Concept development

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Outline

Introduction

Types of concepts

Definition of concept analysis

Importance of concept analysis

Steps of concept analysis

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 Learning objectives
At the end of this session, the learners are expected to
 Describe the importance of concept analysis for theory
development
 Indentify the activities performed in each steps of
concept analysis
 Practice concept analysis by selecting a phenomenon
which is important to nursing profession

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Introduction to concept
 The main component of theory.
 Is an idea, thought or notion conceived in the
mind.
 May be empirical or abstract depending on their
ability to be observed in the real world

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Type of concept

 Empirical concepts - observed or experienced

through the senses.
 Abstract concepts - not observable which measured
indirectly.
E.g self-esteem, caring, hope, and infinity.

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Purpose of concept
Explain and describe phenomena
Clarify phenomena
Reduce some conceptual confusion
Good concepts are essential to formulate good theory

Nature of concept
Many of the concepts used in nursing are abstract
and nebulous (vague)

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Levels of concepts
Global concepts: these are those represented by the
metaparadigm: person, nursing , environment and health

Middle-range concepts: such concepts as self-care, energy

fields, adaptation, etc., and may be related to one or more of
the global concepts.

Empirical concepts: more precise and include measurable

concepts such as hours of sleep, body temperature, etc.

These may be included under the middle-range concepts of

adaptation or self-care
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Concept development

Approaches used to advance concepts for theory

development

Aimed at clarifying existing concepts or exploring

new ones

Essential for knowledge development in that field

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 Situations need concept development

 Few concept or no concept are available in the

focal area of interest
 Concepts available are unclear, outmoded, or
unhelpful
 Literatures and researches on a concept do not
match.

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Strategies for concept development

1. Concept exploration

2. Concept clarification

3. Concept analysis

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Strategies cont’d. . .
Concept exploration - Used when new concepts are
identified and before they become an accepted
component of nursing dictionary
Concept clarification – used to refine concepts that
have been used in nursing without clear and shared
agreement on the properties or meanings given to them
Goal - To refine existing definition
- Sharpen theoretical definitions
- Discover new relationships 11
Concept analysis

A technique or mental activity that requires

critical approaches to uncovering
subtle(UNDERSTATED) elements of meaning
that can be embedded in concepts.
It is a core activity in the development of theory

In order to extend the knowledge base of nursing,

a concept analysis needs to focus on concepts
relevant to the metaparadigm.
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Concept analysis cont’d…

Nursing may be better served if the meaning of

relevant concepts was clarified rather than time
being spent analyzing concepts which have more in
common with the metaparadigm of other disciplines

Concepts borrowed from other disciplines may be

reconstituted through analysis in order to generate
meanings appropriate for nursing
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Importance of concept analysis
Helps to refine and define an ambiguous concept that
has originated in practice, research or theory

It helps us to differentiate it from similar and dissimilar

concepts (clarify those over used vague concepts)

To operationalize the existence of that concept in

nursing practice
To understand the theory better and to put it in to
practice

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Steps of concept analysis
Step 1: Select the concept of interest

Step 2: Define the aims of the analysis

Step 3: Identify meanings of the concept

Step 4: Determine the defining attributes

Step 5: Identify a model case

Step 6: Identify alternative cases

Step 7: Identify antecedents and consequences

Step 8: Consider context and values

Step 9: Identify empirical indicators

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Step 1: select the concept of interest
A concept may be selected from an intuitive feeling or an
area of concern.

The best concept analyses tend to have their roots in

clinical phenomena
 This helps to bridge the theory– practice gap in that the
end result has more credibility and relevance for practice.
 The developed theory can be more easily used and tested
in practice

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Step 1 cont’d…

While giving care a practitioner’s attention may be

attracted to a particular phenomenon
 Attention grabbing
Then attention giving

Example of attention giving question: ‘what are

the properties of pre-operative anxiety?’

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Step 1 cont’d…
To ensure that the nursing focus is not inadvertently
ignored, nurses persistent with probing questions
such as:

How is the phenomenon related to nursing’s body of

knowledge?

Would understanding the phenomenon contribute to

better understanding of a patient care issue?

How would questions relating to the phenomenon be

significant for nursing?
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Step 1 cont’d…
Once these questions have been answered, label
the phenomenon with a word or a short phrase.

Contain one cardinal idea and be fundamental to

the definition/description of the phenomenon;
 This label is a concept

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Step 1 cont’d…
Example: intuition, caring, compassion, spirituality,
loneliness, loss…

It may be helpful to categorize the concept requiring

analysis within the metaparadigm.

E.g.
 ‘well-being’ may be subsumed under health
 ‘identity’ or ‘body image’ under person

 ‘caring’ or ‘empathy’ under nursing

 ‘energy field’ under environment
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Step 1 cont’d…

For the first analysis we undertake it may also be a

good idea to avoid broad concepts: e.g.
communication

A range of concepts can be selected for analysis:

sorrow, hope, intuition, caring, grief, restlessness,
trust, quality of life, dignity, comfort, feeling,
burnout, etc.

