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14 "Concept analysis"
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Original Articles
Resourcefulness: A Concept Analysis
Soon Rim Suh, Young Im Park, Sung Jae Kim, In Ja Kim, Mee Ock Gu, Young Hee Yang, Eun Nam Lee, Song Ja Park, Eun Ok Choi, Dong Suk Lee, In Sook Lee, Eun Ok Lee
Journal of Nurses Academic Society 1997;27(2):329-340.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.329
AbstractAbstract PDF

Resourcefulness was analyzed by Walker and Avant's method to make a theoretical framework for nursing. Also, the appropriate Korean terminology was identified. "Resourcefulness" means the ability to use internal and external resources to eliminate or to control stress. 'Resourcefulness' is chosen to be the most appropriate term to reflect the concept of resourcefulness. Upon the concept analysis availability, controllability, confidence, and self-instruction were identified as the defining characteristics of resourcefulness. Contrary to other work, "availability" means the ability to use the social resources as well as the internal cognitive-behavioral resources. "Controllability" means the ability to delay or control immediate gratification of one's needs or to divert one's own mood in order to solve problem. "Confidence" is the self-efficacy belief in one's control ability. "Self-instruction" is the cognitive ability to instruct oneself positively. Resourcefulness is learned by active experience, vicarious experience, and formal or informal instruction or a need for change. As a result of the use of resourcefulness, the target behavior performed immediately and ultimately improve the quality of life or adaptation. Therefore, it is necessary to develop the instrument including the defining attributes identified in this study. Also, it is necessary to simultaneously analyze the related concepts of self-efficacy, self-control, and self-regulation for appropriate use.

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Concept Analysis and Development of Suffering -Application of Hybrid Model Method
Kyung Ah Kang
Journal of Nurses Academic Society 1996;26(2):290-303.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.290
AbstractAbstract PDF

There is a need to define the concept of suffering more appropriate in the context of Korean culture. This research is an attempt to analyze and develop the concept of suffering by applying the Hybrid Model suggested by Schwartz -Barcott and Kim. The data were collected from March 20, 1995 to September 17,1995. The subjects of the study were eight persons including in-patients and out-patients of a general hospital who were diagnosed as having cancer and those resting in sanatoria for natural treatment of cancer. Qualitative research methods of in-depth interview and participant observation were used for data collection. The contents of the interviews were recorded on tape. Data-analysis progressed according to the 3 phases suggested by the Hybrid Model. For each case, in-depth interview data and participant observation data were included and the attributes of suffering revealed in these data were analyzed. Finally, by summarizing the results from each case, the attributes of suffering, its dimensions, definition, and processes observed in the field were suggested. According to the results of the study, the following new definition of suffering is suggested: Suffering is a fundamental and inevitable experience of all human beings. When each individual experiences loss, damage, and pain which threaten one's personal integrity, suffering is perceived differently among each individual depending on their personal inner factors, one's significant others, exterior circumstances and stimuli, and the ultimate meaning of life. Suffering brings severe and unendurable distress which accompany despair, powerlessness, anxiety, bitterness, fear, anguish, guilt, depression, withdrawal and anger. The results of this study suggest that the more responsibility and burden a cancer patient felt, the more suffering she/he experienced and it tended to be more relevant to one's significant others and exterior circumstances and stimuli; the less responsibility and burden a cancer patient had, the less suffering she/he experienced and it tended to be related to one's inner factors. These findings have implications for nursing profession. When caring for patients who experience suffering, nurses need to consider the influence of responsibility, burden, and each dimension of suffering. Moreover, appropriate nursing interventions aimed at relieving pain and satisfying the spiritual need of patients experiencing loss need to be developed and implemented more widely.

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The Concept Analysis of Hope: Among Cancer Patients Undergoing Chemotherapy
Mi Soon Song, Eun Ok Lee, Young Sook Park, Yang Sook Hah, Young Sook Shim, Su Jeong Yu
Journal of Korean Academy of Nursing 2000;30(5):1279-1291.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1279
AbstractAbstract PDF

The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows: In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.

