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PubMed1998

Psychiatric patients' views on the concept of self-determination: findings from a descriptive study.

Using content analysis of unstructured interviews, this study examined the views of 72 long-term psychiatric patients on the concept of self-determination. The aim was to shed further light on the meaning of the concept for the purpose of developing a better tool for evaluation. One-third of the patients were familiar with the concept, another third had never heard of self-determination. The majority (52 patients) presented their views and definitions regardless of whether they had heard of the concept before. Content analysis revealed two central aspects in the definitions: an intrapersonal aspect, with self-determination defined in relation to the patients themselves or to their own activities; and an interpersonal aspect, with the focus on the patients' relationship with other persons. In spite of its limitations, the study certainly adds to our understanding of the concept of self-determination. It demonstrates that psychiatric patients are capable of offering valuable insights into key concepts of nursing, even if they are abstract. The results open new avenues for strengthening the self-determination of psychiatric patients.

Adult↗

PubMed2001

Healing: analysis of the concept.

Healing, a concept familiar to many nurses has recently gained wide recognition and use in both professional and lay circles. In spite of the wide use and scrutiny of the term, the concept remains confusing and inexact. Lack of clarity in meaning leads to multiple definitions, communication problems and difficulties in measurement and theory development. Continued discussion and examination of healing and related concepts will help nurses more clearly define this important concept. The Walker and Avant method of concept analysis can be applied to the concept healing for exploring and clarifying its meaning. Healing, as defined here, is a natural, active and multidimensional process that is individually expressed with common patterns. Body condition, personal attitudes and relationships influence healing.

Adaptation, Psychological↗

PubMed2001

Concept analysis of expertise of occupational health nurses applying Rodgers's evolutionary model.

The purpose of this study was to clarify the concept of expertise among occupational health nurses. The material consisted of 24 research articles and one theory article published between 1983 and 1997. These were analysed using Rodgers's concept analysis model. The analysis revealed that the surrogate term was authority, and the related concepts were specialist, professional, practitioner and generalist. The attributes of the concept of expertise were associated with roles, profession, position, title and functions. The antecedents of the expertise were identified as knowledge and skills, education, training, experience, personal characteristics and work-related opportunities. The consequences of the expertise were economic and health benefits. Most commonly, the expertise of occupational health nurses referred to clients, workplaces and health-care units. Changes in the concept of expertise were also examined and a definition of expertise formed. Concept clarification is necessary for the development of occupational health education, practice and theory building.

Health Services Research↗

PubMed2002

[The concept of hyperthymia].

The article reviews the conceptual history of "hyperthymia". Since K. W. Stark had used this term in the early 19(th) century, it has developed in two different directions: (1) to delineate a psychopathological syndrome and (2) to define a type of personality disorder (psychopathy). As Kurt Schneider's personality disorder (psychopathy) concept was easily understood and highly practicable, it became influential during the 20(th) century. Earlier before, psychiatrists such as E. Mendel, C. Wernicke and C. G. Jung had described entities such as "chronic mania", "hypomania" or "sanguinic degeneration", which were rather similar to each other. We analyze the historical development of such concepts. Emil Kraepelin was highly influential, as he introduced "constitutional excitation" into a broad concept of manic-depressive illness and saw it as a very mild form. After Kraepelin such spectrum concept was first forgotten. Only in recent years these historical considerations were confirmed by empirical observations, although a separate hyperthymic disorder is neither part of DSM-IV nor ICD-10. The concept of a hyperthymic temperament or a hyperthymic personality is a trait-marker and should be differentiated from hypomania as a state-marker. Nowadays, the importance of hyperthymia is not so much one of a disorder requiring treatment; rather the concept has interesting genetic, diagnostic and conceptual consequences.

Bipolar Disorder↗

PubMed2000

On the value-neutrality of the concepts of health and disease: unto the breach again.

A number of philosophers of medicine have attempted to provide analyses of health and disease in which the role that values play in those concepts is restricted. There are three ways in which values can be restricted in the concepts of health and disease. They can be: (i) eliminated, (ii) tamed or (iii) corralled. These three approaches correspond, respectively, to the work of Boorse, Lennox, and Wakefield. The concern of each of these authors is that if unrestricted values are allowed to infect our concepts of health and disease, then anything could be construed as healthy or diseased. They believe that, if at all possible, such a result should be avoided. Unfortunately, as I argue, this result is unavoidable and such attempts to limit values in these concepts are destined to fail. I argue for this position by showing how each of these three attempts to provide value-restricted analyses of health and disease fail as analyses of the concepts of health and disease and that they fail because of their attempts to restrict the role of values in their accounts. I also show how, despite their best efforts, each of these analyses are, themselves, value-driven and value-laden. This leads to the conclusion that values infect our concepts of health and disease at all levels.

