Of the many controversies that have accompanied the growth of nursing as a discipline, few have been debated as long and as vigorously as the question of which paradigm should guide nursing science. Despite more than 20 years of discussion, the question remains unresolved. This article discusses the concept of paradigm, explores the paradigms that influence nursing science, and presents a comparison of the advantages and disadvantages of theoretical unification and mutiparadigmism. Additionally, the implications and consequences of multiparadigmism for the present and future development of nursing as a science within a practice discipline are presented.

The purpose of this study was to test the effectiveness of a multicomponent smoking cessation intervention in African American women residing in public housing. The intervention consisted of: (a) nurse led behavioral/empowerment counseling; (b) nicotine replacement therapy; and, (c) community health workers to enhance smoking self-efficacy, social support, and spiritual well-being. The results showed a 6-month continuous smoking abstinence of 27.5% and 5.7% in the intervention and comparison groups. Changes in social support and smoking self-efficacy over time predicted smoking abstinence, and self-efficacy mediated 6-month smoking abstinence outcomes. Spiritual well-being did not predict or mediate smoking abstinence outcomes. These findings support the use of a nurse/community health worker model to deliver culturally tailored behavioral interventions with marginalized communities. ß

Purpose Evaluate impact of breathing awareness meditation (BAM), Botvin LifeSkills® Training (LST), and health education control (HEC) on ambulatory blood pressure (BP) and sodium excretion in African American (AA) adolescents. Methods Following three consecutive days of systolic blood pressure (SBP) screenings, 166 eligible participants (i.e., SBP > 50th – 95th percentile) were randomized by school to either BAM (n = 53), LST (n= 69), or HEC (n=44). In-school intervention sessions were administered for three months by health education teachers. Before and after the intervention overnight urine samples and 24-hour ambulatory SBP, diastolic blood pressure (DBP), and heart rate (HR) were obtained. Results Significant group differences were found for changes in overnight SBP and SBP, DBP and HR over the 24-hour period and during school hours. The BAM treatment exhibited the greatest overall decreases on these measures (Bonferroni adjusted, ps <.05). For example, for school-time SBP, BAM showed a change of −3.7 mmHg compared to no change for LST and a change of −0.1 mmHg for HEC. There was a non-significant trend for overnight urinary sodium excretion (p = .07) with the BAM group displaying a reduction of −.92 ± 1.1 mEq/hr compared to increases of .89 ± 1.2 mEq/hr for LST, and .58±0.9 mEq/hr for HEC group. Conclusion BAM appears to improve hemodynamic function and may impact sodium handling among AA adolescents at increased risk for development of cardiovascular disease (CVD).