Family resilience of cancer patients:a concept analysis

Objective:The concept of family resilience of cancer patients was discussed through literature review,which provided reference for nursing of cancer patients.Methods:China National Knowledge Infrastructure(CNKI),Wanfang Database,SinoMed,PubMed,Web of Science,and Embase were systematically searched,and the concept analysis method proposed by Walker and Avant was adopted.Results:In this study,we defined the concept of family resilience,identified attributes,and analyzed the antecedents and consequences.The proposed operational definition of family resilience was:After a family member is diagnosed with cancer,the whole family can actively explore its own unique internal and external resources and advantages,strengthen self-regulation,jointly cope with the crisis by establishing close family relationships,providing mutual support to family members,and interacting with the outside world.Conclusions:The definition of family resilience of cancer patients is conducive to the development of measurement tools and the improvement of family outcomes of adult cancer patients by intervening family resilience factors.

Radiation dermatitis wet healing:a concept analysis

Objective:To explore the concept of radiation dermatitis wet healing through a literature review and provide references for future treatment of patients with radiation skin injury.Methods:Related ar ticles selected from China National Knowledge Infrastructure(CNKI),Wanfang Database,Pub Med,Web of Science,Medline,and EBSCO were analyzed with Rodger’s concept analysis.Results:We identified the application status of wet healing in domestic and foreign literature,defined explicit attributes of the procedure,and clarified concepts related to wet healing of radiation skin injury to provide a reference for the management of radiation dermatitis with wet healing.Conclusions:Treatment of radiation dermatitis with wet healing is a unique procedure.Analyzing this concept can contribute to its development in the future and can offer a theoretical basis for treatment of patients with radiation skin injury.

Cognitive frailty in the elderly:a concept analysis

Frailty is a recession of age-related reserves caused by a variety of causes and is becoming the most important clinical syndrome that affects the health of the elderly.In the elderly,frailty and cognitive dysfunction often exist,and some people have proposed cognitive frailty.Cognitive frailty is an elderly syndrome that increases the risk of dementia,in the same time,and can independently predict the adverse health outcomes of the patient and affect the quality of the patient's survival.This paper,under the guidance of Walker and Avant method,provides theoretical basis for early recognition and intervention of cognitive weakness in the elderly.

Role based access control design using Triadic concept analysis

Role based access control is one of the widely used access control models.There are investigations in the literature that use knowledge representation mechanisms such as formal concept analysis(FCA),description logics,and Ontology for representing access control mechanism.However,while using FCA,investigations reported in the literature so far work on the logic that transforms the three dimensional access control matrix into dyadic formal contexts.This transformation is mainly to derive the formal concepts,lattice structure and implications to represent role hierarchy and constraints of RBAC.In this work,we propose a methodology that models RBAC using triadic FCA without transforming the triadic access control matrix into dyadic formal contexts.Our discussion is on two lines of inquiry.We present how triadic FCA can provide a suitable representation of RBAC policy and we demonstrate how this representation follows role hierarchy and constraints of RBAC on sample healthcare network available in the literature.

Physical restraint in mental health nursing: A concept analysis

Objective: Physical restraint is frequently used in medical services,such as in mental health settings,intensive care units and nursing homes,but its nature varies in different institutions.By reviewing related literature,this study aims to clarify the concept of physical restraint in mental health nursing.Method: Three databases (PubMed,PsyclNFO and CINAHL) were retrieved,and Walker and Avant's concept analysis method was used to analyze the concept of physical restraint in mental health nursing.Results: Physical restraint is a coercive approach that enables the administration of necessary treatment by safely reducing the patient's physical movement.It should be the last option used by qualified personnel.Antecedents of physical restraint are improper behavior (violence and disturbance) of patients,medical assessment prior to implementation and legislation governing clinical usage.Consequences of physical restraint are alleviation of conflict,physical injury,mental trauma and invisible impact on the institution.Discussion: This study defined the characteristics of physical restraint in mental health nursing.The proposed concept analysis provided theoretical foundation for future studies.

Self-care:A concept analysis

Objectives:There is extensive literature from various disciplines on self-care,an important aspect of nursing intervention via evaluation and education,but its meaning remains unprecise due to the difficulty integrating the diverse definitions developed over time across disciplines.Therefore,it is vital to clarify the meaning of self-care and formulate the defining attributes,antecedents,and consequences to self-care.Methods:Walker and Avant’s concept analysis approach was used to analyze the concept of self-care.A search of the literature was completed using the databases CINAHL,PubMed,and EBSCOhost for years 1975e2020;literature search included peer-review articles,full-text publications,and available in English.A total of 31 articles were reviewed,and saturation was reached.Results:An extensive review of the literature revealed salient characteristics that reflected the most frequently used terms associated with the concept.Guided byWalker and Avant’s method,three defining attributes emerged as common themes:awareness,self-control,and self-reliance.Conclusions:A clarified definition was identified:the ability to care for oneself through awareness,selfcontrol,and self-reliance in order to achieve,maintain,or promote optimal health and well-being.

