1169770
research-article2023
NSQXXX10.1177/08943184231169770Nursing Science QuarterlyFawcett
Essays on Nursing Science
Thoughts About the Metaparadigm
of Nursing: Contemporary Status
and Recommendations for Evolution
Jacqueline Fawcett, RN; PhD; FAAN1
Abstract
In this essay, I present my original and most recent versions of nursing’s disciplinary metaparadigm, along with others’
versions of the metaparadigm. I conclude the essay by joining others in issuing a call for decolonization of nursing knowledge,
with an emphasis in this essay on decolonizing nursing’s metaparadigm by asking if a metaparadigm is needed and, if so, what
its content should be.
Keywords
decolonization, history, metaparadigm, nursing
I frequently receive reports from ResearchGate about cita-
tions to articles I have published. Recently, several authors
have cited my 1984 article, “The Metaparadigm of Nursing:
Present Status and Future Refinement.” With apologies for
immodesty, I wondered how many citations there have been
to that article since its publication. Much to my surprise, a
November 8, 2022, search of Web of Science (https://www.
webofscience.com/wos/medline/full-record/
MEDLINE:6565629) yielded a total of 151 citations, includ-
ing 140 in the Web of Science Core Collection, 1 in the
BIOSIS Citation Index, 1 in the Chinese Science Citation
Database℠, and 9 in the SciELO Citation Index. Two of the
151 were self-citations, that is, my own citations to my 1984
article in two of my other articles.
Of concern to me is that so many authors are citing my
original publication (Fawcett, 1984) about the metapara-
digm—which is the component of knowledge that articulates
the boundaries of a discipline, so to distinguish one disci-
pline from another—rather than the versions that have
evolved from that time. I suspect that is due to subsequent
versions being published in my books rather than in journal
articles (Fawcett, 1989, 1995, 2000, 2005; Fawcett &
DeSanto-Madeya, 2013), as it is more difficult to retrieve
citations to the contents of books than citations to journal
articles when searching electronic databases.
My Initial and Current Versions of
Nursing’s Metaparadigm
I initially identified the metaparadigm of nursing as com-
prising four concepts and three statements, each of which
linked two concepts. Most recently, I have revised the four
Nursing Science Quarterly
2023, Vol. 36(3) 303­–305
© The Author(s) 2023
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/08943184231169770
https://doi.org/10.1177/08943184231169770
journals.sagepub.com/home/nsq
metaparadigm concepts to reflect contemporary interests in
our discipline and linked the four concepts in one statement,
which links all four concepts.
Both versions of the metaparadigm are shown in the table.
It is important to note that the concepts of the metaparadigm
are concepts per se not, as some authors have indicated when
citing my version, metaparadigms themselves. That is, there
is one metaparadigm that has four concepts, rather than four
metaparadigms.
Other Versions of Nursing’s
Metaparadigm
In between my initial and current versions of the metapara-
digm, several other versions have been offered by other
scholars. The concepts and statements that have been men-
tioned in the literature about nursing’s metaparadigm are
listed in the box.
Decolonizing Nursing’s Metaparadigm
My thoughts about nursing’s metaparadigm and those of the
authors of other versions of nursing’s metaparadigm have
always been from a Eurocentric White privilege perspective.
As interest by nurses and members of other disciplines has
begun to acknowledge the limitations of this perspective,
calls for decolonization of knowledge have been issued (see
Chinn, 2002).
1
Professor, Department of Nursing, University of Massachusetts Boston,
Boston, MA, USA
304 Nursing Science Quarterly 36(3)

Table. Fawcett’s Version of the Metaparadigm of Nursing: Concepts and Linking Statements: From 1984 to 2022.
Metaparadigm Concepts Linking Statement(s)

Fawcett (1984) Fawcett (1984, p. 85)

Person 1. The principles and laws that govern the life process, well-being, and optimum function of human beings [links person and health]
Environment 2. The patterning of human behavior in interaction with the environment in normal life events and critical life situations [links person
Health and environment]
Nursing 3. The processes by which positive changes in health status are affected [links health and nursing]
Fawcett (2022) Fawcett (2022)
Human Beings Nursologists’ activities are directed toward human beings and planetary health within the context of the global environment [links human
Global Environment beings, environment, health, and nursologists’ activities]
Planetary Health
Nursologists’ Activities

Box. Other Versions of Nursing’s Metaparadigm Concepts and Statements.

