Avant's Concept Analysis Research Articles

Concept Analysis: The Occupational Experiences of Long-Term Care Nurses-Navigating Fragmented Transitions.

Transitions are broadly defined as movements from one place, stage, or subject to another. However, transitions which are broken and incomplete are referred to fragmented transitions. The aims of this concept analysis were to analyze the navigation of fragmented occupational transitions among long-term care nurses and to develop a working conceptual definition of fragmented occupational transitions to inform diverse stakeholders. Concept analysis. Google Scholar, PubMed, and the Cumulative Index of Nursing and Allied Health Literature databases were accessed. Identified sources were interprofessional scholarly literature published between January 1, 2018, and January 1, 2024, and seminal references. Walker and Avant's eight-stage concept analysis method. Occupational transitions in long-term care are fragmented leading to grievous challenges across multiple aspects of nurses' lives. An analysis of the literature using a Transitions Theory lens reveals that their thoughts, feelings and ethical decisions are influenced over time by these transitions. Cardinal attributes include: (1) Fragmentation, (2) Ill-timing, (3) Disruption, (4) Liminality, (5) Ambiguity, (6) Ambivalence and (7) Facilitators/Inhibitors. Antecedents stem from external sources and facility-led initiatives. Consequences encompass product and process outcomes. Product outcomes include physical and psychological conditions, and process outcomes encompass resilience, flexibility, connection, coping, creativity, and communication. This concept analysis advances the science for understanding nurses' occupational transitional experiences in long-term care. It will assist in risk assessment and instrument development ultimately improving the quality of long-term care. Fragmented occupational transitions in long-term care are multifaceted and complex phenomena that require distinct responses from government, healthcare leaders, and scholars to improve the plight of long-term care nurses and stakeholders. Dr. A. I. Meleis contributed to this article by sharing her vast insight into transitions.

Organizational Culture: A Concept Analysis.

Organizational culture is complex because different systems and patterns influence it. It is linked with the decreasing turnover rate of nurses, increasing job satisfaction and commitment, and improving performance. This concept was examined using Walker and Avant's concept analysis method. The five attributes of organizational culture are workplace environment, behaviors, values, beliefs, and attitudes. Antecedents are people, communication, teamwork, leadership, and relationships. The consequences are described as a positive and negative organizational culture. Nurse educators and administrators should examine their workplace culture to make it easy to introduce change to their environment.

The Therapeutic Use of Self: A Concept Analysis

Background: The therapeutic use of self is an essential concept in nursing, involving the intentional use of personal qualities, emotional intelligence, and interpersonal skills to promote healing and improve patient outcomes.Objective: This study aims to conduct a comprehensive concept analysis of the therapeutic use of self, identifying its defining attributes, antecedents, consequences, and empirical referents in nursing practice.Methods: Using Walker and Avant's eight-step concept analysis methodology, we systematically reviewed existing literature. Data were collected from databases such as PubMed, Google Scholar, and Sci-Hub. Key defining attributes, antecedents, consequences, and empirical referents were identified and analyzed. The data were synthesized to present both qualitative and quantitative insights. The analysis included five main attributes: interpersonal skills, use of self, emotional intelligence, empathy, and self-disclosure. Additionally, we reviewed empirical referents for measuring this concept’s practical efficacy.Results: The analysis revealed that integrating therapeutic use of self in nursing significantly enhances patient satisfaction by 40%, improves nurse-patient communication by 35%, and reduces nurse burnout by 25%. Moreover, the concept's impact on patient outcomes was positively correlated with the presence of empathy and emotional intelligence.Conclusion: The therapeutic use of self is a critical factor in improving patient-centered care and reducing nurse burnout. Incorporating it into nursing education and practice will likely yield better patient outcomes and healthcare delivery.

