Advances in Nursing Science最新文献

Nursing is a professional discipline defined by professional standards and practice grounded in scientific knowledge, evidence-informed decision making, and ethical responsibility. This practice is supported by ontological, epistemological, and theoretical foundations that enable nurses to address the complexities of human health and illness. Viewed through the lens of metamodernism, nursing is further affirmed as a profession in which authority and identity are continually enacted through the integration of scientific rigor and relational care, standardization and contextual responsiveness, and technical competence and moral accountability. Thus, we affirm that nursing stands as a profession and that nurses are professionals.

Nursing theory's history reflects a movement from scientific legitimacy toward epistemic reflexivity. We situate that shift within nursing's metatheoretical evolution, expanding from hierarchies of abstraction to include pluricentric, context-responsive, and justice-oriented paradigms. It advances a reflexive grammar of theorizing organized around 6 prepositions (from, about, through, for, with, and towards), each identifying a locus of reflexivity. This grammar of interdependent reflexive loci reconceives theorizing as contingent, embodied, relational, and political labor that makes it explicit how positionality, onto-epistemologies, beneficiaries, sociomaterialities, and values shape knowledge creation. This transcends theorizing from being a procedural task to a dialogical, ethical, and imaginative act.

Paternal postpartum depression is an underrecognized public-health concern affecting approximately 10% of new fathers in the US.1 Despite this prevalence, paternal postpartum depression remains underdiagnosed and poorly addressed within obstetric and mental-health systems that prioritize maternal experience.1 Emerging evidence indicates that fathers face substantial barriers, including gendered expectations of parenting, limited health care inclusion, and face stigmas in their help-seeking habits, contributing to the strain and adverse child outcomes. This theory integrates Gender Role Conflict Theory, Transitions Theory, and Family Stress Theory, positioning adaptation as a dynamic, feedback-driven process shaped by masculine beliefs, partner support, and systemic inclusion. The theory, Reciprocal Adaptation in Postpartum Fathers: A Mid-Range Theory of Role Negotiation, Relational Reciprocity, and Family Adjustment, points to the influence of nurses as pivotal agents in recognizing paternal distress, promoting early screening, and facilitating family-centered care that supports both fathers and families.

Dependency-related skin injuries (DRSIs) are prevalent in community care and substantially impair quality of life. This study develops a situation-specific nursing theory to guide community practice. Using Im's integrative method, we triangulated a pilot interview, a scoping review, focus groups with primary/community nurses, and in-depth patient interviews. An integrative process yielded Parallel Itineraries, a theory that integrates 4 core concepts-community care, healing progression, dependency status, and individual experience-and advances propositions linking them. The theory delineates nursing's distinctive contribution and prioritizes early prevention at the onset of dependency, etiologic management, case coordination, shared decision-making, and continuity of care in the community.

There is a lack of evidence describing the lived experience of the early healing period (72 hours to 6 weeks post-transplant) and its meaning to people undergoing liver transplant surgery. To address this gap, a qualitative hermeneutic phenomenological approach guided by Newman's Theory of Health as Expanding Consciousness was used to describe and interpret the meaning of the early stage of healing post liver transplantation. We conducted 2 semistructured interviews with 9 participants (8 men, 1 woman; ages 31-70 years). Six themes were identified: Waiting to die while preparing to live; Desire to help others as a way of supporting themselves; Misaligned expectations that complicate the healing process; Nonjudgmental, nonstigmatizing healing; Financial and employment difficulties as a barrier to healing; and History of adverse childhood experiences as a barrier to healing. The overarching conceptualization of the study was the awareness of the need to address past traumas as central to whole-person healing. Findings highlight the many educational, psychosocial, financial, and interpersonal challenges faced by this population that should be considered to improve the healing process.

Problematic internet use among adolescents has recently emerged as a significant concern. Currently, there is no nursing theory available to guide nurses in addressing this issue. This study aims to describe a situation-specific nursing practice theory designed to promote healthy internet use in adolescents. A four-step integrative approach was used to develop a situation-specific theory. A comprehensive literature review, cognitive-behavioral and developmental theories, expert opinions, and findings from theory testing formed the primary sources. As a result, the Care Bag Theory for Healthy Internet Use in Adolescents (CHIA) was developed. The theory may guide nurses in promoting healthy internet use in adolescents.

This article applies Barrett's theory of Power as Knowing Participation in Change (PKPC) to teaching social justice advocacy to undergraduate college students. The author designed and implemented a seminar that integrated PKPC principles through experiential learning, multimedia resources, and reflective assignments, using the HIV advocacy movement as a case study to demonstrate how awareness, choice, intentional action, and involvement in change can address social inequities. Students created advocacy projects addressing contemporary social inequities by identifying a group power profile and developing a power prescription. The seminar demonstrated the potential of PKPC as a transformative framework for education and activism across disciplines.

Quantitative health research remains anchored in positivist assumptions that can obscure structural drivers of inequity. This article introduces the CARE Model-Community-accountability, Anti-oppression, Reflexivity, and Equity-centered evidence-to align quantitative methods with critical epistemologies. Drawing on critical theories, qualitative methodology, and existing critical quantitative approaches, the proposed model details implications for study design, measurement, coding strategies, modeling choices, interpretation, and dissemination. CARE offers a systematic approach for rigorous, reflexive, and community-guided inquiry that reframes variables, integrates structural context, and informs action. The model advances quantitative research that not only documents disparities but also targets the systems that produce them.

Safety for transgender, non-binary, and gender-expansive (TGNE) individuals includes freedom from discrimination, stigma, and threats to psychological well-being. This paper presents an application of Roy's adaptation model (RAM) to examine safety across the physiological, self-concept, role function, and interdependence modes through a fictional case study of a TGNE patient in a nurse-client encounter. Our analysis reveals how nurses can foster affirming environments, address systemic barriers, and use theory to guide adaptive and equitable care. This application highlights the connection between nursing theory and practice and demonstrates how RAM can inform nurse-led interventions to support TGNE patients' adaptation, well-being, and experiences of safety.