Concepts
Man
Client
Client Domain
Human Wholeness
Human Dignity
Society
Environment Domain
Environmental Cultural Context
Humanhealthenvironment Relationship
Health/Healing/Well-Being
Interaction
Quality Of Life
Practice Domain
Client-Nurse Domain
Nursing Processes
Nursing Process
Nursing Therapeutics
Caring
Human Care
Human Care/Caring
Role
Social Systems
Transitions
Social Justice
Time
Statements
The nurse interacts with the client and the environment for the purpose of facilitating the health of the client (Newman, 1983).
“[H]uman care/caring [is] the central phenomenon and essence of nursing” (Leininger, 1990, p. 19).
“Care is the essence of nursing and the central, dominant, and unifying focus of nursing” (Leininger, 1991, p. 35).
“[H]uman care, health, and environmental cultural context must become the central focus, essence, and dominant domains of nursing knowledge” (Leininger, 1995, p. 97).
“[H]uman care and caring [are] the central, distinct, and dominant foci to explain, interpret, and predict nursing as a discipline and profession” (Leininger, 2002, p. 47).
“Nursing is the study of caring in the human health experience” (Newman, Sime, & Corcoran-Perry, 1991, p. 3).
“The theme of caring is sufficiently dominant, when combined with the theme of the human health experience, to be considered as the focus of the discipline” (Newman,
Sime, & Corcoran-Perry, 1992, p. vii).
“Nursing is the study and practice of caring within contexts of the human health experience” (Malloch et al., 1992, p. vi).
“I believe that caring and healing are core processes of nursing” and that caring is “being with others” (Lewis, 2003, p. 37).
The focus of the discipline is “facilitating humanization, meaning, choice, quality of life, and healing in living and dying” (Willis, Grace, & Roy, 2008, pp. E32-E33).
“The core focus of nursing, the metaparadigm, is the human-universe-health process” (Parse 1997, p. 74).
“Nursing is the study of human health and illness processes. Nursing practice is facilitating, supporting and assisting individuals, families, communities, and/or societies
to enhance, maintain and recover health, and to reduce and ameliorate the effects of illness. Nursing’s relational practice and science are directed toward the explicit
outcome of health related quality of life within the immediate and larger environmental contexts” (Thorne et al., 1998, p. 1265).
“The central phenomenon [of nursing] is the respect for or the restoration of human dignity, our being in community, our sea, our moral imperative” (Jacobs, 2001, p. 33).