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 Step 2: Define the aims of the analysis
Among many reasons to undertake concept analysis
To reduce a complex concept to its component parts for
examination of its internal structure to increase its
explanatory power
To examine and clarify confusing or unclear concepts in an
existing theory and provide the basis for operational
definitions
For refining and generating research questions and
hypotheses
Allow the operationalization of variables for testing a
theory or hypothesis through a research study

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Step 2 cont’d…

 Clarifies overused concepts

 Differentiates a concept from other similar yet
different concepts
 Lays the foundation for theory development
 The outcome of a successful concept analysis is
the identification of empirical indicators to
reliably inform the presence or absence of the
concept.

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Step 2 cont’d…
This Step should provide a good rationale as to
why we are undertaking the process at all.

Research-based justification for selecting a

particular concept may be provided.

The prime purpose for undertaking an analysis is

to clarify and to create conceptual meaning for a
clinical phenomenon.

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Step 2 cont’d…

This step will also set the parameters for later

steps in the process

If the purpose was to investigate fear or

hopelessness among coronary care patients then
this will guide us towards those indicators and
attributes identified as an aid to recognizing and
investigating these concepts.

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Step 3: Identify meanings of the concept

Involves trawling (searching) the literature to find

as many pertinent meanings of the concept as
possible

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Step 3 – meaning cont’d…
If the concept was ‘caring’, note that it could be
perceived as a noun or an adjective, whereas ‘care’
could be a verb

‘Care’ could also mean caution or attention or

protection.

It is a good idea to keep searching until you reach

the stage of ‘diminishing returns’, where no new
meanings are being uncovered.
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Step 3 – meaning cont’d…

Definitions are often unclear and ambiguous, so

simply providing a list of definitions of a concept
should not be interpreted as undertaking an analysis.

It is also recommended to examine what theorists or

researchers have said about the concept.

Do not confine the search to nursing, but include all

those who have attempted to use the concept within
their theory or study.
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Step 3 – meaning cont’d…
Sources that may give you an insight into the use
of the concept:
Professional, popular, classical and
philosophical literature
Poetry
Books of quotations
Music
Paintings
Photographs
Dictionary
Colleagues
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Step 4: Determine the defining attributes
 The meanings of the concept identified in Step 3 explicate
(clarify) the particular characteristics of the concept that
occur again and again.
 These refer to as the ‘defining attributes’ of the concept.
 In essence, the defining attributes distinguish the concept
from similar or related concepts.
 For each concept there may be a list of several defining
attributes

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Step 4: Defining attribute cont’d…
 It is better to have 3 or 4 defining attributes that really
characterize the concept well
 E.g. Of a defining attribute:

Caring - providing for another

Empathy - demonstrating concern

Attachment - visual contact

 Ensure that the defining attributes are examined for their
degree of consistency with nursing’s perspective.
 Differentiate the concept being analyzed from dissimilar
ones
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Step 4: Defining attribute cont’d…
Test for necessity – checking the ability of the
attributes to differentiate the concept from
dissimilar concepts

Test of sufficiency - the entire list of defining

attributes is considered

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Step 4: Defining attribute cont’d…
 When undertook a concept analysis of ‘caring’. It
identified the following defining attributes of
caring:
Serious attention
Concern
Providing for
Regard, respect, or liking

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Step 5: Identify a model case
A model case is a pure example of the concept being used
and should include all the defining attributes.

Extract from the literature illustrating a real-life event or a

clinical example that accurately describes the concept

Model case enhances the degree of clarification and

credibility of the concept

There must be no contradictions between the model case

and the defining attributes

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Model case for ‘self-care’
A 30 year old woman has just been diagnosed with Type I
diabetes. She returns from her health clinic armed with
literature she received after educational sessions with the
diabetes nurse educator and dietician. Included in this
literature is a phone number that she may call for additional
support, should she have questions. She also has a follow-
up appointment to reinforce the new knowledge she
received at today's’ session. Over the next several days and
weeks, she begins to make lifestyle changes.

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Model case cont’d…

Her eating habits are changing based on self-selected choices.

She begins an exercise program. With the assistance of her
diabetes nurse educator she becomes adept at giving herself
insulin injections. Four times a day she checks her blood sugar.
When she returns to the clinic one month later for one of her
follow up visits she feels confident that she is able to manage
this disease. Her lab results reflect this also. This individual
has been empowered to successfully implement self-care.