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Spirituality: Concept Analysis
Pok Ja Oh, Kyoung Ah Kang
Journal of Korean Academy of Nursing 2000;30(5):1145-1155.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1145
AbstractAbstract PDF

The purpose of this study is to explore the concept spirituality and to gain understanding of nursing intervention that may improve spiritual well-being. The concept analysis framework developed by Walker and Avant (1995) was used to clarify the concept. In the study, 'Harmonious Interconnectedness', 'Transcendence', 'Integrative Energy' and 'Purpose and Meaning in Life' emerged as the critical attributes of spirituality. The first attribute, 'harmonious Inter- connectedness', has three categories including intrapersonal, (self), interpersonal (others/ nature) and transpersonal (the Supreme Being). The second attribute, 'Transcendence', is defined as the ability to extend one's own self beyond the limits of usual experiences and to achieve new perspectives. This attribute is demonstrated by 'coping with situations', to 'self-healing', and 'transformation'. The third attribute of spirituality is 'Integrative Energy', which integrates all dimensions and acts as a creative and dynamic force that keeps a person growing and changing. 'Integrative Energy is also defined as an inner resource that gives a sense of empowerment. Therefore the highly spiritual person demonstrate 'inner peace', 'growing', 'inner strength,' and 'well-being'. The fourth attribute 'Purpose and Meaning in Life' represents a sense of connectedness with one's inner values and with a greater purpose in life. It is demonstrated by 'hope' and 'a powerful life'. In this study, the antecedents of the spirituality represented as 'spirit' and its potential enablers were 'Introspection/reflection', 'Interconnectedness with all living things', and an 'Awareness of a Higher-Power'. The consequences of this concept may be described as 'physical, psychosocial, and spiritual well-being'. Empirical referents of this are 'purposeful life' 'self-worth' 'hope' 'love' 'service' 'forgiveness' 'trust/belief' 'inner peace' 'self-actualization' 'religious practices' 'transformation' 'inner strength' and 'coping'. In conclusion, spirituality can be defined based on these critical attributes. Spirituality is a dynamic, integrative energy based on a feeling of harmonious interconnection with self, others and a higher power. Through it, one is enabled to transcend and to live with meaning and purpose in life.

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Fatigue in People with Cancer: Concept Analysis
Eun Hyun Lee
Journal of Korean Academy of Nursing 1999;29(4):755-765.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.4.755
AbstractAbstract PDF

Most people experience fatigue at some point in their lives, and they say the word 'fatigue' in their ordinary conversational speech. The ordinary word is used as a military or engineering term and has been studied in various different disciplines such as ergonomics, physiology, psychology, medicine, and nursing. In spite of its widespread uses, however, fatigue has not been well defined. The terms of fatigue is thus often used with different meanings and is applied in diverse contests that had led to a confusion of ideas. In people with cancer, fatigue is reported as a major distress. Despite the importance of fatigue in cancer patients, the phenomena of fatigue is poorly understood. Therefore, the purpose of the present study is to analyze the concept of fatigue in people with cancer. The process for the concept analysis was guided by Walker and Avant's conceptual analysis methodology. The identified attributes of fatigue in the present study were subjective feeling, lack of energy, sustenance, and multi-dimensions. The antecedents were cancer treatment and economic status. The consequences were decreased daily, vocational, leisure, and social activities, uncertainty, and difficulties in adjustment. Symptoms(pain, anorexia, and insomnia) and emotional disturbance were not clear whether they are antecedents or consequences. However, they are related with cancer related fatigue. Even though still in the beginning stage, instruments measuring cancer related fatigue have been developed by some nursing investigators.

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An Analysis of the Concept 'Empowerment'
Ok Hee Koo
Journal of Korean Academy of Nursing 1998;28(1):37-46.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.1.37
AbstractAbstract PDF

Recently the concept of 'empowerment' not only attracts attention in the area of management but also is considered as an useful concept in the areas of nursing theory, practice, education, and research. The purpose of this paper is to clarify the meaning of the concept 'empowerment'. More concretely, it is to find the concept that can be applied appropriately to the area of nursing management. This study uses Walker and Avant's(1983) process of concept analysis. The attributes of empowerment based on the concept can be defined concisely as follows: 1. a dynamic and interaction process. 2. a partnership which values self and others : power shaving. 3. mutual decision-making using resources, opportunities, and authority 4. accept autonomy and responsibility Antecedents of empowerment consist of 1) mutual trust and respect, 2) education and support, 3) participation and commitment. In regard to the consequences of empowerment, it is expected to 1) positive self-esteem, 2) ability to sex and reach goals, 3) the promotion of organization's effectiveness and productivity, 4) provide effective and high quality health-care, 5) a sense of hope for the future. The concept of empowerment is certainly believed that it will help future nurses since they needs an integrated technique that can treat acute and chronic patients' nursing, individuals, families, and communities. Therefore, it is necessary to develop the instrument including the defining attributes identified in this study. Also, it is need follow up study of this concept.

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Spirituality: Concept Analysis Based on Hybrid Model
Pok Ja Oh, Kyung Ah Kang
Journal of Korean Academy of Nursing 2005;35(4):709-720.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.4.709
AbstractAbstract
Purpose

The purpose of this study was to obtain a clearer understanding of spirituality and examine the process of spirituality through defining the meaning and attributes of spirituality.

