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Positivism and Paradigm Transformation in Nursing: A Narrative–Philosophical Review
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Akbar Javadi    , Mehrdad Amiri * , Heshmatolah Heydari |
| Department of Philosophy and Islamic Theology, Faculty of Literature and Humanities, Lorestan University, Khorramabad, Iran , Amiri.m@lu.ac |
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Abstract: (12 Views) |
Background and aim: Philosophical debates in nursing have examined the nature of valid knowledge and its adequacy for practice, education, and policy. Positivism, as the dominant paradigm, has provided scientific legitimacy through empiricism and measurability, yet its reductionism has limited nursing’s ability to address relational and experiential dimensions of care, prompting critiques and the rise of alternative paradigms.
Materials and methods: A philosophical narrative review was conducted by searching through PubMed, Scopus, Web of Science, CINAHL, ProQuest, and supplementary sources (1985–2025). Of the 412 records identified, 12 were included in this review. Data were synthesized through interpretive analysis involving immersion, comparative critique, thematic coding, and integration into a conceptual framework.
Results: Positivism has shaped nursing’s scientific identity, but it has also generated epistemological gaps. Post‑positivism, interpretivism, critical theory, realism, and mixed methods have expanded the epistemological landscape, fostering methodological pluralism. Contrasting perspectives, such as critiques of “qualitative positivism,” have also enriched the debate. Synthesizing these insights, the Evolutionary Nursing Paradigm Pathway (ENPP) was developed, depicting four stages of positivist dominance, recognition of gaps, emergence of alternatives, and consolidation of pluralism.
Conclusion: Nursing knowledge is increasingly defined by epistemological pluralism, where research questions—not paradigmatic allegiance—guide methodological choice. The ENPP framework clarifies the role of paradigms in nursing’s ongoing development and strengthens the discipline’s capacity to address care complexities, promote health equity, and deepen understanding of health and illness.
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| Keywords: Positivism, nursing epistemology, paradigm transformation, post positivism, epistemological pluralism, critical realism. |
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Full-Text [PDF 439 kb]
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Type of Study: Research |
Subject:
Special
Received: 2026/02/22 | Accepted: 2024/04/1 | Published: 2024/04/1
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