Critical Inquiry Into Philosophical Perspectives Underlying Nursing Research on Acute Coronary Syndrome

Abstract

The purpose of this critical inquiry was to identify and describe philosophical perspectives in published primary reports of acute coronary syndrome nursing research. A state of the science literature review revealed a dearth of studies regarding the philosophical perspectives underlying nursing research. A descriptive study incorporating systematic and integrative literature review strategies was performed. The conceptual framework used in the analysis was based upon Fawcett's (1993) three philosophical worldviews synthesized from various sources: Reaction, Reciprocal-interaction, and Simultaneous action. Quantitative and qualitative data analysis techniques such as descriptive statistics and matrix analysis of patterns and themes was performed on the 43 articles included in the study sample. Seven themes were identified: 1) Disease Management, 2) Health Pattern Recognition and Experiences, 3) Human Agency, 4) Integrative Nursing for Symptom Management, 5) Nursing Knowledge and Guideline Recommendations, 6) Patient Education, and 7) Symptom Management. Although there was a lack of explicit philosophical perspectives underlying acute coronary syndrome nursing research, a majority of articles aligned with two nursing philosophical perspectives; simultaneous action worldview and reciprocal-interaction worldview, as compared to the reaction worldview considered to be more representative of a non-nursing philosophical perspective (e.g. the biomedical model). Whereas no key tenets of Fawcett’s conceptual framework specify gender and ethnicity characteristics, results also revealed most articles described sample groups as predominantly male and white. In addition, an overlap in thematic categorizations between the simultaneous action and reciprocal-interaction views suggested the need for a more comprehensive nursing philosophy for nursing knowledge development. The extant philosophical view proposed to address the ontological and epistemological overlap is Reed's (2011) intermodernism. In conclusion, nurses across diverse practice areas must be more diligent in explicitly identifying philosophical perspectives underlying nursing research as well as incorporating diverse gender and ethnic patient populations into their studies. The integration of the more humanistic, emancipatory, and holistic philosophical perspective of intermodernism into nursing knowledge development is warranted.