Conceptual Analysis of Self-Management in Patients with Hypertension

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

Self-management in patients with diabetic foot ulcer:a concept analysis

Objective:This paper presents an analysis of the concept of patient outcomes.Methods:The present study conducted searches on various databases,including Wanfang,Sinomed,CNKI,Pub Med,Cochrane Library,Embase,Web of Science,and Ovid.The paper followed the Walker and Avant concept-analysis approach.Results:Initially,899 pieces of literature were identified through the search process,and after screening,41 of them were ultimately included in the analysis.The identified attributes of the concept included(1)capability,(2)decision making,and(3)action.These antecedents were shaped by factors such as illness perception,self-efficacy,and family and social.The consequences included(1)physiological effects,(2)psychological effects,and(3)social influence.Conclusions:The concept analysis of self-management in patients with diabetic foot ulcers(DFUs)not only aids in clinical practice and suppor ts interventions,but also contributes to the development of self-management theory.The common goal of clinical medical staff is to assist DFU patients in improving cognitive ability,making correct self-management decisions,and enhancing self-management behavior.

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.

Rule acquisition of three-way semi-concept lattices in formal decision context

Three-way concept analysis is an important tool for information processing,and rule acquisition is one of the research hotspots of three-way concept analysis.However,compared with three-way concept lattices,three-way semi-concept lattices have three-way operators with weaker constraints,which can generate more concepts.In this article,the problem of rule acquisition for three-way semi-concept lattices is discussed in general.The authors construct the finer relation of three-way semi-concept lattices,and propose a method of rule acquisition for three-way semi-concept lattices.The authors also discuss the set of decision rules and the relationships of decision rules among object-induced three-way semi-concept lattices,object-induced three-way concept lattices,classical concept lattices and semi-concept lattices.Finally,examples are provided to illustrate the validity of our conclusions.

Feasibility assessment of LID concept for stormwater management in China through SWOT analysis

The strengths weaknesses opportunities and threats SWOT analysis method is applied to assess the feasibility of traditional stormwater management and low impact development LID in China.The results show that traditional stormwater management has many disadvantages e.g.only stormwater collection and discharge or flooding peak-flow regulation is taken into consideration but lack of many important functions such as on-site infiltration non-point pollution control ecological treatment etc.Meanwhile as a new stormwater management concept the LID system has many advantages e.g.LID can not only control rainwater quantity but also effectively prevent non-point pollution. Moreover LID is easy for implementation and cost effective and operation and management can also be done easily.LID has attracted more and more attention from governmental authorities at different levels and the majority of practitioners. Therefore LID has bright prospects for wide applications in China.

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.

Concept Analysis: Family Resilience

Background: Although the concept of family resilience has had increased popularity in recent studies, conceptual and methodological issues need to be addressed. Aim: The purpose of this paper is to analyze the current status of the concept of family resilience in research and to suggest future needed directions for research. Methods: The structure of the analysis derives from Rodgers’ evolutionary concept analysis. Data for the analysis were retrieved using six electronic databases through phrasal search with “family resilience” as search terms. 38 were included in the current review. Results: Six dimensions of family resilience were identified: 1) collective confidence;2) interconnectedness;3) positive life view;4) resourcefulness;5) open communication patterns;and 6) collaborative problem-solving. Three possible antecedents of family resilience were identified: 1) perceived sense of disequilibrium;2) spirituality/shared belief systems or religious beliefs;and 3) families’ strong will to overcome adversities. Consequences of being resilient include: 1) acceptance of the situation;2) change in life perspectives;3) enhanced relationship qualities;4) reinforcement of resilient properties;and 5) improved health-related outcomes. Conclusion: Although the concept of resilience has been adopted as a useful strength-based perspective to understand family adaptation in the presence of adversity, it still needs further conceptual and methodological refinements. Multiple dimensions, cultural differences and variations of the concept within longitudinal designs should be examined with data gathered from multiple family members in order to improve family resilience research and its application to nursing practice. Implications for future research and intervention are suggested.

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.

Emotional intelligence in professional nursing practice:A concept review using Rodgers's evolutionary analysis approach

Background:Knowledge around emotional intelligence originated in the 1990s from research regarding thoughts,emotions and abilities.The concept of emotional intelligence has evolved over the last 25 years;however,the understanding and use is still unclear.Despite this,emotional intelligence has been a widely-considered concept within professions such as business,management,education,and within the last 10 years has gained traction within nursing practice.Aims and objectives:The aim of this concept review is to clarify the understanding of the concept emotional intelligence,what attributes signify emotional intelligence,what are its antecedents,consequences,related terms and implications to advance nursing practice.Method:A computerized search was guided by Rodger's evolutional concept analysis.Data courses included:CINAHL,PyschINFO,Scopus,EMBASE and ProQuest,focusing on articles published in Canada and the United Stated during 1990e2017.Results:A total of 23 articles from various bodies of disciplines were included in this integrative concept review.The analysis reveals that there are many inconsistencies regarding the description of emotional intelligence,however,four common attributes were discovered:self-awareness,self-management,social awareness and social/relationship management.These attributes facilitate the emotional well-being among advance practice nurses and enhances the ability to practice in a way that will benefit patients,families,colleagues and advance practice nurses as working professionals and as individuals.Conclusion:The integration of emotional intelligence is supported within several disciplines as there is consensus on the impact that emotional intelligence has on job satisfaction,stress level,burnout and helps to facilitate a positive environment.Explicit to advance practice nursing,emotional intelligence is a concept that may be central to nursing practice as it has the potential to impact the quality of patient care and outcomes,decision-making,critical thinking and overall the well-being of practicing nurses.

