueprint for action,”12 which subsequently contributes to achieving nursing's ultimate goals. A unique characteristic of situation-specific theories would be its pragmatic aim for nursing research and practice, which could be best explained from a neo-pragmatic perspective.

METHODS

A literature review was conducted to identify the properties of situation-specific theories that were published in the literature. The article search/retrieval process is summarized in Figure 1. For the literature review, PubMed, CINAHL, and PsycInfo were searched using keywords of “situation-specific theory” and “nursing” (no time limit) to identify the articles that presented situation-specific theories. Across the databases, 132 articles were identified, after eliminating overlapping articles. Then, 121 articles in English that were published in nursing journals were identified. Only those published in nursing journals were included because this analysis focused on the properties of nursing theories. For the convenience of approach, book chapters were excluded in this analysis. Also, excluded were literature reviews and editorials because they did not include detailed information on the theories themselves. The articles that simply presented the usages of theories in research or practice were omitted since they did not give detailed information on theories themselves. Also, articles on theory applications in education or practice as well as discussion/methodological articles were omitted because of the same reason. Articles reporting theory evaluation/testing (eg, studies testing the propositions of situation-specific theories) were also omitted due to their lack of information on theories themselves. Because of these exclusions, the findings reported in this article need to be carefully interpreted.

Figure 1.
Figure 1.:
The article search/retrieval process.

Through the inclusion and exclusion process, 15 articles on situation-specific theories were selected for this analysis.25–39 Then, full texts of all the 15 articles were reviewed and analyzed using a content analysis while intentionally trying to identify the properties of situation-specific theories that were reported in the articles. The properties of situation-specific theories from the original article by Im and Meleis12 were used as the framework for the analysis: (1) “low level of abstraction,” (2) “reflection of specific nursing phenomenon,” (3) “context,” (4) “readily accessible connection to nursing research and practice,” (5) “reflection of diversities in nursing phenomena,” and (6) “limitation of generalization.” First, the full texts of individual articles were summarized in a table with 4 categories including the purpose of theorizing, sources of theorizing, theorizing process, and linkages to research or practice. The summary table is available elsewhere where the theory development process of individual theories was analyzed and discussed.40 Then, the table was coded using line-by-line coding, and the codes were grouped by the properties of situation-specific theories from the original article by Im and Meleis.12 Finally, the codes in individual groups were categorized, and the categories were compared and condensed to identify the themes reflecting the properties of existing situation-specific theories.

THE PROPERTIES OF SITUATION-SPECIFIC THEORIES

The findings of the literature review are summarized in Table 1 according to the properties of situation-specific theories suggested by Im and Meleis.12

Table 1. - A Summary of the Findings on the Properties of Existing SSTs by the Properties of SSTs Proposed by Im and Meleis
Properties of SSTs by Im and Meleis Properties of Existing SSTs
Low level of abstraction Targeted to explain a nursing situation of a specific population with a low level of abstraction
Reflection of specific nursing phenomenon Reflected on specific nursing phenomena of interests with high specificity
Context Used an integrative approach through multiple sources of theorizing that allowed the contextual understanding of a phenomenon from multiple points of views
Readily accessible connection to nursing research and practice Developed based on the findings from research and/or practice (eg, literature reviews, research projects, and clinical exemplars) using multiple and heterogenous steps of development process
Clearly connected to research and/or practice by providing directions for future usages of theories in research and practice
Reflection of diversities in nursing phenomena Incorporated diversities and complexities in contemporary nursing situations by targeting specific populations of migrant farmworker women, seasonal farmworkers, Asian Americans, Korean immigrant women, older adults, and people with chronic diseases/conditions such as diabetes, cancer, chronic HBV infection, and heart failure.
Developed situation-specific theories through heterogeneous patterns of steps in theorizing process to reflect diversities and complexities in nursing phenomenon.
Limitation of generalization Reflected diversities and complexities in nursing phenomenon, subsequently resulting in limited generalizability of situation-specific theories.
Abbreviations: HBV, hepatitis B virus; SSTs, Situation-Specific Theories.

