a multidimensional analysis of the epistemic origins of nursing

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International Journal of Nursing Studies 43 (2006) 113–122

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A multidimensional analysis of the epistemic origins of nursingtheories, models, and frameworks

Jason W. Becksteada,�, Laura Grace Becksteadb

aUniversity of South Florida, College of Nursing, 12901 Bruce B. Downs Boulevard, MDC 22, Tampa, FL 33612-4766, USAbUniversity of Tampa, USA

Received 9 September 2004; accepted 30 September 2004

Abstract

The purpose of this article is to introduce our notion of epistemic space and to demonstrate its utility for

understanding the origins and trajectories of nursing theory in the 20th century using multidimensional scaling (MDS).

A literature review was conducted on primary and secondary sources written by and about 20 nurse theorists to

investigate whether or not they cited 129 different scholars in the fields of anthropology, biology, nursing, philosophy,

psychology, and sociology. Seventy-four scholars were identified as having been cited by at least two nurse theorists

(319 citations total). Proximity scores, quantifying the similarity among nurse theorists based on proportions of shared

citations, were calculated and analyzed using MDS. The emergent model of epistemic space that accommodated these

similarities among nurse theorists revealed the systematic influence of scholars from various fields, notably psychology,

biology, and philosophy. We believe that this schema and resulting taxonomy will prove useful for furthering our

understanding of the relationships among nursing theories and theories in other fields of science.

r 2004 Elsevier Ltd. All rights reserved.

Keywords: Nursing theory; Multidimensional scaling; Epistemic space

Science is the systematic investigation and explanation

of the world around us. In order to organize their work

and its results, scientists have divided science into

major fields. Herbert (1959, p. 11)

1. Introduction

1.1. Epistemic space

The progress of science is the work of creative minds.

However, every creative mind that contributes to

e front matter r 2004 Elsevier Ltd. All rights reserve

urstu.2004.09.021

ing author. Tel.: +1813 974 7667;

5418.

ess: [email protected] (J.W. Beckstead).

scientific advance works within two limitations. It is

limited by ignorance, for each discovery waits upon that

other that gave way to it. Discovery and its acceptance

are also limited by the habits of thought that pertain to

the culture of any region or period; slow change is the

rule. Given that advances in science build upon

discoveries that have been widely accepted or sufficiently

established, we can envision scientific knowledge as

having a progressive, or positive trajectory, moving

from a position of less knowledge to one of more.

Different fields of science, or bodies of scientific knowl-

edge, may be said to have originated at different points

in history and to be growing at different rates, affected

by advances in relevant technology and cultural mores.

These developments take place in what we label as

epistemic space. Epistemic space is the unlimited expanse

d.

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ARTICLE IN PRESS

Scie

nce

of th

e M

ind

(�)

Science of the Body (�)

New TheoreticalDevelopments

New TheoreticalDevelopments

EstablishedKnowledge

Nursing

Medicine

Fig. 1. Schematic representation of epistemic space showing the

relative placement of metaparadigms of nursing and medicine.

Science of the Mind encompasses psychology, anthropology,

and sociology. Science of the Body encompasses biology,

chemistry, and physics.

J.W. Beckstead, L.G. Beckstead / International Journal of Nursing Studies 43 (2006) 113–122114

in which all knowledge is located. Individual bits of

knowledge and the defined relationships among them

constitute the system of inquiry known as science. We

assume that the amalgamation of scientific knowledge

occurs within such space.

According to Kuhn (1977), the term metaparadigm

may be used to refer to the set of highly abstract

concepts that identify the phenomena of interest to a

scientific field or discipline. The metaparadigm is the

most abstract component in Fawcett’s (2000) structural

hierarchy of nursing knowledge containing the global

concepts of interest to the discipline and their relation-

ships. Metaparadigms summarize the intellectual and

social missions of a discipline and place a boundary on

its subject matter (Kim, 1989). As such, the metapar-

adigm guiding research in a discipline distinguishes that

discipline from others. The metaparadigm of nursing

identifies for the nurse researcher the study of ‘‘the

wholeness or health of humans, recognizing that hu-

mans are in continuous interaction with their environ-

ments’’ (Donaldson and Crowley, 1978). The

metaparadigm of medicine, in contrast, identifies for

the physician researcher the study of the causes,

diagnosis, and treatment of diseases (Fawcett, 1993).

Next we turn to the juxtaposition of these two

metaparadigms in epistemic space.