Biometry↗

PubMedDate not supplied

Perceptions of the concept of health among patients in mental health nursing.

Health has been a central concept in nursing science since the 18th century but the holistic concept of health that includes both the body and the soul, still has to be clarified. The concept of health is often unclear and represents an unreachable ideal state that can be hard to use as a realistic goal in nursing care. The aim of this study was to describe how the patient perceives the concept of health in mental health nursing. Twelve patients with experience of mental health nursing were interviewed and the data were analyzed with a phenomenographic approach. The patients described nine different perceptions that were divided into three descriptive categories: autonomy, meaningfulness, and community. All of these are important to achieve health. There is ambiguity about the possibility to influence the concept of health. Health is described, on the one, hand as a prerequisite to experiencing freedom and finding meaning in life and, on the other hand, it is believed that the search for meaning and the courage to fight and try in spite of the disease is what leads to health. The patients' descriptions are mostly about things that they need in the present time to achieve health, but health as a process with growth and potential for development does not appear that clearly. One conclusion is that mental health nursing must deliver a more process-focused nursing care where the concept of health is visibly used as a goal for all nursing interventions.

Adult↗

PubMed1998

A concept analysis of energy. Its meaning in the lives of three individuals with chronic illness.

Energy is an essential concept in nursing which seems to be a key concept in the daily life of three individuals with chronic illness. Much has been done within the natural sciences to investigate and explain the concept, but studies on the meaning of energy and how it is experienced are difficult to find. A review of the existing literature reflects that energy has been an important term for nursing theorists, both in empirical studies and in nursing theories. In this study the principles of the hybrid model developed by Schwartz-Barcot & Kim of concept development were used to examine: (a) how the concept has been outlined in the literature within different disciplines, (b) how energy is experienced in the daily lives of three individuals with chronic illness, and finally, (c) the existing literature compared and contrasted with the empirical findings. The experience of having energy was very important for all three individuals. Energy was a familiar term which each individual linked most directly with his or her feeling states and the ability to perform daily activities. It demanded attention every day. Energy was defined as the individual's potential to perform physical and mental activity. The study indicates that this concept has potential for theory development and for clinical practice.

Activities of Daily Living↗

PubMed1997

College student reasoning about illness and psychological concepts.

Cognitive-developmental reasoning level in dealing with illness and psychological concepts, experiences with physical illness and psychological difficulties, locus of control orientation, and demographic variables were assessed in 101 college students. On average, the students' reasoning about both illness and psychological concepts was in transition from concrete to formal operational levels. However, the students' cognitive-developmental reasoning levels varied across illness and psychological domains and across some concepts within each domain. The reasoning levels for illness concepts were found to be significantly more advanced than the reasoning levels for psychological concepts. Female students' reasoning scores for psychological concepts were significantly higher than those of male students. Descriptive information for locus of control orientation, experience with illness, and psychological problems, as well as associations between variables and comparisons of means, are provided. The study's implications for college health providers in terms of treatment, prevention, and educational strategies are discussed.

Adult↗

PubMed2002

A concept model for individual surveillance in genetic cancer care.

OBJECTIVE: To present the concept of individual surveillance in genetic risk management as a complex collection of other concepts, and to propose a model that represents how these component concepts may relate to each other. CONCEPT: The concept of "individual surveillance" has a set of lexical conditions, called critical attributes, antecedents, and consequence. The attributes are derived from the historical and contemporary use of the word and must be present for conceptualization. Antecedents are conditions that must exist before individual surveillance can occur, and consequences are those events that will always occur after individual surveillance. The popular association of surveillance with real or suspected criminal activity may design a predilection for critical attributes and confuse concept attainment. Before involving patients and family members in surveillance activities, clinicians should explore the subjective meaning of participation. MODEL: The model can be used, by a clinician and a patient, to describe and understand the meaning of individual surveillance for participants in a systematic, holistic, and highly personal way.

Follow-Up Studies↗

PubMed2005

Interprofessionality as the field of interprofessional practice and interprofessional education: an emerging concept.