Assessing the maturity of the “Family Centered Care” concept: A review of concept analyses studies

BackgroundConcept analysis studies play major role in clarifying and operationalizing concepts. This approach has been used to clarify and advance knowledge about the concept of Family Centred Care (FCC). The concept of FCC has been studied by many nursing scholars using different methods. AimThis review aimed to combine outcomes of concept analysis studies to assess the level of maturity of the concept of Family Centred Care. MethodsFormal electronic databases (MEDLINE and CINAHL) and informal (Google Scholar) were searched using the terms “Family Centred Care” and “concept analysis”. The Morse concept maturity evaluation approach was used to appraise the retrieved studies. Results35studies were identified of which12 met the inclusion criteria and were included in the analysis. Three studies used Walker and Avant concept analysis methodology, three applied the Rodgers evolutionary model while six applied modified mixed/hybrid approaches. While a few provided a definition of FCC, none have been able to confirm the maturity of the concept. This review summarized the different trials to analyze the concept of FCC supporting the rethinking of the model and emergence of new models such as Child and Family Centred Care (CFCC). ImplicationsConcept analyses should be done periodically to assess the maturity of emerging concepts. Previously published FCC concept analyses manuscripts show the concept has evolved and gained significant recognition and acceptance over time. A clearer definition of FCC supports its positive impact on patient outcomes. A comprehensive FCC tool that can evaluate the effective delivery of FCC is needed.

Ecological care in nursing practice: a Walker and Avant concept analysis

BackgroundToday, the human population faces an increasing array of emerging environmental challenges. Despite its importance, nurses often neglect ecological issues, which can compromise patient health. While the ecological nursing perspective has the potential to lead to innovative care approaches that benefit patients, the nursing profession, and the environment, the concept of ecological care lacks a clear definition and its dimensions remain unclear. This study aimed to analyze and clarify the concept of ‘ecological care’ in the nursing discipline.MethodsWalker and Avant’s analysis method was used to identify descriptions, antecedents, consequences, and empirical referents of the concept of ‘ecological care’ in nursing. We searched the databases (PubMed, Scopus, PsycINFO, CINAHL, ERIC, SID, and IranDoc) using the keywords “ecological,” “nurse,” and “nursing” using Boolean operators “AND” and “OR” in the title and abstract fields both in English and Persian to identify relevant literature on ecological care in nursing.ResultsEcological care, as a multidimensional concept, encompasses ecological thinking, ecological attitude, ecological awareness, ecological sensitivity, and ecological literacy. This entails the optimal utilization of environmental factors to provide patients with high-quality care and preserve ecological sustainability through environmentally friendly behaviors.ConclusionsThe findings highlight the need to elucidate, endorse, and solidify ecological thinking in all aspects of nursing care including nursing management, education, and research, which can lead to improved care quality, patient safety, and sustainability. Within this framework, nursing educators could play an essential role in integrating ecological care into nursing education. The study emphasizes the need to integrate ecological thinking into all aspects of nursing.

Personal Resilience in Patients with Type 2 Diabetes Mellitus: A Concept Analysis

Introduction: The most common kind of diabetes is type 2 diabetes mellitus (T2DM), which accounts for 95% of all DM cases. Microvascular and macrovascular complications burden patients physically, psychologically, socially, and economically. Patients must be resilient to live more affluent lives. Personal resilience in T2DM patients is essential in nursing practice and the development of nursing science. Understanding the concept of personal resilience is important to minimize bias and distortion in using the concept of resilience, especially in T2DM patients. Objectives: This study aimed to clarify the concept of personal resilience in T2DM patients. Methods: Walker and Avant's concept analysis approach was applied. A literature search was performed using Google Scholar, ProQuest, ScienceDirect, and PubMed databases. The articles used from the databases were published between 2013 and 2022. Results: The attributes determining the level of personal resilience of T2DM patients are survival, adaptation, and recoverability. The antecedents include self-esteem, spirituality, culture, self-efficacy, optimism, hope, and age. The consequences include adherence, quality of life, effective coping, equilibrium, and illness perception. Conclusions: The three attributes, antecedents, and consequences of good personal resilience identified from the concept analysis could improve the researchers' understanding of personal resilience and its implementation in the care of T2DM patients along with the complexity of the problems experienced by patients. The clarity of this concept lies in the reference for treatment that focuses on empowering the personal abilities of T2DM patients to carry out self-management to achieve prosperous quality of life.

Sexuality education for school-aged children and adolescents: A concept analysis.

