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Four concepts in Nursing

Conceptual framework vs. Theoretical framework

Nursing Concept Development, Types, Sources and Nursing Metaparadigm

Conceptual and Operational definition

Nursing Concepts

Abstract vs concrete concepts

Concept analysis

Concept synthesis

Concept derivation

Continuous vs. Discrete

Prof. Tyrone C. Hora

Presentation objectives

Presentation Objectives

Discuss the concept of "concept", types,sources and definitions of concepts.

Discuss the concepts of person, health, environment, and nursing (metaparadigm).

The Concept of "concept"

The concepts of "concepts"

  • Concepts are term that refers to phenomena that occur in nature or in thought.

  • Concepts have been compared to bricks in a wall that lend structure to science (Hardy, 1973).

  • Concepts are formulated in words that enable people to communicate their meanings about realities in the world (Cutcliffe & Mc Kenna, 2005; Kim, 2010).

The concepts of "concepts"

Concepts are more than terms, and constructing conceptual meaning is a vital approach to theory building in which mental constructions or ideas are used to represent experiences (Chinn and Kramer, 2011).

Formal study of concepts enhances knowledge development for nursing through naming, creating, and confirming the phenomenon of interest (Parse, 2006).

Clarifying, recognizing, and defining concepts that describe phenomena is the purpose of concept development or concept analysis.

These processes serve as the basis for the development of conceptual framework, theories, and research studies.

Purposes of Concept Development

A considerable portion of the conceptual basis of nursing theory, research, and practice has been constructed using concepts adopted from other discipline.

Example: The concept of basic human needs, is adopted from the Theory of Abraham Maslow an expert in psychology.

Why concept development or analysis is so important in nursing?

Reexamination of these adopted concepts for relevance and fit is important.

The process of applying "borrowed" or "shared" concepts from other discipline may have altered their meaning, and it is important to review them for appropriateness of application.

Appropriateness of application of concept

Hupcey, Morse, Lenz, and Tason, 1996

Some concepts are poorly defined with characteristics that have not been describe, whereas other concepts that have been defined may present with inconsistency between the definition and its use in research.

Appropriateness of application of concept in research

Morse, Hupcey, Mitcham, and Lenz, 1996

Types and definition Concepts

Types of concepts (Dubin, 1978)

1. Enumerative concepts

Characteristics: Are always present and universal.

( Example: age, height, weight)

2. Associative concepts

Characteristics: Exist only in some conditions within a phenomenon; may have a zero value.

Example: Income, presence of disease, anxiety

3. Relational concepts

Characteristics: can be understood only through the combination or interaction of two or more

enumerative or associative concepts. (example: elderly - must combine concepts of age

and longevity, mother - must combine man, woman, and birth)

Continuation: Types of concepts, Dubin, 1978

4. Statistical concepts

Characteristics: Relate the property of one thing in terms of its distribution in the population

rate.

(example: Average blood pressure, HIV/AIDS prevalence rate)

5. Summative concepts

Characteristics: Represent an entire complex entity of a phenomenon; are complex and not

measurable.

(example: Nursing, health, and environment)

Sources and categories of concepts

In nursing, concepts have been borrowed or derive from other disciplines; (such as adaptation, culture, and homeostasis or developed directly from nursing practice and research; (such as maternal - infant bonding, health - promoting behaviors, breastfeeding attrition). (McEwen, 2014)

In nursing literature, concepts have been categorized in several ways (concrete or abstract, variable or non variable, and theoretically or operationally define), (Hardy, 1973)

Categories of Concepts (Hardy, 1973)

Concrete concepts

- have simple directly observable empirical referents that can be seen, felt, or heard.

- limited by time and space and are observable in reality.

Example: color red, nurse, rock music, doctor

Abstract concepts

- are not clearly observable directly or indirectly and must be define in terms of observable concepts (Jacox, 1974).

- it is independent of time and space.

- The more abstract a concept is, the more it transcend time and geography (Meleis, 2012).

Example: social support, role, personality, love, hate

Categories of Concepts (Hardy, 1973)

Variable (Continuous) Concepts

- permit classification of dimension or graduation of phenomena on a continuum (Hardin, 2010).

