A concept analysis of professional commitment in nursing.

The aim of this concept analysiswas to develop a contemporary operational definition of Clinical Judgement in nursing. Concept analysis. Rodgers' evolutionary method of concept analysis. Throughout the study, the authors followed the SRQR checklist. This concept analysis guided the development of an operational definition of clinical judgement, within the context of nursing, articulated as Clinical judgement is a reflective and reasoning process that draws upon all available data, is informed by an extensive knowledge base and results in the formation of a clinical conclusion. The purpose of this concept analysis was to propose a detailed definition of clinical judgement in nursing, that reflected its theoretical base within today's contemporary healthcare system. Using Rodgers' evolutionary method of concept analysis, surrogate terms, attributes, antecedents and consequences were identified, and a contemporary definition was developed. No patient or public contribution was required to design or undertake this research.

Concept analysis is a technique used to determine defining attributes, with the purpose of developing a concept to expand nursing knowledge. The interrogation of attributes, antecedents, and consequences aids in clarifying ambiguity with a view to developing an operational definition. Establishing a clear definition of a concept lays the groundwork for future research and practice. Nursing students embark on a sequenced set of clinical learning experiences as a primary component of their undergraduate program. Being bullied is common in clinical practicum experiences for nursing students and is often seen as unavoidable, resulting in negative impacts on student learning, health care team functioning deterioration, decreased quality of care for patients, and negative impacts on retention and satisfaction with the nursing profession. Numerous studies have investigated the concept of bullying in the profession, yet the range of how bullying manifests creates a challenge for analysis and agreement of the concept. Rodgers’s (2000) evolutionary method was used for this literature-based concept analysis to lead to a meaningful understanding of the concept over time by identifying attributes, antecedents, and consequences. Attributes specific to bullying of nursing students in the clinical environment included intentionality, temporality, negative interactions, denied opportunities, and workload challenges. Several surrogate terms were identified in this analysis. Antecedents identified for bullying included power imbalances, working conditions, entrenched behaviour, and organizational dysfunction. Consequences associated with bullying affect students, the nursing profession, and the workplace. The most prevalent finding from this concept analysis is that bullying is used to describe many different types of behaviour. This analysis contributes to the foundation of evidence supporting the discussion around the need for continued clarity and further research on the phenomenon of bullying in the clinical environment. Further analysis is needed to clarify the concept of bullying to expand knowledge in the nursing discipline by addressing the antecedents to influence change in nursing education. Clarity on how bullying is defined is necessary to facilitate recognizing and reporting bullying and developing effective interventions.

Background: Critical thinking is a cornerstone of nursing practice, essential for effective clinical judgment, decision-making, and patient safety. Despite its recognized importance, the concept of critical thinking remains inconsistently defined and variably applied in nursing education and practice, particularly within the Pakistani context. Objective: This concept analysis aims to clarify and define critical thinking in nursing education by examining its attributes, antecedents, consequences, and empirical referents. Methodology: Walker and Avant’s eight-step concept analysis framework was employed. A systematic literature search was conducted using PubMed, CINAHL, Medline, ScienceDirect, and Wiley Online Library. Relevant peer-reviewed articles, textbooks, and theoretical papers were reviewed to explore definitions, uses, surrogate terms, defining attributes, and measurement indicators of critical thinking in nursing. Results: Critical thinking in nursing was identified as a multidimensional cognitive process characterized by analysis, evaluation, clinical reasoning, problem-solving, decision-making, creativity, and open-mindedness. Antecedents included formal education, clinical exposure, supportive learning environments, and individual cognitive traits. Consequences encompassed improved patient outcomes, enhanced quality of care, professional satisfaction, and safer clinical practice. The Watson–Glaser Critical Thinking Appraisal emerged as a key empirical referent for measuring critical thinking abilities. Conclusion: This concept analysis provides a comprehensive and clarified understanding of critical thinking in nursing. A shared conceptualization can support curriculum development, guide teaching strategies, and strengthen clinical practice, ultimately contributing to improved patient care and professional competence among nurses.

