Beyond One “Universal” Nursing Theory: Building a Pluriverse of Nursologies

 

Article Information

Cleofas, J. V. (2024). Building a Pluriverse of Nursologies: A paradigm for decolonial theory and knowledge development in nursing. Nursing Philosophy, 25, e12497. https://doi.org/10.1111/nup.12497

What this study is about

This paper is a theoretical essay (not an empirical study) that asks a deceptively simple question: Who gets to define what nursing knowledge is—and whose nursing knowledge gets treated as “real theory”? The author argues that nursing, like many health disciplines, carries deep “colonial baggage” in how it builds, evaluates, and circulates knowledge. Even when nursing claims to be global, the theories most widely taught and cited often come from a relatively narrow set of Western and Global North institutions and traditions.

To address this, the paper introduces a new guiding framework: the Pluriverse of Nursologies (PoN)—a paradigm meant to help nursing scholars and educators build theory differently, especially in (neo)colonized, indigenous, and marginalized communities.

Why this matters

How we define “valid knowledge” shapes:

• what gets funded and published,
• what gets taught as “core nursing,”
• what is seen as “evidence,” and
• what kinds of care are considered legitimate.

If nursing knowledge is organized like a one-way pipeline—where theory is made “at the center” and applied “at the margins”—then local realities and community-rooted practices can become invisible, under-theorized, or treated as mere “context.” That harms not only scholarship but also the credibility and effectiveness of nursing in diverse settings.

The core problem: epistemic violence

The paper uses the term epistemic violence to describe a pattern where dominant knowledge systems silence, devalue, or overwrite the knowledge of marginalized groups. In nursing, the author argues, this has happened historically (during formal colonial eras) and continues today (in more subtle, institutional forms).

Two historical illustrations are discussed:

• Colonial nursing projects that dismissed indigenous healing and spirituality, framing colonized people as “uncivilized.”
• Public health and nursing development under colonial governance (including in the Philippines), where local bodies and lifeways were treated as objects of surveillance and “modernization.”

The point isn’t that nursing is uniquely “bad”—it’s that nursing developed inside broader colonial histories and global power structures, and those structures still shape what is rewarded as “good science” or “good theory.”

The pyramid: how global nursing knowledge gets organized

To explain today’s problem, the paper uses “pyramidal epistemology” (from sociologist Raewyn Connell). Picture a pyramid:

• At the top: a small set of institutions, journals, and theorists (mostly Western/Global North) that define key concepts, “grand theories,” and what counts as legitimate knowledge.
• At the base: scholars and practitioners in the Global South and marginalized communities who are often pressured to adopt the top’s frameworks to be publishable or “credible.”

In this pyramid, nursing scholars outside the “center” may be encouraged to contribute knowledge only if it fits pre-approved categories—and that can flatten local meanings, languages, and realities.

A key example: the nursing metaparadigm

The essay uses the well-known nursing metaparadigm (person–environment–health–nursing) as a major example of how universal frameworks can unintentionally reproduce hierarchy. The metaparadigm has helped nursing present itself as a coherent discipline, but the author argues that it was shaped largely by Western assumptions and can be too broad—or too culturally specific—to capture what matters in many communities.

For instance, the idea of “person” can lean toward individualism, while many cultures understand personhood as relational (e.g., the Filipino concept of kapwa, or shared selfhood). The author also notes how meaning changes across languages—for example, Spanish cuidado carries nuances that do not map neatly onto English “care.”

The alternative: pluriversality

Instead of treating one knowledge system as universal, the paper proposes pluriversality: the idea that we live on one planet with many valid sciences/ways of knowing. Pluriversality is not “anything goes.” It is a structured stance that:

• recognizes multiple knowledge traditions,
• asks how power shapes what gets called “truth,” and
• builds relationships across knowledge systems without forcing them into a single mold.

The author summarizes pluriversality into two linked “missions”:

1. Decenter and dismantle
   Expose and resist the hidden rules that keep the pyramid standing (e.g., gatekeeping, publication bias, “universal” concepts that erase context, and default reliance on Western frameworks as the starting point).
2. Relink and revitalize
   Bring marginalized nursing knowledge traditions into the center of disciplinary conversation—not as “add-ons,” but as sources of theory-making. This includes building epistemic solidarity: different communities learning from each other toward shared goals like justice and liberation.

The proposal: the Pluriverse of Nursologies (PoN)

PoN reframes nursing as not one unified “universe” of knowledge, but a pluriverse made up of multiple nursologies—distinct systems of nursing knowledge rooted in different histories, languages, and communities.

