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KUHN’S REVOLUTI ONARY THEORY AND I TS I NFLUENCE ON THE
CONSTRUCTI ON OF NURSI NG KNOW LEDGE
Mar ilene Loew en Wall1 Telm a Elisa Car r ar o2
Wall ML, Carraro TE. kuhn’s revolut ionary t heory and it s influence on t he const ruct ion of nursing knowledge. Rev Lat ino- am Enferm agem 2009 m aio- j unho; 17( 3) : 417- 22.
This is a t heor et ical r eflect ion, gr ounded in t he ideas of “ r ev olut ion t heor y ” and it s influence on t he nur sing pr ofession. Accor ding t o aut hor s, m any nur sing schools hav e assim ilat ed pr ogr ess t heor y and em br aced t he claim t hat nur sing follow s t he sam e r evolut ionar y developm ent al m odel as t he ot her sciences analyzed by t his m odel. Thu s, t h is r eflect ion addr esses t he t h esis t h at t h e ex ist en ce of a sin gle par adigm is n ot accept able, especially in nur sing, w hich w or k s, assist s and car es for hum an beings w ho pr esent differ ent per cept ions of healt h/ illness event s. I t argues t hat , for nursing, t he exist ence of m ult iple paradigm s indicat e a st rong dynam ic science t hat encour ages cr eat iv it y , fost er s t he debat e of ideas and is open t o quest ioning.
DESCRI PTORS: k now ledge; nur sing t heor y ; m odels, nur sing
LA TEORÍ A REVOLUCI ONARI A DE KUHN Y SU I NFLUENCI A EN LA CONSTRUCI ÓN
DEL CONOCI MI ENTO DE LA ENFERMERÍ A
Se t rat a de una reflexión t eórica form ulada a part ir de las ideas sobre la “ t eoría de la revolución” y su influencia en la pr ofesión de enfer m er o. Según algunos aut or es, v ar ias escuelas de enfer m er ía asim ilar on la t eor ía del pr ogr eso y adh ir ier on a la posición qu e af ir m a qu e la en f er m er ía sigu e el m ism o m odelo r ev olu cion ar io de desarrollo que las dem ás ciencias analizadas por ese m odelo. Así, est a reflexión se refiere a la t esis de que la exist encia de solam ent e un par adigm a no es acept able, pr incipalm ent e par a la enfer m er ía, que t r abaj a, asist e y cuida de seres hum anos que present an dist int as percepciones acerca de las sit uaciones de salud y enferm edad. Señala que, par a la enfer m er ía, la ex ist encia de m últ iples par adigm as indica una ciencia fuer t e y act iv a, que incent iv a la cr eat iv idad, est im ula el debat e de ideas y se m uest r a abier t a a cuest ionam ent os.
DESCRI PTORES: conocim ient o; t eor ía de enfer m er ía; m odelos de enfer m er ía
A TEORI A REVOLUCI ONÁRI A DE KUHN E SUA I NFLUÊNCI A NA CONSTRUÇÃO
DO CONHECI MENTO DA ENFERMAGEM
Tr at a- se de r eflex ão t eór ica, for m ulada a par t ir das ideias acer ca da “ t eor ia da r evolução” e sua influência na pr ofissão en fer m agem . Segu n do au t or es, v ár ias escolas de en fer m agem assim ilar am a t eor ia do pr ogr esso, aderiram à posição de que a enferm agem segue o m esm o m odelo revolucionário de desenvolvim ent o com o as dem ais ciências, analisadas por esse m odelo. Desse m odo, essa reflexão rem et e à t ese de que a exist ência de apenas um par adigm a não é aceit áv el, pr incipalm ent e par a a enfer m agem , que t r abalha, assist e e cuida de ser es h u m an os qu e apr esen t am dif er en t es per cepções sobr e as sit u ações de saú de e doen ça. Apon t a qu e, par a a en fer m agem , a ex ist ên cia de m ú lt iplos par adigm as in dica u m a ciên cia for t e e at iv a, qu e en cor aj a a cr iat iv idade, est im ula o debat e de ideias e se m ost r a aber t a par a quest ionam ent os.