Transformative learning in nursing education: A concept analysis

Objective:There is vast literature on transformative learning,which is an important aspect of nursing education,but its meaning remains unclear.It is therefore important to clarify the meaning of transformative learning,identify its attributes,antecedents and consequences to increase its use in nursing education,practice and research.Methods:Walker and Avant's method was used,and the process provided a structured way to analyse the concept of'transfonnative leaming'.Nursing education dictionaries,encyclopaedias,conference papers,research articles,dissertations,theses,journal articles,thesauri and relevant books through the database library and intemet searches were reviewed.One hundred and two literature sources were reviewed,and data saturation was reached.Results:The results of the concept analysis of transformative learning within the context of nursing education identified three categories,namely,1)Antecedents as cognitive and affective perspective,democratic education principles and inspiration;2)Process through three phases,namely i)awareness through self-reflection,ii)the meaningful interactive,integrative and democratic construction process,and iii)metacognitive reasoning abilities;and 3)Outcomes.A theoretical definition of transformative learning was formulated.Theoretical validity was ensured.Conclusion:The results of the concept analysis of transformative learning were used to describe a model to facilitate transformative learning within the context of nursing education.

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.

Concept analysis of adherence

Objective: To explore the concept of adherence in the context of rehabilitation of patients with chronic illnesses. This concept analysis is helpful in predicting health behaviors and intentions including physical activity and dietary behaviors in patients with chronic illnesses. Methods: The framework of Walker and Avant was used to analyze the concept of adherence. Results: Adherence is defined as the extent to which a person’s behavior, such as taking medication, following a diet, and/or executing lifestyle changes, corresponds to agreed recommendations from a health-care provider. The antecedents of adherence are the biomedical status of the individual, social support, self-efficacy, and education. Self-report questionnaires and patient self-reporting are the most common measurement tools of adherence. Thus, the reliable and valid instrument of monitoring adherence in the clinical settings is challenging. Conclusions: Analyzing the concept of adherence is necessary to help understand how best to promote adherence to improve healthrelated outcomes.

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.

Occupational burnout in nurses:a concept analysis

Objective:This paper aims to clarify the concept of occupational burnout(OB)as well as develop appropriate methods to relieve or prevent OB in the nursing profession.Methods:Walker and Avant's eight-step approach of concept analysis was applied.Results:OB was defined as a chronic form of work-related stress.Accurately,it was characterized by emotional exhaustion,depersonalization/cynicism,and reduced personal accomplishment/inefficacy.Antecedents of burnout included(a)demographic characteristics;(b)chronic exposure to work-related stressors;(c)quantitative and qualitative job demands;(d)lack of job resources;and(e)personality traits.Consequences involved(a)individual’s unfavorable quality of life;(b)negative impact on the organization;and(c)poor services quality.Although the Maslach Burnout Inventory(MBI)is perceived as an ideal tool to measure burnout and hence,it is used worldwide,whether this instrument fits to measure this concept for nurses has still not yet been verified and thus further research is needed.Conclusions:By proposing a comprehensive definition of the concept,this analysis contributes to recognition of the process of OB of nurses.All nurses are vulnerable to OB.Hence,burnout in nursing needs to be recognized as a critical factor in the delivery of safe patient care.It proposes that the prevention of OB would be achieved through team communication training,mindfulness group,education,etc.

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.

A Concept Analysis of Mentoring in Nursing Leadership

Attention in the literature has been given to the critical state of nursing leadership development. There is a need to identify effective ways to sustain and develop nursing leaders. Mentoring has been identified as an invaluable tool to attract and retain new nurse leaders. Examining the concept of mentoring in nursing leadership provides a greater understanding of its importance in today’s healthcare system. The concept of mentoring will be analyzed using the framework developed by Walker and Avant. A literature review was conducted to examine the current usage of the concept of mentoring. Consistent with Walker and Avant’s framework, defining attributes, antecedents, and consequences of mentoring have been identified. Further illustration of this concept is provided by describing model, borderline, related, and contrary cases. Demonstrating the occurrence of the concept of mentoring, Empirical referents will also be explored.

Comment of Walker and Avant’s method of concept analysis

In order to promote the nursing discipline to developindependently and scientifically, nursing practice shouldbe guided by nursing theory instead of intuition andexperience of nurses [1]. Nursing theory can assist nursesto deliver individual patient’s care and help to improveobservation and recognition of specific patient need, be itbiological, psychological or social [2]. Nursing theory hasdeveloped quickly and successfully in recent decadesinternationally; however, it is still in the early stage ofdevelopment in China.

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.