“High specificity and low level of abstraction”

All the situation-specific theories that were included in this analysis (100%) reflected specific nursing phenomenon of interests with high specificity. For instance, the situation-specific theory by Baird and Reed41 described and explained the well-being of a specific population (refugee women) in cultural transition. In their situation-specific theory, Chang and Im26 described and explained the quality of life among a specific population of older South Korean adults who were diagnosed with type 2 diabetes. The situation-specific theory by Clingerman27 reflected the migration transition of a specific population—migrant farmworker women.

A low level of abstraction was also noted in all 15 situation-specific theories that were included in this analysis (100%); all the theories targeted to explain a nursing situation of a specific population. Because of the high specificity, the low level of abstraction in situation-specific theories could be natural. The specific populations that were targeted in the situation-specific theories included refugee women in cultural transition,41 older South Korean adults with type 2 diabetes,26 migrant farmworker women,27 Korean Americans at risk for a chronic hepatitis B virus (HBV) infection,34 migrants and seasonal farmworkers,38 and so on. Indeed, about 67% of the theories were to explain nursing phenomenon among racial/ethnic minority groups including migrant farmworker women, seasonal farmworkers, Asian Americans, and Korean immigrant women. About 20% of the theories were to explain nursing phenomenon among older adults. About 33% of the theories targeted to explain nursing phenomenon among specific populations with chronic diseases/conditions (diabetes, cancer, chronic HBV infection, and heart failure).

“Contextual understanding”

All the situation-specific theories (100%) that were included in this analysis were developed using an integrative approach through multiple sources of theorizing that allowed contextual understanding of the phenomenon from multiple points of views. In the theorizing process of all the situation-specific theories, multiple theories and multiple research studies provided the basis for conceptualization and theorizing. For instance, to develop the critical caring theory of protection for migrants and seasonal farmworkers,38 2 theories (the Integrative Model of Environmental Health Research and the Falk-Rafael's Critical Caring perspective) were used. In the development of the situation-specific theory of the correlates of Hepatitis B Virus Health-Related Behaviors of Korean Americans,34 6 research studies provided the basis for induction: 3 qualitative studies among HBV patients, community health leaders, and general informants; 2 HBV blood screening studies among general community dwellers and Asian American Pacific Islander community dwellers; and a quantitative survey among general households. Without the integrative approach using multiple sources for theorizing, situation-specific theories could not be easily developed based on understanding of the contexts where specific nursing phenomena happened.

“Direct linkages to research and practice”

All the situation-specific theories that were analyzed (100%) aimed to link the theories to research and/or practice through their development process and through their propositions for future research and practice. All the situation-specific theories were developed based on findings from research and/or practice (eg, literature reviews, research projects, and clinical exemplars) using multiple and heterogenous steps of development process. Multiple and heterogeneous steps of theory development process would be essential to directly link situation-specific theories to nursing research or practice by reflecting the diversities and complexities of the real world. For example, the situation-specific theory of Asian immigrant women's menopausal symptom experience in the United States was developed based on induction from a literature review and from the findings of a study on menopausal symptom experience among Asian immigrant women in the United States.29 The situation-specific theory for enabling safety35 was also developed based on induction from a literature review and clinical experience (to develop an initial version of the theory) and reinduction from a literature review (to develop the final theory). The critical caring theory of protection for migrants and seasonal farmworkers38 was developed based on induction from a literature review (to develop an initial theory) and reinduction from a literature review (to develop the final theory). The revised situation-specific theory of heart failure self-care37 was also developed based on induction from clinical discussion, research findings, and discussion with international colleagues. The direct linkages of research and practice to the development process of situation-specific theories were crystal clear.