Our perspective, or weltanschauung, of nursing and

medical knowledge begins with Descartes’ dualism of

mind and body which provides a means for defining the

metric of our epistemic space. Believing as he did that

the body’s behavior can be in no way guided by purpose,

Descartes was naturally eager to show that there exists a

sharp distinction between body and mind. He split the

world into two types of being, volitional thought and

physical or spatial matter. Since his time, the specialties

of science have emerged consistent with this distinction.

Epistemic space may be represented using a multi-

dimensional coordinate system in which science exists

and expands outward from an origin (corresponding to

relatively established knowledge) in various directions

encompassing new theoretical developments. Consider

two perpendicular axes representing the trajectories of

scientific knowledge development. The first, C, corre-

sponds to the sciences of the mind (e.g., psychology,

sociology, anthropology, etc.) being spontaneous and

teleological. The second, b, represents the sciences of thebody (e.g., biology, chemistry, physics, etc.), being

wholly mechanical. Using such a metric, all scientific

knowledge in nursing and medicine may be positioned in

epistemic space by assigning general coordinates that

reflect the relative influences of established knowledge

from the sciences of psychology, biology, etc., as

reflected in their metaparadigms. We consider the health

sciences, namely nursing and medicine, as comprising

the application and adaptation of established scientific

knowledge (i.e., knowledge that is relatively close to the

origin of our epistemic space) to the promotion,

improvement, and maintenance of human health and

well-being. Thus, our placement of nursing and medicine

in epistemic space (see Fig. 1) is consistent with their

metaparadigms; nursing being more concerned with,

and more influenced by, established knowledge derived

from work in the social sciences, arguably offering more

teleologic explanations, while medicine is more con-

cerned with, and influenced by, the mechanistic ex-

planations afforded in biology and chemistry.

1.2. Purpose

The purpose of this article is to introduce our notion

of epistemic space and to demonstrate its utility for

understanding the origins and trajectories of nursing

theory in the 20th century using multidimensional

scaling (MDS). Whether a particular assemblage of

nursing knowledge qualifies as a philosophy, theory,

conceptual model, or an organizing framework, has

been debated by various scholars (e.g., Fawcett, 1993,

2000; Meleis, 1997; Reed, 1995; Whall, 1996). The

subtleties of such discussions are by no means trivial,

however, for our purposes we will use the term ‘‘nurse

theorist’’ to refer to those individuals who have

substantively affected the developments of nursing as a

science during the 20th century, and the term ‘‘theory’’

in reference to the body of their published work that has

lead to such developments.

1.3. Nursing theory and epistemic space

In comparison to other sciences, nursing is in the

early stages of scientific development (Bishop, 2002).

ARTICLE IN PRESSJ.W. Beckstead, L.G. Beckstead / International Journal of Nursing Studies 43 (2006) 113–122 115

Examination of the published works by various nurse

theorists reveals that many of them have built upon the

established knowledge amassed in the mind–body

sciences, consistent with our notion of nursing’s

coordinates in epistemic space. Different foundational

ideas, both conceptual and philosophical, have predis-

posed nurse theorists to describe and explain the

phenomena of concern to the discipline in diverse ways

(Kim, 1999). Our concern is with such foundational

ideas. We propose that by analyzing patterns in the

citation of scholars it is possible to discern, with a

reasonable degree of objectivity, similarities in the

epistemic origins of nurse theorists’ foundational ideas.

In other words, it is possible to position nurse theorists

in epistemic space on the basis of the established

knowledge that influenced their critical thinking and

research endeavors. This approach to comparing nurse

theorists is taxonomic rather than typologic. These two

methods of classification are distinguished succinctly by

Hair and Black (1998): a taxonomy is an empirically

derived classification, while a typology is a conceptually

based one. To conduct this analysis, we employed a

quantitative technique known as MDS. This technique is

briefly explained below.

1.4. Multidimensional scaling

MDS comprises a family of geometric models for

representation of data in two or more dimensions and a

corresponding set of methods for fitting such models to

actual data. The goals of MDS are (a) to find a low (e.g.,

two or three) dimensional space in which points in the

space represent the objects being studied and such that

the distances between the points in the space match, as

well as possible, the original similarities (or differences)

between the objects and (b) to represent the space and

the relationships among objects as a geometric model or

picture. This second goal distinguishes MDS from

factor-analytic methods (Shepard, 1972). Factor-analy-

tic methods generally require a solution of greater

dimensionality than do MDS methods (Napier, 1972).