Patient outcomes in the field of nursing: A concept analysis

Purpose:This paper reports an analysis of the concept of patient outcomes.Methods:The Walker and Avant concept analysis approach was applied.Results:The attributes of patient outcomes include(1)patient functional status(maintained or improved),(2)patient safety(protected or unharmed),and(3)patient satisfaction(patient reporting of comfort and contentment).These attributes are influenced by the antecedents of individual patient characteristics and health problems,the structure of healthcare organizations and received health interventions.Additionally,patient outcomes do significantly impact the quality of nursing care,the cost of effective care and healthcare policy making formulation.Conclusion:Providing good nursing care to all patients is a central goal of nursing.Patient outcomes in nursing are primarily about the results for the patient receiving nursing care.This analysis provides nurses with a new perspective by helping them to understand all the components within the concept of patient outcomes.

A concept analysis of cultural competence

Objectives:To clarify the meaning and reduce ambiguities of the concept cultural competence,and promote consistency in using the concept in nursing dialog,research,and practice.Method:Using Walker and Avant's method of concept analysis.Results:Cultural competence is the gradually developed capacity of nurses to provide safe and quality healthcare to clients of different cultural backgrounds.Its defining attributes are cultural awareness,cultural sensitivity,cultural knowledge,cultural skill,and dynamic process.Antecedents are cultural diversity,cultural encounter,and cultural desire.Consequences involve three beneficiaries,as follows:clients,nurses,and healthcare organizations.Empirical referents are primarily consisted in self-reported tools.Conclusions:The understanding of cultural competence of nurses that emerged in this concept analysis will contribute to the development of a rigorous design of instruments or research.

Self-management A concept analysis of self-management for cancer patients’ home-based rehabilitation

Objective： To explore and clarify the concept of self-management in the context of cancer patients’ home-basedrehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to developself-management strategies and enables them to improve their ability in symptom self-management of home-basedrehabilitation. Method： Walker and Avant’s framework （2011） was used to analyse the concept of self-management.Results： Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation,problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge andsocial support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes andquality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Managementscale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether thisinstrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thusfurther research is needed. Conclusion： According to the concept analysis, nurses should encourage cancer patients toinvolve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management ofhome-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.

Concept analysis of coping with multiple sclerosis

Objective:The concept of coping with disease appears frequently in the literature;however,there is no precise definition of coping.The aim of this study is to clarify coping concept,and to identify its attributes,antecedents,and consequences in patients with multiple sclerosis.Methods:Rodgers'evolutionary method of concept analysis was used to clarify the concept of coping.A literature review was conducted with key terms‘multiple sclerosis’,‘coping’,‘adjustment’,and‘deal with’.After searching databases,1370 papers were found for the period 1995e2017.Finally,55 articles and texts were selected for analysis.Data analysis was carried out using thematic analysis.An independent researcher checked the process to ensure credibility and reduce personal bias.Results:Coping with multiple sclerosis is a multidimensional concept with three main attributes:maintenance of emotional balance,acceptance of the disease,and self-regulation.Social support,awareness toward the disease,attitude toward the disease,and religious-spiritual beliefs were found as antecedents.Health promotion,adherence to treatment regimen,independence in personal life and social relationships,and improvement of family relationships were found as consequences of these attributes.Conclusion:These findings not only add to the body of knowledge in health science,but also serve as an important motivation for further theory development and research in this context.Nurses and health professions can also benefit from a deeper understanding of coping concept in providing and planning healthcare for these patients.

Concept analysis of nurse burnout

Objective:To explore the concept of burnout among nurses.Through this concept analysis would expect in assisting hospital management departments in establishing supportive programmes to manage burnout of nurses.Method:Walker and Avant’s framework is adopted for the concept analysis of burnout.Results:Burnout is a syndrome that can happen among helping professions which characterized as emotional exhaustion,depersonalization,and reduced personal accomplishment.The antecedents of burnout are cognitive-competence,role overload,role conflict,lack of social support,and rewards.On the other hand,the consequences of burnout could be both personal and organizational,such as sub-clinical issues,behavioral change,absenteeism,and poor quality of care.Conclusion:The analysis of burnout on its attributes,together with antecedents and consequences(Appendix A)and presenting with case study,it may help the nurse to gain a better understanding of nurse burnout and build coping strategies.