Sexuality education is essential for children and adolescents to make better choices regarding their sexual well-being. Parents, teachers, and healthcare providers are not always comfortable talking to school-age children about sex, making sexuality education a concept of interest to be explored. The purpose of this paper is to explain the concept of sexuality education in school-aged children and adolescents. This paper uses Walker and Avant's concept analysis to help clarify its meaning. The sexuality education concept is explored in this article in the views of educating school systems K-12 with three types of sexuality education (abstinence-only, abstinence-plus, and comprehensive sexuality education). Literature from 1990 to 2023 was retrieved using PubMed, Google Scholar, and CINAHL. A model case is used to demonstrate the importance of sexuality education. A borderline case and a related case are proposed to explain other uses of the concept. Defining attributes, antecedents, consequences, and empirical referents are explored. Antecedents of sexuality education are grouped into three categories: resources, political environment, and social beliefs. A conceptual understanding of sexuality education can foster nurses' confidence in talking to their patients about this topic and encourage nurses to advocate for comprehensive sexuality education nationwide.

Care biography: A concept analysis.

In this article, we investigate how the concept of Care Biography and related concepts are understood and operationalised and describe how it can be applied to advancing our understanding and practice of holistic and person-centred care. Walker and Avant's eight-step concept analysis method was conducted involving multiple database searches, with potential or actual applications of Care Biography identified based on multiple discussions among all authors. Our findings demonstrate Care Biography to be a novel overarching concept derived from the conjunction of multiple other concepts and applicable across multiple care settings. Concepts related to Care Biography exist but were more narrowly defined and mainly applied in intensive care, aged care, and palliative care settings. They are associated with the themes of Meaningfulness and Existential Coping, Empathy and Understanding, Promoting Positive Relationships, Social and Cultural Contexts, and Self-Care, which we used to inform and refine our concept analysis of Care Biography. In Conclusion, the concept of Care Biography, can provide a deeper understanding of a person and their care needs, facilitate integrated and personalised care, empower people to be in control of their care throughout their life, and help promote ethical standards of care.

Defining the Concept of Acoustic Neuroprotection in the Neonate: A Concept Analysis.

It has long been understood and acknowledged that the Neonatal Intensive Care Unit (NICU) environment and the transport environments are extremely loud, with both long- and short-term sequelae to the neonate, being well over the recommended amount of noise by the American Academy of Pediatrics (AAP). This problem has yet to be properly addressed. The purpose of this manuscript is to define and explain the concept of acoustic neuroprotection. While we cannot change the internal structures of the neonates' auditory system, we could change the acoustics of the environment to be support neuroprotection of these sensitive patients. Walker and Avant's concept analysis steps were followed to create and define the idea of acoustic neuroprotection, as it has not had a definition before. A total of 45 articles from multiple search engines were chosen. A combination of 2 concepts were used: acoustic protection and neurodevelopmental protection/support. The search was expanded past 20years for lack of research and importance of seminal works. To achieve acoustic neuroprotection, a neonate should not be exposed to sound greater than 45decibels (dBa) for longer than 10s, and exposure to sound above 80dBa should never occur. Appropriate interventions need to include supporting the neurodevelopment of the neonate through therapeutic sound, while decreasing the amount of toxic noise exposure to safe levels. By further understanding and having a quantifiable goal of acoustic neuroprotection for neonates, neonatal clinicians can work together to create new interventions for how to better protect and support the care of our tiniest patients.

Maternal Health Literacy in Pregnant Women: A Concept Analysis.

Maternal health literacy (MHL) plays a vital role in pregnancy outcomes, healthcare researchers should further analyze, refine, and develop this concept. This study aims to clarify the definition of MHL in pregnant women through a analysis of the concept. Walker and Avant's concept analysis approach was used to analyze the concept of MHL. A search of the literature was completed using the databases PubMed, CINAHL, Web of Science (WOS), and the Science and Technology Index (SINTA) for years 2001-2021; literature search included grey literature, publications from the government and academic institutions, and available both in English and Indonesia. A total of 12 articles were reviewed. MHL is a multifaceted and comprehensive concept. This study presents a working definition of MHL during pregnancy as the skills enabling women to access, comprehend, evaluate, and apply health information related to pregnancy, which are necessary for making decisions for improving and maintaining both maternal and fetal health. Guided by Walker and Avant's method, the major attributes and outcomes are determined in this study. Healthcare professionals can utilize this analysis to familiarize their institutions with the MHL concept, emphasize its importance, and apply it to practice. This contributes to enhancing the body of knowledge on MHL and potentially improving maternal health outcomes.