The MDS approach used in the current study is

nonmetric in the sense that the data are nominal (a

theorist cited, or did not cite a scholar). Typical (i.e.,

linear) factor analysis models have been criticized when

applied to dichotomous data due to the non-positive

definite nature of such covariance matrices, and non-

linear factor analysis models for determining dimension-

ality are unavailable or limited by sample size (see

Meara et al., 2000 for discussion).

The basic function of MDS may be illustrated by

using travel times between a group of cities in order to

reconstruct a map of their geographic locations. For

example, Greenacre and Underhill (1982) used flying

times between major airports. In this case, a single

attribute, travel time, served to quantify the proximity

or similarity between objects (i.e., cities). More interest-

ing applications have involved the use of multiple, and

less objective, attributes to quantify the proximities

among rare Scotch whiskies (Lapointe and Legendre,

1994) and among Renaissance painters (Davenport and

Studdert-Kennedy, 1972). The adequacy of the resulting

‘‘map’’ may be expressed using a general measure of

stress in the system, i.e., the lack of fit between the actual

proximities and those that result from the analysis. The

stress measure is the square root of the normalized

residual sums of squares and ranges from 0.00 to 1.00,

with smaller values indicating less stress and a better

solution (Kruskal and Wish, 1978).

MDS was originated in the 1930s when Young and

Householder (1938) showed how starting with a matrix

of distances between points in Euclidean space, co-

ordinates for the points could be found such that

distances are preserved. It was later popularized by

Torgerson (1958), who applied it to the problem of

psychological scaling. Since then it has been used in

nursing research (see Houfek, 1992; Wilson and Retsas,

1997) and numerous other disciplines: biometrics—

Lawson and Ogg (1989), counseling psychology—

Fitzgerald and Hubert (1987), ecology—Tong (1989),

ergonomics—Coury (1987), forestry—Smith and Iles

(1988), lexicography—Tijssen and Van Rann (1989),

tourism—Fenton and Pearce (1988), and brain con-

nectivity—Goodhill et al. (1995). Given the inherently

Cartesian nature of our notion of epistemic space, it

seemed reasonable to us to employ MDS in an attempt

to objectively position nurse theorists in multidimen-

sional space.

2. Method

We began by compiling a list of 129 scholars in the

fields of anthropology, biology, nursing, philosophy,

psychology, and sociology from popular text books in

each field. This list operationally defined ‘‘established

knowledge’’ for the purpose of our analysis. Next, a

literature review was conducted on primary and

secondary sources (see Appendix A) written by and

about the 20 nurse theorists listed in Table 1. Although

not exhaustive, this list represents the major contribu-

tors to nursing scholarship during the 20th century

based on our review. One hundred and sixteen of our

scholars were cited by at least one of the theorists

studied here. A data matrix was constructed with nurse

theorists as columns and scholars as rows. If a nurse

theorist cited a particular scholar, a ‘‘1’’ was placed in

the corresponding cell of the matrix, otherwise the cell

was coded ‘‘0’’. (Due to space constraints, the data

matrix is not reprinted here; however, it is available

ARTICLE IN PRESS

Table 1

Results of multidimensional scaling of nurse theorists

Theorist Symbol Coordinates

Dimension 1 Dimension 2 Dimension 3

Abdellah AD 1.2029 �0.8487 �0.9220

Hall HL 2.4563 0.4174 �0.7988

Henderson HN 0.7511 �0.2561 0.7169

Johnson JN �1.3440 1.6144 �0.3485

King KG 0.0298 0.5143 0.6540

Leininger LN �1.3451 �0.7929 �0.4077

Levine LV �0.1962 �0.0399 �0.3417

Neuman NU �1.3547 1.9066 �1.0503

Newman NW �0.8655 �0.0157 2.3113

Orem OM �0.6498 0.3037 0.6928

Orlando OR 1.8926 �0.6526 �0.2701

Paterson and Zderad PZ 1.4397 0.1254 1.4503

Parse PR �1.0807 0.5279 1.1461

Peplau PP 0.5863 0.9732 �0.7746

Riehl RL �0.7939 �1.7827 �2.0639

Rogers RG �0.0155 0.4519 0.1511

Roy RY �0.1301 0.1194 �0.2520

Travelbee TV �0.0632 �0.4507 0.0752

Watson WT 0.2095 0.1587 0.1711

Wiedenbach WB �0.7294 �2.2737 �0.1392

Note: Proximities between theorists were based on the proportion of their shared citations (k ¼ 74) using Russell and Rao’s similarity

coefficient for binary data. MDS solution produced a stress value ¼ 0.167, and R2 ¼ 0:826:


from the first author.) This approach does not distin-

guish whether a nurse theorist cited a scholar to support,

or contradict her theory; such was not our intent.

