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Unitary-transformative theoretical approaches impact nursing theories and the four concepts of nursing metaparadigm by providing extensive analysis and proposing the need to have alternative nursing principles that provoke changes to provide action-oriented quality care.  The approaches impact the theories by emphasizing the need to present action-oriented knowledge to meet current healthcare demands.  Cowling III (1999) notes that there is sufficient evidence of various actions within practice strategies based on unitary transformative theories that improve nursing and healthcare today.  This means the approaches affect grand theories to inform best practices that enhance a person’s patterned view with self-organized energy. Despite having theoretical tenets of unpredictability and acausality, unitary transformative approaches can be useful in theoretical accounts because they emphasize shifting attention from predictive capacity to generative capacity. When theories are considered for generating new alternatives, implying shifting the notion of basing grand theories on observed facts to one that provokes possibilities of new actions, there can be an improvement of action-oriented quality care.

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