Method

Concept analysis was done in the three phases, theoretical phase, fieldwork phase, and analytical phase suggested in the Hybrid Model. Five people participated in the fieldwork phase.

Results

Spirituality is activated through self-awareness which occurs as spirit being activated through self-introspection, and through restoration of the relationship with Supreme Being. This interconnectedness with Supreme Being has an absolute impact on one's harmonious interconnectedness with self and neighbors, thus leads all the critical attributes of spirituality to be revealed. The core energy of this harmonious interconnectedness is love. When activated, it has a great impact on an individual as integrative energy, leads one to go beyond everyday experience as well as to have new perspectives, and to live a satisfactory life in every aspect.

Conclusion

The results of this study suggest that promotion of connectedness is the most important element in spiritual nursing interventions. The results can also be used effectively in developing spirituality assessment scales and theory.

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Concept Analysis of Endotracheal Suctioning(ETS)
Young Mee Ahn
Journal of Korean Academy of Nursing 2005;35(2):292-302.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.2.292
AbstractAbstract PDF
Purpose

Concept analysis was performed on the behavioral concept of endotracheal suctioning (ETS), to identify the goal, to develop astandardized clinical protocol, to identify the antecedents and consequences, and to differentiate the improper use of ETS.

Method

Walker & Avant's concept analysis was employed using clinical guidelines, books and review articles in which the procedures of ETS were written in detail and published in Pubmed within the last 20 years.

Result

The macro-goal of ETS was to remove accumulated respiratory secretions. Three defining attributes of ETS were identified; catheter, suctioning and asepsis. Each attribute involved empirical referents, such as the size and depth of thecatheter, the suction pressure, duration and method for suctioning. The antecedents of ETS were identical to the clinical evidences for the need of ETS such as the nursing assessment data. The consequences of ETS serve as an evaluation criteria on the effectsof ETS based on the goal of ETS.

Conclusion

The concept analysis of ETS demonstrates an example of considering a specific nursing protocol of ETS as a behavioral concept, applying concept analysis to it to identify it's key behavioral components as defining attributes and empirical referents and then developing and applying the standard ETS protocol.

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Concept Analysis of Patient Safety
Mi Ran Kim
J Korean Acad Nurs 2011;41(1):1-8.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.1
AbstractAbstract PDF
Purpose

This study was conducted to investigate the clear concept of patient safety and obtain theoretical evidences.

Methods

Research was conducted using Walker & Avant's conceptual analysis process.

Results

Patient safety was defined as an activity that minimizes and removes possible errors and injuries to patients. It includes a basic desire to secure the patient's right to safety, and the legal regulations and duties of medical teams. The results of the establishment of a safety culture are patient-centered medical treatment and caring. Antecedents were found to be open and clear communications, continuous education and training for health care personnel, sufficient allocation of qualified personnel, cooperation among departments, improvements in the recognition of patient safety. Consequences were found to be the provision of high quality medical care and treatment, and increase in patient satisfaction.

Conclusion

Patient safety as defined by the results of this study will contribute to the foundation of institutionalization of the pursuit of patient safety and creation of a hospital culture focusing on patient safety as a first priority.

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Quality of Pediatric Nursing Care: Concept Analysis
Miyoung Choi, Kyungsook Bang
J Korean Acad Nurs 2010;40(6):757-764.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.757
AbstractAbstract PDF
Purpose

This paper is a report of a concept analysis of 'quality of pediatric nursing care'.

Methods

Rodgers's evolutionary method of concept analysis was used. Data were collected from published literature related to quality of pediatric nursing care.

Results

Quality of pediatric nursing care was identified with three dimensions and seven attributes: 1) nurse's character: technical competence, interpersonal competence, 2) nurse's activities: developmentally appropriate care, attentiveness, entertainment, 3) nurse-parent interaction: nurse-parent partnership, emotional support. Antecedents of quality of pediatric nursing care were 'child and parent's expectation about pediatric nursing care', 'previous caring experience of pediatric nurses'. Consequences of quality of pediatric nursing care were 'meet child and parent's needs' and 'better health outcomes.'

Conclusion

'Quality of pediatric nursing care' is a core concept in pediatric nursing practice. Appropriate instruments to operationalize the concept need to be developed.

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Concept Analysis of Resilience in Patients with Cardiovascular Diseases
Su-Jin Shin, Duk-Yoo Jung, Eun-Hee Hwang
J Korean Acad Nurs 2009;39(6):788-795.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.788
AbstractAbstract PDF
Purpose

The purpose of this study was to define and clarify the concept of 'resilience' in patients with cardiovascular diseases.