DESCRI TORES: con h ecim en t o; t eor ia de en fer m agem ; m odelos de en fer m agem
1Nurse- Midwife, Doct oral St udent , Universidade Federal de Sant a Cat arina, Facult y, Universidade Federal do Paraná, Brazil, e- m ail: m lwall@uol.com .br; 2RN,
Ph.D. in Nursing Philosophy, Facult y, Universidade Federal de Sant a Cat arina, Brazil, e- m ail: t elm acarraro@nfr.ufsc.br.
Art igo Teórico
Rev Lat ino- am Enferm agem 2009 m aio- j unho; 17( 3) : 417- 22 www.eerp.usp.br/ rlae
I NTRODUCTI ON
M
a n y p h i l o so p h e r s a n d sci e n t i st s h a v e in v est ig at ed scien t if ic d ev elop m en t ov er t im e( 1 - 3 ).Different t heories have been put forward t o describe m o d e l s o f sci e n t i f i c a d v a n ce m e n t s b a se d o n r et r osp ect iv e an aly zes of ad v an cem en t s, b ot h in n at u r al an d ph y sical scien ces, as w ell as in social scien ces.
The quest ion “ how does science dev elop?” has occupied t he m ind of philosophers and scient ist s an d w as al so p r esen t i n t h e sear ch f o r a so u n d t heor et ical gr ounding in nur sing. Which pr ocess or pr ocesses, or pat h s, h as n u r sin g gon e t h r ou gh t o achieve t he current level of developm ent ? Nurses have u sed ep ist em ic f r am ew or k s, t h at is, p r e- ex ist en t scient ific m odels t o answer t his quest ion. The use of t hese t heoret ical references has cert ainly influenced t he growt h and developm ent of t he nursing discipline. During recent years, nursing m anaged t o build si g n i f i ca n t a n d co n n e ct e d k n o w l e d g e o f ca r e , int eract ion, and healt h, for inst ance. How ev er, it is necessary t o cont inuously re- t hink t he developm ent of t he foundat ion of nursing, especially t he t heoret ical p r o g r e ss, so a s t o p e r m i t t h e e v a l u a t i o n a n d organizat ion of fut ure knowledge.
Th eo r i es h av e h ad an d st i l l h av e a v er y im port ant role in t he developm ent of nursing. However, k now ledge encom passes m uch m or e t han t heor ies, n am ely, r esear ch , com m on sen se, ph ilosophy an d also nursing pract ice. I n t his way, nursing’s t heoret ical dev elopm ent can be classified t hr ough t he t heor ies of revolut ion, evolut ion and int egrat ion( 4).
The t heory of evolut ion describes changes in a given direct ion, following from t he sm allest t o t he lar gest , fr om t he sim plest t o t he m or e com plex. I n t he t heory of int egrat ion, t he const ruct ion of nursing k now ledge is seen as an ev olut ionar y pr ocess t hat has passed t hr ough sev er al cr ises, w her e differ ent ideas and t heories can exist side by side( 4).
I n t his cont ext , t his st udy aim s t o provide a reflect ion on t he developm ent of science described in t h e book Th e St r u ct u r e of Scien t ific Rev olu t ion s( 5 )
p u b lish ed in 1 9 6 2 an d id eas p r op osed( 4 , 6 ) b y t h e
“ t heory of revolut ion” and it s influence on t he nursing pr ofession .
We underst and t hat t he t hought s put forward her e coincide w it h t he concer ns and suggest ions of scholar s and hope t hey help pr ofessionals assum e new at t it udes, new pr act ices, new w ays of t hinking
and being, even subm it t ing em ergent nursing m odels t o sci e n t i f i c a n a l y si s so a s t o a ch i e v e su p e r i o r knowledge, accept ed by t he scient ific com m unit y, and also t o achieve bet t er result s in care pract ice( 7- 9). As
pr ofessionals w ho deliver car e, t each and r esear ch, nurses need t o consider several kinds of knowledge, pr act ices and cult ur es, alw ay s seek ing t he “ hum an polit ical abilit y t o k now how t o cr it ically t hink and i n t e r v e n e i n a n i m m a n e n t q u e st f o r i n cr e a se d aut onom y”( 10).
