Shadow and Substance: Values and Knowledge

Abstract

This essay is about the factors that influence the making of judgements in science: the shadow and the substance. We will review some studies that indicate the clear requirements of quality nursing research in order to examine outcomes and measures. The knowledge of methods assumes - and this is particularly true of quantitative traditions - objectivity or neutrality in the science of inquiry. The epistemological problem is that any process that generates and interprets outcome research is value-laden. Often left unexamined is the impact of the researcher's biases and values on the direction of the inquiry and the interpretation of findings. For example, we recently found that 45% of sole-supporting parents on welfare were depressed, as observed by the nurses. Our social scientist colleagues, from the same data set, noted, "Isn't it amazing that as many as 55% of sole-supporting parents on social assistance programs are not depressed?" Given the current emphasis on evidence-based nursing, who will raise questions concerning the impact of this value-laden evidence on practice, and on planning and policies, considering the nature and extent of our services? Is there such a thing as comprehensiveness in science? What we set out to quantitatively measure or qualitatively notice reflects our values and assumptions about important variables, mechanisms, pathways, and interactions. We find what we intend to notice, or indeed fail to find what we did not even know enough to notice. Do we ever consider measuring simultaneously (noticing) the opposite, or the unintended effects - the harms and risks - as well as the benefits and impacts? Is the glass half empty or half full? Is it short or tall? Are the contents 7-Up