A key move here is redefining “nursology” not as a single new name for nursing, but as a knowledge system about nursing phenomena, where there can be many “nursologies.” Importantly, the “actor” of nursing may be named differently across contexts (and those names carry epistemological meaning). The essay offers examples of nursologies that could enrich the discipline, such as:

• Latin American concepts grounded in cuidado,
• indigenous frameworks like Two-Eyed Seeing,
• emancipatory traditions like Black feminist nursing praxis,
• and locally rooted projects such as Narsolohiyang Pilipino.

Instead of a strict hierarchy of metaparadigm → grand theory → middle-range theory → practice, PoN imagines nursing knowledge as an ecology of knowledges: a more democratic landscape where multiple traditions coexist, interact, and co-create.

Caveats

The paper warns against turning this into a simplistic “West bad / local good” binary. PoN does not demand abandoning Western theories; it argues they should be treated as one nursology among many, used in counter-hegemonic (non-dominating) ways.

The author also flags real barriers: language dominance, profit-driven research agendas, publication gatekeeping, institutional inertia, and unequal access to higher education that limits who gets to participate in theory-making spaces.

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Policy/practice recommendations (actionable takeaways)

These are practical steps aligned with PoN’s goals—useful for educators, journal editors, research leaders, and policy stakeholders:

1. For nursing schools and curriculum leaders

• Teach “core theory” as contested and situated, not universal.
• Require at least one assignment where students theorize from local concepts/language (e.g., kapwa, cuidado, indigenous frameworks), not only “apply” Western models.

2. For journals, editors, and reviewers

• Reduce gatekeeping by valuing non-Western conceptual work and non-English sources where appropriate.
• Encourage (or require) authors to include a positionality statement when making universal claims.

3. For research funders and institutions

• Fund projects that develop context-rooted theory, not only projects that replicate existing frameworks.
• Support translation, multilingual dissemination, and community co-authorship models.

4. For nursing researchers and professional organizations

• Build South–South and indigenous-led research networks (not only North–South partnerships).
• Treat collaboration as knowledge co-creation, not data extraction.

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Glossary of key terms

• Decoloniality — An approach that examines how colonial power continues after formal colonial rule, especially in knowledge, institutions, and culture—and works to undo those harms.
• Coloniality — The ongoing patterns of domination (economic, political, cultural, epistemic) that persist even when colonies are “independent.”
• Epistemic violence — Harm done when dominant knowledge systems silence, degrade, or replace the ways of knowing of marginalized peoples.
• Pyramidal epistemology — A global knowledge structure where “theory” is produced by a small elite center and then exported to the margins, which are expected to follow.
• Western Modern Science (WMS) — A tradition of knowledge-making often treated as universal and objective, but shaped by particular histories and power relations.
• Global North / Global South — Broad terms describing unequal global power relations (not simply geography): wealthier, dominant centers vs. historically colonized/peripheral contexts.
• Nursing metaparadigm — A widely taught framework describing nursing’s core concepts: person, environment, health, and nursing.
• Nursology / nursologies — Here: a system of nursing knowledge. The paper argues there can be many nursologies, rooted in different cultures and histories.
• Pluriversality — The idea that there are many legitimate ways of knowing; knowledge should not be forced into one “universal” framework.
• Delinking — Intentionally refusing to treat dominant Western frameworks as the default starting point for understanding a phenomenon.
• Border thinking — Knowledge-making that happens at the “edges” of dominant systems, drawing from multiple traditions without submitting to one.
• Ecology of knowledges — A vision of knowledge as a diverse, interacting ecosystem rather than a strict hierarchy.
• Epistemic solidarity — Building respectful, justice-oriented relationships across knowledge traditions to learn and theorize together.
• Relational onto-epistemology — A view that “what exists” (ontology) and “how we know” (epistemology) are shaped through relationships, not isolated objects.
• Holarchy / holon — A hierarchical way of organizing knowledge (e.g., metaparadigm above theories). The paper contrasts this with an “ecology” model.
• Kapwa — A Filipino concept of shared selfhood (“self-in-the-other”), highlighting relational personhood.
• Cuidado — A Spanish term related to care/caring, with cultural and ethical nuances that may not map neatly onto English “care.”
• Two-Eyed Seeing — An indigenous-informed approach that values learning from both indigenous and Western knowledge systems without collapsing one into the other.
• Praxis-oriented — Not just theory: a commitment to action and transformation based on emancipatory values.