ANS Adv Nurs Sci
· 2026 Jan-Mar 01 · PMID 40956127
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BACKGROUND: Self-care is essential in the management of chronic illness. In 2012, we published a middle-range theory addressing self-care as a process of maintaining health through health-promoting practices and managing...BACKGROUND: Self-care is essential in the management of chronic illness. In 2012, we published a middle-range theory addressing self-care as a process of maintaining health through health-promoting practices and managing chronic illness. Three key concepts in the theory were self-care maintenance, self-care monitoring, and self-care management. Self-care maintenance refers to those behaviors performed to improve well-being, preserve health, or maintain physical and emotional stability. Self-care monitoring is the process of routine vigilant surveillance, self-awareness, and body monitoring or body listening. Self-care management involves the response to signs and symptoms when they occur. In 2019, we updated the theory, specifying the important contribution of symptoms to self-care. Assumptions and propositions of the theory were specified in the original publication; both are expanded in this update. PURPOSE: Here, we update the theory to reflect changes in our thinking and what has been learned from published literature and discussions with others. An important addition is a detailed discussion of 6 essential intrapersonal requirements for self-care: experience, knowledge, skills, reflection, decision-making, and motivation. These requirements interact dynamically; the order in which they are presented is not meant to reflect the order in which they are developed. IMPLICATIONS FOR PRACTICE AND RESEARCH: These factors are particularly important in guiding the development of self-care interventions. Readers can now refer to this version instead of the 2012 publication.
Unitary Rogerian concepts are more evident in nursing's evolving disciplinary discourse since the seventies. This article explores ancient universal Laws of Nature that coincide with Unitary Nursing/Caring Science. These...Unitary Rogerian concepts are more evident in nursing's evolving disciplinary discourse since the seventies. This article explores ancient universal Laws of Nature that coincide with Unitary Nursing/Caring Science. These principles of life have not been addressed in nursing literature. Rogers' Science of Unitary Human Beings in convergence with Watson's Transpersonal Caring Science/Unitary Caring Science, are highlighted as evidentiary exemplars of the presence of these Natural Laws, referred to as Hermetic truths. By uncovering the universals that underpin Unitary Nursing/Caring Science, the discipline of Nursing is helped to mature to a higher level of consciousness, affirming the timeless universal unitary nature of Human-Universe phenomena of Nursing.
In 1986, Yarling and McElmurry published a provocative article in Advances in Nursing Science that challenged the notion of nurses as moral agents. They argued that the hierarchical structure of hospitals, which placed p...In 1986, Yarling and McElmurry published a provocative article in Advances in Nursing Science that challenged the notion of nurses as moral agents. They argued that the hierarchical structure of hospitals, which placed physicians at the center of decision-making, limited nurses' autonomy and ethical agency. While nurses today continue to face complex ethical challenges, significant strides have been made. Nurses are now widely recognized as moral agents whose primary commitment is to their patients, families, and communities. This essay underscores the central role of moral agency in ethical nursing practice. To fully support this role, healthcare institutions must foster environments that respect and empower nurses. This includes recognizing their contributions to patient safety and quality care, and ensuring they have the resources needed to navigate the evolving demands of modern nursing.
The nursing profession currently exists in the untenable position of holding social justice as a core value of the profession but operating within dominant oppressive systems of colonialism and racism. Decolonizing and I...The nursing profession currently exists in the untenable position of holding social justice as a core value of the profession but operating within dominant oppressive systems of colonialism and racism. Decolonizing and Indigenizing nursing are proposed as strategies toward reconciliation; however, little is known regarding specific nursing actions toward decolonizing and Indigenizing the profession. This scoping review highlights approaches, barriers, goals, and the utility of decolonizing and Indigenizing nursing knowledge, education, research, and practice. Synthesizing these will provide ideas and inspiration leading to praxis while also highlighting the reality of the challenges of this work.
Existential uncertainty dominates the patient experience in cardiac inherited diseases due to unpredictable disease course and the risk of sudden cardiac death. Traditional uncertainty theoretical models inadequately cap...Existential uncertainty dominates the patient experience in cardiac inherited diseases due to unpredictable disease course and the risk of sudden cardiac death. Traditional uncertainty theoretical models inadequately capture the unique facets of uncertainty associated with these diseases. Using Walker and Avant's theory derivation method, an uncertainty theory for nursing practice was developed by adapting concepts from self-organized criticality and grounding them with Parse's Human Becoming Theory within the Unitary Transformative Paradigm. This innovative synthesis enhances the understanding of uncertainty factors among vulnerable patients, potentially improving nurses' capacity to provide holistic, person-centered care and develop targeted clinical interventions addressing existential concerns.