METHOD
This is a r eflect ive st udy. The St r uct ur e of Sci e n t i f i c Re v o l u t i o n s( 5 ) a n d Th e Ro a d Sci e n ce
St ruct ure( 11) were t horoughly st udied and t heir cent ral
concept s scr ut inized so as t o pr ov ide a m or e solid t heoret ical base. Following, t he book was read bot h in English, it s original language( 6,12), and in it s Germ an
t r anslat ion( 4), seek ing t o under st and t he genesis of
nur sing as science and it s t heor et ical dev elopm ent based on t h e t h eor y of r ev olu t ion an d h ow it h as influenced nur sing.
THE REVOLUTI ON ARY THEORY AN D I TS
I NFLUENCE ON NURSI NG
Thom as Kuhn began his academ ic career as a t h eor et ical ph y sicist an d cam e in t o con t act w it h scholars who st udied t he hist ory of science, which he con sider ed a v er y f er t ile f ield of st u dy. I n a lon g int erview held at t he Universit y of At hens in 1995 he t alked about him self, “ here is a m an who has never t rained as a philosopher, who has been an am at eur learning ever m ore about t he subj ect by him self, of int eract ions, et c. – but not a philosopher. A physicist w h o b ecam e a h i st o r i an t o an sw er p h i l o so p h i cal purposes”( 11).
He was probably one of t he first scient ist s t o d escr ib e t h e ev olu t ion of scien t if ic t h in k in g as a cont radict ory process in which scient ific developm ent does not occur sim ply by t he const ant accum ulat ion of know ledge, but rat her, is essent ially evolut ionary a n d o ccu r s t h r o u g h r u p t u r e s a n d i s m a r k e d b y
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t hen, ext raordinary invest igat ions are carried out and f i n a l l y g u i d e t h e p r o f e ssi o n t o a n e w se t o f com m it m en t s, t o a n ew b asis f or t h e p r act ice of science”( 5).
I n 1981, 20 years aft er t he publicat ion of his book( 5), he w rot e an art icle in w hich he show s t hat
r e v o l u t i o n a r y ch a n g e s a r e d i f f e r e n t a n d m o r e pr oblem at ic becau se t h ey in v olv e discov er ies t h at can n ot be accom m odat ed w it h in t h e lim it s of t h e concept s used so far. “ One cannot m ove from t he old t o t he new sim ply by adding t o w hat w as alr eady known [ …] nor one can fully describe t he new in t he vocabulary used by t he old and vice- versa”( 11).
I n ph ilosophy, t h e t er m r ev olu t ion can be u n d e r st o o d a s “ r a d i ca l ch a n g e o f a n y cu l t u r a l sit uat ion”( 13). He st at ed t hat “ t he cent ral change cannot
be ex per ienced in a fr agm ent ed way, it inv olv es a relat ively sudden t ransform at ion”( 11).
Science develops in leaps and “ crises are a necessar y pr e- condit ion for t he em er gence of new t heories” t hat com pet e wit h each ot her, and anom alies and deficiencies em erge, leading t o t he rej ect ion of a t heory and adopt ion of anot her( 5). Crises “ need only
t o be t he usual pr elude, pr ov iding a m echanism of self- correct ion, capable of ensuring t hat t he rigidit y of norm al science does not rem ain forever wit hout a challenge”( 5).
D e sp i t e o t h e r b a si c f a ct s t h a t ca n b e addressed so as t o underst and his scient ific act ivit y, we focus on t he concept s of paradigm and scient ific com m unit y, as well as on t he five periods proposed i n t h e St r u ct u r e o f Sci en t i f i c Rev o l u t i o n s( 5 ) t h at
ch ar act er ize scien t if ic d ev elop m en t . He calls t h e periods: pre- paradigm , norm al science, anom alies and crises, t he revolut ionary and t he new period of norm al science, also called post - r ev olut ionar y.