It is of importance to understand and communicate caring ethics as a ground for qualitative caring environments. Research is needed on nursing attributes that are visible in nursing leadership since it may give bases for reflections related to the patterns of specific contexts. The aim of this study was to illuminate the meaning of crucial attributes in nursing leadership toward an ethical care of patients in psychiatric in-patient settings. The design of the study was descriptive and qualitative with a phenomenological hermeneutical approach. Participants and research context: The study comprised focus group interviews with nurses working in indoor psychiatric care who participated after giving informed consent. Ethical considerations: Since the topic and informants are not labeled as sensitive and subject to ethical approval, it is not covered by the ethics committee's aim and purpose according to Swedish law. However, careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. When identifying the thematic structures, analysis resulted in three major themes: To supply, including the following aspects: to supply evidence, to supply common space, and to supply good structures; To support, including the following aspects: to be a role model, to show appreciation and care, and to harbor; To shield, including the following aspects: to advocate, to emit non-tolerance of unethical behavior, and to reprove. Leadership is challenging for nurses and plays an important role in ethical qualitative care. These findings should not be understood as a description about nurse manager's role, which probably has different attributes and more focus on an organizational level. Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care.

De-escalation of aggressive behaviour in healthcare settings: Concept analysis

The purpose of this study is to give clarity to the concept of professional identity, drawing from health-related fields to help provide a common language and understanding for research and practice. Professional identity, professionalism, professional socialization, and other related terms are often used without a clear definition or with conflicting definitions. This can lead to misunderstandings and assumptions that complicate research and confuse educators and professionals in guiding novice members. Concept analysis. Initially, 737 articles were identified by searching CINAHL, PubMed Central, Google Scholar, Academic Search Complete, PsyINFO, and SocINDEX for the period 2000 to 2019. Finally, 68 studies met the inclusion criteria, 60 of which are discussed in this concept analysis. This concept analysis uses the method described by Walker and Avant. This concept analysis clarifies the definition of professional identity, using literature from health and related professions, as containing the attributes: skills and functions; knowledge values and ethics; personal identity; group identity; and the influence of the context of care. A more clear definition of professional identity will help researchers to have more precision in their analyses and provide mentors and educators with a clear goal.

To conduct a concept analysis of evidence-based leadership in a nursing context. Rodgers' evolutionary method was employed to identify attributes, antecedents, consequences, definitions and surrogate and related terms. We systematically searched three databases (PubMed, Cumulative Index to Nursing and Allied Health Literature and Scopus) for relevant publications. The databases were searched from their inception to 4 February 2024. We included 12 papers published between 2005 and 2022. The attributes include leadership attributes (personality, developing common goals and visions and influencing others) and evidence-based attributes (valuing evidence-based practice, integrating evidence and adapting evidence). The antecedents include individual internal factors (commitment to growth and proficiency in implementation science) and individual external factors (growing need for evidence-based practice, training support and available resources), while the consequences are personal growth, organisational benefit and disciplinary development. Based on the concept analysis, evidence-based leadership can be defined as a process whereby individuals, based on their personality and values towards evidence-based practices, integrate the best evidence into practice, adapt the evidence integration process based on evaluations and influence others towards achieving a common goal and vision. This concept analysis enhances our understanding of evidence-based leadership, guiding nurses to integrate evidence into their leadership practices to achieve specific goals and visions within the healthcare context. Future studies could consider developing instruments to evaluate evidence-based leadership based on this refined concept, ultimately promoting nurses' leadership competencies in real-world settings. This concept analysis not only raises awareness of the responsibilities of nurses as healthcare professionals, including the provision of evidence-based practice, but also facilitates their effective execution of these responsibilities. Empowering nurses to actively incorporate evidence into their leadership practices can further enhance the quality of healthcare delivery. Not applicable. Not applicable.

To critique existing concept analyses of quality of life and develop a definition applicable for young people with chronic illness. Quality of life is a commonly used phrase but there is no universal definition. Five perspectives of quality of life have been proposed: sociological, economic, psychological, philosophical and ethical. However, health has emerged as an important but distinct perspective. The nursing profession has made a substantial contribution to the understanding of the interrelationship of health and quality of life. Literature review. A search on electronic databases to April 2007 was made using the terms 'quality of life' and 'concept analysis'. Papers were included in the review if they used a recognised method of concept analysis and were conducted by nurses. A new concept analysis was then performed specifically focusing on young people's experiences of living with chronic illness. Eight concept analyses were identified, all of which had limitations. All the concept analyses were based on adult literature so did not take into consideration developmental changes, language level, or young people's construction of health and illness. The new concept analysis found that young people living with chronic illness generally view themselves and their lives in the same way as their healthy peers. While their aspirations are often constrained by illness and treatment the relationship between illness and life cannot be seen in isolation of development. Previous definitions of quality of life derived from concept analyses with adult populations do not adequately represent the experience of young people with chronic illnesses, but can be made more specific by incorporating important attributes such as developmental stage and the importance of peer group and family. The current analysis provides a clear definition of quality of life from the health perspective which is specific for use with young people with chronic illness to guide practice and research.