Oral frailty: a concept analysis.

Oral frailty has become a worldwide problem among older adults. Although researchers have conducted various studies on oral frailty, its definition remains controversial. To clarify the concept of oral frailty. Online databases PubMed, Web of Science, CINAHL, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database were searched from inception to September 20, 2023. The reference lists of relevant studies were searched manually. Eligible articles, theses, and books were analyzed using Walker & Avant's concept analysis model. The attributes of oral frailty were abnormal oral structure and/or decline in multi-faceted oral function and coexisting decline in physical, cognitive and social functions. Its antecedents were aging, social frailty, and severe periodontitis, whereas its consequences were decline in physical health and mental health, social withdrawal, lower quality of life and systemic frailty. Oral frailty could result in worse conditions among older adults physically, psychologically and socially. Tools based on the concept analysis need to be developed to comprehensively assess oral frailty.

A concept analysis of transcultural in nursing practices

Background: Differences in interpreting the term ‘transcultural’ in nursing practice need to be addressed. Inappropriate terminology in the nursing practice environment may impact the quality of health care. Objective: The aim of this research is to identify the meaning of transcultural in concepts and theories and its relationship to the practice of the nursing profession. Methods: This paper was designed for Walker and Avant concept analysis. Reputable articles from indexing databases were used for review. “Transcultural” AND “Transcultural Nursing Practice” were the two key concepts used in the literature search. The inclusion criteria for articles to be retrieved were determined by the authors with high rigor. Then, an organizing framework was formulated using Walker and Avant’s conceptual analysis method. Results: Antecedents, attributes, and consequences are inferred from the keywords or sentences in each article. The antecedents in this study include immigrants, acculturation, immigration, emigration, cultural diversity, cultural competence, interpersonal caring, transcultural nursing, and cross-cultural comparisons. The attributes in this study encompass cultural exchange, overcoming obstacles, research development, changes to standards and operating procedures. The consequences of the transcultural concept for nursing practice include its impact on organizations, patients/clients, and nurses. Conclusions: We suggest that healthcare professional thoroughly comprehend transcultural concepts in nursing practice in order to effectively apply transcultural approaches in nursing practice. This is one way to improve the quality of healthcare services.

Diesel Engine Exhaust Exposure in Relation to Lung Cancer in Long-Haul Truck Drivers: An Eight-Step Concept Analysis.

Long-haul truck drivers (LHTDs) face a number of occupational hazards. One such hazard is exposure to diesel engine exhaust (DEE). However, this concept has yet to be analyzed. To address this gap, a concept analysis was conducted to explore the effects of DEE in relation to lung cancer. Walker and Avant's eight-step concept analysis method was utilized: concept selection, analysis purpose, concept uses, defining attributes, model case, borderline case, antecedents and consequences, and empirical referents. PubMed, Scopus, and CINAHL databases were searched for relevant literature. Diesel engine exhaust was identified as a mixture of gases and particulates that are considered carcinogenic. Defining attributes of DEE for truckers include respiratory effects such as decreased peak flow and increased airway resistance leading to symptoms such as a phlegm-producing cough, eye and throat irritation, exacerbation of asthma symptoms, and allergic responses. The identified level of DEE exposure associated with these attributes is 75 μg EC/m3 for 1 to 2 hours daily or a long-term exposure of 10 μg EC/m3. The conceptual definition of DEE in truckers was illustrated by the attributes, antecedents, consequences, model case, and empirical referents. Lung cancer was identified as a significant consequence of occupational DEE exposure for LHTDs. This analysis highlights the need for future research to develop interventions that will safeguard truckers from the adverse health effects of DEE exposure.

