Metaparadigm and watson

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Metaparadigm and watson

Dust-free hospital rooms decrease the incidence of asthmatic attacks

Clinical case: A nurse observes that cleaning the hospital room and constant changing of the bedsheets of an asthmatic patient significantly reduced the incidence of asthmatic attacks.

Asthma is a chronic obstructive lung disease presenting with symptoms of wheezing, chest tightness, and shortness of breath following exposure to allergens. It is more prevalent among atopic individuals and develops due to genetic susceptibility and environmental exposure to trigger allergens. The inflammation and airway remodeling are associated with mast cell activation. Environmental exposure to allergens such as dust mites, pollen, smoke, and dust may trigger asthmatic attacks among asthmatic individuals.

However, a clean environment free of the triggering allergens reduces the incidences of asthmatic attacks. Following the pathophysiology of asthma, an allergen is the trigger of the attack. As such, it is reducing the levels of the environmental trigger allergens significantly decreases the incidence of asthmatic attacks. According to Pruitikanee et al., 2021, there was a significant decrease in the incidence of attacks among patients after maintaining low levels of dust in rooms. The study employed intelligence monitoring to monitor dust levels in the participants’ rooms leading to low levels of allergens that translated to a lower risk of an asthmatic attack.

Additionally, Gautier & Charpin (2017) demonstrated that constant exposures to environmental allergens present indoors and outdoors were linked to a higher incidence and more severe asthmatic attacks. Furthermore, avoidance through personal protection such as wearing masks and occupational hygiene was linked to lower incidences of asthmatic attacks. Prevention outside the hospital was like high hygiene levels at home with regular cleaning to eliminate the allergens.

The proposition is that creating a dust-free environment for asthmatic patients through observing general hygiene will decrease the incidence of asthmatic attacks among such patients.


Gautier, C., & Charpin, D. (2017). Environmental triggers and avoidance in the management of asthma. Journal of asthma and allergy10, 47–56.

Pruitikanee, S., Kongcharoen, J., Puttinaovarat, S., Thongkaew, A., & Kongdee, N. (2021). Intelligent Dust Monitoring Application in Patient Room. International Journal of Online & Biomedical Engineering17(10).



Week 6-Metaparadigm of Nursing

The central tenet of the nursing theory developed in the second and fifth weeks of this course is modifying the environment to optimize outcomes for asthma patients. The theory states that a hygienic physical environment (Concept A) reduces (proposition) asthmatic trigger pollutants from the air (Concept B) and asthmatic exacerbations (Concept C). Like other nursing theories, this theory also has the four major nursing metaparadigms. According to Nikfarid et al.  (2018), metaparadigms are concepts that comprise the central issue of a discipline and provide a structure of how the discipline should function. The four metaparadigms in nursing are person, environment, health, and nursing.

The four metaparadigms have a basic definition applicable to all nursing theories. According to McEwen and Wills (2019), a person refers to the recipients of care, often patients and their families. It also encompasses spirituality, culture, family, friends, and socioeconomic status. The environment includes all factors that influence health. The factors may be intrinsic or extrinsic. The health metaparadigm refers to the perceived and objective wellbeing of a patient. The last metaparadigm is nursing, and it entails professional activities undertaken by nurses to care for a patient. Nursing care may focus on a person’s physical, mental and social wellbeing.

The four metaparadigms are represented in the developed theory. Person refers to the asthmatic patients who receive care services. Environment refers to the physical setting of the patient, including the hospital ward bedding and the quality of air within the patient’s hospital room. Health is the optimal control of asthma devoid of exacerbations or attacks. The nursing metaparadigm entails all actions to promote a hygienic environment and minimize the patient’s exposure to environmental triggers of asthma.


McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing. Philadelphia Baltimore; New York: Wolters Kluwer.

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 medicine11, (6). PMID: 30258556; PMCID: PMC6150916.