Rather, this approach serves as a proxy indicating

whether or not a nurse theorist was influenced (for good

or ill) by the writings of a particular scholar, at least to

the extent that she felt compelled to cite his or her work.

It could be argued that this approach has some

limitations. Scholars might be cited for reasons such as

availability rather than because of their intrinsic merit.

Theorists may have read and may have been influenced

by scholars they did not cite (and it may also happen

that some cited works they had not read!). While

recognizing these limitations, this form of citation

analysis does have the virtue of providing an objective

measure similarity in such a context (Everett and

Pecotich, 1993).

The data matrix was used to calculate a matrix of

proximity scores between all pairs of nurse theorists.

Proximity scores reflect the degree of similarity or

dissimilarity among a set of objects being compared on

a set of characteristics (Beckstead, 2002). There are

numerous proximity coefficients for various types of

data (see Cox and Cox, 2001, for review). For the

purpose of quantifying the proximity between nurse

theorists based on similarities in their patterns of cited

scholars, we used Russell and Rao’s similarity index.

For any two nurse theorists, this index was defined as

the number of shared citations over the total number of

scholars qualifying for our analysis (see below). This

measure was chosen from among several appropriate for

binary data because it does not count conjoint absences

as reflecting similarity (i.e., two theorists are not

considered similar because they omitted the same

scholars) and because conceptually it represents the

similarity between theorists in terms of the proportion of

operationally defined established knowledge that they

share. Scholars cited by only one nurse theorist, do not

contribute to these proximity scores; their inclusion

essentially constitutes ‘‘noise’’ and degrades the relia-

bility of resulting proximity scores (Hair and Black,

1998). To be included in the analysis a given scholar had

to have been cited by at least two nurse theorists.

Proximity scores were thus based on 319 citings of 74

scholars: three from anthropology, seven from biology,

15 from nursing, eight from philosophy, 35 from

psychology, and six from sociology.

2.1. Data analysis

The proximity matrix was analyzed using Alternating

Least squares SCALing (ALSCAL) developed by

Takane et al. (1977). ALSCAL is an extremely flexible

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Table 2

Correlations among coordinates for nurse theorists on the scaling dimensions and the proportion of scholars cited from various

disciplines

Discipline Dimension 1 Dimension 2 Dimension 3

Anthropology �0.181 �0.256 �0.117

Biology �0.434 0.733 �0.141

General systems theorya �0.441 0.691 �0.207

Nursing �0.114 �0.413 0.098

Philosophy (all) �0.134 0.098 0.788

Philosophy (existential)b �0.058 0.066 0.751

Psychology (all) 0.779 0.097 �0.097

Psychology (personality)c 0.916 �0.226 �0.255

Sociology 0.232 �0.335 �0.521

Note: Italicized values indicate the discipline(s) dominating each dimension.aThere were seven biologists cited, three of these were cited by nurse scholars for their work in general systems theory.bEight scholars of philosophy were cited, three of these were noted existentialists.cThere were 35 psychologists cited, 12 of these were personality theorists.

J.W. Beckstead, L.G. Beckstead / International Journal of Nursing Studies 43 (2006) 113–122 117

procedure that can handle data that are: (i) nominal,

ordinal, interval, or ratio; (ii) complete or have missing

observations; (iii) symmetric or asymmetric; (iv) condi-

tional or unconditional; (v) replicated or unreplicated

(see Cox and Cox, 2001, for further discussion). The

procedure is available as part of the SPSS package. Our

application specified a nonmetric (ordinal level) analysis

employing the Euclidean distance model. This model

was applied to a full matrix of symmetric proximity

scores.

3. Results

MDS was successfully applied to the proximity matrix

relating nurse theorists based on similarities in patterns

of the scholars they cited. Initially, we examined a two-

dimensional solution given the nature of epistemic space

proposed in Fig. 1. This solution produced a stress

index ¼ 0.225 and an R2 ¼ 0:757; however, we could not

discern any systematic pattern in the coordinate values.