The phase preceding t he form at ion of science is ch ar act er ized by dif f er en t act iv it ies an d by t h e d isor g an izat ion t h at is f ou n d w h en a p ar ad ig m is adopt ed. Norm al science is t he period when one act s w it h in a g iv en p ar ad ig m accep t ed b y a scien t if ic com m unit y. I n t his per iod scient ist s advance w it hin t he problem s t he adopt ed paradigm perm it resolving, but t hen experience difficult ies, called anom alies, which t h e cu r r e n t p a r a d i g m ca n n o t r e so l v e . As t h e se anom alies m ult iply, a crisis is reached and is resolved by t he em ergence of a new paradigm , t hat is, scient ific revolut ion, and a new period of norm al science begins. A p a r a d i g m i s co m p o se d o f “ u n i v e r sa l l y ack now ledged scient ific r ealizat ions, w hich pr ov ide,
for som e t im e, m odel pr oblem s and solut ions for a com m unit y of pract it ioners of a science.”( 5) According
t o him , t his t erm appears in an “ inherent ly circular” form , because it is what scholars share in a scient ific com m unit y, which in t urn is com posed of people who sh ar e a par adigm( 5 ). I n on e of h is last w or k s, h e
m ent ions t hat “ paradigm was a perfect ly good word, unt il I ruined it ”( 11).
Thus, aft er several crit iques, he adds in 1969 a post script t o his work where he not es, “ one quickly realizes t hat t he t erm paradigm is used in m ost of t he book wit h t wo different m eanings. On t he one side, it indicat es t he w hole const ellat ion of beliefs, v alues, t ech n i q u es, et c. sh a r ed b y m em b er s o f a g i v en com m unit y. On t he ot her side, it denot es a t ype of elem ent of t his const ellat ion: concr et e solut ions t o puzzles which when em ployed as m odels or exam ples, can replace explicit rules as basis for t he solut ion of rem aining puzzles of norm al science”( 5).
The t erm paradigm was t hen replaced by t he t erm “ disciplinary m at rix: disciplinary because it refers t o t h e co m m o n p o ssessi o n o f p r a ct i t i o n er s o f a part icular discipline, is com posed of ordered elem ent s of several species [ …] t hey work as a set ”( 5).
These ideas influenced t he dev elopm ent of nursing knowledge, especially t he concept paradigm , underst ood as a com prehensive repert ory of beliefs, v alues, law s, pr inciples, t heor et ical m et hodologies, and ways t o im plem ent it . They had t he funct ion of g u id in g t h eor et ical p r op osit ion s, t h e f u n d am en t al nat ure of t he discipline and m et hodological st rat egies. They also provided a level of consensus on t heoret ical m et h od s an d t ech n iq u es. Th e p ar ad ig m con t ain s q u est i o n i n g o f p ar t i cu l ar ar ea o f k n o w l ed g e an d “ puzzle” solut ions t hat aid t he scient ific com m unit y t o solv e pr oblem s in t he discipline and also ser v e as exam ples of it s m at uring process( 4,6).
Anot her nursing scholar uses t he t erm nursing paradigm when she put s forward t he represent at ion of con t em por an eou s k n ow ledge. Sh e believ es t h at t he par adigm w or ks as a fr am ew or k t hat lim it s t he unit , t he set , in which st ruct ures can develop. Hence, nur sing scient ist s and t heor ist s can use t heor et ical r efer en ces fr om an ot h er scien ce bu t t h ey n eed t o cl a r i f y t h e i r u n d e r st a n d i n g o f : h u m a n b e i n g , env ir onm ent , healt h and nur sing, being allow ed t o a d d o t h e r s t h e y d e e m n e ce ssa r y. Be ca u se t h e concept s and pr oposit ions of a par adigm ar e br oad and global, t hey do not offer any orient at ion t o concret e act i v i t i es i n ei t h er n u r si n g r esear ch o r p r act i ce. Rev Lat ino- am Enferm agem 2009 m aio- j unho; 17( 3) : 417- 22
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Different t heories have key point s t hat converge and m or e r ecent t heor ies, t hat is, new t heor ies, do not aim t o refut e or overt hrow older t heories( 14- 15).
A paradigm has several funct ions and one of t hem is t o ident ify t he nur sing dom ain so t hat t he u se d co n ce p t s a n d p r o p o si t i o n s o f f e r t h e i r o w n perspect ive t o t he discipline’s research and pract ice, m aking a dist inct ion from t he dom ains of rem aining disciplines. A paradigm needs t o precisely involve t he phenom ena relevant t o a discipline – t his requirem ent is only valid when t he concept s and proposit ions are g l o b a l a n d t h e r e i s n o r e d u n d a n cy i n t h e i r inform at ion( 14- 15).
