Feb 23, 2024 Week 3: Steps of Concept Analysis
Week 3: Steps of Concept Analysis
Week 3: Steps of Concept Analysis
The World Health Organization (WHO) defines Quality of life (QoL) as a person’s view of their situation in life in the perspective of the culture and value systems where they live, and with regard to their expectations, goals, standards, and concerns (Sarwar et al., 2019). It is the physical and mental health that a person perceives over time. QoL is further defined as how a person is healthy, comfortable, and able to engage in or take pleasure in life events. The term QoL is innately ambiguous since it can refer to an individual’s experience of their life and the living conditions in which people find themselves (Sarwar et al., 2019). The purpose of this assignment is to describe the defining attributes of QoL, the antecedent and consequence, create a model case, and theoretically apply the concept.
Three Defining Attributes
The three defining attributes of QoL are: A feeling of satisfaction with one’s life generally; A satisfactory state of physical, emotional, social, and mental health as established by the person referred to; The mental ability to establish one’s own life as satisfactory (Van Leeuwen et al., 2019). For example, for a person to say they have a good QoL, they need to be satisfied with their overall life. Besides, they should be satisfied with their physical, emotional, social, and mental health. They should be satisfied with their body’s physiological performance to have balance and harmony with themselves and others. They should also have a positive self-esteem and body image and positive and productive social interactions, personal relationships, and social support (Van Leeuwen et al., 2019). Lastly, a person with a good QoL exhibits the mental ability to assess their life as satisfactory.
Antecedent and Consequence of The Concept
An antecedent is not necessarily a causative factor, but it is important for the concept to occur and can contribute to its cause. An antecedent of QoL is an individual’s ability to make a decision (Haraldstad et al., 2019). An individual may feel that it is important to get on with life. However, the decision often depends on the limitations their QoL imposes, such as physical activity and socialization levels. Individuals evaluate their lives and make decisions, which can sometimes improve or worsen their QoL (Haraldstad et al., 2019). On the other hand, consequences refer to factors that follow the occurrence. A consequence of QoL is acceptance of one’s circumstances. The results of a positive QoL are coping, adaptation, and satisfaction with life (Haraldstad et al., 2019). However, the results of a negative QoL are a lack of satisfaction and risk-taking behavior beyond that of a person’s age.
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Model Case
A model case is an example of the use of a concept that shows all of its defining attributes. The following is a model case for QoL: A 32-year-old man gets home from work one evening. As he parks his SUV in the parking lot next to his wife’s car, his two children, 5-year-old and 3-year-old, run and scream with joy to welcome him home. He can also see his wife smiling and waving at him at the door. The children hug him and help him carry some snacks he brought for them. When he gets to the house, his wife hugs and welcomes him and offers him a cup of tea. He sits and tells himself, “I have the life I was dreaming of; there is nothing I wish to change.” He reflects on how lucky he is to have a happy family, a successful business, good health, and supportive friends. Many people look upon him and wish their life was a fraction of his.
The model case demonstrates the quality of life. The three defining attributes are presented in the case. The man has an overall sense of happiness and satisfaction with his life. He has the mental ability to evaluate his life. Besides, he feels he is in good health since he can do the things he wishes to. Furthermore, other people also assess her life be of quality.
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Theoretical Applications of the Concept
Peplau’s nursing theory applies to the concept of QoL. QoL is entrenched in Peplau’s theory as an indefinable, extensive phenomenon. Peplau considers QoL as a subjective view of the condition of an individual’s life, which is equal to a person’s wellbeing and psychological wellness and often connected with health (Hagerty et al., 2018). A relationship is fundamental in Peplau’s theory, whereas QoL is considered a by-product of the relationship and thus significant to the theory. Peplau proposed that QoL is mostly a subjective perception and varies with changing conditions; (time and situation-dependent) (Hagerty et al., 2018). Nonetheless, QoL is considered an intangible quality in the theory.