This paper proposes a new concept and a frame of reference that should permit the development of a better understanding of a phenomenon that is the development of a cohesive and integrated health care practice among professionals in response to clients' needs. The concept is named "interprofessionality" and aims to draw a clear distinction with another concept, that of interdisciplinarity. The utilization of the concept of interdisciplinarity, which originally concerns the development of integrated knowledge in response to fragmented disciplinary knowledge, has caused some confusion. We need a concept that will specifically concern the development of a cohesive practice among different professionals from the same organization or from different organizations and the factors influencing it. There is no concept that focuses clearly on this field. Interprofessionality concerns the processes and determinants that influence interprofessional education initiatives as well as determinants and processes inherent to interprofessional collaboration. Interprofessionality also involves analysis of the linkages between these two spheres of activity. An attempt to bridge the gap between interprofessional education and interprofessional practice is long overdue; the two fields of inquiry need a common basis for analysis. To this end, we propose a frame of reference, an interprofessional education for collaborative patient-centred practice framework. The framework establishes linkages between the determinants and processes of collaboration at several levels, including links among learners, teachers and professionals (micro level), links at the organizational level between teaching and health organizations (meso level) and links among systems such as political, socio-economic and cultural systems (macro level). Research must play a key role in the development of interprofessionality in order to document these linkages and the results of initiatives as they are proposed and implemented. We also believe that interprofessionality will not be pursued without the requisite political will.

Canada↗

PubMed2001

Conceptions of depressive disorder and its treatment among 17 Swedish GPs. A qualitative interview study.

BACKGROUND: Making clinical decisions for psychiatric patients in general practice is a complicated issue. A marked variation in the prescribing rates for antidepressant drugs in general as well as between geographical regions has been reported. Also, GPs tend to underestimate and undertreat depressive disorders. OBJECTIVES: The aim of this study was to explore GPs' conceptions of depressive disorder and its treatment. METHOD: A qualitative semi-structured interview was carried out on 17 GPs, selected to ensure variation of pre-conditions, in the county of Orebro, Sweden. Informants' conceptions about four depression-related issues were determined: the depressive disorder, antidepressant drugs, the treatment decision and psychotherapy. RESULTS: Conceptions of the four themes varied widely among informants in the interviews. However, the informants shared certain conceptions concerning the selection of drugs and drug treatment of major depression as well as the patient's role in deciding whether or not to treat pharmacologically. CONCLUSIONS: The study adds knowledge of GPs' thoughts about depressive disorder and their diagnostic and treatment preferences. Utilizing the concepts discussed herein, a quantitative study will be conducted to analyse how GPs' conceptions of depression are inter-related.

Adult↗

PubMed1998

Quality of life in persons with non-small cell lung cancer: a concept analysis.

Quality of life, as a concept, has received increased attention in recent years. In fact, issues related to quality of life have been identified as among the top three priorities for research by the Oncology Nursing Society. Several nurse investigators have underscored the importance of quality of life research as an outcome measure to evaluate the effectiveness of nursing interventions. Given its significance in contemporary nursing practice, a clear understanding of the definition and dimensions of quality of life is essential for future development of an empirical knowledge base for practice. This article presents a concept analysis of quality of life as it relates to the health care of individuals with non-small cell lung cancer. An evolutionary method of concept analysis is used as a guide for examining the historical context of the concept, defining the concept, identifying antecedents, recognizing consequences, and distinguishing related concepts. A theoretical model of health-related quality of life is proposed on the basis of this analysis, and future directions for research in this population are discussed.

Carcinoma, Non-Small-Cell Lung↗

PubMed1997

Congenital clubfoot. Month of conception.

The medical records of 330 children who were born with uncomplicated congenital clubfoot were reviewed retrospectively. To determine their months of conception, the duration of gestation was extrapolated and those which were less than 40 weeks were noted. The years of conception for the studied children were from 1956 to 1994. Months of the year were ascribed angle values and the distribution of conceptions per month were grouped in radial manner. Using a circular analysis for variance a lack of uniform circular distribution was found for the grouped months of conception. There is a significant seasonal variation in the data. The mean month of conception was June. This finding is at variance with the peak months of conception for the population of the United States for the years 1989 through 1993. The theory that congenital clubfoot is caused by an intrauterine Enterovirus may be supported by this data. The summer and fall peak of Enterovirus infections in temperate climates coincide with the stage of embryologic development (> 8 weeks) which would allow an anterior horn cell lesion to lead to a deformity such as congenital club foot.

Clubfoot↗

PubMed1998

Death concepts in suicidal adolescents.

