Nursing Metaparadigm

Nursing Metaparadigm

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How does the nursing metaparadigm impact the implementation of culturally proficient nursing care?

The nursing metaparadigm impact the delivery of nursing care. This includes the implementation of culturally proficient nursing care. The nursing metaparadigm refers to a set of theories providing structure in how the discipline should function. They consist of four basic concepts.  The first concept is the person. This focuses on the receiver of nursing care. The second concept is the environment (Nikfarid et al., 2018). This focuses on the surroundings that affect the receiver of care. The third concept is health. This is the access to health care and the extent of wellness that a patient has. The fourth concept is nursing. It involves the delivery of optimal health care in a safe and caring environment for a patient. These four concepts act as defining elements of boundaries of the nursing discipline (Nikfarid et al., 2018). They set nursing apart from other disciplines. However, nursing metaparadigm omit care and culture concepts hindering the implementation of culturally proficient nursing care.

The nursing metaparadigm is supposed to improve the delivery of care. However, they hinder the implementation of culturally proficient nursing care. According to Leininger, the four concepts of nursing metaparadigm fail to support the implementation of culturally competent nursing care (Leininger, 2006a). Leininger found the four concepts inappropriate, questionable, and inadequate to support transcultural nursing. For example, Leininger questioned the use of the word ‘person’, one of the four basic concepts of nursing metaparadigm. In western cultures, the term ‘person’ is a dominating concept. In non-western cultures, using such terms is almost a taboo. This is considering that the term does not agree with their collectivist culture. Leininger finds the use of this term as questionable as it would lead to cultural clashes.

According to Leininger, the concept of environment in complex and should be viewed from a holistic perspective. Then, she defines health as a state of wellbeing that is constituted and defined culturally. Leininger also disagrees with the use of the term nursing to explain the nursing metaparadigm.  She sheds light on the weakness of the nursing metaparadigm which hinders the implementation of culturally appropriate care. Leininger argues that the absence of two concepts, culture and care in the nursing metaparadigm limits the adequacy of the metaparadigm (Leininger, 2006a). In the theory of Culture Care, Leininger focuses on these missing concepts to provide culturally competent nursing care. Such care would occur when there is a satisfactory and meaningful match between the behavior of nurses and the cultural beliefs and values of the patients.

Nurses can’t deliver culturally competent care without knowledge in cultural competency models. Nurses need to develop an in-depth understanding of the relationship between health and a patient’s ethnicity. This way, they can be in a position to provide culturally competent care. By understanding and describing the belief systems from different cultures, nurses can predict a patient’s health beliefs and anticipate the care needs of this patient even when they come from different cultural backgrounds (Leininger, 2006a).

The nursing metaparadigm includes four basic concepts including the person, health, environment, and nursing. While these concepts facilitate the delivery of nursing care, they hinder the implementation of culturally proficient nursing care. This is because they omit two important concepts, that is, care and culture, which would help patients focus on the relationship between health and a patient’s ethnicity. Including the two concepts would facilitate the implementation of culturally proficient nursing care.


Leininger, M, (2006a). Culture care diversity and universality theory and evolution of the           ethnonursing method. In M.M. Leininger & M. R. McFarland (Eds), Culture care          diversity and universality: A worldwide nursing theory, 1-41. Sudbury, MA: Jones          and Bartlett.

Nikfarid, L., Hekmat, N., Vedad, A. & Rajabi, A. (2018). The main nursing metaparadigm            concepts in human caring theory and Persian mysticism: a comparative study. Journal      of Medical Ethics and History of Medicine, 11(6).