Much emphasis has been placed on the importance of the environment as a determinant of health; however, little theoretical work in nursing has specifically articulated the importance of the nursing practice environment as a factor in patient outcomes. This work advances the unitary-transformative-caring paradigm by focusing on the concept of integrality and exploring the nursing meta-paradigm concepts (nursing, environment, human being, and health) through integral philosophical inquiry.
Center for Health Policy and Outcomes Research, School of Nursing, University of Pennsylvania, Philadelphia.
Correspondence: Olga F. Jarrín, PhD, RN, Center for Health Policy and Outcomes Research, School of Nursing, University of Pennsylvania, 418 Curie Blvd, 384R, Philadelphia, PA 19104 (firstname.lastname@example.org).
The author thanks her dissertation chair, E. Carol Polifroni, EdD, RN, and committee: Barbara Bennett Jacobs, PhD, RN, W. Richard Cowling III, PhD, FAAN, Amy Kenefick, PhD, RN, and Peggy L. Chinn, PhD, FAAN, for their critical insight and support as these ideas developed over many years. She acknowledges funding that supported her education, training, and research while these ideas were developed and refined: the University of Connecticut predoctoral fellowship, the federal Graduate Assistance in Areas of National Need predoctoral fellowship, and her current postdoctoral fellowship from the National Institute of Nursing Research training grant “Advanced Training in Nursing Outcomes Research” (T32-NR-007104, Linda Aiken, PI).
The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article.