Theory of Integral Nursing

Theory of Integral Nursing

Who is she?

• Very spiritual
• Very new age
• Very patient and Nurse centric
• Believes nursing should be a global intervention to promote, profession and access to care

What does she do?

• Nurse
• Professor
• Theorist
• Author

Why this Theory? Think mind, body and soul of the patient, the nurse, how they mesh in the world and how their actions lay the foundations for moral reasoning and a prosperous life…. But what does that mean?

Dr. Dossey’s Theory mimics that of Dr. Watson in that they are both Grand Theorists in the caring sciences. Dr. Dossey’s work was through Dr. Watson’s mentoring and developed The Theory of Integral Nursing Pioneer and founder of American Holistic Nurses Association Theory framework is used for the Nightingale Initiative for Global Health

https://www.dosseydossey.com/theory-of-integrated-nursing

https://www.dosseydossey.com/theory-of-integrated-nursing

Theory of Integral Nursing (2008)

• Evolved from the Holistic Nursing Theory by Dr. Dossey
• Grand Theory
• 5 Components
• “Theory in Action” AKA relatable once you figure it all out
• It encompasses healing at the center
• Focuses on healing from a patient, nurse and environment standpoint
• Many components relating to self, others, health, environment and facility/unit/department/clinic/community

Content of a nursing theory includes the subject matter and building blocks that give a theory its form. In the Theory Integral Nursing, the subject matter and building blocks are:

• healing
• The metaparadigm of nursing
• Patterns of Knowing
• The Four Quadrants that are adapted from Wilber’s integral theory
• The AQAL

Let’s break it down….

Healing includes knowing, doing, and being, and is a lifelong journey and process of bringing together aspects of oneself at deeper levels of harmony and inner knowing leading toward integration.

The first content component in the Theory of Integral Nursing is Healing

Healing is transformed when we consider four perspectives of reality in any moment.

But what does that mean?

The Nursing Metaparadigm

Component 2: Metaparadigm of Nursing The recognition of the intersection of all these components necessary in the healing process Ah-Ha moment: It’s a process

3rd Content Component:

• Ways of Knowing: (Carper’s Philosophy)
• Empirical Knowing (science)

• Personal Knowing (what you bring to the situation based on your personal experience)

• Not Knowing (added in the 2000’s by Dr. Carper): allows for new solutions, possibilities and insight thus generating new knowledge

• Aesthetic Knowing: (Art of Nursing)

• Ethical Knowing (moral component to any situation)

• Sociopolitical Knowing added in the 2000’s (current events affecting healthcare, the patient and the nurse)

4th Component

She defines the Integral Process or human experience of healing with 4 perspectives as: (adapted from Wilber’s Integral Theory)

• The “I” the individual interior (personal, intentional)
• The “It” individual exterior
• The “We” intersubjective cultural shared values
• The “Its” the interobjective systems structures

But wait, there’s more…

Wilber, a physicist, designed a model uniting all the known laws of the universe into one all-embracing theory that would explain everything in existence

And just… When you thought it was over… It has just begun…

The AQAL: Component 5 The all quadrants all levels Combining it all in one “Everything all at once” “One stop shopping theory”…

Wilber’s AQAL

…and Here… It is…

The Theory of Integral Nursing:

• holistic worldview that crosses all areas and cultures
• includes all aspects of human existence: spiritual, intellectual, emotional, physiological, psychological and social.

Addressing the Patient: The theory addresses patient’s unique internal and external factors affecting their wellness, and internal and external factors must be addressed for healing to take place.

The theory aims at restoring and supporting health and wellness throughout a person’s life, as all components are interconnected to heal mind, body, spirit and community

This theory is holistic and culturally centric and can benefit worldviews of patient care, nursing, nursing science, holistic nursing, nursing research and future studies

The sociopolitical aspect of the theory addresses healing based on today’s current events as well, currently impacting:

• Women’s Health
• Environmental Hazards affecting health
• Mental Health/Therapy
• Pain
• Wellness
• Holistic Practices

The theory considers all factors that affect health, including body, mind, spirit, and community. With an increased integral awareness and a holistic worldview, nurses who practice this theory have new opportunities and ways to strengthen their abilities in the care they provide and the advocacy they provide.

Theory In Action: The True Essence of this Theory

Utilization and Limitations

Practical Uses:

• Education and Training
• Doctoral Studies and Research Development
• QI/PI Projects
• Mixed Method (Studies)
• Magnet Journey
• Whole Health Initiatives
• Clinical awareness issues (Mental Health, Addiction, STD, Homelessness, HIV)

• Theory’s existence since 2008
• From a first look, its overwhelming
• Difficult to decipher
• Language is obscure and difficult to understand and "out there"
• Limited research studies, most qualitative

Utilization and Limitations

Practical Uses: Advocacy

• End of Life care model
• Maternal Health
• Pediatrics (parental perspective as well)
• Cultural Competence
• Cultural: Holistic Health
• Women’s Health Issues
• Nightingale Initiative on Global Health

• Theory’s existence since 2008
• Since it is overwhelming to view let alone understand, it is seldom used in quantitative studies
• Often used for qualitative studies
• Not a lot of literature rela ted to limitations based on the study findings mostly because qualitative in nature

Currently being used at a College

https://nnmc.edu/home/academics/schools-and-departments/nursing-health/rn-to-bsn-program/theory-of-integral-nursing/

Other areas for Theory Utilization:

• QI/PI Projects

• Education and Staff Development

• Frameworks for Nursing Centers

• Mixed Method (Studies)

• Magnet Journey/Pathway to Excellence

• Whole Health Initiatives

• Clinical awareness issues (Mental Health, Addiction, STD, Homelessness, HIV)

• Community

• Globally

Areas of Utilization

• Modeling in patient care settings
• Nursing Orientation
• Pain Clinics
• Outpatient/Outreach Clinics
• ER’s, ORs
• Rehab centers
• Infusion clinics
• Nursing Homes
• Holistic Health Centers

Question 1: Aside from the examples provided, what are other examples of how the Theory of Integral Nursing can be applied in your everyday practice?

Question 2: How can the Theory of Integral Nursing be applied at the Macro level?

Question 3: How can the Theory of Integral Nursing be applied at the Meso level?

Question 4: How can the Theory of Integral Nursing be applied at the Micro level?

References Billay, D., Myrick, F., Luhanga, F., & Yonge, O. (2007). A Pragmatic View of Intuitive Knowledge in Nursing Practice. Nursing Forum, 42(3), 147–155. https://doi.org/10.1111/j.1744-6198.2007.00079.x Carnago, L., & Mast, M. (2015). Using Ways of Knowing to Guide Emergency Nursing Practice. Journal of Emergency Nursing, 41(5), 387–390. https://doi.org/10.1016/j.jen.2015.01.011 ‌ Dossey, B. M. (2008). Theory of Integral Nursing. Advances in Nursing Science, 31(1), E52–E73. https://doi.org/10.1097/01.ans.0000311536.11683.0a ‌Montes‐Sandoval, L. (1999). An analysis of the concept of pain. Journal of Advanced Nursing, 29(4), 935–941. https://doi.org/10.1046/j.1365-2648.1999.00971.x ‌

This presentation was brought to you by: Afton Stoneking and Marisa Tapia Ohio State University College of Nursing Via Genial.ly https://genial.ly/templates/

Thank you