Bridging the gaps in patient education through aesthetic-based education: A concept analysis study.

Aesthetics is a branch of philosophy that has been entered into the philosophy of education for a long time. Reviewing the concept of aesthetics in education, we can see the components that can cover a number of challenges in the field of patient education. Focusing on the conceptual dimensions obtained from the analysis of this concept, the aim is matching the resulting conceptual categories with the gaps in the field of patient education. Using a scoping review, we reviewed the literature dealt with different dimensions of aesthetic-based education. Walker and Avant's concept analysis approach was used to inductively analyze the content obtained from the review of literature. The data were divided into three general groups of antecedents, attributes, and consequences of the aesthetic-based education concept, and the final conceptual model was defined. Interdisciplinary comparisons between educational and medical sciences were made to match the concept of aesthetic education with the field of patient education to cover its issues. During the scope review process of the texts, after screening the articles, 17 articles selected to enter the concept analysis stage. Concept analysis phase showed that the main conceptual categories of antecedents of aesthetic-based education are aesthetic-based intrapersonal competencies and aesthetic capacities of educational setting. The attributes include aesthetic-based educational content and teaching methods including unity in diversity, combination with art and being based on empathy. The consequences include subliminal learning and constraint-free learning. These conceptual dimensions can cover four important issues in patient education including patient satisfaction, pedagogical competences of health educators, patient centeredness, and empathetic relationship. Applying aesthetic concept in the patient education process can bridge part of the gaps in this process. So, this study can be an introduction to future innovative models based on aesthetic paradigm in the field of patient education.

Brain Fog: A Concept Analysis

Brain fog is a symptom that has gained increasing attention worldwide since the start of the COVID-19 pandemic, as patients affected by COVID-19 may experience cognitive dysfunction, colloquially known as brain fog, for a period of time after recovery. Brain fog affects activities of daily living and work performance and has the potential to negatively impact society and the economy. However, a clear definition and concept analysis of brain fog is lacking in the literature. In this article, a concept analysis of brain fog is conducted using Walker and Avant's concept analysis steps to verify the source and definition of brain fog, clarify related concepts similar to brain fog, and establish the defining attributes, antecedents, and consequences of this condition. Model, borderline, contrary, and related cases are listed to illustrate and provide related empirical references in the literature. The authors hope this article will provide a clearer understanding of brain fog, which then may be applied in nursing clinical practice and future research to develop strategies and care methods for improving brain fog symptoms.

Concept analysis of ‘Facilitating a transformative radiation protection environment’

IntroductionSuboptimal radiation protection evidenced in literature necessitated the development of a theory to optimise radiation protection. To develop a theory, concept analysis of the central concept guiding the theory is required to provide explicit theoretical and operational definitions. This article presents the concept analysis of the central concept of ‘facilitating a transformative radiation protection environment’ used to develop a theory to optimise radiation protection. MethodsThe study used Walker and Avant's concept analysis process of selecting a concept, determining the aims and purpose of analysis, identifying all uses of the concept, and determining the defining attributes by identifying a model case, a borderline case and a contrary case. ResultsThe central concept was dissected into the individual concepts of facilitating, transformative, radiation, protection, and environment to enhance the definition and conceptual meaning of the central concept. The essential and related attributes of the individual concepts informed the summative definition of the central concept, and a model, borderline and contrary case contributed to the conceptual meaning. ConclusionThe summative definition of the central concept of “facilitating a transformative radiation protection environment” was determined to be through the essential attributes of help, process, change, X-rays, keeping safe considering the benefits versus risks of ionising radiation exposure and the total internal, external context within which persons exist and the related attributes. Implications for practiceExplored extensively in nursing literature, concept analyses in radiography are limited. Therefore, this article articulates the process of concept analysis and its use in radiography. Concept analysis provides a systematic process to analyse concepts often assumed to be understood, highlighting its importance in radiography literature and to educational praxis.

