01 May WHAT IF WERE NOT SURE WHAT THE CONCEPT IS THAT IS THE LABEL FOR A PHENOMENON OF INTEREST?
Dr. Meleis is one our foremost nurse scholars and has such a grasp of difficult theoretical content. (You can see a video about her through the mediasite presentations on nurse theorists in the theoretical basis unither life is quite extraordinary). Meleis (1997) describes a phenomenon (singular) as An aspect of reality that can be consciously sensed or experienced (p. 11). Phenomena (plural) can be described from evidence that is sense based and can be seen, heard, smelled, or felt, or is derived from evidence that is grouped together through connections.
For example, lets say that you notice that in the PICU, more children seem to die during the 3 to 11 pm shift than any other. In this example, just observing the deaths does not make the phenomenon; it is the grouping together and making a connection between the deaths and the shift that makes it a phenomenon (Meleis, 1997). Another example: You are flying home from Europe and you feel tired, groggy, and have trouble adjusting to the new time zone and remembering. These are all related to the phenomenon of flying or specifically flying across time zones. What is a phenomenon in your practice that you are noticing?
For example, is it that you are seeing immigrant patients come in repeatedly to the hospital for conditions that would have been avoided if they had followed discharge instructions from previous admissions? This is the phenomenon that you are observing repeated admissions for non-English speaking immigrants in your community. Does this make sense to you? Give it some thoughtfor some of us it may take a lot of thought (Im one of those people).
Nowhow does that relate to concepts? According to our friend Meleis (1997), a concept is a term used to describe a phenomenon or a group of phenomena (p.12). A concept provides us with a concise summary of thoughts related to a phenomenon a labeling of sorts. If we didnt have that label, we would have to go into detail to describe the phenomenon. So, from our example above related to flying, we can give that the label jetlag. Our concept is jetlag.when you hear that term, you automatically think of what that meansthat groggy icky feeling you get when flying across time zones. From our other example of a phenomenon related to the repeated admissions of immigrants, we might say that the concept is health literacy. What if were not sure what the concept is that is the label for a phenomenon of interest? Search the literature and read about the concepts, particularly focusing on concept analysis to figure out if the label (concept) is correct. Sometimes, the appropriate labeling of the phenomenon will be very clear and other times it is more abstract.
In your readings from Chapter 7 in your Chinn & Kramer (2011) text, you can see that a concept lies along a continuum from the empiric (more directly experienced) to the abstract (more mentally constructed). For example, (chapter 7) the most concrete empirical concepts are those that can be directly experienced such as height and weight (at one end of the continuum), and progress and get more and more abstract, to self-esteem and wellness. Do you see the difference? Of course, the more empiric and concrete, the easier it is to understand and measure. The more abstract the concept, the more difficult to understand and measure. The most abstract concepts, such as self-esteem and wellness in our example, are often called constructs. I know.another term to keep straight but this term, construct, is used quite frequently to represent abstract concepts.
How does this relate to theory? Concepts are the building blocks of theory.
So, when you are thinking about your phenomenon of interest and come up with the appropriate concept, there may be a theory out there that also might fit. We will be thinking about theories in the units to come.
In our class discussion, I want you to share your phenomenon of interest and the corresponding concept. If its confusing for you, review your readings and think about our examples here. Also, feel free to ask for feedback from peers in the discussion area. I will be entering the discussion periodically, but I want you all to share your wisdom with each other. The discussion is not a one way discussion between me and all of you, but an area for dialogue between students with periodic faculty comment.
The Concept Analysis Assignment:
How do we make sure we understand what a concept means and how it applies to our phenomenon of interest? We do a concept analysis. We are including some examples of concept analysis articles below that may be helpful for you to review as you prepare for your paper.
Examples of Concept Analysis Articles:
Hansen-Kyle, L. (2005). A concept analysis of healthy aging. Nursing Forum, 40(2), 45-57.
Purdy, I. B. (2004). Vulnerable: A concept analysis. Nursing Forum, 39(4), 25-33.
Shattell, M. (2004). Risk: A concept analysis. Nursing Forum, 39(2), 11-17.
Simonelli, M.C. (2005). Relapse: A concept analysis. Nursing Forum, 40(1), 3-10.
