Concept Analysis Stephanie Hobbs NR 501: Theoretical Basis for Advanced Nursing Instructor: Dr. Patricia Fedorka September 30, 2012 Introduction According to McEwen & Wills (2011), concept analysis is an approach to clarify and define terms so that writers and readers have a common language. The process of a concept analysis is to: 1. Select a concept 2. Determine the aims or purposes of analysis 3. Identify all the uses of the concept possible 4. Determine the defining attributes 5. Indentify model case 6. Identify borderline, related, contrary, invented and illegitimate cases 7.
Identify antecedents and consequences 8. Define empirical referents The concept health is referred to as the ability to function independently; adapt to life’s stressors; achievement of one’s full potential and unity of mind, body and soul. Jean Watson identified health as one of many concepts used to understand the theory or science of human caring (McEwen & Wills, 2011). Purpose of the Analysis The purpose of this analysis is to clarify and define the term health. Clarification of this concept is essential to the function of caregivers.
Everyone responsible for providing care should be knowledgeable of what health is. Many believe they know what health is but after a closer look, it is revealed that at best, it is fleeting and partially understood. Also, it is necessary for medical personnel to understand the difference between health, care and nursing (Lee & Ross, 2008). Uses of the Health Concept According to Walker & Avant (2011), dictionaries, colleagues, thesauruses, and scholarly literature should be used to identify the uses of the concept. A search for the literature on health was done by using Medline, CINAHL and Google Scholar.
An online dictionary and thesaurus was also used. Dictionary Definition The English version of this word has many meanings. Webster defines health as the condition of being sound in mind, body, or spirit; especially: freedom of physical disease or pain. Other definitions by Webster are the general condition of the body, a flourishing condition, and a general condition or state (Merriam-webster. com). Defining Attributes Attributes as described by Walker & Avant (2011) are characteristics or descriptors. These attributes will help distinguish health from nursing and care. A state of complete physical, mental and social well being * A dynamic state of functioning within the limitations of the person (Artinian, 1991) * Unity and harmony within the mind, body and soul (Watson, 1999) * The expanding of consciousness; an evolving pattern of the whole of life (Newman, 1999) Model Cases 1. A 17 year old has given birth to twins and been referred to the Following Baby Back Home Program. On the initial visit, the nurse finds the mother is withdrawn and displaying signs of depression. She knows very little about the babies behaviors and is not very concerned about what the nurse or social worker is saying.
Upon further assessment, the mother reveals that she and the father are no longer together. The nurse also finds out later that mom was severely anemic at discharge and experiencing excruciating headaches. On the next visit, the nurse convinces mom to schedule her follow up appointment and she explains how anemia affects her and her ability to care for the babies. Although the client denied feeling depressed, the nurse discussed signs of post partum depression and got the client to sign a contract saying she would call for help if she felt like urting herself or the babies. After returning to the office, the nurse called the physician’s office to make him aware of her involvement with the client and her assessment. The nurse also refers the client to a program called ACCESS. This program provides parenting classes as well as counseling for teen parents and emergency help with diapers and formula. After visiting the client for a few months there is a noticeable difference in the way she interacts with the babies as well as her overall appearance and energy level.
The client is also attentive and interested in what the home visitors are talking about. The client states that she is taking medication for the anemia and on birth control. She is getting counseling and taking a parenting class through the ACCESS program. She also says she enjoys the program because she interacts with other teenager going through the same thing she is. This model reflects health because it contains many of the defining concepts. Any of the concepts missing could cause the client to not be in good health.
It also demonstrates why the nurse must have good assessment skills and address as many areas as possible that affect the client’s health. 2. An elderly lady diagnosed with Hypertension and Type II Diabetes presents to a Community Health Center for a follow up appointment. During triage, the client’s blood sugar is 357mg/dl and her blood pressure is 180/206. After speaking with the nurse, it is revealed that the client has been evicted from her home, has little to no food to get her through the month and did not purchase her medication due to a lack of money.
The nurse shares this information with the physician and the social worker. After the physician gets the blood sugar and blood pressure under control, the social worker enrolls the client into some med assistant programs and calls the nearest women’s shelter to secure her a bed. The nurse gives her enough samples to last until her meds come in. The client states she will follow the regimen prescribed by her physician. This model clearly demonstrates how social issues affect overall health. After the clients social needs were met, she was able to focus on taking care of her physical health.