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Model case cont’d…
The above model case illustrates the defining characteristics
of self-care through the inclusion of specific behaviors such
as:

Dietary changes

Blood glucose monitoring and

Exercise

Additional defining characteristic of self-care is the inclusion

of a nurse or other health care professional to facilitate the
process.
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Step 6: Identify alternative cases

Provide examples of what is not the concept

Alternative cases include

Related cases
Borderline cases
Contrary cases

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Related case
In a related case all the defining critical attributes
are missing but the concept is still seen as similar
in meaning to the concept
Related cases may represent concepts that are
often confused with the concept under study

E.g. the concept stress with burnout

Fear with anxiety
Adaptation with coping
Comfort with care
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Related case cont’d…
 E.g. of related case ‘self-care’
 An individual with chronic fatigue syndrome attends
a self-help group meeting with the intent to learn
how to cope with his illness and receive support
from fellow chronic fatigue patients. By attending
this meeting the individual will gain knowledge into
his disease process and be empowered to do more to
help himself.
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Related case cont’d…

 However, there is no evidence of any actual self-

care behaviors or activities occurring,
 Although there is similarity in the two concepts of
self-help and self-care.

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Borderline case
This example is very similar to a model case but
some of the defining attributes are missing

Identifying borderline cases helps to clarify the

attributes which are an essential prerequisite of the
model case and helps to reduce the blurring of the
boundaries between cases.

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Borderline case cont’d…

E. g. of border line case ‘self-care’

At the end of a weekend, a college student packs to

return to his campus dorm. As he prepares to leave
in his car, his parents call out “take care of
yourself”. He responds with “I will”.

This demonstrates the parents concern for their

child’s welfare and safety.

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Borderline case cont’d…
The parents are implicitly suggesting to their son to
utilize self-care measures like
Use of seat belts
Driving within the speed limit and
Getting adequate sleep and exercise

However, there is no evidence of whether the son

is actually performing these behaviors

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Contrary case
This case represents what is not the concept being
analyzed

Chinn and Kramer (1995) warn against simply

identifying an opposite case to the model case

When examining the concept of ‘self-care’, a

contrary case would be an example of an
interaction where a individuals were consciously
harming a themselves.
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Contrary case cont’d…
 E.g. of contrary case of ‘self-care’
 A 35 year old woman who has felt an enlarging breast lump
for over a year. It has now enlarged to the size of a golf ball.
She consumes 3-4 alcohol drinks daily, smokes 2 packages
of cigarettes daily, doesn’t exercise, and her last visit for a
physical examination was after the birth of her last child 10
years ago. She doesn’t trust the news media and therefore
pays no attention to health news reported in newspapers and
on television.
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Step 7: identify antecedents and
consequences

Antecedents
 An antecedent contribute to the occurrence of the
concept/the predisposing factors certain concept
 It gives an indication of the purpose of the analysis and the
clinical arena
 Consider that something cannot be an antecedent and a
defining attribute at the same time.

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Step 7: Antecedents cont’d…

 E.g. of antecedents of ‘self-care”

 Need to maintain health and prevent disability
Patient with chronic illness
 Need to alleviate the symptoms of a disease
process

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Step 7: Consequences

Consequences are those events or outcomes that

happen after the occurrence of the concept.

Example for ‘self-care’ positive/negative

Pregnant women may practice negative self-care

behaviors. Examples include using alcohol or
drugs and smoking during pregnancy (Negative)

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Step 7: Consequences cont’d…

 Self-care activities modify and improve on

achievements made during the course of
rehabilitation for patients following stroke disease.
 Self-care is viewed as enabling these individuals to
maintain and comply with treatments consistently
(positive)

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Step 8: consider context and values

Concepts have different meanings depending on

the context in which they are used.

E.g. Caring in an ICU may be perceived differently

from caring in an elderly rehabilitation unit or in
Africa compared to Japan.

Contextually, language and culture play a major

role in how concepts are viewed.

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Step 8: Contexts and value cont’d…
Values and beliefs are also important considerations

Dependency may be seen as a normal social need

in some communities but as a burden on society in
others

Clients’ self-care may be seen as important and

valuable by some nurses but as upsetting to the
ward routine by others.

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Step 9: identify empirical indicators
 These are clear referents for measuring or
appraising the existence of the concept.
 Referred to as the operationalization of a concept
 In some cases, the empirical indicators will be the
same as the defining attributes identified in step 4
above.

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Step 9: Empirical indicators cont’d…
 Such indicators are useful in research and practice
 Because they can provide criteria by which a
concept can be measured
 The foregoing stepwise concept analysis has not
been without its detractors.

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Assignment
 Select a concept or phenomenon of your interest in nursing, analyze it
after searching at least 40 literatures, summarize it in five pages and
1500 words and submit with in five days . Remember it accounts for
20% of your evaluation.
 N.B. Appropriate referencing is essential and encouraged
 Evaluation criteria
1. completeness of the steps (4%)

2. Clarity in each steps (4%)

3. Number of reference and words (4%)

4. originality, clarity and formatting of the document (4%)

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