科學哲學觀演化與護理知識典範順勢

Nursing Knowledge: The Evolution of Scientific Philosophies and Paradigm Trends

不同的哲學觀所根據的典範不同，主張論點亦有多樣性及重複性，而典範是一種信念（belief）及實務（practice）的型態，可提供該專業領域對欲探詢問題的透視（lens）或架構，它引導護理研究的進行。另一方面，為了迎合健康照護需求的改變，護理亦以實證研究為基礎，而實證的真正意涵引發護理學者的辯證，至今，仍未有主導護理的典範產生，學者們所主張的不同典範，在研究應用各有其優勢和限制。整體而言，護理知識發展的典範進程從1950年代Peplau、Henderson至1980年代的Orem皆偏向人是可以測量的量性觀，到了1990年代有較大的轉變，Guba、Parse等學者們主張存在脈絡的質性觀。護理典範對於護理知識的貢獻不可輕之，但辯論卻也不曾間斷，專注個人的典範所建構的知識會片段不完整，多元使用不同典範才能回答不同的研究問題，所以學者們彼此的包容及共容觀，經互相溝通後方能提供護理人更整合性的世界觀，提升多面向研究累積知識。

Different aspects of philosophy are derived from different paradigms that contain various main points, some of which are repeated or overlap. Belief and practice are two components of a paradigm that provide perspective and framework and lead to nursing research. Changes in healthcare have popularized empirical and evidence-based research in the field of nursing research. However, the evidence-base study approach has given rise to a certain level of debate. Until now, no standard paradigm has been established for the nursing field, as different professionals use different paradigms in their studies. Such provides certain limitations as well as advantages. The quantitative aspects of a nursing paradigm were developed by Peplau and Henderson (1950) and Orem (1980). Such remained the standard until 1990, when Guba and Parse proposed qualitative viewpoints in contextual features. Therefore, the nursing paradigm has made great contributions to the development of knowledge in nursing care, although debate continues due to incomplete knowledge attributable to the presentation of knowledge and insight within individually developed paradigms. It is better to apply multiple paradigms to different research questions. It is suggested that better communication amongst experts regarding their individual points of view would help nursing members to integrate findings within the global pool of knowledge and allow replication over multiple studies.