The justification of caring science.

Abstract

This journal is living thanks to the efforts of the first generation of Nordic caring and nursing scientists. We have to be grateful for all of this work that has contributed significantly to today′s situation with caring science as an academic discipline in every university, with professors and many scholars all contributing to good research and health care. The term caring science is used here in order to demonstrate that the discipline is not related to a specific profession. The concept nursing science is problematic as it may indicate that it is nurses that do research, but if nursing is seen in the present participle form with the same meaning as caring, nursing science is interchangeable with caring science. In the field of empirical research, one can see a huge development in international collaborations, in advanced method development and also in the amount of international scientific publications from Nordic scholars in caring science. At the same time, a tradition of basic research and theory development in health care has grown in the Nordic countries. Alongside this positive development accounted for above, we also see a worrying tendency that many scholars almost deny that there exists a discipline of caring science worldwide and have very little knowledge of its base of ontology, theories and concepts. Also in the clinical field, caring science is seldom a basis for patient care, at least not in the Nordic countries. It is said that the scientific perspective is too far away from what happens in the clinical field. Why is this so? One reason for not accepting caring science as an (autonomous) discipline is that the scientific subject and the profession are mixed together. If the professional perspective is dominant, it seems more natural to build the science from a multidisciplinary perspective with different subjects as medicine, psychology, sociology, etc. On the other hand, if we have a disciplinary perspective on caring science, it is the ontology and ethos that primarily defines the scientific subject and gives focus to the research performed and theory development. If, for example, the goal of the discipline is to protect life and health, caring science can mainly do this by protecting the inner or existential life and health of the patient. Medicine protects life and health by medical measures and should do so. Caring science is justified by finding its own disciplinary point of departure and from there on defining its field of research. ‘Clinical caring science’ as a scientific discipline situated closer to the praxis field than caring science is a way to transcend the theory–praxis gap. It studies clinical expressions of the theory base. Also, observed clinical phenomena are transferred back to the discipline in order to deepen the understanding of the phenomenon and thereby use this understanding for better patient care by application of that knowledge. Katie Eriksson, Kari Martinsen and Karin Dahlberg, scientists from Finland, Norway and Sweden, respectively, have with co-researchers contributed significantly to a theoretical basis of caring science, with a special focus on what we have chosen to call ‘the Nordic tradition of caring science’ 1. The research accounted for in the Nordic tradition of caring science shows how accurate a disciplinary perspective is in modern times. All three scholars concentrate on caring science as a human science as a basis for both patient care and science. A human science perspective with its close connection to existential matters and professional natural care (close to the natural lived experiences of the patients, relatives, etc.) gives caring science, a societal justification as no other discipline studies clinical phenomena from this perspective. In the article, it is concluded that it is relevant to talk about a Nordic tradition, where a joint view on the science′s core ontology and ethics seems to correspond. A human science perspective is essential to all three scholars with the patient and his/her world of health and suffering as a basis for a caring with openness, pliability, compassion and seeing with the heart′s eye. As authors, we conclude that this Nordic tradition with values, concepts and theoretical development will continue to grow and form basis for future research in caring science. Also research on self-care shows the importance of a disciplinary perspective. An example of this inspired by the Nordic caring science tradition is the empirical research where the concept of ‘self-care’ is studied, interpreted and discussed in women with chronic pain 2.Clinical data showed that the concept self-care had to be problematized as the clinical phenomena did not fit in with the concept. Clinical expression showed that compassion as a caring science concept had to be added in order to understand the existential transfer from passivity to self-care in the patients. Self-care is extended from Orem′s theory with an existential view and interpretation, saying that the relationship with caregivers and a caring environment seemed to be crucial for transition from passivity to self-care. In the article ‘Dressing an existential wound’ 3, people′s suffering and health in a long-term care perspective have been studied in the context of a disaster. Without research questions and interpretation of collected data from a caring science perspective, it would have been a fragmented understanding of data. This shows the accuracy of a clinical caring science perspective that is related to practice. The essential understanding of people's needs in a long-term period of time is expressed in eight theses, all aimed to understand how a natural and existential care can be given flexibly and naturally in a long-term perspective. In this project, caring science′s ontology and conceptual base have worked closely together with empirical data in a hermeneutic process. A conclusive remark that must be made is that caring science needs a renaissance in the minds of all scholars and caregivers, in order to enhance caring to an optimal level.