All the situation-specific theories that were included in this analysis were also clearly connected to research and/or practice by providing directions for future usages of theories in research and practice. For instance, the situation-specific theory by Baird and Reed41 was proposed to be used in future intervention development for immigrants and refugees that could facilitate their cultural transitions. The situation-specific theory by Chang and Im26 was also proposed to be used in future development of interventions (diabetes education programs) to improve the quality of life of older South Korean adults with type 2 diabetes. The situation-specific theory by Im et al32 was proposed to be used in future intervention development to increase their participation in physical activity.

“Reflecting diversities and complexities with limited generalizability”

All the reviewed situation-specific theories (100%) incorporated diversities and complexities in contemporary nursing situations by targeting specific populations of migrant farmworker women, seasonal farmworkers, Asian Americans, Korean immigrant women, older adults, and people with chronic diseases/conditions such as diabetes, cancer, chronic HBV infection, and heart failure. Subsequently, due to their foci on specific populations, the situation-specific theories have inherent limitations in generalizability. For instance, the situation-specific theory by Baird and Reed41 targeted a specific population of refugee women in cultural transition. Thus, this theory could provide a lens to approach the specific population of refugee women in cultural transition, but it might not be easily used to approach other groups of women in cultural transition (eg, Chinese immigrant women in cultural transition from mainland China).

To reflect diversities and complexities in nursing phenomenon, it would be necessary to develop situation-specific theories through heterogeneous patterns of steps in theorizing process. Individual situation-specific theories that were included in this analysis (100%) were developed in individually unique steps. The revised situation-specific theory of heart failure self-care37 combined induction and deduction using a “Theory-Practice-Research-Collaboration” strategy (the original situation-specific theory of heart failure self-care—clinical discussion—updated research findings—discussion with international colleagues). The situation-specific theory of Asian immigrant women's menopausal symptom experience in the United States29 combined deduction and induction using a “Theory-Literature Review-Research-Theory” strategy (the middle-range transitions theory—a literature review—a research study). The critical caring theory of protection for migrants and seasonal farmworkers38 combined induction and deduction using a “Theory and Theory-Literature Review strategy” (the Integrative Model of Environmental Health Research and the Falk-Rafael's Critical Caring perspective—a literature review). The situation-specific theory for enabling safety35 combined induction and deduction using a “Literature Review-Practice-Literature Review-Theory” strategy (a literature review—clinical experience—a literature review—Ricoeur's ethical intention). This unique development process of individual situation-specific theories could help reflect diversities and complexities in nursing phenomenon, subsequently resulting in limited generalizability of situation-specific theories.

DISCUSSIONS

The findings of the literature review strongly support that the properties of existing situation-specific theories are consistent with the properties that were originally proposed by Im and Meleis.12 These properties are congruent with the philosophical stance of neo-pragmatism; the linkages between the properties of existing situation-specific theories and the major tenets of neo-pragmatism are summarized in Table 2.

Table 2. - The Linkages Between the Properties of Existing SSTs and Tenets of Neo-pragmatism
Properties of Existing SSTs Major Tenets of Neo-pragmatism
High specificity and low level of abstraction Objecting the universal truth and representationalism
Supporting diversities and multiplicities of truths
Supporting that the world exists in multiple ways (not in 1 way) and the world could not be represented by 1 method
Contextual understanding Supporting that each specific nursing phenomenon would require different conceptualization and theorization based on contextual understanding with the assumption of multiple truths
Direct linkages to research and practice Asserting that the most important aspect of theories would be if the theories serve or do not serve the discipline's goals
Reflecting diversities and complexities with limited generalizability Supporting that there exist multiple ways that the world exists and multiple methods that could be used to accurately represent the world
Supporting multiple truths, objecting the idea of one perspective superior to another, and not believing in one unchangeable truth.
Abbreviation: SSTs, Situation-Specific Theories.

