Advanced Theoretical Perspectives for Nursing

Nursing is a complex and dynamic profession that requires both practical skills and theoretical knowledge. Nursing theory is a way of explaining, understanding, and predicting phenomena related to nursing practice, education, and research. Nursing theory can also guide the development of advanced practice nursing (APN), which is a level of nursing practice that involves expanded clinical competence, autonomy, and leadership.

According to Fagerström (2021), APN can be based on four nursing science perspectives: health, holism, ethos, and caring. These perspectives reflect the historical and international development of nursing as a discipline and a profession. They also provide a common foundation for the various roles and domains of APN, such as clinical nursing practice, ethical decision-making, coaching and teaching, consultation, collaboration, case management, leadership, research and development.

Health is a central concept in nursing that can be defined in different ways depending on the context and perspective. For APN, health can be seen as a dynamic process of adaptation and balance between the individual, the environment, and the society. Health can also be seen as a resource for living and a goal of nursing interventions. APN can promote health by providing holistic assessment, diagnosis, treatment, prevention, and health education to individuals, groups, and communities.

Holism is another core concept in nursing that emphasizes the interrelatedness and interdependence of all aspects of human existence: biological, psychological, social, cultural, spiritual, and environmental. Holism also recognizes the uniqueness and diversity of each person and situation. APN can apply holism by respecting the values, beliefs, preferences, and needs of each patient and by providing individualized and comprehensive care that addresses all dimensions of health.

Ethos is a nursing science perspective that refers to the fundamental ethical approach of nursing. Ethos is based on the respect for human dignity, autonomy, integrity, and vulnerability. Ethos also involves caring for oneself, others, and the environment. APN can embody ethos by adhering to ethical principles and standards in their practice, by advocating for patients’ rights and interests, by fostering trusting relationships with patients and colleagues, and by engaging in reflective practice and lifelong learning.

Caring is perhaps the most distinctive and essential perspective of nursing science. Caring is both an art and a science that involves knowledge, skills, attitudes, values, emotions, and actions. Caring is expressed through compassionate presence, empathic understanding, attentive listening, therapeutic communication, skillful intervention, and mutual empowerment. APN can demonstrate caring by providing holistic care that is sensitive to patients’ experiences of health and illness, by creating a healing environment that supports patients’ well-being and recovery,
and by participating in research and development that contributes to the advancement of nursing knowledge and practice.

In conclusion, advanced theoretical perspectives for nursing can help APN to understand their role and function in various contexts of health care delivery. They can also help APN to integrate evidence-based practice with values-based practice that is person-centered and caring-oriented.


Fagerström L.M. (2021) Theoretical Perspectives on Advanced Practice Nursing. In: A Caring Advanced Practice Nursing Model. Advanced Practice in Nursing. Springer Nature Switzerland AG.

Meleis A.I. (2007) Theoretical Nursing: Development & Progress (4th ed.). Lippincott Williams & Wilkins.

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