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Nursing Metaparadigm and Theories – Theoretical Frameworks of Advanced Nursing Practice

Introduction and Thesis

Climate change is a pressing global issue with far-reaching consequences, including significant impacts on human health. As a result, nursing leaders are faced with the challenge of addressing climate-change-induced health effects on the US population. This paper aims to explore the theoretical frameworks that underpin advanced nursing practice in relation to this phenomenon of interest (POI). The nursing metaparadigm, which encompasses the four fundamental concepts of nursing – person, environment, health, and nursing – provides a solid foundation for understanding and addressing climate-related health issues. Additionally, grand nursing theories, middle-range theories, and complexity theory offer valuable insights and guiding principles for nursing leaders seeking to mitigate the adverse health effects of climate change. By examining these theoretical frameworks, this paper seeks to equip nursing leaders with a comprehensive understanding of the conceptual underpinnings that can inform their strategies and interventions in addressing climate-change-induced health effects on the US population. This paper explores the nursing metaparadigm, grand nursing theories, middle-range theories, and complexity theory as theoretical frameworks that can guide advanced nursing practice in addressing climate-change-induced health effects on the US population.

Nursing Metaparadigm: Relationship to POI

The nursing metaparadigm, introduced by Fawcett in the 1970s, serves as the foundational conceptual framework for the nursing profession, encompassing the four essential concepts: person, environment, health, and nursing (Thorne, 2020).

The concept of “person” in the nursing metaparadigm refers to the recipient of nursing care, which in the context of climate-change-induced health effects includes individuals, families, communities, and populations affected by the consequences of climate change (Borge & Miller, 2020). This concept highlights the need for nursing leaders to consider the diverse needs and vulnerabilities of different populations when addressing climate-related health issues.

The concept of the “environment” component of the metaparadigm encompasses the physical, social, cultural, and ecological factors that influence health and well-being (Thorne, 2020). Climate change is a prime example of an environmental factor that profoundly impacts human health, making it a crucial consideration for nursing leaders in developing strategies to mitigate its effects (Shukla et al., 2021).

The concept of “health” in the metaparadigm encompasses physical, mental, and social well-being, not merely the absence of disease (Thorne, 2020). Climate change poses a multifaceted threat to health, including increased risk of infectious diseases, respiratory illnesses, and mental health issues, among others (Watts et al., 2021). Nursing leaders must adopt a holistic approach to address the diverse health implications of climate change.

The four components of the nursing metaparadigm are intrinsically interrelated and collectively provide a comprehensive framework for addressing climate-change-induced health effects on the US population. By considering the interplay between the person, environment, health, and nursing, nursing leaders can develop holistic, evidence-based strategies to mitigate the impacts of climate change on human health (Borge & Miller, 2020).

Nursing Theory

Grand Nursing Theory

The Theory of Human Caring, developed by Jean Watson, is a grand nursing theory that emphasizes the importance of a caring relationship between the nurse and the person being cared for (Watson, 2018). The theory’s conceptual framework is centered around the concept of “caring,” which encompasses the spiritual, philosophical, and relational dimensions of nursing practice.

Within the framework of Watson’s Theory of Human Caring, addressing climate-change-induced health effects on the US population requires a deep understanding of the lived experiences and unique vulnerabilities of individuals, communities, and populations affected by climate change (Portela Dos Santos et al., 2023). Nursing leaders must cultivate a caring environment that promotes empathy, compassion, and respect for the diverse needs of those impacted by climate-related health issues.

The theory emphasizes the importance of promoting health and well-being through a holistic approach that considers the mind, body, and spirit (Watson, 2018). In the context of climate-change-induced health effects, this holistic perspective is crucial, as the impacts of climate change extend beyond physical ailments and encompass mental and emotional well-being, as well as social and ecological factors (Watts et al., 2021).

Furthermore, Watson’s Theory of Human Caring underscores the significance of creating a healing environment that supports the therapeutic nurse-patient relationship (Watson, 2018). Nursing leaders addressing climate-related health issues must strive to create environments conducive to healing, which may involve fostering collaborative partnerships with interdisciplinary teams, community organizations, and policymakers to develop comprehensive and sustainable solutions (Shukla et al., 2021).

The Theory of Human Caring provides a comprehensive framework for nursing leaders to address climate-change-inducedclimate-change-induced health effects by emphasizing the importance of caring relationships, holistic care, and the creation of healing environments (Sturmberg, 2021). By integrating the principles of this grand nursing theory, nursing leaders can develop patient-centered, compassionate, and culturally responsive strategies to mitigate the adverse health impacts of climate change on the US population.

Middle Range Theory

The Theory of Transitions, developed by Afaf Meleis, is a middle-range theory that focuses on the process of transition and its implications for nursing practice (Meleis, 2010). The theory defines transition as “a passage from one life phase, condition, or status to another” (Meleis et al., 2000, p. 17), and it provides a framework for understanding the complex nature of transitions and the factors that influence them.

In the context of climate-change-induced health effects, the Theory of Transitions is highly relevant as individuals, communities, and populations may experience various transitions related to environmental changes, displacement, and health challenges (Papadopoulos et al., 2021). Nursing leaders must understand the multidimensional nature of these transitions and develop interventions that facilitate healthy adaptation and coping mechanisms.