Reflection
QoL concept applies to advanced nursing practice (APN) since APRNs must understand that QoL is the degree to which individuals enjoy a good life. Besides, APRNs should understand that a person enjoys a good life when they attain a balance in their relations with themselves and others by creating and maintaining adequate conditions and personal potentials over the life course. QoL, without a doubt, is relevant to APN practice. Patients often consult NP on how to achieve the best possible QoL for themselves or their loved ones. For an NP to help these patients and their families, they must themselves reflect on what is meant by QOL.
References
Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2018). Peplau’s Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?. Nursing science quarterly, 30(2), 160–167. https://doi.org/10.1177/0894318417693286
Haraldstad, K., Wahl, A., Andenæs, R., Andersen, J. R., Andersen, M. H., Beisland, E., … & Helseth, S. (2019). A systematic review of quality of life research in medicine and health sciences. Quality of life Research, 28(10), 2641-2650. https://doi.org/10.1007/s11136-019-02214-9
Sarwar, S., Aleem, A., & Nadeem, M. A. (2019). Health-Related Quality of Life (HRQOL) and its correlation with academic performance of medical students. Pakistan journal of medical sciences, 35(1), 266–270. https://doi.org/10.12669/pjms.35.1.147
Van Leeuwen, K. M., Van Loon, M. S., Van Nes, F. A., Bosmans, J. E., De Vet, H. C., Ket, J. C., … & Ostelo, R. W. (2019). What does quality of life mean to older adults? A thematic synthesis. PloS one, 14(3), e0213263. https://doi.org/10.1371/journal.pone.0213263
Concept analysis is mainly associated with boundary work which directs A given discipline as well as creates connections between theory, research, and actual practice. The concept of palliative care forms a vital apsect in the nursing profession. The Kolcaba’s Comfort theory perfectly incorporates palliative care given that she employs a holistic approach which is focused majorly in enhancing patients well being. Palliative care is basically the concept of healthcare professionals working as a team to provide comfort and alleviate patient suffering as a result of a number of illnesses and medical conditions (Lafond et al., 2019). This paper provides literature review in addition to themes and ideas of the selected concept. It also elaborates the characteristics and different aspects of palliative care. The empirical referents elaborate the ways that can be utilized in measuring the magnitude of the concept. Several patients cases have also been reviewed for inclusion of the attributes of palliative care.
Definitions/Explanation of Nursing Concept
Palliative care refers to the focus on alleviating the patient’s strains and symptoms especially those suffering from terminal and serious illnesses. The main objective of palliative care is to reduce patients suffering and promote their wellness and general quality of life. Palliative care can also be defined as an approach which is aimed at improving the patients quality of life, both adults and children, together with their families as a result of a terminal illness (Lafond et al., 2019). Pain and suffering alleviation can be best achieved through identifying the illness in its early satges, conducting correct assessment, and coming up with the most appropriate plan to handle the issue. The healthcare care team for the patient is usually made up of nurses, physicians, pharmacists, social workers, chaplains, psychiatrists and nurse aides, among others. the family members of the patients are usually educated by the team on how to cope up with the situation and help in caring for the patient. in as much as palliative care mainly focuses on terminally ill patients, those who are receiving curative care may also pose as candidates. Apart from the hospital, the patient can also receive palliative care from home or even nursing homes. It is also important to assess the financial status of the family when deciding on the type of care plan to implement. Communicating and discussing with the patient the available care plan options makes them feel in control of their care.
Literature Review
Different pieces of literature have elaborated the different aspects of palliative care for enhanced understanding of this nursing concept. According to Blackhall et al. 2016, palliative care should be made available to every member of the community. The healthcare system must allocate adequate resources to ensure that patients with terminal illness together with there family members receive quality care and adequate support when needed. Healthcare workers should also be adequately trained to intervene appropriately when it comes to taking care of patients with terminal illness. Miller, Lima and Thompson, 2015, reported that most of the deaths recorded in nursing homes are as a result of nurses being unable to alleviate pain and suffering. As such, nurses need to receive adequate education, training, and experience to be able to appropriately take care of patients with terminal illness by alleviating pain and suffering and educate their family members on how to cope up with and take care of their loved ones. Aldridge et al., 2016, assessed the barriers preventing widespread implementation of palliative care in the united states. They found out that shortage of education and training programs, inadequate workforce trained in palliative care and a poor policy domain as a result of fragmented healthcare system were the main barriers to the spread of palliative care in the US. As a result, appropriate policy should be put in place in America to enhance more educational opportunities and resources to promote palliative care.