The three-dimensional solution produced a stress

index ¼ 0.167, an R2 ¼ 0:826; and afforded a mean-

ingful interpretation of the dimensions in epistemic

space as described below.1 The resulting coordinates are

presented in Table 1.

In an attempt to provide substantive interpretation of

the three dimensions resulting from the scaling of nurse

theorists, point-biserial correlations between coordinates

1It is not unusual for a higher-dimensional configuration to

be more readily interpretable than a lower-dimensional config-

uration given the relationship among configurations of different

dimensionality is more complex with MDS than for other

methods (see Kruskal and Wish, 1978, p. 92, for further

discussion).

on each dimension and whether or not a scholar was

cited by nursing theorists were calculated. Common

citations by theorists located at similar coordinates

provide a criterion for determining the meaning of each

dimension. This analysis proved cumbersome to inter-

pret given the large number of scholars cited. Instead,

we first grouped scholars according to their discipline

and then examined the correlations between the

proportions of each nurse theorist’s citations from the

fields of anthropology, biology, nursing, philosophy,

psychology, and sociology, and the theorist’s coordi-

nates on each dimension (see Table 2). This approach is

a form of property vector fitting (see Jones and Koehly,

1993) and is useful for interpreting MDS solutions and

deciding how many dimensions to retain. These correla-

tions suggest that as coordinates on Dimension 1

increase so do the proportions of scholars cited from

the field of psychology (r ¼ 0:779). As noted above,

there were more scholars cited from this field than any of

the others examined here. The most often cited were

Abraham Maslow, Carl Rogers, and Gordon Allport;

all noted for their work in the area of personality theory

(see Feist, 1985; Hergenhahn, 1980). Hence, we decided

to examine more closely the proportion of personality

psychologists cited by each nurse theorist in relation to

their coordinates on Dimension 1 and found this

relationship to be quite strong (r ¼ 0:916). Values on

Dimension 2 appear to correspond to the proportion of

biologists cited (r ¼ 0:733). Three of the seven biologists

cited were referenced for their work in general systems

theory; again we decided to examine more closely a

subset of scholars. Coordinates on Dimension 2 were

also related to the proportion of these general systems

theorists cited (r ¼ 0:691). Dimension 3 seems most

related to the proportion of scholars cited from

philosophy (r ¼ 0:788). Closer examination of these

ARTICLE IN PRESS

-1

0

1

2

-2-1

0

1

2

-2-1

01

2

Psy

chol

ogy

(D1)

Phi

loso

phy

(D3

)Biology (D

2)

RL

WB

LN NU

AD

LV

JN

RY

PP

TV

OR

RG

WT

HL

OM

KG

PR

HN

NW

PZ

Fig. 2. Three-dimensional plot of epistemic space accommo-

dating nurse theorists based on MDS analysis of shared

scholars cited from disciplines of anthropology, biology,

nursing, philosophy, psychology, and sociology. Symbols

corresponding to nurse theorists are identified in Table 1.


citations revealed that coordinates on Dimension 3 were

consistently related to the proportion of these philoso-

phers considered to be existentialists (r ¼ 0:751). The

relationships among nurse theorists in multidimensional

space are shown in Fig. 2. For ease of interpretation, the

dimensions have been labeled according to their

descriptions above.

The initial utility of our dimensional interpretation of

the MDS solution becomes apparent when the coordi-

nates of various nurse theorists are examined. For

example, nurse theorists often described as existential-

phenomenologists, namely, Newman (NW), Paterson

and Zderad (PZ), and Parse (PR) are located at the high

end of Dimension 3 (toward the ‘‘front’’ of the figure),

which is consistent with the fact that they cited a greater

proportion of existential philosophers (Heidegger,

Nietzsche, Sartre) than did other nurse theorists. Nurse

theorists identified as systems theorists, Neuman (NU),

Johnson (JN), and King (KG) are located more toward

the high end of Dimension 2 (at the right-hand side of

the figure) consistent with their having cited a greater

proportion of scholars in the fields of biology and

general systems theory (e.g., Hans Seyle, and Ludwig

von Bertalanffy). Nurse theorists Hall (HL) and

Orlando (OR) had the highest coordinate values on

Dimension 1, consistent with the nature of their theories

being influenced by the work of personality psycholo-

gists such as Carl Rogers and Harry Stack Sullivan. At

the other end of Dimension 1 we find nurse theorist

Leininger (LN), known for her transcultural perspective.

