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developing nursing theories to the stages of prediction and prescription. Concepts and relationships of a theory can be evaluated and tested through research. For example, if a theory states that a person is a human energy field and suggests that there is an exchange of energy between two persons, research can be designed to evaluate such an exchange. For a theory to reach the stages of prediction and prescription, a considerable body of research is needed. Theories are divided into two main categories: grand theories, which are broad in scope and apply to all of nursing, and midrange theories, which apply to specific specialty areas or particular aspects of care. Most of the theories that are presented as nursing theories are grand theories (Watson’s Theory of Transpersonal Caring, Parse’s Theory of Human Becoming, or Erickson, Tomlin, and Swain’s Modeling and Role-Modeling Theory). Examples of midrange theories include theories of comfort, maternalrole attainment, self-transcendence, and the synergy model for critical care. A recent nursing textbook presents 16 theories for professional nursing practice. Adding some of the midrange theories could easily provide a list of nearly 30 theories. Full description of these theories is beyond the scope of this chapter; however, Table 5-2 presents a summary of the theories used most frequently in holistic nursing practice. Interdisciplinary Theories of Interest to Nursing Today, there are two wide-reaching interdisciplinary theories that have proven useful in thinking about the changing modern environment where a nurse can feel lost in the middle of fast-paced action, uninterpretable observations, and situations of great human need. These two theories are Complex Adaptive Systems Theory (or simply Complexity Science) and Ken Wilber’s Integral Theory. These theories present important ideas and concepts that are being brought into nursing thought and have already made contributions to nursing theory development. These theories may provide holistic nurses with a framework to articulate care needs and processes to other members of the healthcare team, as these theories may have more acceptance in team interactions than something perceived as “nursing.” In addition, both of these theories permit a nurse to enter dialogue and thinking with other health team members about theory in general and may be an entrée to discussing nursing-specific theoretical perspectives that affect the care situations at hand. For these reasons, each is discussed briefly. Complexity Science is defined as the study of complex adaptive systems.10 This is a science that addresses diverse or multifaceted elements that are able to change, react, and adapt and that are interconnected in some way. As in Systems Theory, the elements studied from this theory adapt independently and affect the whole. However, Complexity Science focuses on systems that have a “densely connected web of interacting agents, each operating from its own schema,”11, p. 255 addressing structures that are self-organized, unpredictable, and ever changing. This theory is useful when working within a structure that faces challenges of uncertainty, the need to act, the lack of a predictable outcome, and a level of complexity in which even complicated techniques such as model building and forecasting are inadequate to take into account all contingencies. Modern healthcare organizations are a perfect example of the type of system requiring a new way of thinking. Complexity Science suggests that, when organizations face uncertainty, managers can best operate by distributing (rather than centralizing) control and supporting individual parts (or people) of the organization who are trying to develop solutions. Complexity Science postulates that, in an uncertain environment, freedom to innovate, coupled with qualities of intelligence and resourcefulness, will produce best outcomes. Astin and Forys suggest that following the Interdisciplinary Theories of Interest to Nursing 115 9781284082463_CH05_PASS02.indd 115 25/02/15 6:08 pm TABLE 5-2 Summary of Selected Nursing Theories Used in Holistic Nursing Practice Theory Theorist Date of First Publication Major Concepts or Ideas Current Uses Theory of Environmental Adaptation Florence Nightingale Louise Selanders 1860 19989 Providing external supports for healing to take place. Emphasizing the health properties of the environment (9781284082463_CH05_PASS02.indd 116 25/02/15 6:08 pm TABLE 5-2 Summary of Selected Nursing Theories Used in Holistic Nursing Practice Theory Theorist Date of First Publication Major Concepts or Ideas Current Uses Theory of Health as Expanding Consciousness Margaret Newman 1994 Health is expanding consciousness that includes an individual’s total pattern. Nursing is caring—a moral imperative. People are open systems. Health–illness as a unitary process. Research is praxis. Used in all practice settings. Work within this theory focuses on the meaning and purpose of living with illness. Theory of Human Becoming Rosemarie Rizzo Parse 1981 A person is a unitary whole. Nurses guide clients to make choices concerning health. Nurses offer authentic presence. Health is a process of becoming, a personal commitment, and a process related to lived experiences. Used in all practice settings. Work within this theory focuses on
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