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.

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.

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.

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.

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.

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.

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.

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.

Anxiety: a concept analysis

Anxiety is often mentioned in people's daily life,especially in the field of medicine and psychology.For nursing,a clear understanding of anxiety is conducive to clinical nursing practice and research.Under the guidance of the Walker and Avant method,this article conducts a concept analysis of anxiety that provides a comprehensive and rounded analysis of anxiety and helps nurses gain a better understanding of anxiety.

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.

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.

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 Ethical Competence of Nursing Students and Nurses

[Aim] This study aimed to conduct a concept analysis and clarification of ethical competence of nursing students and nurses, and further clarify the components. [Method] Rodger’s concept analysis method was used. A literature search was conducted using the ICHUSHI database, MEDLINE, and CINAHL databases. The keywords included in the search were ethical competence. A total of 24 published articles were analyzed. [Results] As a concept of ethical competence among nursing students and nurses, five categories of [ethical sensitivity], [ethical reasoning], [ethical decision making], [ethical practice], [ethical reflection], obviously became. As a component, two categories of antecedent factors and three categories of consequences were identified. I defined ethical competence in nursing students and nurses, “including nursing students and nurses thinking processes and nursing practice and reflection to solve ethical problems Behavioral characteristics”. [Conclusion] Review of nursing practice from an ethical perspective [ethical reflection] is indispensable for clarifying self-tasks and deepening better nursing practice.

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.

A conceptual analysis of the meaning of comfort at the end-of-life using the Walker and Avant(2014)Framework

Objective:The aim of the authors is to clarify the concept of comfort at the end-of-life in order to support understandings of fundamental nursing care needed at this stage of healthcare.Methods:The Walker and Avant framework was applied to develop a deeper understanding of the concept of comfort at the end of life.Results:Five defining attributes of comfort in the end-of-life were identified and they are having a peaceful home-life environment,trust and consolation,proximity and social-cultural support,alleviation of suffering,and a process of integrated intervention by nurses.Conclusions:At the end-of-life patients commonly experience physical,psychological,social-cultural,and environmental discomfort.Patients’families also encounter significant challenges.However,their comfort needs are often secondary to that of the patient.Additionally,a lack of clarity exists regarding the holistic meaning of comfort at the end-of-life,which can largely be confined to understandings of physical comfort for the patient,with a limited understanding of addressing family/caregivers’needs.Therefore,this concept analysis may provide some guidance in this regard and also provides support toward a more integrated understanding of the concept.

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.