I now join those calls and ask readers of this essay who
are of diverse cultures and those who reside in various non-
Eurocentric countries to contribute their perspectives of our
disciplinary metaparadigm—whether there is a need for a
metaparadigm of nursing and, if so, what is its content. Such
initiatives should result in decolonization of nursing’s
metaparadigm, which means that all of us will be able to
acknowledge and honor “the terms of the people, the frames
of reference, and knowledge patterns that come from other
countries and cultures” on which to base research, education,
and practice (Chinn, 2022, p. e1241).
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Fawcett
Funding
The author received no financial support for the research, author-
ship, and/or publication of this article.
ORCID iD
Jacqueline Fawcett https://orcid.org/0000-0002-1091-8873
References
Chinn, P. L. (2022). Decolonizing nursing knowledge. Nursing
Philosophy, 23(4), e1241. https://doi.org/10.1111/nup.12410
Fawcett, J. (1984). The metaparadigm of nursing: Present status and
future refinements. Image: The Journal of Nursing Scholarship,
16(3), 84-87. https://doi.org/10.1111/J.1547-5069.1984.TB013
93.X
Fawcett, J. (1989). Analysis and evaluation of conceptual models of
nursing (2nd ed.) F. A. Davis.
Fawcett, J. (1995). Analysis and evaluation of conceptual models of
nursing (3rd ed.). F. A. Davis.
Fawcett, J. (2000). Analysis and evaluation of contemporary nurs-
ing knowledge: Nursing models and theories. F. A. Davis.
Fawcett, J. (2005). Contemporary nursing knowledge: Analysis
and evaluation of nursing modes and theories (2nd ed.). F. A.
Davis.
Fawcett, J. (2022). Evolution of one version of the metaparadigm of
nursology with an invitation to decolonize this version. https://
nursology.net/2023/01/17/evolution-of-one-version-of-our-
disciplinary-metaparadigm/
Fawcett, J., & DeSanto-Madeya, S. (2013). Contemporary nurs-
ing knowledge: Analysis and evaluation of nursing models and
theories (3rd ed.). F. A. Davis.
Jacobs, B. B. (2001). Respect for human dignity: A central phenome-
non to philosophically unite nursing theory and practice through
consilience of knowledge. Advances in Nursing Science, 24(1),
17-35. https://doi,org/10.1097/00012272-200109000-00005
Leininger, M. M. (1990). Historic and epistemologic dimensions
of care and caring with future directions. In J. S. Stevenson
& T. Tripp-Reimer (Eds.), Knowledge about care and caring:
305
State of the art and future developments (pp. 19-31). American
Academy of Nursing.
Leininger, M. M. (1991). The theory of culture care diversity and
universality. In M. M. Leininger (Ed.), Culture care diver-
sity and universality: A theory of nursing (pp. 5-65). National
League for Nursing Press.
Leininger, M. M. (1995). Transcultural nursing: Concepts, theo-
ries, research and practices. McGraw-Hill.
Leininger, M. (2002). Essential transcultural nursing care concepts,
principles, examples, and policy statements. In M. Leininger &
M. R. McFarland, Transcultural nursing: Concepts, theories,
research, and practice (3rd ed., pp. 45-69). McGraw-Hill.
Lewis, S. M. (2003). Caring as being in nursing: Unique or ubiq-
uitous. Nursing Science Quarterly, 16(1), 37-43. https://doi.
org/10.1177/0894318402239065
Malloch, K., Martinez, R., Nelson, L., Predeger, B., Speakman,
L., Steinbinder, A., & Tracy, J. (1992). To the editor [Letter].
Advances in Nursing Science, 15(2), vi– vii.
Newman, M. A. (1983). The continuing revolution: A history of
nursing science. In N. L. Chaska (Ed.), The nursing profession:
A time to speak (pp. 385-393). McGraw-Hill.
Newman, M. A., Sime, A. M., & Corcoran-Perry, S. A. (1991). The
focus of the discipline of nursing. Advances in Nursing Science,
14(1), 1-6. https://doi.org/10.1097/00012272-199109000-00002
Newman, M. A., Sime, A. M., & Corcoran-Perry, S. A. (1992).
Authors' reply [Letter to the editor]. Advances in Nursing
Science, 14(3), vi-vii.
Parse, R. R. (1997). The language of nursing knowledge: Saying
what we mean. In I. M. King & J. Fawcett (Eds.), The language
of nursing theory and metatheory (pp. 73-77). Sigma.
Thorne, S., Canam, C., Dahinten, S., Hall, W., Henderson, A.,
& Kirkham, S. (1998). Nursing’s metaparadigm concepts:
Disimpacting the debates. Journal of Advanced Nursing, 27(6),
1257-1268. https://doi.org/10.1046/j.1365-2648.1998.00623.x
Willis, D. G., Grace, P. J., & Roy, C. (2008). A central unifying
focus for the discipline. Facilitating humanization, mean-
ing, choice, quality of life, and healing in living and dying.
Advances in Nursing Science, 31(1), E28-E40. https://doi.
org/10.1097/01.ANS.0000311534.04059.d9