The process of analyzing a concept helps you understand and define the concept to determine its fit for your phenomenon of interest. It really gives you insight into your phenomenon and helps you see how the concept works. It also helps clarify those concepts that are commonly used in nursing but mean different things to different people. Here at the USA College of Nursing, the faculty have decided to use a variation of the Walker and Avant method of concept analysis. These authors adapted Wilsons 1963 concept analysis methodology. Walker and Avants concept analysis methodology is fairly straight forward, but does require some thought. Probably the most difficult step is actually selecting a concept to begin with. You will be posting your phenomenon of interest and corresponding concept in the class discussion for this unit. As I discuss this methodology in the upcoming paragraphs, keep in mind that my reference is the Walker and Avant text: Walker, L. O., & Avant, K. C. (2005). Strategies for theory construction in nursing (4th ed.). Upper Saddle River, NJ: Pearson Prentice Hall. (As an aside: Why is it important for you to know my source of information? First, you need to know that were not pulling information out of thin airthere really is an accepted methodology that is universally used. Second, you may want to purchase this text for use should you decide to publish your paper. Publish my paper , you say??? Yes, absolutely! The concept analysis papers you see in the literature were primarily published by graduate nursing students. If you desire to publish your paper, feel free to talk with one of your faculty members to help you. Very often we are happy to publish with students for second authorship. It is an expectation of working with someone else on a manuscript that you include them with an offer for authorship. If you primarily wrote the paper, then you should definitely be first author, even as a student. Its your work unless your professor has to do almost a complete rewrite then you need to discuss with them about order of authorship. (Most professors I know are happy to be second author.)
Select a Concept
We have already talked about selection of the conceptthat is derived from your phenomenon of interest. Feel free to toss out ideas to your colleagues in the class discussion. The faculty member will let you know if your concept has been approved. Typically, your concept will be fine unless it has an odd twist or absolutely no applicability to your phenomenon and then well question what youre thinking. Dont feel defensiveremember our class discussions are to mimic dialogue in a classroom as if were all around a conference table tossing out ideas and brainstorming. In the same breath, I want to remind everyone to be respectful, courteous, and professional at all times in the course (even when you are aggravated and want to say how you feel). (Another aside: If you receive a grade or an email that angers you, wait at least 24 hours before hitting reply and sending an email).
Significance to your practice and to nursing:
We want to hear from you why you think the concept is important. What is it about this concept that is significant to your practice and to nursing? Referring to our previous example about the health literacy concept for the phenomenon of frequent readmissions for non-English speaking immigrantswhy is that important to your practice? Exbecause you are spending time and resources providing care to individuals that could be avoided.those individuals are suffering through additional hospitalizations and all of the related consequences. Why is it important to nursing? Think about the big picture of how the lack of access to information in their language causes many immigrants difficulties adhering to medical regimens.impact on the healthcare system for our nation. Is this making sense to you?
Identify uses and define the concept:
This section is so very important! What you want to do is look at many, many different sources for uses and definitions of your conceptdictionaries, literature, thesauruses, colleagues. Do not stick only to the nursing or medical literature. Present the historical development of the concept and its origins in language. Gather all the definitions you can find, even those that you think are unrelated. For example, if your concept is coping, then even look at uses from the architecture literaturethere are copings on buildingscoping saws, a coping garment..etc. Even though you may not think it is related to nursing, looking at a concept from as many different perspectives as possible helps you gain a thorough understanding of your concept and gives it a richness in meaning. You will be required in the rubric (guidelines) of the paper to obtain definitions from at least 5 sources and 3 different disciplines. This is a minimum expectation. Look at literature from other disciplines such as engineering, business, art, etc Some concepts will have many more definitions/uses and remember that you want to be as thorough as possible (within the limits of the page limit of 7 pages of text, which is strictly enforced)
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Define the attributes (include antecedents & consequences):
As you are looking at the uses and definitions of the concept, make a list of the characteristics you are seeing over and over. You want to try to show the cluster of attributes that are the most frequently associated with the concept and gives the analyst the broadest insight into the concept. Also include the antecedents and consequences. Antecedents are those events or incidents that must occur prior to the occurrence of the concept. Thus an antecedent (nor a consequence) cannot be a defining attribute. Consequences are those events or incidents that occur as a result of the occurrence of the conceptthe outcomes of the concept. In the coping example, an antecedent was an intensely stressful stimulus the consequence was the regaining of balance. These may be difficult to understandbe sure to refer to the concept analysis examples for further review.
Cases: Write these as actual scenarios.
Model Case:
The model case, also often called the exemplar case, is an example of what the concept looks like. You need to apply the co
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