Applying ethical principles is crucial in providing nursing services to patients in any setting. Ethical principles serve as a foundation for nurses to deliver holistic care while avoiding harm to patients. To enhance our understanding of the principle of autonomy, an analysis of its concept can be conducted. However, research on concept analysis related to the ethical principle of autonomy in nursing is limited. This study aims to present a nursing perspective analysis of the concept of autonomy. Using the Walker and Avant (2011) approach, a concept analysis process was conducted by reviewing literature on autonomy through the ProQuest and Google Scholar databases. The search was restricted using the keywords "autonomy" and "intensive care unit" and the publication time frame from 1896 to 2023. Walker and Avant's (2011) concept analysis method involves eight steps that identify the attributes, antecedents, and consequences of autonomy, leading to an operational definition of the concept. This concept analysis reveals that autonomy is the right to freedom or independence for individuals based on their desires, assumptions, and preferences in determining decisions and goals that align with good rules. Autonomy enables patients to attain goals, satisfaction, goodness, and comfort. Keywords: Concept analysis; intensive care unit; autonomy; hospital care; emergency care; nursing practice

This study conducted a conceptual analysis of gamification in healthcare utilizing Rogers’ evolutionary concept analysis methodology to identify its attributes and provide a method for its applications in the healthcare field. Gamification has recently been used as a health intervention and education method, but the concept is used inconsistently and confusingly. A literature review was conducted to derive definitions, surrogate terms, antecedents, influencing factors, attributes (characteristics with dimensions and features), related concepts, consequences, implications, and hypotheses from various academic fields. A total of 56 journal articles in English and Korean, published between August 2 and August 7, 2023, were extracted from databases such as PubMed Central, the Institute of Electrical and Electronics Engineers, the Association for Computing Machinery Digital Library, the Research Information Sharing Service, and the Korean Studies Information Service System, using the keywords “gamification” and “healthcare.” These articles were then analyzed. Gamification in healthcare is defined as the application of game elements in health-related contexts to improve health outcomes. The attributes of this concept were categorized into 2 main areas: attraction and achievement. These categories encompass various strategies for synchronization, enjoyable engagement, visual rewards, and goal-reinforcing frames. Through a multidisciplinary analysis of the concept’s attributes and influencing factors, this paper provides practical strategies for implementing gamification in health interventions. When developing a gamification strategy, healthcare providers can reference this analysis to ensure the game elements are used both appropriately and effectively.

The management of challenging behaviours in inpatient with intellectual disability and/or autism spectrum disorders can lead to an escalation of control measures. In these complex situations where patients have an intellectual disability/autism spectrum disorder accompanied by a psychiatric comorbidity, the experiences of caregivers related to the crisis management have rarely been studied. This study examined the moral experiences of caregivers related to challenging behaviours' management and alternatives to control measures. Using Charles Taylor's hermeneutic framework, a 2-month focused ethnography with a participatory approach was used. Sixteen caregivers were interviewed in a Canadian mental health setting for adults with intellectual disability/autism spectrum disorder and psychiatric comorbidity. The research was conducted in compliance with the Declaration of Helsinki and local Research Ethics Board approval. Written informed consent was collected systematically from participants. By accounting for caregivers' moral experiences, this study sheds light on a neglected dimension of the care relationship: the vulnerability of the caregiver. We highlight the main barriers and facilitators to alternatives to control measures. First, a caregiver's vulnerability was characterised by the overall impact of challenging behaviours and the moral distress associated with the use of control measures and exclusion mechanisms of intellectual disability/autism spectrum disorder patients. Second, a strong ambiguity between care and control measures and a lack of inclusive approaches were identified as the two main barriers to challenging behaviour management. Third, the involvement, both professional and personal, of caregivers was deemed necessary to implement alternatives to control measures. A conflict of values opposes two conceptions of autonomy: a rational autonomy, which is counterproductive to the reduction of control measures, versus a relational autonomy based on shared vulnerability. The recognition of caregiver's vulnerability is a benchmark to create alternative approaches, which defuse the logic of control and promote an ethics of care within which caregivers' self-concern can be understood as fostering mutual respect.