First, “high specificity and low level of abstraction” in situation-specific theories could be supported by neo-pragmatism. As mentioned earlier, neo-pragmatism is a postmodern version of pragmatism.14 Thus, basically, neo-pragmatism has similar philosophical positions of postmodernism.42 Neo-pragmatism negates the universal truth and representationalism14 that require high level of abstraction. Rather, neo-pragmatism emphasizes that language produces meanings by allowing the usages of words that are familiar to the community and could result in consensus among the people.13 Subsequently, truth is from consensus through open and liberal discussion.16 Thus, neo-pragmatism supports diversities and multiplicities of truths,13 which are congruent with high specificity and low level of abstraction in situation-specific theories.

Second, the property of “contextual understanding” agrees with the philosophical stance of neo-pragmatism as well. As neo-pragmatism supports multiple truths16 and negates the universal truth and representationalism,14 it obviously supports the necessity of situation-specific theories because individual nursing phenomena would require different conceptualization and theorization based on contextual understanding with the assumption of multiple truths. As presented in the findings, multiple combinations of induction and deduction were used in development of situation-specific theories to adequately reflect a specific nursing phenomenon with contextual understanding. Actually, the multiple combinations of induction and deduction process would be necessary to adequately reflect major concepts and subconcepts that could be directly associated with specific nursing phenomena within the specific sociopolitical contexts. By deducting from existing theories, the situation-specific theories could consider all major concepts and subconcepts that have been theorized in existing theories, laws, principles, or facts.12 By inducting from multiple sources of theorizing (eg, research, literature reviews, and clinical exemplars), the situation-specific theories could broadly reflect major concepts and subconcepts that have been known to be associated with specific nursing phenomena in the literature.14

Third, the property of “direct linkages to research and practice” that was found in this analysis is also congruent with the philosophical stance of neo-pragmatism. Again, from a neo-pragmatic perspective,16 the most important aspect of situation-specific theories would be whether the theories serve or do not serve nursing discipline's goals. The property of “direct linkages to research and practice” strongly supports that situation-specific theories serve the goals of nursing discipline through their linkages to research and practice. Also, as mentioned earlier, Im and Meleis12 asserted that situation-specific theories would provide “blueprint for action,” which emphasizes the pragmatic aim of situation-specific theories. Indeed, situation-specific theories were originally proposed as a new type of nursing theories because nursing needed the theoretical bases that could meet the dire needs of nursing to link theory to research and practice.6,7,12 Thus, even just from this original goal of situation-specific theories, situation-specific theories are congruent with the philosophical stance of neo-pragmatism.

Finally, the property of “reflecting diversities and complexities with limited generalizability” is also congruent with the philosophical stance of neo-pragmatism. Neo-pragmatism supports that there exist multiple ways that the world exists and multiple methods that could be used to accurately represent the world.13 Also, neo-pragmatism supports the assumption of situation-specific theories on multiple truths, objects the idea of one perspective superior to another, and does not believe in one unchangeable truth.16 Thus, neo-pragmatism supports the aim of situation-specific theories to reflect diversities and complexities in nursing phenomenon with limited generalizability.

CONCLUSIONS

In this article, the properties of existing situation-specific theories were identified through a literature review and discussed in terms of their linkages to neo-pragmatism. Using the properties of situation-specific theories proposed by Im and Meleis12 as the framework for the analysis, the properties of existing situation-specific theories that were published in the literature were identified first. Then, the findings on the properties of existing situation-specific theories were discussed while considering the major tenets of neo-pragmatism. It was obvious that neo-pragmatism could be another philosophical root of situation-specific theories in addition to postempiricism, critical social theory and feminism, and hermeneutics. Neo-pragmatism provides the philosophical basis that situation-specific theories reflect diversities and complexities in nursing with high specificity and contextual understanding. More importantly, neo-pragmatism provides the philosophical basis that situation-specific theories serve the goals of nursing discipline by providing the theoretical bases that could be easily used in research and practice. Actually, from a neo-pragmatic perspective, this would be the raison d'être of situation-specific theories.