Family functioning integrated with diabetes self-management： a concept analysis

Although the concept of family functioning has gained recent popularity, the terms ＂family functioning＂ and ＂family resilience＂ are sometimes confused and used interchangeably. The aim of this concept analysis was to clarify what is meant by family functioning in the context of diabetes self-management by assessing specific attributes, antecedents, and consequences. A concept analysis model by Walker and Avant was applied. The identified attributes of family functioning in a diabetes self-management context included problem-solving, communication, roles, affective responsiveness, affective involvement, and behavioral control. Antecedents included family structure, socioeconomic status, family functioning relationships, family stage, and life events. Consequences included family satisfaction, family cohesion, and family relationships. This analysis provided a deeper understanding of a family functioning concept within a diabetes self-management context. It is recommended that health care providers should be aware of antecedent factors that could inhibit outcome improvement. Further research is needed to explain family functioning attributes in relation to antecedents and potential consequences.

People-Centered Care: Concept Analysis

Purpose: This study aims to clarify the definition, attributes, antecedents, and consequences of the concept of people-centered care (PCC). Method: Rogers and Knafl’s evolutionary method was used to analyze the concept of People-centered care. The cords such as “Attributes,” “Antecedent,” and “Consequences” were extracted on the coding sheet. The extracted contents of each of the “Attributes,” “Antecedent,” and “Consequences” from the created coding sheets were summarized as codes, and similar codes were categorized. Result: We included 33 studies in the analysis. As a result of the analysis, we identified four attributes (the subject is people, approaches to improving and enhancing health issues, relationships as a basis for partnership building, and behavioral attitudes for building partnerships), four antecedents (changes in social conditions, increasing people’s ownership of their health, health issues in modern society, and care in a variety of settings), and three consequences (achieving goals set by the people themselves, self-transformations of both people and healthcare providers, and social transformations). Discussion: Based on the analysis results, PCC was defined as “an initiative in which people step forward and partner with health care providers to improve and enhance health issues in individuals and communities.” In various social and individual changes, the realization of PCC is expected to result in the achievement of goals set by the people themselves together with health care providers and the transformation of individuals and society.

Tools and Algorithm for Concept Analysis Using Medical Data

Drug taxonomy could be described as an inherent structure of different pharmaceutical componential drugs. Unfortunately, the literature does not always provide a clear path to define and classify adverse drug events. While not a systematic review, this paper uses examples from the literature to illustrate problems that investigators will confront as they develop a conceptual framework for their research. It also proposes a targeted taxonomy that can facilitate a clear and consistent approach to understanding different drugs and could aid in the comparison to results of past and future studies. In terms of building the drugs taxonomy, symptoms information were selected, clustered and adapted for this purpose. Finally, although national or international agreement on taxonomy for different drugs is a distant or unachievable goal, individual investigations and the literature as a whole will be improved by prospective, explicit classification of different drugs using this new pharmacy information system （PIS） and inclusion of the study＇s approach to classification in publications. The PIS allows user to find information quickly by following semantic connections that surround every drug linked to the subject. It provides quicker search, faster and more intuitive understanding of the focus. This research work can pretend to become a leading provider of encyclopedia service for scientists and educators, as well as attract the scientific community-universities, research and development groups.

Adherence-A concept analysis in the context of cardiac rehabilitation

Objective： To explore and identify the concept of adherence in the context of cardiac rehabilitation. This conceptanalysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence tocardiac rehabilitation programme. Method： Walker and Avant’s framework was used to analysis the concept ofadherence. Results： Adherence is defined as patients collaboration with health care provider, active involvement in thetreatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributesof adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents ofadherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors.Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standardinstrument to measure adherence. Conclusion： Based on the concept analysis, in order to improve patients’ adherence tocardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan andpromote patients’ self-efficacy and prevention relapse.

Partnership in nursing care: a concept analysis

Objectives: This concept analysis aims to provide a better understanding of the term “partnership” in nursing care. A critical review of empirical studies regarding this area, can lay the groundwork for improving partnership between nurses and clients, as well as person- centered nursing care. Methods: A comprehensive literature search used various “partnership”,“nurse”and “clients”search terms to identify relevant studies published from 2007 to 2017. The selected studies had to focus on partnership and nursing care. Walker and Avant’(2004) framework was used when synthesizing the evidence from empirical studies in the concept analysis. It helps to distinguish confusing or unclear concepts, and to promote critical thinking through analyzing its attributes, operational definitions, antecedents, consequences, and reference. Results: In nursing care, partnership is the relationship based on collaboration among individuals, who place trust and confidence in accountability, and who have capability and empathy. The antecedents are health problems or requirements, willingness to sign up as partners and ongoing commitment;while the consequences were presented as improvement in quality of service, treatment outcomes, clients’ safety and satisfaction, financial benefit as well as time constraints and professionals’ emotional burden. The Patient Partnership in Care questionnaire can help assess partnership in nursing care. Conclusion: This concept analysis informs the concept of partnership in nursing care by using Walker and Avant’(2004) framework. By synthesizing the evidence from empirical studies, it provides theoretical and clinical frameworks for nurses to innovate nurse-client relationships - nurses are seen as partners in care instead of experts, which can encourage clients’ self-management and improve person-centered nursing care.