A paradigm has t o have a neut ral perspect ive – t his requirem ent is only valid w hen concept s and pr oposit ions do not pr esent a specific per spect iv e, t hat is, when t hey do not favor a given m odel. I t has t o hav e int er nat ional v alidit y – t his r equir em ent is on ly v alid w h en con cept s an d pr oposit ion s do n ot r epr esent any nat ional or cult ur al beliefs or et hical part icularit ies. Finally, t he nursing paradigm is like a fr am ew or k , so t hat nur ses focus on hum an beings’ int egral healt h, aware t hat t hey progressively int eract wit h t he environm ent , whereas t he m edical paradigm g u i d e s p h y si ci a n s i n d i a g n o si n g a n d t r e a t i n g diseases( 14- 15).
Paradigm s are found in all periods of scient ific act iv it y in w hich t he com m unit y does r esear ch and inv est igat ions. A par adigm pr ev iously accept ed and t h at on ce gu ided r esear ch can pr esen t f ailu r es or anom alies, t riggering crises. Crises m ight be close t o a revolut ionary period, t he point at which a science passes from one paradigm t o anot her. These periods are called pre- paradigm at ic, because t he com m unit y does not yet possess new t heories t o guide scient ific act ivit ies t hat can est ablish a proposal of syst em at ic w or k( 5).
For a paradigm t o be accept ed, it should be m ore plausible t han it s com pet it ors but does not need t o ex plain all t he fact s it is confr ont ed w it h. Aft er r ev olut ion, a new par adigm em er ges and st ar t s t o guide all t he scient ific pract ice of a given com m unity. The scient ific com m unit y is “ com posed of pract it ioners of a scien t if ic sp ecialt y. Th ese w er e su b m it t ed t o sim ilar pr ofessional init iat ion and educat ion, t o an ext ent wit hout parallel in m ost of ot her disciplines [ …] in gener al each com m unit y possesses an obj ect of st udy [ …] are always com pet ing and m ost of t he t im e t h e se co m p e t i t i o n s e n d r a p i d l y [ …] t h e y se e t h em sel v es a n d a r e seen b y o t h er s a s t h e o n l y
responsible for seeking a set of com m on obj ect ives, which includes t raining successors [ …] com m unicat ion wit hin t he group is relat ively broad and professionals’ j u d g m en t s a r e r el a t i v el y u n a n i m o u s [ …] t h o u g h p r o f e ssi o n a l co m m u n i ca t i o n b e t w e e n g r o u p s i s som et im es difficult , r esult ing in m isunder st andings, e v o k i n g si g n i f i ca n t a n d p r e v i o u sl y u n su sp e ct e d disagr eem ent s.”( 5)
Techno- scient ific dev elopm ent act iv it ies ar e not novel t o nursing. Many t im es, t his scient ific act ivit y occurred in an unconscious and inform al way and not only t hrough research and t heorizat ion. Also, concept s an d t h eo r i es, t h at i s, t h e st r u ct u r i n g o f n u r si n g k now ledge, ar e dev eloped dur ing nur sing pr act ice. There is a considerable scient ific product ion in nursing generat ed from work processes and concret e realit ies, w hich per m it gr asping cont r adict ions and dy nam ics t hat cont ribut e t o st rat egies aim ed t o change realit y( 16).
The oldest West ern exam ple of t heorizat ion is found in t he hist or y of t he nur se w ho used her experience accum ulat ed in t he Crim ean war, relat ing h e a l t h a n d e n v i r o n m e n t a l f a c t o r s , c a r e a n d sy st em at ic dat a collect ion, hy giene and w ell being. A concept ual v iew of pat ient s as phy sical, spir it ual and int ellect ual beings w ho need w ar m t h, food and a calm env ir onm ent r esult ed fr om her effor t s. She obser v ed t he env ir onm ent , com posed of air, wat er, sew age, ligh t an d clean sin g as an ex t er n al f act or r e l a t e d t o t h e p a t i e n t . H e r w r i t i n g s c o n t a i n co m p o n e n t s o f t h e o r i e s o f d a t a co l l e ct i o n , a n d analy sis of char t s and st at ist ics as w ell as t heor ies on h ealt h an d d isease, w h ich w er e ev alu at ed b y epidem iologist s. Despit es cr it iques, sev er al aspect s such as t he r elat ion bet w een healt h and a healt hy env ir onm ent descr ibed by t his nur se w er e used in t he developm ent of ot her t heories( 4,6,14).