This model also reflects many of the defining concepts. Borderline Case A borderline case gives another example of the concept’s use, but some of the defining attributes are excluded. Borderline cases give readers an idea of what the concept is not (Speros, 2005). A 55 year old male attorney presents to PCP complaining of chest pain, fever and shortness of breath for 3 days. He is told that he has to be hospitalized for a cardiac workout because a myocardial infarction is suspected. He is also told that he will have to have a cardiac catheterization.
The patient reads the consent and refuses to sign it because he does not understand the medical jargon. He leaves against medical advice but is told to take 2 propranolol 80mg and see his physician in 2 weeks. He takes 2 pills once a day and does not return to see his doctor. Contrary Case The following case is contrary to health because it does not reflect the defining concepts. A 26 year old mother from a very small rural community brings her 6 year old to clinic wheezing and short of breath. The mother smokes about 30 cigarettes a day, is very soft spoken, has a limited vocabulary and reads on a fifth grade level.
Mom also has problems spelling words correctly, prints when writing and reverses some of the letters. The child is diagnosed with Asthma and sent home with a nebulizer with albuterol and saline, a peak flow meter, steroid inhalers with spacers, and oral medication. Before leaving mom is asked if she understands how to give the child her medication? Mom states she understands and is then told to stop smoking around the child and return to the clinic in 1 week. Mom verbalizes understanding and leaves. Three days later mom presents to the Emergency room with child in respiratory distress and smelling of smoke.
She states she did not use the nebulizer because she could not “work it”, she gave the both medication twice a day as opposed to each medication daily and she did not have peak flow readings because she thought it look more like a toy. The child smelled strongly of smoke (Speros, 2005). This case clearly shows two people in poor health. It obviously is contrary to the defining attributes of health. Antecedents and Consequences Walker and Avant (1995) describe antecedents as events or incidents that must precede the occurrence of the concept. For some time there was very little theoretical clarity of health for nursing science.
In 1946 The World Health Organization attempted to define health and has since changed or added to the definition a couple of times. Walker and Avant (2005) also described consequences as events or incidents that occur as a result of the concept. Defining or clarifying the health concept has been important and useful to the theoretical basis of nursing. It has helped developed theory, instrument and research (Wang, 2005). Empirical Referents According to Cheng, Foster& Huang, empirical references present how the concept is to be measured or what the observation of a phenomenon should in reality be (tzuchi. om). Jean Watson’s Theory of Human Caring defined three concepts with health being one of them. Margaret Newman’s Theory of Health as Expanding Consciousness model uses two concepts one of those being health. These theories demonstrate the existence of health and how it has helped the nursing profession. Conclusion The concept of health was selected because of the many changes and variations to its definition. The World Health Organization defines health as a complete physical, mental and social well being and not merely the absence of disease or infirmity (who. int).
Regardless of the definition, health is a concept that has helped develop the nursing profession. The Reference Artinian, B. M. , (1991). The development of the intersystem model. Journal of Advanced Nursing, 164 -205. Lee, V. and Ross, J. , (2003). ‘What is Health? ’ Campaign. Canadian Journal of Public Health, 94(5), 360. Ne Newman, M. A. , (1999). Health as expanding consciousness (2nd ed. ). New York: National League for Nursing Press. http://userwww. service. emory. edu/~mrisjor/documents/Rethinking. pdf http://www. merriam-webster. com/dictionary/health http://www. tzuchi. com. w/file/DivIntro/nursing/content/92-3/3. pdf http://www. who. int/about/definition/en/print. html Speros, C. (2005). Health Literacy: Analysis Concept. Journal of Advance Nursing, 50(6), 633-640. Walker, L. O. & Avant, K. C. (1995). Strategies for Theory Construction in Nursing, 3rd ed. Appleton-Century-Crofts, Norwalk, CT. Walker, L. O. & Avant, K. C. (2010). Strategies for theory construction in nursing. Boston: Pearson Wang, Y. (2005). A concept analysis of health. Hu Li Za Zhi The Journal of Nursing, 52(1), 40-43. Watson, J. , (1999). Postmodern nursing and beyond. London: Churchill Livingstone. .