The Metaparadigm of Nursing

A metaparadigm is an overarching framework that provides a comprehensive perspective of a discipline. In nursing, this framework serves to distinguish the profession intellectually, comprising of four concepts which provide a foundation to the content and context of nursing theory and scope of practice (Lee & Fawcett, 2013; Masters, 2014; Schim, Benkert, Bell, Walker, & Danford, 2007). Namely, these foundational concepts are: person, environment, health, and nursing. Hence, the intent of this essay is to describe the four main concepts that make up nursing’s metaparadigm and discuss how they are used in practice, education and research.

Person

The concept of person refers to the recipient of nursing care, such that no person is the object of care and no aspect of wellbeing is left out (Arnold & Boggs, 2001; Thorne, Canam, Dahinten, Hall, Henderson, & Kirkham, 1998). This not only includes disease and illness states, but also psychological, social and spiritual dimensions. Therefore, factors such as gender, lifestyle, behaviors, beliefs, values, coping skills, habits, perceptions and lived experiences are considered (Arnold & Boggs, 2011). This holistic and multi-centered approach also extends to families, communities, and populations (Schim et al., 2007). The concept of person is central to nursing theory and research, and is fundamental to the, “Code of Ethics for Registered Nurses,” as outlined by the Canadian Nurses Association (2008). In practice, ‘person’ is used to guide client teaching and nursing interventions (Kozier, Berman, Snyder, Buck, Yiu, & Stamler, 2014).

Environment

Environment refers to the internal and external context or setting of a person’s social experience (Arnold & Boggs, 2001; Kozier et al., 2014). This consists of physical, psychological, social, cultural, historical, political and economic dimensions; thus, person and environment are fundamentally intertwined (Arnold & Boggs, 2011; Schim et al., 2007; Thorne et al., 1998). The notion of environment is multilayered and constructed, therefore, constantly changing, distinctly serving to shape a person’s health (Thorne et al., 1998). The concept of environment is foundational to the, “Social Determinants of Health: The Canadian Facts,” and in practice, helps the nurse describe, explain, and predict health outcomes and their context (Kozier et al., 2014; Mikkonen &Raphael, 2010).

Health

The notion of health is contextual and an interactive, dynamic process between person and environment (Schim et al, 2007). Both wellness and illness are conceptualized by the ‘person’, existing on a continuum across the lifespan (Arnold & Boggs, 2001).