Ov er t im e, sev er al au t h or s h av e cr it icized r evolut ionar y par adigm at ic t hinking and all of t hem conv er ge on t he idea t hat differ ent and com pet ing par adigm s can har m oniously co- ex ist . Riv alr y is an on g oin g p r ocess, an d in scien ce sev er al r esear ch t radit ions coexist . Som e quest ions em erge: Would it not be possible for sim ilarit ies and differences as well as rivalry and cooperat ion t o exist in each hist orical m om ent in a given discipline? Paradigm s com pet e wit h each ot her and alw ay s pr esent ex t r em es, a cr isis, absolut e differences, t hat is, a revolut ion followed by a period of norm al science( 4).
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t hat som et hing w ent w rong) precede revolut ions so invariably as I im plied in m y original t ext . However, no im por t ant par t of m y ar gum ent depends on t he ex ist ence of cr ises as an essent ial pr e- r equir em ent for revolut ions; t hey only need t he usual prelude so as t o provide a m echanism of self- correct ion”( 5).
Se v e r a l n u r si n g sch o o l s a ssi m i l a t e d t h e t heor y of r ev olut ion and adopt ed t he posit ion t hat n u r sin g f ollow s t h e sam e r ev olu t ion ar y m od el of d ev el o p m en t a s t h e o t h er sci en ces a n a l y zed b y h im . Hen ce, n u r sin g pr ogr ess w as m easu r ed w it h cr i t er i a est a b l i sh ed b y h i m , w h i ch r esu l t ed i n a cr it ical- n eg at iv e ev alu at ion t h r ou g h t h e len ses of r e v o l u t i o n a r y d e v e l o p m e n t , s u c h t h e r e i s a pr edom in an t par adigm t h at sh ou ld be assim ilat ed by t he w hole nur sing( 4).
Ba se d o n l y o n t h i s p r e m i se , n u r si n g a s science, does not dev elop and r em ains in t he pr e-paradigm period, since it would not have periods of n or m al scien ce. Th u s em er ges t h e t h esis t h at t h e ex ist ence of a single par adigm is not accept able in scien ce, esp ecially in n u r sin g , w h ich w or k s w it h , assist s an d car es f or h u m an b ein g s w h o p r esen t d i f f e r e n t p e r ce p t i o n s o f h e a l t h a n d d i se a se sit uat ions( 6,17).
Th is t h esis t h at a sin g le p ar ad ig m is n ot accept able t o nursing is also discussed and expanded by aut hor s w hen t hey st at e t hat t he int egr at ion of qualit at ive and quant it at ive m et hods is advancem ent for nursing science. They argue t hat t he exist ence of m ult iple paradigm s in nursing indicat es a st rong and a ct i v e sci e n ce . Th e y r e v e a l a h e a l t h y sci e n t i f i c com m unit y t hat encourages creat ivit y, t he debat e and change of ideas, prom ot es a diversit y of views, ideas and product ivit y, and is always open t o quest ioning( 18).
The per iods of scient ific dev elopm ent “ can be product ive in t heir capacit y t o exercise quest ioning and logic of t he crit ical m ovem ent , t ranslat ed in t he concept s of crises and rupt ure”. The proposed m odel should respect each realit y so as t o m eet t he needs of hum an beings, be coherent and open so t hat failures can be acknowledged, faced and reorganized( 19).
I t is w or t h obser ving t hat t he dev elopm ent of nursing knowledge should be based on cooperat ion, av oiding a r educt ionist v iew and dogm at ic post ur e when com pet ing for t he dom ain of a paradigm t o t he det rim ent of anot her. The creat ion of new paradigm s in science should allow free expression of art , science and knowledge wit h a view t o recover t he essence of nursing phenom ena( 20).
