Critical Theory: A Foundation for the Development of Nursing Theories
Holter, Inger Margrethe Msn, Rn, Scholarly Inquiry for Nursing Practice
The increasing awareness of the importance of establishing a philosophical foundation for the development of nursing theories has led to an evaluation of the philosophical orientations which implicitly, if not explicitly, form its current basis. This article questions whether empiricism and phenomenology, two popular philosophical orientations in nursing literature, are appropriate as foundations for theory development given the holistic nature often ascribed to nursing. A further question is raised as to whether or not the above orientations have led to a gap between nursing practice and nursing theory development. Critical theory, as propounded by Jurgen Habermas, is delineated and proposed as a more appropriate theoretical foundation for nursing theory development due to its holistic orientation.
In recent years, there has been an increasing awareness of the importance of establishing a philosophical foundation for the development of nursing theories (Benner, 1985; Gortner, 1983; Griffin, 1980; Kim, 1983; Sarter, 1987; Silva & Rothbart, 1984; Suppe & Jacox, 1985; Thompson, 1985). The importance of such an awareness lies in the fact that it provides a frame of reference for understanding and assessing theories, in making assumptions about how one comes to know what one knows, and what the limits of that knowledge may be.
At present, there are several philosophical orientations that appear to form the basis of theory development in nursing. Empiricism and phenomenology are examples of the more familiar orientations, although these are often more implicit than explicit in the nursing literature. Until recently, there has been very little discussion or critique of the alignment of these orientations with the underlying nature of nursing as a discipline (Gortner & Schultz, 1988; Lund et al., 1988; Schultz, 1987; Stevenson & Woods, 1984; Thompson, 1985). There is a gap between nursing practice and nursing theory. Is one reason for this gap the misalignment between the knowledge from which some of the existing nursing theories have been derived and that which is traditionally emphasized as a holistic approach to nursing?
The heightened awareness of the importance of establishing a philosophical foundation for the development of nursing theories is accompanied by shifts in philosophical orientation proposed for nursing science. These shifts have been described as beyond empiricism (science influenced by logical empiricism) and historicism (science influenced by phenomenology) to a philosophy of science employing critical theory, which can lead to critically oriented sciences (Allen, 1985; Allen, 1986; Allen, Benner, & Diekelmann, 1986; Hedin, 1986; Silva & Rothbart, 1984; Thompson, 1985).
The purpose of this article is to introduce critical theory and to argue that critical theory can be helpful in describing the nature of current misalignments between theory and practice. This article will also demonstrate how critical theory can provide a philosophical foundation capable of merging past efforts and enhancing future efforts in the scientific development of nursing knowledge. The first section of the article provides a description of the essential characteristics of critical theory. The second section seeks to show that there have been different interpretations of what is purported to be the nature of nursing and the philosophical orientation upon which nursing theories have been built. Finally, an attempt is made to link critical theory to what are identified as fundamental patterns of knowing in nursing. Questions are raised about a future linkage of critical theory to the scientific development of nursing knowledge.
Critical theory is a school of philosophical thought primarily associated with the Frankfurt School founded in Germany between 1919 and 1939. Critical theory does not exhibit unity, as each contributor to this school of thought has his or her own rather unique interpretation and presentation. …