REFERENCES

1. Ziman J, Midgley M. Pluralism in science: a statement. Interdiscip Sci Rev. 2001;26:153.
2. Ziman J. Emerging out of nature into history: the plurality of the sciences. Phil Trans R Soc Lond. 2003;361:1617–1633.
3. Hookway C. Pragmatism. In: Zalta EN, ed. The Stanford Encyclopedia of Philosophy. Stanford, CA: Stanford University: 2013.
4. James W. Pragmatism. New York, NY: Lits; 2010.
5. Chinn PL. Response: ReVision and passion. Sch Inq Nurs Pract. 1987;1(1):21–24.
6. Meleis AI. Theoretical Nursing: Development and Progress. Philadelphia, PA: Lippincott Williams & Wilkins; 1997.
7. Im E-O. Development of situation-specific theories: an integrative approach. Adv Nurs Sci. 2005;28(2):137–151.
8. Meleis AI. Theoretical Nursing: Development and Progress. Philadelphia, PA: Lippincott Williams & Wilkins; 2018.
9. Smith M, Liehr PR. Middle Range Theory for Nursing. New York, NY: Springer Publishing Company; 2018.
10. Peterson SJ, Bredow TS. Middle-Range Theories: Application to Nursing Research. Philadelphia, PA: Lippincott Williams & Wilkins; 2020.
11. Chinn P. Developing Substance: Mid-Range Theory in Nursing. Gaithersburg, MD: Aspen; 1994.
12. Im EO, Meleis AI. Situation-specific theories: philosophical roots, properties, and approach. ANS Adv Nurs Sci. 1999;22(2):11–24.
13. Rorty R. Philosophy and Social Hope by Richard Rorty. London, England: Penguin Books; 1999.
14. Bunnin N, Yu J. The Blackwell Dictionary of Western Philosophy. Chichester, England: Wiley-Blackwell; 2009.
15. Hickman LA, Dewey J. The Essential Dewey: Pragmatism, Education, Democracy. Bloomington, IN: Indiana University Press; 1998.
16. Mason WH. Constructing a “plausible narrative of progress” for nursing: a neopragmatist suggestion. Nurs Philos Int J Healthc Prof. 2009;10(1):4–13. doi:10.1111/j.1466-769X.2008.00376.x.
17. Paley J. Error and objectivity: cognitive illusions and qualitative research. Nurs Philos Int J Healthc Prof. 2005;6(3):196–209. doi:10.1111/j.1466-769X.2005.00217.x.
18. Sundin O, Johannisson J. Pragmatism, neo‐pragmatism and sociocultural theory: communicative participation as a perspective in LIS. J Doc. 2005;61(1):23–43. doi:10.1108/00220410510577998.
19. Bohman J. Critical theory. In: Zalta EN, ed. The Stanford Encyclopedia of Philosophy. Stanford, CA: Metaphysics Research Lab, Stanford University; 2019.
20. Shalin DN. Critical Theory and the pragmatist challenge. Am J Sociol. 1992;98(2):237–279.
21. Giuliano KK. Expanding the use of empiricism in nursing: can we bridge the gap between knowledge and clinical practice? Nurs Philos Int J Healthc Prof. 2003;4(1):44–52. doi:10.1046/j.1466-769x.2003.00111.x.
22. Hesse-Biber SN. Handbook of Feminist Research: Theory and Praxis. Thousand Oaks, CA: SAGE; 2011.
23. Chinn PL. Feminism and nursing. Annu Rev Nurs Res. 1995;13(1):267–289. doi:10.1891/0739-6686.13.1.267.
24. Draper P. Nursing research and the philosophy of hermeneutics. Nurs Inq. 1996;3(1):45–52. doi:10.1111/j.1440-1800.1996.tb00008.x.
25. Baird MB. Well-being in refugee women experiencing cultural transition. ANS Adv Nurs Sci. 2012;35(3):249–263. doi:10.1097/ANS.0b013e318267260c0.
