Evolution of the Language in the Science of Unitary Human Beings.

This article presents a discussion of the evolution of the language of the Science of Unitary Human Beings from the terms used by Martha Rogers in her 1970 book to changes in terms Rogers introduced in her publications over the ensuing years to new terms and language offered by Rogerian scholars before and after Rogers' death in 1994. The article follows from Rogers' insistence that the language of a science, which evolves from general language, should be specific to the level of abstraction of the relevant concepts.

More Thoughts About the Evolution of the Metaparadigm of Nursing: Addition of Culture as Another Metaparadigm Concept and Definitions of All the Concepts.

This essay is an extension of my previous essay about my recent thoughts about the evolution of the metaparadigm of nursing. In this essay, I introduce the concept of culture as an additional metaparadigm concept and provide definitions for all of the metaparadigm concepts.

More Thoughts About Environment.

The purpose of this essay is to present more thoughts about the environment. This essay is about the internal environment whereas a previous essay published in 2022 was about the external environment. This essay includes an overall understanding of internal environment as well as descriptions or definitions of internal environment given in selected nursing conceptual models. A possible interpretation of internal environment from a Native American perspective is mentioned. A call is issued for understanding of internal environment by persons from diverse cultures.

More Thoughts About Health Policies: Focus on Conceptual Models.

The purpose of this essay is to demonstrate how existing conceptual models of nursing designed for clinical research, education, practice, and administration also can be used to guide health policy development, analysis, evaluation, and research by nurses. The concept of each of various nursing conceptual models that might be represented by health policies is identified.

Thoughts About the Metaparadigm of Nursing: Contemporary Status and Recommendations for Evolution.

In this essay, I present my original and most recent versions of nursing's disciplinary metaparadigm, along with others' versions of the metaparadigm. I conclude the essay by joining others in issuing a call for decolonization of nursing knowledge, with an emphasis in this essay on decolonizing nursing's metaparadigm by asking if a metaparadigm is needed and, if so, what its content should be.

Thoughts About Measuring Concepts: Using Single-Item Indicators and Multiple-Item Indicators.

This essay presents a discussion about using a single item to measure a concept versus using multiple items. The discussion is data-based, using the results from a cross-sectional pilot study of correlates of functional status of women and their male partners who were experiencing high-risk childbearing.

Adaptation to High-Risk Childbearing: Extension of a Preliminary Situation-Specific Theory with Focus on Psychological State and Functional Status / Adaptación a la maternidad de alto riesgo: ampliación de una teoría preliminar de situación específica con enfoque en la condición psicológica y el estado funcional / Adaptação à maternidade de alto risco: ampliação de uma teoria preliminar de situação específica com foco na condição psicológica e no estado funcional

Introduction: Little is known about expectant and new parents' psychological experiences of high-risk childbearing. Objective: The paper is a report analyses of data from a Roy Adaptation Model-guided pilot study of women's and their male partners' adaptation to high-risk childbearing and thereby extends a preliminary situation-specific theory of adaptation to high-risk childbearing. Materials and methods: A previous paper was a comprehensive report of the results of the pilot study except for psychological state, measured by the Multiple Affect Adjective Checklist-Revised. The additional data analyses reported in this paper are for effect sizes of correlations between the Multiple Affect Adjective Checklist-Revised subscales and maternal and paternal functional status inventories. Results: Correlations of small (r = 0.1), medium (r = 0.3), and large (r = 0.5) effect sizes were found for the measures of psychological state and functional status for both women and their male partners except for psychological state positive affect and maternal functional status during the postpartum, and psychological state anxiety and paternal functional status during the postpartum. Conclusions: Overall, no substantial differences were found in psychological state and functional status for women and their male partners during pregnancy and the postpartum. The findings of this secondary data analysis constitute an extension of the preliminary situation-specific theory reported in a previously published paper.

Introducción: poco se conoce sobre las experiencias psicológicas de los futuros y nuevos padres en la maternidad de alto riesgo. Objetivo: dar a conocer unos análisis de datos adicionales a partir de un estudio piloto guiado por el modelo de adaptación de Roy sobre la adaptación de las mujeres y sus parejas masculinas a la maternidad de alto riesgo y, por lo tanto, ampliar una teoría preliminar de situación específica de la adaptación a la maternidad de alto riesgo. Materiales y métodos: el artículo previo fue un informe completo de los resultados del estudio piloto, excepto por la condición psicológica, que se midió mediante la lista de verificación de adjetivos de afecto múltiple revisada. Los análisis de datos adicionales suministrados en este documento corresponden a los tamaños del efecto de las correlaciones entre las subescalas de la lista de verificación de adjetivos de afecto múltiple revisadas y los inventarios de estado funcional materno y paterno. Resultados: se encontraron correlaciones de tamaños de efecto pequeños (r = 0,1), medianos (r = 0,3) y grandes (r = 0,5) para las medidas de condición psicológica y estado funcional tanto para las mujeres como para sus parejas masculinas, excepto para el afecto positivo de la condición psicológica y el estado funcional materno durante el posparto y la condición psicológica de ansiedad y el estado funcional paterno durante el posparto. Conclusiones: en general, no se encontraron diferencias sustanciales en la condición psicológica y el estado funcional de las mujeres y sus parejas masculinas durante el embarazo y el posparto. Los hallazgos de este análisis de datos secundarios constituyen una extensión de la teoría preliminar de situación específica presentada en un artículo publicado con anterioridad.

