title: Complex critical realism: tenets and application in nursing research.
abstract: OBJECTIVE
  To outline the main tenets of critical realism (CR), its use, and future application in nursing.
  
  
  BACKGROUND
  Little work has been done to discuss how CR can be applied to nursing research.
  
  
  RESULTS
  The tenets of CR include recognition of reality independent of human perceptions, a generative view of causation in open systems, and a focus on explanations and methodological eclecticism using a postdisciplinary approach. Critical realism is useful for (1) understanding complex outcomes, (2) optimizing interventions, and (3) researching biopsychosocial pathways. Such questions are central to evidence-based practice, chronic disease management, and population health.
  
  
  CONCLUSIONS
  Critical realism is philosophically strong and potentially useful for nursing research.
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Alex.clark@ualberta.ca
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Clark
authors.forename: Sue L
authors.initials: SL
authors.lastname: Lissel
authors.forename: Caroline
authors.initials: C
authors.lastname: Davis
mesh_terms: D015982:Bias; D034462:Dissent and Disputes; D028781:Ethical Relativism; D055318:Evidence-Based Nursing / Q000458:organization & administration*; D005086:Existentialism / Q000523:psychology; D006801:Humans; D033183:Interdisciplinary Communication; D019359:Knowledge; D017711:Nonlinear Dynamics; D015399:Nursing Research / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010687:Philosophy, Nursing; D033302:Postmodernism; D012107:Research Design; D012586:Science / Q000458:organization & administration*; D013597:Systems Analysis; D017749:Total Quality Management