26. Chang SJ, Im EO. Development of a situation-specific theory for explaining health-related quality of life among older South Korean adults with type 2 diabetes. Res Theory Nurs Pract. 2014;28(2):113–126. doi:10.1891/1541-6577.28.2.113.
27. Clingerman E. A situation-specific theory of migration transition for migrant farmworker women. Res Theory Nurs Pract. 2007;21(4):220–235.
28. Im EO. The situation-specific theory of pain experience for Asian American cancer patients. Adv Nurs Sci. 2008;31(4):319–331. doi:10.1097/01.ANS.0000341412.02177.77.
29. Im EO. A situation-specific theory of Asian immigrant women's menopausal symptom experience in the United States. ANS Adv Nurs Sci. 2010;33(2):143–157. doi:10.1097/ANS.0b013e3181dbc5fa.
30. Im EO, Chang SJ, Nguyen G, Stringer L, Chee W, Chee E. Korean immigrant women's physical activity experience: a situation-specific theory. Res Theory Nurs Pract. 2015;29(1):10–24. doi:10.1891/1541-6577.29.1.10.
31. Im EO, Meleis AI. A situation-specific theory of Korean immigrant women's menopausal transition. Image J Nurs Sch. 1999;31(4):333–338.
32. Im EO, Stuifbergen AK, Walker L. A situation-specific theory of Midlife Women's Attitudes Toward Physical Activity (MAPA). Nurs Outlook. 2010;58(1):52–58. doi:10.1016/j.outlook.2009.07.001.
33. Lee SM. Lee Geropalliative Caring Model: a situation-specific theory for older adults. ANS Adv Nurs Sci. 2018;41(2):161–173. doi:10.1097/ANS.0000000000000195.
34. Lee H, Fawcett J, Yang JH, Hann H-W. Correlates of hepatitis B virus health-related behaviors of Korean Americans: a situation-specific nursing theory. J Nurs Scholarsh. 2012;44(4):315–322. doi:10.1111/j.1547-5069.2012.01468.x.
35. Ohlén J, Andershed B, Berg C, et al. Relatives in end-of-life care—part 2: a theory for enabling safety. J Clin Nurs. 2007;16(2):382–390. doi:10.1111/j.1365-2702.2006.01474.x.
36. Riegel B, Dickson VV. A situation-specific theory of heart failure self-care. J Cardiovasc Nurs. 2008;23(3):190–196. doi:10.1097/01.JCN.0000305091.35259.85.
37. Riegel B, Dickson VV, Faulkner KM. The situation-specific theory of heart failure self-care: revised and updated [published online ahead of print March 13, 2015]. J Cardiovasc Nurs. doi:10.1097/JCN.0000000000000244.
38. Shearer JE. A critical caring theory of protection for migrants and seasonal farmworkers. Public Health Nurs Boston Mass. 2017;34(4):370–379. doi:10.1111/phn.12304.
39. Suh EE. The sociocultural context of breast cancer screening among Korean immigrant women. Cancer Nurs. 2008;31(4):E1–10. doi:10.1097/01.NCC.0000305742.56829.fc.
40. Im EO. Theory development process of situation specific theories. Adv Nurs Sci. 2014;37(1):19–31.
41. Baird MB, Reed PG. Liminality in cultural transition: applying ID-EA to advance a concept into theory-based practice. Res Theory Nurs Pract. 2015;29(1):25–37. doi:10.1891/1541-6577.29.1.25.
42. Senchuk DM. Review of Pragmatism as Post-Postmodernism: Lessons from John Dewey. https://ndpr.nd.edu/news/pragmatism-as-post-postmodernism-lessons-from-john-dewey/ Accessed July 9, 2020.
Keywords:

neo-pragmatism; nursing; philosophy; situation-specific theory; theory; types of theory

© 2020 Wolters Kluwer Health, Inc. All rights reserved.