Introdução: pouco se sabe sobre as experiências psicológicas dos futuros e novos pais na maternidade de alto risco. Objetivo: apresentar as análises de dados adicionais a partir de um estudo-piloto orientado pelo modelo de adaptação de Roy sobre a adaptação das mulheres e seus companheiros à maternidade de alto risco e, portanto, ampliar uma teoria preliminar de situação específica da adaptação à maternidade de alto risco. Materiais e método: tendo em vista que se trata de uma extensão de um artigo publicado anteriormente, o qual foi um relatório completo dos resultados do estudo-piloto, exceto pela condição psicológica, que foi medida mediante a checklist de adjetivos de afeto múltipla revisada, as análises de dados adicionais fornecidas neste documento correspondem aos tamanhos do efeito das correlações entre as subescalas da checklist de adjetivos de afeto múltipla revisada e os inventários de estado funcional materno e paterno. Resultados: foram constatadas correlações de tamanhos de efeito pequenos r = 0,1), médios (r = 0,3) e grandes (r = 0,5) para as medidas de condição psicológica e estado funcional tanto para as mulheres quanto para seus companheiros, exceto para o afeto positivo da condição psicológica e o estado funcional materno durante o pós-parto, e a condição psicológica de ansiedade e o estado funcional paterno durante o pós-parto. Conclusões: em geral, não foram encontradas diferenças substanciais na condição psicológica e no estado funcional das mulheres e seus companheiros durante a gestação e o pós-parto.

Gender Minority Persons' Perceptions of Peer-Led Support Groups: A Roy Adaptation Model Interpretation.

Literature addressing gender minority health has documented adverse behavioral health outcomes. "Gender minority" recognizes identities that include, but are not limited to, transgender and gender nonconforming. Although gender minority affirmative counseling exists, most continue to focus on pathology and diagnosis, leading people in the gender minority community to mistrust services. Sources of social support can ameliorate gender minority psychological distress by providing an environment that affirms gender identities. The purpose of this study was to identify gender minority peoples' perceptions of their experiences in a peer-led support group. The themes were then interpreted within the context of Roy's Adaptation Model.

Created Environment: Evolution of a Neuman Systems Model Concept.

In this essay, we trace the evolution of the definition of the Neuman systems model concept of created environment from its inception in 1989. The created environment is one of three categories of environment in the Neuman systems model; the other two are the internal environment and the external environment. The most recent definition of created environment is offered in this essay as the following: The created environment is a synthesis of the internal and external environments that encompasses the client system's ever-changing awareness of the physiological, psychological, sociocultural, developmental, and spiritual variables, and the intrapersonal, interpersonal, and extrapersonal stressors as beneficial or noxious. As a protective shield, the created environment represents the client system's perceptions and understanding of what is real and what is safe, as discussed with the nurse.

The American Academy of Nursing 50th Anniversary of the Nursing Theory Guided Practice Expert Panel (NTGPEP): Exploring the Past-Re-envisioning the Future.

The Nursing Theory-Guided Practice Expert Panel (NTGP-EP), one of the 14 Expert Panels, is officially designated to advance the mission and strategic goals of the American Academy of Nursing. The NTGP-EP has created a forum for dialogue among nurse scholars interested in advancing nursing theory to promote health and wellbecoming. The purpose of this paper is to share the important work of the NTGP-EP and its history, contributions, and accomplishments, and to propose a member-driven agenda to re-envision our preferred future and the impact of the use of nursing theory to guide nursing education, research, practice, and policy.

Thoughts About Teaching: A Nursing Discipline-Specific Perspective of Lifespan Growth and Development.

This essay addresses a nursing discipline- specific approach to teaching a course about lifespan growth and development. This course may be a requirement for the baccalaureate degree in nursing, offered as a pre-requisite to the nursing major or relevant content may be integrated into clinical courses. Noteworthy is that the content for the course frequently is drawn from the field of developmental psychology. In this essay, I offer a nursing-discipline specific approach guided by Meleis' transitions framework and the Roper-Logan-Tierney model of nursing based on activities of daily living.

Thoughts About Health Policies.

This essay is about health policies. Included are the definition of health policy, the descriptions of the concepts of a conceptual model of nursing and health policy, and examples of various sources of health policies. A central thesis of this essay is that practice guidelines are largely unrecognized as health policies. This thesis provides the connection between the abstract idea of a health policy and what is done in nursing practice. The essay concludes with examples of research questions about nursing and health policies.

Thoughts About Environment.