Unlike Hall and Orlando, her profile of citations was

dominated by anthropologists and sociologists. The

tight configuration of theorists in the central position

(near coordinates 0, 0, 0) cited more scholars from a

wider range of disciplines than did those located in the

periphery of the space.

It occurred to us that coordinate values based on

patterns in citations might be associated with temporal

relationships among the nurse theorists. That is, are the

coordinates systematically related to the nurse theorists’

publication dates? Coordinate values on Dimension 1

were correlated, r ¼ �0:523; with the year in which the

theorists published their initial works (see Meleis, 1997;

Tomey and Alligood, 1998) suggesting that earlier nurse

theorists cited a greater proportion of psychologists than

did theorists publishing later in the century. Publication

dates did not correlate with coordinate values on

Dimension 2 or 3.

Using Fig. 2 and the coordinates in Table 1, it is

possible to make substantive comparisons among

particular nurse theorists on the various dimensions.

We invite the reader to examine coordinate profiles of

the nurse theorists with whom they are most familiar in

order to assess the utility of our analysis.

4. Discussion

Our original description of epistemic space as two

dimensional, stemming from Descartes’ mind–body

dualism, was supported, in part, by the alignment of

MDS axes with differing degrees of citation from

biology and psychology. However, our initial view

may have been too simplistic. The three-dimensional

model of epistemic space containing the nurse theorists

that emerged from our analysis revealed the systematic

influence of scholars not identified with any branch of

science per se, but with writings in existential philoso-

phy. In an effort to integrate this finding into our initial

framework, we offer the following. The accumulation of

knowledge referred to as ‘‘science’’ is derived from sense

experience and may thus be considered a posteriori in

nature. Because sense experience is relative, inconsistent,

and not fully reliable, such knowledge is not regarded as

certain; rather it is probable knowledge. In contrast, the

knowledge offered by philosophy is derived from the

function of reason without reference to sense experience

and may be considered as a priori knowledge, expressing

the definitional relationships among ideas true in

themselves due to their own inherent meaning. Such a

priori knowledge is, by definition, orthogonal to a

posteriori knowledge. To prove useful, our notion of

epistemic space must encompass both these categories of

knowledge. In hind sight, including this dimension

seems obvious if we are to accommodate other a priori

knowledge offered by the field of mathematics.


The more central the coordinates of a nurse theorist in

our multidimensional model, the more scholars, and the

wider the range of disciplines she cited. We might

describe these theorists as having a broader scope to

their inspirational landscape. By contrast, theorists

located more toward the periphery may be described

as being more polarized or influenced by a smaller and

more homogeneous set of scholars.

The themes of adaptation and wholeness, which are

found in the works of various nurse theorists, may be

traced to the field of biology, and more specifically, to

general systems theory which has its own roots in

biology. The study of adaptation to stress, or coping,

was pioneered in the 1950s by Hans Seyle, the most

often cited biologist in our review. General systems

theory, which worked its way into many scientific

disciplines from 1950 through the 1970s, grew out of

the work of biologists Ludwig von Bertanalffy, Anatol

Rapoport, and W. Ross Ashby who directed scientists to

consider, as the proper object of study, the various

arrangements of components that are so interrelated as

to form wholes. The notion that the whole is greater

than the sum of its parts has influenced various nurse

theorists to expound upon the dynamic context in which

patient care takes place and to encourage nurses to move

beyond mechanistic thinking.

Based on the prevalence of their citations, humanistic

personality theorists Abraham Maslow and Carl Rogers

appear to have had the most influence on nurse

theorists. Personality theorists differ in their assump-

tions concerning human nature. According to Feist

(1985) these assumptions center on components such as:

free choice vs. determinism, pessimism vs. optimism,

biological vs. social influences, and the number of basic

motives attributed to the person. Carl Rogers’ view of

humanity is basically positive and optimistic. He

believed that people are essentially forward moving

and that under proper conditions will grow toward self-

actualization. People ordinarily know what is best for

themselves and have a high degree of choice in their

lives. Roger’s person-centered therapy is quite teleologic;

people are seen as striving with purpose toward goals

they freely set for themselves. Maslow’s view of people is

that they are fundamentally good and that the basic

needs that motivate us are not negative or pathological,

but precisely those that result in positive growth

and health. When people’s needs are not met, they

may act in evil or destructive ways. He also believed that

people aim toward self-actualization, thus holding a

purposive or teleological view. Maslow felt that in-

dividuals are shaped by both biology and society and

that the two cannot be separated. Both these psychol-

ogists shared an optimistic view of people as being

capable of self-care and self-determination, given a

secure, nurturing environment; themes that pervade

many nursing theories.

