Epistemic caring: The Leadership, Structure, and Culture Theory of Nursing Research Advancement

BACKGROUND: Nursing research is widely endorsed yet rarely embedded as a sustained institutional function. Organisational priorities privileging efficiency over reflection risk marginalising nursing's epistemic agency and weakening the moral foundations of knowledge production. PURPOSE: To present the Leadership-Structure-Culture (LSC) Theory of Nursing Research Advancement, a middle-range conceptual model that situates research as an ethical and institutional responsibility of nursing practice. METHODS: Using abductive reasoning informed by autoethnography and the Gioia methodology, the theory integrates moral philosophy and organisational science. Conceptual derivation yielded seven propositions and two analytical tools: the LSC Maturity Scale and the Empirical Indicator Matrix. DISCUSSION: LSC reframes healthcare organisations as epistemic ecosystems in which leadership, structural integrity, and culture interact to sustain inquiry as care-based knowledge work. CONCLUSION: The LSC Theory advances an institutional paradigm in which nursing research is recognised as a matter of epistemic justice, professional dignity, and moral responsibility.