A study that was conducted by Kunte, Johansen, and Isenberg-Cohen, 2017, revealed that educating nursing staff, especially nursing assistant on end of life care, reduces the duration of hospital stay leading to an enhanced quality of end of life care at patients home and nursing homes. The nursing assistant normally tends to benefit from a combined education session with nurses. Adams, Miller and Grady, 2016, acknowledged the fact that all patients with unknown treatment and effects usually lie in bed waiting for answers as to why they are suffering. As such, it is important to introduce palliative care to their care plan to offer concomitant treatment. Provision of comfort care has a significant impact on such patient’s wellness. it is also important to acknowledge that fact that emotional fatigue and burnout are common especially among pediatric patients and hence should be addressed appropriately. Lastly, Jonas and Bogetz, based on their study results suggested that it was important to take into consideration the provision of stress reduction workshops in addition to offering counseling for palliative care professional workforce.
Defining Attributes
End of life care (palliative care) is crucial. However, just as elaborated in the Kolcaba’s Comfort theory, caring cannot be defined merely by a succinct statement. As such, it encompasses behaviors and attitudes which healthcare practitioners engage in to help patients. In palliative care, professionals are required to possess a number of attributes such as clinical expertise, trust and honesty, collaboration, family orientation, attentiveness, and deliberateness. Nurses are expected to have clinical expertise on the management of symptoms, and comfort strategies for patients in addition to unique responses to different treatment modalities and the dying process (Kunte, Johansen, and Isenberg-Cohen, 2017). Honesty is essential given that it is the foundation of trust and a healthy therapeutic relationship between the patient, and their families and the healthcare practitioner. Healthcare professionals working in palliative care must be family oriented as result of different patients with different context of multiple and dynamic relationships. Consequently, nurses are expected to be collaborative to be able to come up with cohesive treatment plan for health promotion. Lastly palliative care requires healthcare providers who are goal-directed and purposeful to enhance proper preparations so as to provide the best care and alleviate suffering.
Antecedent and Consequence
One antecedent, in this case, will be development of a new diagnosis or intervention for a chronic disease such as cancer. In such a scenario, both the patient and the nurse will have to embrace the change and enhance outcome. For instance, in the case of cancer patients, pain and suffering are normally caused by the associated signs and symptoms, or even chemotherapy and radiations. As such, in palliative care should enhance new diagnostic criteria for early diagnosis so as to prevent the disease in early stages or come up with new interventions which will alleviate the symptoms with no suffering but instead promote the quality of life of the patient. The main consequence of improved interventions is reduced pain and suffering (Kunte, Johansen, and Isenberg-Cohen, 2017). In palliative care, the priority of the healthcare team is directed towards relief of physical symptoms and maintaining individual dignity and autonomy, in addition to supporting their families. The interventions will also help the affected families deal with impending loss and grief.
Empirical Referents
The main empirical referents in the case of palliative care could be taking measurements of the patient’s pain level and evaluating the respiratory and cardiovascular status. In patients who are conscious, the adult pain scale can be used to assess the level of comfort, as elaborated by the Kolcaba’s Comfort theory. The process is characterized by the patient verbally stating their current pain level based on a scale of 1 to 10, where 1 is the least and 10 the most severe. Patients who are unconscious can utilize the nonverbal scale which entails different facial expressions for different levels of pain (Meier, & Bowman, 2017). pain reduction is key in alleviating suffering and stress and improving patient’s wellness and quality of life. The respiratory and cardiovascular status of the patient can also be utilized in measuring comfort. For instance, tachypnea can be a sign of a patient being in pain. rales and rhonchi also indicate increased secretions, or aspirations or even heart failure. Use of oxygen therapy and pain medications may help in alleviating pain and suffering.