MDS techniques have some limitations that must be

kept in mind when interpreting the findings reported

above. It could be argued that our findings are an

artifact of the sample of nurse theorists chosen, the list

of scholars assessed, and/or the nature of the algorithm

and proximity measure used. Like any flexible modeling

framework or data analysis method, MDS is well suited

to some types of research questions and less appropriate

for others. Nonmetric methods, like the one used here

for analyzing binary data are based on the assumption

that a monotonic relationship exists between the

proximity measures and the interpoint distances derived

by the solution algorithm. Different proximity measures

summarize relationships between objects in different

ways and will produce different MDS results. It is

important that researchers using MDS understand these

measures and choose the one(s) appropriate to their

research goals or questions. Prior to settling on the

Russell and Rao index, we compared several proximity

measures for revealing known dimensionality in small

artificial data sets similar in character to the one

analyzed here. A reviewer of an earlier draft of this

paper raised the issue of sparse data arrays in MDS

analysis. Although the problems resulting from sparse

data arrays have been studied in relation to logistic

regression (see Greenland et al., 2000; Kuss, 2002 for

discussion), MDS techniques are not adversely affected

in the same way because MDS analyzes the proximity

matrix calculated from the raw data array. Our 20� 74

raw data array contained 319 ‘‘1’’s and 1161 ‘‘0’’s. The

resulting 20� 20 proximity matrix contained 380 proxi-

mity scores, 68 of which were 0.00 indicating no shared

citations between particular pairs of nurse theorists. So

long as the appropriate proximity measure is used to

prepare the data for MDS analysis, sparsity in the raw

data array does not present the same problem as it does

in logistic regression methods.

Future generations of nurse theorists, whose work will

no doubt build upon the efforts of the nurse theorists

examined here, are likely to incorporate and adapt new

developments occurring in other fields of science; such is

the nature of scientific progress. As the assemblage of

knowledge comprising nursing science increases, the

dimensionality of epistemic space required to encompass

nursing theory may also increase.

The similarities among nurse theorists in epistemic

space, as examined here, were based on commonalities

in the sources they cited for their intellectual inspiration.

More frequently, similarities among nurse theorists have

been derived through systematic content analysis of

their writings (e.g., Fawcett, 1993, 2000; Meleis, 1997;

Tomey and Alligood, 1998, 2002). The difference in

these two methods may be illustrated with a simple

example. Consider two nurse theorists who cite identical

sources of intellectual inspiration. Our taxonomic

approach would describe them as being quite similar

ARTICLE IN PRESSJ.W. Beckstead, L.G. Beckstead / International Journal of Nursing Studies 43 (2006) 113–122120

to one another, while a typologic (content-derived)

approach could describe them as being quite similar or

quite different from one another depending on how the

two interpreted, adapted, or applied the same sources of

inspiration. As Kuhn (1977) explained, although pro-

ponents of different theories may be looking at the same

phenomena, they may focus on different components,

and they may see different relations among the same

components. We believe, as do many scholars, that a

better understanding of any phenomenon is obtained

through the use of multiple methods of measurement

and analysis. Our notion of epistemic space is offered as

a new schema for examining and understanding the

relationships among the various fields of science. We

invite the reader who is especially familiar with the

works of nurse theorists examined here to explore how

our coordinate system relates to their own content-

derived judgments of the similarities and distinctions

among nurse theorists.

Acknowledgement

Dr. Beckstead is an associate professor at the

University of South Florida College of Nursing. He

works as a statistician/methodologist with nurse re-

searchers and graduate students. Laura Beckstead is a

graduate student at the University of Tampa Depart-

ment of Nursing pursing her MSN.

The authors wish to thank Drs. Mary E. Evans and

Cecilia Jevitt for their help on an earlier draft of this

paper, and Drs. Cecile Lengacher and Linda Moody for

access to numerous publications by and about nurse

theorists. We are also grateful to three anonymous

reviewers for their helpful comments and suggestions.

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a multidimensional analysis of the epistemic origins of nursing

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