ICU Delirium： A concept analysis

Objective： To explore and analyze the concept of intensive care unit （ICU） delirium. Method： Walker and Avant’sstrategy of analysis was adopted to this research. Results： ICU delirium is defined as the presence of an acute cognitiveimpairment, accompanied by a disturbance of consciousness with fluctuating inattention, and the array of dysfunctionsonly developed for a short period of time in ICU. The antecedents of ICU delirium include （1） the high severity of illness,（2） pain, （3） sedative use, （4） immobilization, （5） sleep deprivation and （6） unpleasant awareness. The consequencesinvolve （1） promoting the risks of self-extubation and unplanned removal of catheters, （2） prolonging the length of ICUstay, （3） increasing the mortality of critical patients and （4） Some different ICU delirium assessment instruments aregathered. Confusion Assessment Method for Intensive Care Unit assessment tool （CAM-ICU） was the most populardiagnostic tool used by nurses. Conclusion： Concept analysis as an extension and development of nursing theory cancreate a linkage between practice and theory. It will create a knowledge foundation of ICU delirium and provide atheoretical basis to construct nursing theory. This study can help ICU nurses to understand and recognize ICU delirium.ICU nurses will be enlightened to develop effective interventions of ICU delirium to improve critical patients’ clinicaloutcomes.

Coping： a concept analysis in the cancer context

Objectives： The aim of this paper is to analyse the concept of coping in the cancer context. This concept analysis willprovide a theoretical framework for oncology nurses to help patients cope with the influences of cancer and adapt to theirnew situations. Methods： The concept analysis of coping was conducted according to Walker and Avant＇s method.Results： Coping is defined as a process of dealing with stressful events by means of cognitive appraisal, purposefulefforts, and use of available supports and resources in order to achieve physiological and psychological adjustment.Antecedents to coping involve stressful events, individual personality, individual experience, and available supports andresources. Different coping strategies based on patients’ responses to suffering from cancer bring about positive ornegative results. Effective coping means being well-adapted, which is conducive to patients’ health and optimum qualityof life. Roy’s middle range theory of coping and adaptation processing provides a theoretical framework for the study ofcoping. The Mental Adjustment to Cancer scale and the 15-item Coping and Adaptation Processing Scale are consideredpractical and effectual instruments to measure coping in the cancer context. Conclusions： This concept analysiscontributes to understanding the process of coping with cancer. Oncology nurses should identify cancer patients’ copingpatterns, provide timely and proper professional support and educate effective coping strategies in order to help patientsadapt to their new situations both physiologically and psychologically.

Quality of life in head and neck cancer survivors： A concept analysis

Objective： To identify and clarify the existing definitions of quality of life in head and neck cancer survivors. Thisconcept analysis will inform healthcare professionals of promoting nursing care for head and neck cancer survivors andeventually improve their quality of life. Method： Concept analysis based on Walker and Avant’s framework. Results：Quality of life is a subjective and personally derived cognitive evaluation of global well-being by perceiving a feeling ofoverall life satisfaction in his/her own value, happiness, and the independence to manage daily activities and lifeexperience. Three defining attributes for quality of life were identified： a feeling of overall life satisfaction in his/hervalue, global personal well-being, and independence. An improvement of quality of life means an improvement ofclinical outcome. However, the variety of instruments for measuring life quality makes it difficult for healthcareprofessionals to select a standard one for head and neck cancer survivors. Conclusion： By proposing a comprehensivedefinition of the concept, this analysis contributes to the advancement of knowledge about quality of life in the context ofhead and neck cancer survivorship. Through a sound understanding of the phenomenon, healthcare professions willrecognize or measure head and neck cancer survivors’ life conditions in a more accurate way and to implementintervention where necessary, eventually, improve patients’ life quality in survivorship.

A Concept Analysis of Continuity of Care in Nursing

Purpose： This paper is a report about the concept analysis of continuity of care, to get further understanding of continuity of care. Methods： The Walker and Avant concept analysis approach was applied in this paper. Results： The three attributes include： seamless transfer, flexible reaction and effective interaction. The antecedents were changed needs and patient centred care. In addition, the continuity of care had a significant effect on patients’ outcome, satisfaction and costs. Conclusions： This analysis provides nurses an understanding about continuity of care in both patient’s and care provider’s perspective. Continuity of care is a tailored services provided by care givers, which is an essential element of healthcare system.