Constructed Cases
Palliative Care Model Case: A female patient, 40 years of age, with an end-stage ovarian cancer decided to terminate all her cancer treatment plan and only use palliative care. She wanted to receive the care from her home. They approached a home nurse who was very empathetic and supportive of their decision while discussing the goals of palliative care. The nurses then coordinate the social work in arranging for how the patient will receive the best care. The nurse calls for the family and discusses with them the support plan that has been put in place for them. The plan was initiated after two days, of which the patient’s comfort was addressed and family supported appropriately with an interdisciplinary team.
Borderline Case: A male patient, 68 years of age presented to the clinic with severe hemorrhagic cerebrovascular accident. Patients symptoms included right hemiplegia, confusion, and global aphasia. The patient was placed in a skilled nursing facility by a social worker. The patient’s needs were addressed by the nurse in charge. The nurse also speaks to the patient’s wife and acknowledges her of her husbands’ condition. After a few weeks, the wife comes back complaining that the needs of the patient were never addressed, and her husband dies afterward. She insists on speaking to a chaplain. She ends up in deep sorrow. The patient’s comfort was appropriately addressed, however, the care plan lacked family support and inclusion of an interdisciplinary healthcare team.
Contrary case: A male inmate, 48 years old is suffering from end-stage coronary heart failure. The patient displayed poor prognosis. The patient claims that he is tired with pharmacotherapy and would prefer palliative care. He will be allocated to stay at the prison infirmary shackled to a bed. The patient lies in bed with lots of pain. The nurse who was on duty ignored him as it was almost time for her to take a break. The patient’s family are notified that the patient is suffering from a terminal illness. However, their concerned and questions past this information are ignored. No family support is offered. The patient dies, and the family is left helpless as the social work and chaplain who were to assist with the post mortem arrangements and the bereavement support were overloaded with cases. The patient comfort, support for the family and assistance by an interdisciplinary team were all avoided.
Theoretical Applications of the Concept
Concept analysis is essential in availing the framework which guides the discipline and creates a connection between theory, research and actual practice as stated earlier. It breaks down the concept of effective integration. This enhances new insight on research findings which greatly impacts the development of a theory. One of the nursing theories that greatly aligns with the concept of palliative care in Katharine Kolcaba’s Theory of Comfort. This theory is mainly based on the patient’s overall security and contentment as the primary focus. Consequently, Katherine elaborates the holistic approach utilized in enhancing sociocultural psychospiritual, environmental and physical well-being. She goes ahead to incorporate ease, transcendence, and relief in comfort of a patient who is suffering. According to Lafond, Bowling, Fortkiewicz, Reggio, & Hinds, 2019, comfort has been defined as a positive concept that is associated with activities which strengthen and supports the patient.
Conclusion
In general, palliative care is an important aspect of the nursing profession. It represents a comprehensive approach in enhancing patient’s health and well-being by alleviating pain and suffering especially for patients with terminal illness. Consequently, the patient’s preferences and choices are usually taken into consideration during palliative care. As displayed in Kolcaba’s theory of comfort, holistic care is essential in attending to the patients medical, social, spiritual and emotional needs just like in the case of palliative care. For effective outcome, interdisciplinary resources must be utilized. The caregiver’s concerns must also be acknowledged and addressed appropriately. A support system must also be built for both the patient and his or her family. In this paper I have not exhausted the whole concept of palliative care. However, as a nurse practitioner I will conduct adequate research and adopt appropriate skills especially when it comes to referring a patient. I will also educate the healthcare staff on the concept and related nursing theory. Consequently, I will discuss the attributes of palliative care as elaborated in this paper.
References
Aldridge, M. D., McKendrick, K., Meier, D. E., Hasselaar, J., Van, D. E. M., Garralda, E., Centeno, C., … Centeno, C. (March 01, 2016). Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliative Medicine, 30, 3, 224-239.
Kunte, V., Johansen, M. L., & Isenberg-Cohen, S. (December 01, 2017). Improving Long-Term Care Residents’ Outcomes by Educating Nursing Staff on End-of-Life Communication. Journal of Hospice and Palliative Nursing, 19, 6, 550-555.