- Example: blood pressure, pain, grief, health promoting behavior

Non-variable (Discrete) concepts

- discrete (non interval level) concepts, identifies categories or classes of characteristics.

- Example: gender, ethnic background, religion, marital status, education.

Note: Concepts that describe phenomena according to some dimensions of the phenomena are termed VARIABLES.

Categories of Concepts (Hardy, 1973)

Theoretically (conceptual) define concepts

- theoretical definition gives meaning to a term in context of a theory and permits any reader to assess the validity of the definition.

Operationally define concepts

- tells how the concept is linked to concrete situations and describes a set of procedures that will be performed to assign a value for the concept.

- it permits the the concept to be measured and allow hypotheses to be tested and it form the bridge between the theory and the empirical world (Hardy, 1973).

Examples of theoretically and operationally defined concepts

Concept: Health risk behaviors

Theoretical (conceptual) definition: Health risk behavior is an unhealthy lifestyle choices, such as smoking cigarettes, drug abuse, alcohol abuse, exposure to violence, and unhealthy dietary behaviors.

Operational definition: Health risk behavior is the score on the youth risk behaviors surveillance questionnaire.

Source: Dowdell, E. B. (2012).

Article title: Urban Seventh Grade Student: A report of health risk behaviors and exposure to violence.

From: Journal of School Nursing, 28(2), pp 130-137

Sources of Concepts

Sources of Concepts

When beginning a review of nursing concept found in nursing practice, research, education, and administration, one may look to several places or sources. The sources of nursing concepts may come from the natural world, from research, or derived from other disciplines (existing concepts).

Sources are from:

Naturalistic concept - present in nursing practice

Research-based concept - developed through qualitative research.

Existing concept (other disciplines) - borrowed from other discipline.

McEwen, 2014

1. Naturalistic concepts

- are concepts seen in the nature or in nursing practice.

Example: body weight, thermoregulation, hematologic complications, depression, pain and spirituality.

2. Research - based concepts

- are the results of conceptual development that is grounded in research process.

- Examples:

Help - seeking behavior (Cornally & McCarthy, 2011),

Care transitions (Geary & Schumacher, 2012)

Compassion Fatigue (Jenkins & Warren, 2012)

- Author

Through qualitative, phenomenological, or grounded theory approaches, the researcher may uncover meanings of the phenomena of interest and their theoretical relationships (Parse, 1999; Rogers, 2000).

These is how the researcher or theorist studies the realm of interest and identifies the theme.

3. Existing concepts or (those that came from other disciplines)

- the nursing literature is filled with adapted concepts are well synthesized through derivation from other disciplines.

- Example; Human needs from Maslow's, (1954) hierarchy of

needs.

Stress from Selye, (1956) physiologic theory of the

stress of life.

Conceptual vs. Theoretical Model/Framework

Conceptual, theoretical models and Nursing Metaparadigm

Theoretical model - these are highly established set of concepts that are testable.

Conceptual model - these are representations of an idea or body of knowledge based on our own understanding or perception.

Conceptual framework - is a structure of concepts or theories which are pulled together as a map for the study.

Conceptual Framework

Sample conceptual framework

Person

Blood pressure

Physical fitness

Exercise

Theoretical framework - is a structure of concepts which exist or tested in the literature, a ready-made map for the study.

Theoretical framework

Theoretical framework proposed by; Lydia Hall, a Nurse theorist

Sample

The Person

"The Core"

The Disease

"The Cure"

The Body

"The Care"

Nursing Metaparadigm

Nursing metaparadigm

These are patterns or models used to show a clear relationship among theoretical works in Nursing.

At present many nursing theories focus in these four major concepts; Person, Environment, Health, and Nursing

Person - is the recipient of nursing care; includes individuals, families, and communities.

Person

Environment - the external and internal aspects of life that influence the person.

Environment

Health

Health - is the holistic level of wellness that the person experience.

Nursing

Nursing - is the interventions of the nurse rendering care in support of, or in cooperation with the client.

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