SOME CONSI DERATI ONS
The discussion abov e per m it t ed elabor at ing sev er al id eas. Th e cou r se of r ev olu t ion ar y t h eor y i n n u r si n g d e v e l o p m e n t f o cu se d o n g i v i n g t h i s discipline t he st at us of science, t hough, it does not e n co m p a ss t h e d e scr i p t i o n o f t h e m a g n i t u d e o f s c i e n c e : N u r s i n g . I f , i n o n e ’ s a n a l y s i s , o n e per ceiv es t h at t h e t h eor y of r ev olu t ion assign s t o a scient ific com m unit y an aggr essiv e feeling dur ing cr ises, t he int er act ion t ak es on sev er al aspect s: it occu r s t h r ou g h com p et it ion w it h t h e ob j ect iv e of d o m i n a t i n g t h r o u g h d e f e a t ; t h e r e v o l u t i o n a r y pr ocess dev elops t hr ough r eplacem ent , elim inat ion an d d iscon t in u it y k n ow led g e d ev elop m en t is on ly a p p r o x i m a t i o n , a r g u m e n t a t i o n i s co n f r o n t a t i o n , w hich necessit at es a decline in one par t y and finally, ev aluat ion is cr it ical and dest r uct iv e, r esult ing in a com p et it iv e an d cr it ical en v ir on m en t .
Com pet it ion per se should not be encouraged am ong nursing professionals, but rat her cooperat ion so t hat t he developm ent of it s knowledge achieves a h i g h e r p u r p o se , w h i ch i s t h e m u l t i d i m e n si o n a l t ransform at ion of t he cont ext t o which it belongs.
Nursing as science, discipline and profession, seek s t h e t r u t h , i n t h e sen se o f co n st r u ct i n g a consist ent t heoret ical fram ework, so as t o cont ribut e t o i n d i v i d u a l a n d co l l e ct i v e e v o l u t i o n , w h e t h e r individuals belong t o a scient ific com m unit y or not . A scient ific com m unit y com m it t ed t o changing a given par adigm , or nur sing foundat ions, can be ident ified in groups of nurses who work in pract ice or academ ia – t h r o u g h t e a ch i n g , r e se a r ch , m u l t i p r o f e ssi o n a l gr oups, because t he ack now ledgem ent of differ ent sciences can be applied in nursing.
These scient ific com m unit ies seek m at ur it y, w hich does not necessarily im ply t he presence of a paradigm , because t ransit ion perm it s us t o achieve a d ev elop ed scien ce t h at p ossesses p ar ad ig m s t h at i d e n t i f y ch a l l e n g i n g p u zzl e s, p r o v i d i n g cl u e s t o solut ions, assuring an int elligent pract ice.
A revolut ion is a kind of change involving a g i v e n t y p e o f r e - co n st r u ct i o n o f t h e g r o u p ’ s com m it m ent , which does not necessarily need t o be a g r eat ch an g e, b u t n eed s t o b e u n d er st o o d as opposed t o cum ulat ive changes.
Man y of t h e cu r r en t ly g en er at ed con f lict s r e su l t f r o m sh o ck s b e t w e e n p e o p l e w h o h a v e a n t a g o n i st i c p e r sp e ct i v e s b e ca u se w h e n o n e i s pr isoner of a par adigm one har dly accept s anot her Rev Lat ino- am Enferm agem 2009 m aio- j unho; 17( 3) : 417- 22
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com pet ing paradigm . I t is wort h highlight ing t hat it is im port ant t o gain int ellect ual flexibilit y t o be able t o change a par adigm , car efully analy zing it , seek ing t he abilit y t o appropriat ely opt for universes int o which we are insert ed.
Nu r si n g se e k s, a m o n g o t h e r t h i n g s, int egralit y, percept ion, experiences, m ult iple realit ies,
t he em ergence and exist ence of m ult iple phenom ena, t hus, t he role of nursing as science is t o keep seeking k n ow led g e, b ear in g in m in d t h at “ w h at on e sees depends bot h on what one looks at and also on what one’s pr ev ious v isual- concept ual ex per ience t aught one t o see. I n t he absence of such t raining, t here can only be [ …] st unning and int ense confusion”( 5).
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