This paper proposes Technology-Enhanced Wisdom (TEW), a middle-range theory to guide nursing practice in the age of artificial intelligence. Building on Nelson's Data-to-Wisdom continuum and developed using Walker and Av...This paper proposes Technology-Enhanced Wisdom (TEW), a middle-range theory to guide nursing practice in the age of artificial intelligence. Building on Nelson's Data-to-Wisdom continuum and developed using Walker and Avant's theory synthesis method, TEW identifies 6 mediating concepts - context, perception, veracity, trust, usability, and competency - that shape how nurses integrate artificial intelligence (AI)-enhanced insights. TEW provides a framework for synthesizing internal knowledge with machine-generated information to support ethically grounded, human-centered decisions. As AI transforms health care, TEW offers a timely theoretical foundation for wisdom-driven, technologically informed nursing care, positioning technology not as a replacement for human wisdom but as a co-pilot in advancing it.
ANS Adv Nurs Sci
· 2025 Aug · PMID 40862633
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This study evaluated the impact of Advance Care Planning (ACP) facilitator training on home care nurses' competencies and the effects of an ACP program led by trained nurses on patient-family outcomes. A one-group pretes...This study evaluated the impact of Advance Care Planning (ACP) facilitator training on home care nurses' competencies and the effects of an ACP program led by trained nurses on patient-family outcomes. A one-group pretest-posttest design assessed nurses (N = 28) after a 3-day online workshop, while a randomized controlled trial examined patient-family outcomes (N = 39). Nurses showed significant improvements in confidence, and attitudes related to ACP post-training. However, the ACP program did not yield significant patient-family outcome changes. As ACP demand grows, tailored training is essential to equip nurses with the skills needed for their roles and practice settings.
ANS Adv Nurs Sci
· 2025 Aug · PMID 40862628
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This paper examines the art of nursing through linguistic appreciation interpreted from Paley's method of concept analysis and is situated within Carper's fundamental ways of knowing. Examining the theoretical framework...This paper examines the art of nursing through linguistic appreciation interpreted from Paley's method of concept analysis and is situated within Carper's fundamental ways of knowing. Examining the theoretical framework for the art of nursing, a historical exploration for disciplinary dialogue, analyzing and interpreting existing art of nursing literature, and identifying prominent attributes embrace multiple conceptions. Five constitutive meanings develop the art of nursing as: a craft, an aesthetic, nursing science, transpersonal caring, and multiple ways of knowing. Narratives of operationalization allow an exploration with the art of nursing for use in nursing education, research, and practice.
ANS Adv Nurs Sci
· 2025 Aug · PMID 40763079
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First-degree relatives (FDRs) of colorectal cancer patients in China face distinctive health behavior challenges shaped by cultural and familial contexts. Little is known about how familial responsibilities influence the...First-degree relatives (FDRs) of colorectal cancer patients in China face distinctive health behavior challenges shaped by cultural and familial contexts. Little is known about how familial responsibilities influence their health motivations. This study explored FDRs' perceptions and motivations regarding healthy lifestyles using a qualitative descriptive design. Semi-structured interviews with 16 FDRs revealed 2 themes: (1) Health Perceptions in Cultural Context-integrating traditional Chinese medicine with modern views, with contradictions about exercise/tobacco/alcohol; and (2) Dual Role of Family Responsibility-acting as both motivation and barrier when interacting with economic pressures. Culturally adapted interventions addressing multilevel socioeconomic factors are essential.
Breast cancer recurrence remains a significant challenge, impacting patient survival and quality of life. This study aimed to identify lifestyle factors influencing recurrence through a meta-analysis of 20 studies encomp...Breast cancer recurrence remains a significant challenge, impacting patient survival and quality of life. This study aimed to identify lifestyle factors influencing recurrence through a meta-analysis of 20 studies encompassing 53 datasets. Using Comprehensive Meta-Analysis (CMA) 4.0 software, significant factors such as alcohol consumption, dietary habits, metabolic syndrome, and sleep patterns were identified. Findings emphasize the critical role of lifestyle modifications in reducing recurrence risk, advocating for educational interventions to inform breast cancer survivors. The integration of lifestyle education in clinical practices and policy efforts is crucial to supporting survivors and lowering recurrence rates effectively.
This article examines Professional Human Caring in Nursing within the evolving landscape of artificial intelligence (AI). As AI becomes increasingly integrated into healthcare, it necessitates a philosophical, moral, eth...This article examines Professional Human Caring in Nursing within the evolving landscape of artificial intelligence (AI). As AI becomes increasingly integrated into healthcare, it necessitates a philosophical, moral, ethical, and transpersonal spiritual foundation to safeguard nursing's core disciplinary values. Watson's Unitary Caring Science and Theory of Transpersonal Human Caring offer a guiding framework for sustaining Professional Human Caring in the face of advancing AI technologies. Furthermore, Watson's 10 Caritas Processes ® serve as a timeless philosophical and theoretical anchor, ensuring that human caring remains central to nursing. This article explores key AI-related questions and strategies through a disciplinary philosophical lens, reinforcing that AI in nursing should enhance rather than diminish the essence of Professional Human Caring.