The purpose of this essay is to discuss what is meant by the external environment within our discipline. The essay includes an overview of attention to environment that began when human beings first inhabited the planet and has continued to contemporary times within the context of nursing conceptual models. The finally recognized need for attention to global environmental conditions that include climate and climate change is cited. The essay concludes with a call for decolonizing the disciplinary meanings of environment.

More Thoughts About Concept Analysis: A Different Approach.

The author of this essay presents a new approach to concept analysis based on the usage pattern of words, in contrast to literature-based analysis of concepts. This new approach is based on the premise that words exist, whereas concepts do not exist.

Defining the social determinants of health for nursing action to achieve health equity: A consensus paper from the American Academy of Nursing.

BACKGROUND: The 2019-2020 American Academy of Nursing (Academy, 2019) policy priorities document states that "they have a clear and distinct focus on social determinants of health and uses this lens to advance policies and solutions within each of the three overarching priorities" PURPOSE: This consensus paper seeks to establish conceptual clarity and consensus for what social determinants of health mean for nursing, with emphasis on examples of health policies that advance planetary health equity and improve planetary health-related quality of life. METHODS: Volunteers from five Expert Panels of the Academy met via videoconference to determine roles and refine the focus of the paper. After the initial discussion, the first draft of the conceptual framework was written by the first three authors of the paper and, after discussion via videoconference with all the co-authors, successive drafts were developed and circulated for feedback. Consensus was reached when all authors indicated acceptance of what became the final version of the conceptual framework. FINDINGS: A conceptual framework was developed that describes how the social determinants of health can be addressed through nursing roles and actions at the individual, family, and population levels with a particular focus on the role of health policy. The paper provides a specific health policy example for each of the six key areas of the social determinants of health to illustrate how nurses can act to improve population health. DISCUSSION: Nursing actions can support timely health policy changes that focus on upstream factors in the six key areas of the social determinants of health and thus improve population health. The urgent need to eliminate systematic and structural racism must be central to such policy change if equity in planetary health-related quality of life is to be attained.

Empirical Indicators: Conceptual and Theoretical Origins / Indicadores empíricos: orígenes teóricos y conceptuales / Indicadores empíricos: origens teóricas e conceituais

This paper discusses the connections between nursing conceptual model concepts, middle-range theory, and situation-specific theory concepts, as well as between the theory concepts and how they are measured, that is, empirical indicators. Three types of empirical indicators are described­instruments, assessment tools, and interventions­and an example of each type is given. The paper's central thesis is that a conceptual model concept is ­or should be­ the starting point for selecting or constructing an empirical indicator.

En el presente artículo, se analizan las conexiones entre los conceptos del modelo conceptual, la teoría de rango medio y los conceptos de la teoría de situaciones específicas de enfermería, así como entre los conceptos teóricos y cómo se miden estos, es decir, los indicadores empíricos. Se describen tres tipos de indicadores empíricos ­instrumentos, herramientas de evaluación e intervenciones­ y se da un ejemplo de cada tipo. La tesis central del artículo es que un concepto de modelo conceptual es ­o debería ser­ el punto de partida para seleccionar o construir un indicador empírico.

Neste artigo, são analisadas as conexões entre os conceitos do modelo conceitual, a teoria de médio alcance e os conceitos da teoria de situações específicas de enfermagem, bem como entre os conceitos teóricos e como estes são medidos, isto é, os indicadores empíricos. São descritos três tipos de indicadores empíricos (instrumentos, ferramentas de avaliação e intervenções) e é dado um exemplo de cada tipo. Argumenta-se que um conceito de modelo conceitual é ­ ou deveria ser ­ o ponto de partida para selecionar ou construir um indicador empírico.

Chief Nursing Officer Perspectives on Nursing Theory-Guided Practice.

OBJECTIVE: The purpose of this study was to identify what guides nursing practice. BACKGROUND: Change occurred when the Magnet Recognition Program® no longer required a nursing theory. METHODS: This was a mixed-methods study to identify the process used to implement nursing theory-guided practice and the relationship to professional practice recognition. Deidentified quantitative data were collected from 36 chief nursing officers (CNOs). Seventeen CNOs participated in the qualitative interview. RESULTS: Thirteen CNOs were from a Magnet®-designated facility. Ten CNOs were on the Magnet journey, and 2 had no intent to seek Magnet recognition. Two CNOs were from a Pathway to Excellence®-designated facility. One CNO was on the Pathway to Excellence journey. The majority of respondents who were Magnet® recognized who participated in the survey used Watson's Theory of Human Caring. Themes were identified that share the benefits and strategies to integrate nursing-guided theory into nursing processes, structures, and outcomes. CONCLUSION: Findings will benefit CNOs as they make decisions related to pursuing Magnet status recognition.

More Thoughts About Models of Nursing Practice Delivery.

This is the second of two essays about five models of nursing practice delivery-total patient care, functional nursing, team nursing, primary nursing, and the attending nurse. Primary nursing and the attending nurse are discussed in this essay. The other three models were discussed in a previous issue of Nursing Science Quarterly. Each model is described and its connection with nursing discipline-specific knowledge is discussed. The extent to which each model ascribes accountability for practice also is discussed.