Walker and Avant have been pivotal in guiding researchers toward publishing concept analysis articles. However, limited studies have explored the trends of concept analysis within the nursing context. This topic is particularly relevant today as it can inspire and inform future concept analysis publications. This study utilized a literature review design to examine the evolution of concept analysis in nursing. A total of 54 articles were identified through a systematic search across six databases. These articles were categorized into four key themes: psychological responses, healthcare system improvement, behavior, and patient-focused concepts. A comprehensive table was developed to summarize how each concept was defined by scholars, and trends over a five-year period were analyzed. The findings revealed that psychological responses were the most frequently studied theme and vice versa, research focusing on behavior showed a decline over time. Despite this trend, patient-centered concepts demonstrated consistent attention throughout the period. The study also highlighted a consistent emphasis on understanding psychological impacts and promoting patient involvement in decision-making processes. Based on these findings, future research should focus on developing caring interventions that address patients' psychological needs. Such research will further strengthen the role of nursing in fostering holistic innovation care. Keywords: Caring intervention, concept analysis, future publication, holistic innovation, psychological needs

To explore the meaning of healthcare self-management support for post-discharged stroke patients. Rodgers' evolutionary approach was used to identify antecedents, attributes, related terms, surrogate terms and consequences. Literature from 2012 to 2022 was searched from MEDLINE, CINAHL, PsycINFO and Google Scholar. Three antecedents preceded healthcare self-management support for post-discharged stroke patients: loss of inpatient support, preparedness for self-management and presence of self-management support. Healthcare self-management support for post-discharged stroke patients was defined by eight attributes: pre-discharge assessment and planning; provision of continuous education and training; collaborative goal-setting; reinforcement and documentation of vital information; coordination of post-discharge care; provision of rehabilitation support and promoting community reintegration; provision of counselling support; and using clear communication, patient empowerment and promoting self-efficacy. The identified consequences of the concept were as follows: improved patient outcomes; improved life quality; decreased healthcare cost; decreased re-admission rate and inpatient care burden; and decreased complication rate. Healthcare self-management support for post-discharged stroke patients is an emerging concept that can help to significantly improve stroke patients' health outcomes and life quality. However, its applicability is uncertain considering the workload, time and resources available to healthcare professionals. There is a need for future studies to focus on the feasibility and applicability of this concept in clinical practice and to identify any challenges healthcare providers may have in supporting stroke patients after discharge. This concept analysis brings clarity to the concept of healthcare self-management support of post-discharged stroke patients and distinguishes it from other self-management supports. It provides an opportunity for further studies and a pathway for generalized healthcare self-management support for stroke patients after discharge to improve health outcomes and quality of life. No patients, service users, caregivers or members of the public were involved in conducting this concept analysis.

Primary care depression: evidence-based guidance for disseminating systems of care

The purpose of this article was to analyze the concept of "the fighter in the intensive care unit (ICU)" per the scientific literature and the impact this mentality has on care administered in the ICU. A literature review and a concept analysis based on Rodger's evolutionary method were performed to identify surrogate terms, antecedents, attributes, and consequences pertaining to the "fighter" in the ICU. Thirteen articles with a focus on "the fighter" were included in this analysis. There is a strong desire to remain optimistic and maintain high spirits as a coping mechanism in the face of extreme prognostic uncertainty. Themes that emerged from the literature were the need to find inner strength and persist in the face of adversity. The concept of "the fighter in the ICU" can serve as either adaptive or maladaptive coping, depending on the larger clinical picture. Patient experiences in the ICU are fraught with physical and psychological distress. How the patient and family unit cope during this anxiety-provoking time is based on the individual. Maintaining optimism and identifying as a fighter can be healthy ways to adapt to the circumstances. This concept analysis highlights the importance of holistic care and instilling hope particularly as patients may be nearing the end of life.