Teaching concept analysis to graduate nursing students

Biopsychosocial rehabilitation in the working population with chronic low back pain: a concept analysis

OBJECTIVE

To identify the essential attributes of biopsychosocial rehabilitation for chronic low back pain in the working population.

DESIGN

A concept analysis was conducted according to the 8-step method of Walker and Avant. This framework provides a clear concept and theoretical and operational definitions.

METHODS

Five databases were searched, followed by a systematic screening. Subsequently, attributes, illustrative cases, antecedents, consequences and empirical referents were formulated.

RESULTS

Of the 3793 studies identified, 42 unique references were included. Eleven attributes were identified: therapeutic exercise, psychological support, education, personalization, self-management, participation, follow-up, practice standard, goal-setting, social support, and dietary advice. Subsequently, illustrative cases were described. Antecedents, such as motivation, preparedness and a multidisciplinary team, were found, together with consequences such as decreased pain, less sick-leave and increased function and work status. Finally, examples of empirical referents were given.

CONCLUSION

This study identified the attributes that are necessary to develop biopsychosocial rehabilitation intervention programmes for chronic low back pain. The defined concept of biopsychosocial rehabilitation for chronic low back pain may serve as a solid base to further develop and apply interventions. Future research should focus on the objectification of biopsychosocial rehabilitation and conceptualization regarding how personalization is done.

Instrumental support: A conceptual analysis

The aim of this paper was to use the Walker and Avant method of concept analysis to evaluate the concept of instrumental support in the context of hospital to home care transitions. Findings from this concept analysis suggest three defining attributes of instrumental support: informal support providers, tangible support, and unmet personal needs. Antecedents identified: a strong and supportive social network, an independently functioning adult, an illness resulting in hospitalization, a change in functional status, and the patient being discharged home from the hospital. Consequences of not having adequate instrumental support: unsuccessful recovery at home, increased risk for hospital readmission, decline in physical functioning, health complications, and increased risk of mortality. Empirical referents: patient's report of successful recovery, returning to an independent level of functioning, and the lack of hospital readmission or health complication. A model and a contrary case study were developed to provide examples of clinical cases related to instrumental support. Recommendations related to clinical practice include evaluating the availability/adequacy of instrumental support before hospital discharge and including the identified instrumental support person in the discharge planning process. There are proven benefits of having people within one's social network providing instrumental support during the home recovery period.

Food Insecurity in Older Adults in Canada and the United States: A Concept Analysis

A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified: (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.

Community engagement in the Faculty of Health Science: A concept analysis

Background

Community engagement has been given different interpretations by scholars and organisations; in addition, current scientific literature has not reached a consensus on how it is defined. This difference in conceptualisation may lead to confusion regarding the meaning. The researcher observed that academic staff from the Faculty of Health Science at an institution of higher education in Namibia are not certain of what counts as community engagement. This has led to some activities from the faculty being cancelled from the institutional review reports as they were not recognised as community engagement.

Aim

The aim of this article is to describe the concept analysis of community engagement.

Setting

the study took place at a faculty of health science at a university in Namibia.

Method

Concept analysis was done in accordance with the eight steps of the Walker and Avant model. A literature search was conducted to capture all potential definitions and uses of community engagement. A total of 225 definitions and uses of community engagement were recorded and used in the concept analysis. A list of definitions and uses of the concept of community engagement were documented with their citations, in a table with three columns. The first column (analysis) consisted of the identified definitions and uses of community engagement from the relevant literature. The second column (synthesis) consisted of reduced statements of the content presented in the first column. The third column (derivation) consisted of the final reduction into categories and connotations derived from the second column.

Findings

Three broad categories were revealed as findings: (1) the antecedents of community engagement, which included community challenges, health inequalities, societal needs and the need for a social responsive approach in education, research and services; (2) a three-phase process of community engagement; and (3) the outcomes of community engagement. A theoretical definition and a conceptual map for the concept of community engagement were drawn from the findings.

Recommendation

The results of the concept analysis of community engagement will be used to develop strategies for its facilitation in the Faculty of Health Science.

Shepherding: A concept analysis

The purpose of this analysis was to explore the concept of shepherding as it applies to nursing. Shepherding is a term used in chaplaincy literature to describe the guidance and protection a chaplain offers. While this term may be appropriate to the relational work of nurses, it has yet to be defined in the nursing literature. Walker and Avant's eight-step method for concept development was utilized. An electronic search using "shepherd/shepherding and nursing or health or inpatient" was performed in eight databases related to nursing, medicine, health, social sciences, and chaplaincy. Scholarly articles, in English, with substantive references to shepherding were included. Four defining attributes related to shepherding were identified: relational interaction, safety and comfort, reciprocal guidance, and transformation through possibilities and actualization. The operational definition of shepherding was thus identified as a relational interaction between the nurse and a patient or family during a transformational crisis. The nurse accompanies the patient, ensuring safety, and comfort and, through reciprocal guidance, the nurse supports the patient to understand possibilities and actualize possibilities based on the patient's preferences.