Methods

A hybrid model was used to develop the concept of resilience. The model included a field study carried out in Cheonan, Korea. The participants in this study were 9 patients with cardiovascular diseases who underwent a percutaneous coronary intervention.

Results

The concept of resilience was found to be a complex phenomenon having meanings in two dimensions: the personal-dispositional and interpersonal dimensions. Four attributes and seven indicators were defined.

Conclusion

A resilient person was defined as one who has a positive attitude toward restoration, the power to reconstruct and control his/her disease (personal dimension), and support from a supportive system with supportive persons (interpersonal dimension). In the clinical setting, resilience plays an important role in managing the care plans of cardiovascular patients. Therefore, nurses who work closely with patients suffering from cardiovascular diseases should be aware of the attributes and indicators of resilience to enhance the resilience of their patients.

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Concept Analysis of Relocation Stress - Focusing on Patients Transferred from Intensive Care Unit to General Ward -
Youn-Jung Son, Sung-Kyung Hong, Eun Young Jun
J Korean Acad Nurs 2008;38(3):353-362.   Published online June 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.3.353
AbstractAbstract PDF
Purpose

This study was conducted to analyze and clarify the meaning of the concept for relocation stress-focusing on patients transferred from an intensive care unit to a general ward.

Methods

This study used Walker and Avant's process of concept analysis.

Results

Relocation stress can be defined by these attributes as follows: 1) involuntary decision about relocation, 2) moving from a familiar and safe environment to an unfamiliar one, 3) broken relationship of safety and familiarity, 4) physiological and psychosocial change after relocation. The antecedents of relocation stress consisted of these facts: 1) preparation degrees of transfer from the intensive care unit to a general ward, 2) pertinence of the information related to the transfer process, 3) change of major caregivers, 4) change in numbers of monitoring devices, 5) change in the level of self-care. There are consequences occurring as a result of relocation stress: 1) decrease in patients' quality of life, 2) decrease in coping capacity, 3) loss of control.

Conclusion

Relocation stress is a core concept in intensive nursing care. Using this concept will contribute to continuity of intensive nursing care.

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Concept Analysis of Insight
Jiwon Hwang
Journal of Korean Academy of Nursing 2007;37(3):353-364.   Published online April 30, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.3.353
AbstractAbstract PDF
Purpose

This study is aimed to analyze and clarify the ambiguous concept of insight.

Method

This study used the process of Walker & Avant's concept analysis.

Results

Insight can be defined in terms of its attributes as follows: Insight 1) comes as a release to the tension of inquiry, (2) is the outcome of the process to discover the overall structure of the problem situation and psychologically restructurize it, (3) comes suddenly and unexpectedly, (4) is to clearly perceive the solution of the abstract problem, and (5) promotes obtaining another new insight. The antecedents of insight include inquiry that can not be resolved easily and also a state where basic knowledge related to the inquiry can be utilized. The consequence of the insight is (1) a new judgement is made, (2) the problem is solved, (3) previous insight is retained and transferred, and it also facilitates the generation of fresh insight, and (4) it passes into the habitual texture of one's mind.

Conclusion

Nurse educators need to facilitate nursing students and nurses to accumulate systematically, various information that can become the basis of insight and provide them with an opportunity to experience a variety of problems. In addition, it is important to provide questions to learners as an education strategy to allow them to gain insight into problem solving. From now on, insight needs to be studied in conjunction with critical thinking and questioning in order to enhance nurses' ability to resolve problems.

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A Concept Analysis of Assertiveness
Hyoung Sook Park, Young Ok Yang
Journal of Korean Academy of Nursing 2006;36(3):468-474.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.468
AbstractAbstract PDF
Purpose

The purpose of this study was to analyze and clarify the meaning of the concept, assertiveness.

Method

This study used Walker and Avant's process of concept analysis.

Results

1. Attributes of assertiveness were defined as 1) Self-esteem 2) Comprehension to others 3) Clarification of the subject 4) Verbal communication 5) Non-verbal communication 2. The antecedents of assertiveness consist of these facts 1) The occurrence of a conflict situation 2) The occurrence of will to stick to one's opinions 3. There are consequences occuring as a result of assertiveness 1) Positive self-confidence 2) Increased comprehension or consideration to others 3) Expand of mutual respect 4) Maintenance of continuously cooperative relationship with each other 5) Output of acceptable results to each other.

Conclusion

Assertiveness is a core human behavior and is key to interpersonal relationships. Using the components of the concept of assertiveness, many conflicts in a nursing situation can be effectively prevented.

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