Intentionality is an important concept for nurses to study for professional and theoretical reasons. Lewis states that intentionality is best studied within an active, rather than reactive, worldview. This article is a level-by-level outline of Lewis' five-level model for the study of intentionality. These levels are: necessity, interactive necessity, action intent, divergent intent, and conscious intent. Newman's tri-part categorization of nursing theory paradigms (particularate-deterministic, interactive-integrative, and unitary-transformative) proves to be a useful framework to compare the Lewis model of intentionality with nursing theory. Examples from nursing theory development, such as the Roy adaptation model, chronotherapeutics, Rogers' theory of unitary human being, health as expanding consciousness, and therapeutic touch, are used to support all five levels of intentionality in providing guidance for practice and research by nurse theorists.
Associate Professor, University of Miami School of Nursing, Coral Gables, Florida