OBJECTIVE: To investigate the relationship between components of death concept (preoccupation with death, death as a pleasant state, and death as final) and suicidal behavior in adolescents. METHOD: The death concepts of 51 suicidal inpatients, 102 nonsuicidal inpatients, 36 emergency room suicidal subjects, and 81 normal controls were compared using Pfeffer's Child Suicide Potential Scale. In addition, the IQ level as well as emotions that potentially influence the death concept were measured. RESULTS: Both groups of suicidal adolescents evaluated death as more pleasant than the nonsuicidal groups. All the study groups equally perceived death as a final state. Suicidal inpatients were more preoccupied with death than nonsuicidal inpatients, but surprisingly among all study groups, including normal controls, the emergency room suicidal subjects were the least preoccupied with death. Partialing out depression, anxiety, and aggression specifically augmented the association between preoccupation with death and suicidality. Thus the relationship between death concept and suicidality appears to be a direct one. No correlation was found between suicidality and intelligence level. CONCLUSIONS: Elements of death concept distinguish suicidal from nonsuicidal as well as between hospitalized versus nonhospitalized suicidal adolescents. Thus the death concept evaluation is potentially valuable in the assessment of adolescents with a high risk for suicide.

Adolescent↗

PubMed2001

The impact of concept of health on health behavior.

Although previous studies have examined selected factors influencing health behavior, the complex interplay of the concept of health and health behavior in persons with chronic illness has not been investigated. The purpose of this study was to investigate the individual effects of six factors in the concept of health on the health behavior of Taiwanese people with chronic illness. A sample of 372 persons with chronic illness completed instruments measuring their concept of health and health behavior. Six proposed models were assessed using the maximum likelihood estimation, which is implemented by LISREL 8.3. The overall fit of the models tested in this study lends support to the assertion that the factors of the concept of health affect health behavior. Zest for life, serenity and meaning were the strongly affecting factors. These factors each accounted for 34-43% of the variance in health behavior. The results of this study support the notion that the health behavior of people with chronic illness can be predicted by their concept of health. Further research using a longitudinal design is needed to clarify the causal relationship between the concept of health and health behavior in Taiwanese people with chronic illness.

Adult↗

PubMed2005

Active concept learning in image databases.

Concept learning in content-based image retrieval systems is a challenging task. This paper presents an active concept learning approach based on the mixture model to deal with the two basic aspects of a database system: the changing (image insertion or removal) nature of a database and user queries. To achieve concept learning, we a) propose a new user directed semi-supervised expectation-maximization algorithm for mixture parameter estimation, and b) develop a novel model selection method based on Bayesian analysis that evaluates the consistency of hypothesized models with the available information. The analysis of exploitation versus exploration in the search space helps to find the optimal model efficiently. Our concept knowledge transduction approach is able to deal with the cases of image insertion and query images being outside the database. The system handles the situation where users may mislabel images during relevance feedback. Experimental results on Corel database show the efficacy of our active concept learning approach and the improvement in retrieval performance by concept transduction.

Algorithms↗

PubMed1989

Concepts, analysis and the development of nursing knowledge: the evolutionary cycle.

Nursing currently evidences concern with the development and clarification of its knowledge base. As a part of this focus, attention has often been directed towards concepts and methods of clarification. Although the method of concept analysis has been employed often to provide conceptual clarity, the foundations and implications of conducting an analysis of a concept have not been well explored in nursing. In this article, the philosophical foundations of the approach to concept analysis popularized by Walker & Avant (1983) are examined. Modifications of this method are offered, along with a framework for interpreting the findings of an analysis. The result is a view of concepts and an approach to analysis that may be of use in the clarification of a variety of concepts of interest in nursing.

Humans↗

PubMed1996

Parent participation: a concept analysis.

Parent participation has become a central tenet of paediatric nursing in the United Kingdom. The purpose of this paper is to explore the meaning of parent participation, to clarify the concept to benefit children and their families, and to increase understanding among practitioners. The concept analysis utilized was directed by Rodgers' "evolutionary approach' that views concept development as an ongoing dynamic process. A review of British literature and research studies indicated that parent participation is a complex and multi-dimensional concept. In the evolution of parent participation, the terminology changed from "parental involvement' to "partnership in care', to "care-by-parent' and finally to "family-centred care'. The analysis reveals a lack of coherence in the descriptions, with the terminology changing but the underlying theme remaining parent participation. Parent participation can be conceptualized as a composite of attributes that relate to the family, the nurse and their relationships. Those attributes include: negotiation, control, willingness, competence and autonomy. The concept of family-centred care is gradually assuming importance in the literature. This acknowledgement of the family is long overdue. However the concept remains poorly defined and urgent clarification is needed in this area. To adopt a family-centred care approach, a radical paradigm shift is required.

Clinical Competence↗