The Theory of Transitions identifies four key concepts: the nature of transitions, transition conditions, patterns of response, and nursing therapeutics (Meleis, 2010). By examining the nature of climate-related transitions, such as forced migration or chronic illness, nursing leaders can gain insights into the specific challenges and needs of affected populations (Portela Dos Santos et al., 2023). Additionally, understanding the transition conditions, including personal, community, and societal factors, can inform the development of tailored interventions that address the unique circumstances of each population (Papadopoulos et al., 2021).

The Theory of Transitions aligns with Watson’s Theory of Human Caring by recognizing the importance of caring relationships and holistic care during times of transition (Meleis, 2010; Watson, 2018). Both theories emphasize the need for nurses to understand and respect the unique experiences and perspectives of individuals and communities and to develop interventions that promote healing, well-being, and personal growth.

Complexity Theory

Complexity science is a transdisciplinary field that aims to understand the behavior of complex systems, which are characterized by nonlinearity, emergence, and self-organization (Rouse, 2008). Complex adaptive systems (CAS) are a type of complex system that exhibit adaptive behavior, meaning they can learn and evolve in response to changes in their environment (Conrad, 2023).

In the context of climate-change-induced health effects, complexity science, and CAS provide a valuable framework for understanding the intricate interplay between environmental, social, economic, and political factors that contribute to and exacerbate the health impacts of climate change (Sturmberg, 2021). By adopting a complexity lens, nursing leaders can gain insights into the dynamic and interconnected nature of these factors and develop more effective strategies to address the complex challenges posed by climate change.

One specific CAS that is highly relevant to the POI is the healthcare system itself, which is a complex adaptive system composed of various interconnected components, including healthcare facilities, healthcare professionals, patients, and regulatory bodies (Rouse, 2008). The principles of complexity science, such as nonlinearity, emergence, and self-organization, are evident in the healthcare system’s response to climate-change-induced health effects (Radley et al., 2021). Nursing leaders must recognize and leverage these principles to create adaptive and resilient healthcare systems capable of addressing the evolving health needs of populations affected by climate change.

Furthermore, the principles of complexity science can also be applied to understanding the complex dynamics of climate-change-induced environmental and social systems, such as urban environments, ecosystems, and communities (Conrad, 2023). By identifying and analyzing the interconnections and feedback loops within these systems, nursing leaders can develop interventions that address the root causes of climate-related health issues and promote sustainable solutions that account for the intricate relationships between environmental, social, and health factors (Radley et al., 2021).

Conclusion

In conclusion, this paper has explored the theoretical frameworks that underpin advanced nursing practice in addressing climate-change-induced health effects on the US population. The nursing metaparadigm, with its four fundamental concepts of person, environment, health, and nursing, provides a comprehensive foundation for understanding the multifaceted nature of climate-related health issues. Grand nursing theories, such as Watson’s Theory of Human Caring, offer guiding principles for cultivating caring relationships, promoting holistic care, and creating healing environments. Middle-range theories, like Meleis’ Theory of Transitions, shed light on the complex transitions experienced by individuals and communities affected by climate change and inform the development of nursing interventions that facilitate healthy adaptation. Additionally, complexity theory and the concept of complex adaptive systems provide a lens through which nursing leaders can understand and address the intricate interplay of environmental, social, economic, and political factors contributing to climate-change-induced health effects.

References

Portela Dos Santos, O., Melly, P., Joost, S., & Verloo, H. (2023). Climate Change, Environmental Health, and Challenges for Nursing Discipline. International Journal of Environmental Research and Public Health20(9), 5682. https://www.mdpi.com/1660-4601/20/9/5682

Meleis, A. I. (2010). Transitions theory: Middle range and situation specific theories in nursing research and practice. Springer Publishing Company. https://books.google.com/books?hl=en&lr=&id=TdLhXm5fpx8C&oi=fnd&pg=PR7&dq=Meleis,+A.+I.+(2010).+Transitions+theory:+Middle-range+and+situation-specific+theories+in+nursing+research+and+practice.+Springer+Publishing+Company.&ots=7lIqAQSKFZ&sig=JZ3_yU31hFmnAsi_XvbLQwvpdus

Meleis, A. I., Sawyer, L. M., Im, E. O., Messias, D. K. H., & Schumacher, K. (2000). Experiencing transitions: an emerging middle-range theory. Advances in nursing science23(1), 12–28.

https://journals.lww.com/advancesinnursingscience/Fulltext/2000/09000/ExperiencingTransitionsAnEmergingMiddleRange.6.aspx

Mazhin, S. A., Khankeh, H., Farrokhi, M., Aminizadeh, M., & Poursadeqiyan, M. (2020). Migration health crisis associated with climate change: A systematic review. Journal of education and health promotion9.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271932/ Radley, D. C., Gottfried, J., Higgins, P., & Conrad, K. (2023). The Era of Climate Change Medicine—Challenges to Health Care Systems. The Ochsner Journal23(1), 7. https://www.ochsnerjournal.org/content/ochjnl/23/1/7.full-text.pdf

Rouse, W. B. (2008). Health care as a complex adaptive system: implications for design and management. Bridge-Washington-National Academy of Engineering-38(1), 17. https://search.iczhiku.com/paper/KZ6FfM1bdjPoyP6a.pdf

Sturmberg, J. P. (2021). Systems design for health system reform. Handbook of Systems Sciences, 735-764. https://link.springer.com/content/pdf/10.1007/978-981-15-0720-5_56.pdf

Watson, J. (20i8). Nursing: The philosophy and science of caring. Nursing Administration Quarterly3(4), 86–87. https://journals.lww.com/naqjournal/citation/1979/00340/nursing__the_philosophy_and_science_of_caring.10.aspx

 

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