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The systematic enrichment of knowledge for application in actual practice is the foundation of the nursing profession. In translating knowledge into professional practice, there are a number of associated or linking elements, which are philosophy, metaparadigm and theory.
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A basis of knowledge in nursing is theory. Theories are ideas or suppositions that provide explanations of a particular phenomenon. These could be useful in understanding and finding solutions to problems. Theories could also explain the links between concepts to create an understanding of these concepts and their implications. These also identify the ways of conceptualizing the central focus of disciplines. (Alligood & Tomey, 2006) An example is Watson’s human care theory, which explains human care as the moral ideal of delivering nursing intervention through shared experiences with people (Alligood & Tomey, 2006). This theory explains care in the context of nursing practice. Concepts comprise this theory. The human care theory connects the concepts of care, moral position, and subjective human experiences. This theory also point to the focus of the nursing profession, which is the provision of care in a morally ideal manner through specific interventions that necessitates human interaction.
While theory is a source of knowledge in the nursing profession, this remains largely disjointed from actual practice. Theories explain knowledge about phenomenon, such as human care in nursing practice but it needs to be broken down into areas of concern of a particular discipline such as the nursing profession.
Metaparadigm constitutes this link. A metaparadigm is a statement identifying what are relevant to a discipline or a community sharing this relevance. These are the major areas of concern or focus of the discipline. In the nursing profession, a metaparadigm provide the boundaries of nursing practice. The metaparadigms in nursing are person or client, environment, health, and nursing. (Alligood & Tomey, 2006) In the human care theory, the client or patient is a relevant focus because they are the recipient or target of nursing interventions. Patients have different needs and identifying these needs requires interaction between the nurse and the patient. The environment is another relevant focus of care because the spatial and relational environment affects the effectiveness of care. Health is also a salient focus because this determines the holistic wellbeing of patients as the point of reference for needed care and the effectiveness of interventions. Nursing is the last focus, which refers to the caring relationship between a nurse and a patient.
A theory explains a phenomenon and a metaparadigm points to the areas of focus of a phenomenon but there remains a gap in connecting to practice. Another connecting element is necessary to support practice. This element is philosophy.
A philosophy is a set or system of beliefs and values. Philosophy guides action by providing a basis of identifying acceptable, appropriate or standard action given different circumstances. These beliefs and values came from lessons of best practices. (Alligood & Tomey, 2006) A philosophy aligned with the human care theory and metaparadigms of nursing is holistic intervention, which requires the interventions and delivery of care to include components targeting the body, mind, emotions, spirituality, social wellbeing, and overall development. In practice, intervention includes medicine, interaction, fiduciary relationship, information sharing or transparency, inclusive decision-making, participatory intervention, and other practices subsumed by the metaparadigms of nursing and explained by theories.
Philosophy, metaparadigm and theory are the interconnected elements linking knowledge with practice. Theory constitutes knowledge, metaparadigm identifies the focus of a discipline adhering to a set of theories, and a philosophy guides action within the bounds of focus of a given discipline and theoretical knowledge.
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