Adams, L. S., Miller, J. L., & Grady, P. A. (January 01, 2016). The Spectrum of Caregiving in Palliative Care for Serious, Advanced, Rare Diseases: Key Issues and Research Directions. Journal of Palliative Medicine, 19, 7, 698-705.
Blackhall, L. J., Read, P., Stukenborg, G., Dillon, P., Barclay, J., Romano, A., & Harrison, J. (January 01, 2016). CARE Track for Advanced Cancer: Impact and Timing of an Outpatient Palliative Care Clinic. Journal of Palliative Medicine, 19, 1, 57-63.
Jonas, D. F., & Bogetz, J. F. (June 01, 2016). Identifying the Deliberate Prevention and Intervention Strategies of Pediatric Palliative Care Teams Supporting Providers during Times of Staff Distress. Journal of Palliative Medicine, 19, 6, 679-683.
Meier, D. E., & Bowman, B. (March 01, 2017). The changing landscape of palliative care. Generations, 41, 1, 74-80.
Miller, S. C., Lima, J. C., & Thompson, S. A. (January 01, 2015). End-of-life care in nursing homes with greater versus less palliative care knowledge and practice. Journal of Palliative Medicine, 18, 6, 527-534.
Lafond, D. A., Bowling, S., Fortkiewicz, J. M., Reggio, C., & Hinds, P. S. (January 01, 2019). Integrating the Comfort Theory™ Into Pediatric Primary Palliative Care to Improve Access to Care. Journal of Hospice and Palliative Nursing : Jhpn: the Official Journal of the Hospice and Palliative Nurses Association, 21, 5, 382-389.
At the end of Week 4 your concept analysis is due. This discussion provides an opportunity to start this assignment.
Select a nursing concept, supported by a nursing theory, and address the following components included in a concept analysis:
• Definition of concept
• Identification of three attributes of the concept
• Description of one antecedent and one consequence of the concept
• Identification of at least one empirical referent
• Brief explanation of theoretical applications of the concept (How is the concept relevant to a nursing theory?)
This information does not have to be comprehensive but provides a foundation to the upcoming
assignment. Be sure to include scholarly references.
NR 501 Week 3: Steps of Concept Analysis
NR 501 Week 3: Development of Nursing Theory and Concept Analysis
At the end of Week 4 your concept analysis is due. This discussion provides an opportunity to start this assignment.
Select a nursing concept, supported by a nursing theory, and address the following components included in a concept analysis:
• Definition of concept
• Identification of three attributes of the concept
• Description of one antecedent and one consequence of the concept
• Identification of at least one empirical referent
• Brief explanation of theoretical applications of the concept (How is the concept relevant to a nursing theory?)
This information does not have to be comprehensive but provides a foundation to the upcoming
assignment. Be sure to include scholarly references.
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Collapse SubdiscussionAdelaida Larduet Mayeta-Peart
Adelaida Larduet Mayeta-Peart
Jan 14, 2018Jan 14 at 11:25am
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Hi Professor Talley and colleagues,
Definition of concept: The concept this author has selected for analysis is caring. The caring concept is found in the nursing Theory of Human Caring, this Nursing Theory was developed by Jean Watson. According to Chamberlain College of Nursing (CCN) concept and theory analysis are dominant instruments that benefit and bring light to the nursing practice. There are eight steps to carry out when developing a concept analysis. These steps will be discussed by the writer during this discussion question.
The concept of interest for this discussion question is Caring. Caring and nursing are two terminologies that are impossible to be separated. According to Lindberg, Fagerstrȍm, Sivberg, & William (2014) caring is the basis of nursing and is firmly connected to ethos, whereas nursing primarily relates to actual work done by the nurses.
Caring is the core of nursing
and is closely connected to ethos, whereas nursing mainly
relates to the actual work done by the nurses
According to Lindberg, Fagerstrȍm, Sivberg, & William (2014) caring quality encompass respect for patient self-determination, practice aspect of nursing, caring relationships that nurses and patients establish and the health and wellness attitude. In other words, it is crucial in caring to have an understanding of the culture, attitude, variability, relationship, action and acceptance.
To provide a description of one antecedent and one consequence of the concept we could start by stating that nursing education is of paramou
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