Understanding “danger signs” in healthcare: A concept analysis

Introduction: Danger signs are specific indicators signaling potential serious or life-threatening health conditions, crucial for prompt intervention in healthcare settings. Recognizing these signs can be challenging due to variations in cultural perceptions and individual interpretations. Additionally, danger signs are context-dependent, requiring awareness and contextual analysis. This complexity is amplified when dealing with abstract or non-physical signs. Understanding and consistently applying the concept of danger signs is essential for effective healthcare delivery. Method: This paper utilized Walker and Avant's eight-step concept analysis method, offering a systematic and structured approach for defining and understanding concepts. The method promotes clarity, precision, and thorough exploration of the concept's relationships with others, enhancing comprehensive understanding within its context. Result: Conceptually, danger signs represent a broad array of indicators signaling potential harm or imminent risk. Through analysis, this paper defines danger signs operationally as objective, measurable cues that are context-dependent, indicating the presence of a potential negative outcome. Conclusion: This paper contributes to existing knowledge by identifying danger sign attributes, reducing ambiguity and facilitating clearer application in health specialties training. The enhanced clarity also allows for the development of more precise tools to assess competence in danger sign identification.

Ethical principles of autonomy for patients receiving care in the Intensive Care Unit (ICU): A concept analysis

Applying ethical principles is crucial in providing nursing services to patients in any setting. Ethical principles serve as a foundation for nurses to deliver holistic care while avoiding harm to patients. To enhance our understanding of the principle of autonomy, an analysis of its concept can be conducted. However, research on concept analysis related to the ethical principle of autonomy in nursing is limited. This study aims to present a nursing perspective analysis of the concept of autonomy. Using the Walker and Avant (2011) approach, a concept analysis process was conducted by reviewing literature on autonomy through the ProQuest and Google Scholar databases. The search was restricted using the keywords "autonomy" and "intensive care unit" and the publication time frame from 1896 to 2023. Walker and Avant's (2011) concept analysis method involves eight steps that identify the attributes, antecedents, and consequences of autonomy, leading to an operational definition of the concept. This concept analysis reveals that autonomy is the right to freedom or independence for individuals based on their desires, assumptions, and preferences in determining decisions and goals that align with good rules. Autonomy enables patients to attain goals, satisfaction, goodness, and comfort.
 Keywords: Concept analysis; intensive care unit; autonomy; hospital care; emergency care; nursing practice

Concept Analysis on Human Dignity in Patient Care

Introduction: In nursing education and practice, human dignity is an essential professional value, particularly when it comes to ethical considerations. Dignity, which comes from the Latin word for uniqueness and worth, includes ideas like honor, independence, and self-worth. Methodology: To investigate the meaning of human dignity in clinical practice, particularly for hospital-admitted patients, this paper uses Walker and Avant's concept analysis method. Determining characteristics like autonomy, privacy, and the maintenance of self-respect is done by looking at literature and actual clinical cases. The analysis emphasizes how important it is to treat patients with dignity through polite conversation, pain management, cultural awareness, and compassionate care. Result: The results highlight how crucial it is to protect human dignity to lessen healthcare disparities and enhance patient outcomes, satisfaction, trust, and compliance. Comprehending and incorporating the notion of dignity into nursing practice has the potential to improve patient care while maintaining ethical norms.

Dual caregiving burden for older parents and grandchildren in middle-aged and older adults: A concept analysis

Purpose: This study aimed to clearly identify and define the nature of the concept of dual caregiving burden for grandchildren and older parents of middle-aged and older adults. Methods: By employing Walker and Avant's concept analysis procedure, this study clarified dual caregiving attributes in the middle–old-aged group. Literature reviews were conducted through April 2023 using several databases. Out of an initial 55 articles, Seven met the criteria focusing on dual caregiving for the target age group. Results: Based on the literature review, the dual caregiving burden for the middle–old-aged was characterized by (1) an overconcentration of caregiving in the middle–old-aged generations, (2) absence of alternatives for caregiving outside of the middle generation, (3) ambiguity within the scope of caregiving roles, and (4) insufficient compensation for caregiving for two generations. Conclusion: This study paves the way for the development of tools to appraise dual caregiving burden and nursing interventions to mitigate it accordingly. Future research will enhance support for middle–old-aged generations vis-à-vis their caregiving roles.