Clinical judgement in nursing - An evolutionary concept analysis.

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.

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.

Ocular frailty: A concept analysis.

The aim of this study was to explore the concept of impostorism as applied to nursing and other disciplines. Impostorism has not been well defined or studied in nursing. Researchers have not studied connections between role transition stress of new graduates and impostorism, despite evidence that nursing students experience impostorism during undergraduate studies. Rodgers' evolutionary concept analysis was the method used in this study. The databases used were Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature, Health and Psychosocial Instruments, Health Source: Nursing/Academic Edition, Medical Literature Analysis and Retrieval System Online, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, SocINDEX, and Dissertations and Theses databases. All nursing-specific citations were included in the literature sample. Of the remaining non-nursing citations, stratified random sampling provided 28 non-nursing citations. An additional purposive sampling of seminal impostorism publications resulted in 46 resources for analysis. Concept analysis revealed that key attributes of impostorism include fear of failure and difficulty accepting praise. Impostorism antecedents relate to personality, attribution, family, workplace, and sociodemographic variables. According to concept analysis, a conceptual definition emerges of impostorism as a subjective, inaccurate self-assessment involving feelings of intellectual and professional incompetence and fraudulence despite external evidence of success. Impostorism has undergone evolutionary changes in various disciplines. However, the nursing discipline needs more research related to nurses' experiences with impostorism in the workplace.

Veterans returning from combat have a greater risk for developing posttraumatic stress disorder (PTSD) and greater severity of psychosocial functioning impairment. Previous research has demonstrated the strong association between PTSD and psychosocial functioning impairment. Psychosocial functioning is an ambiguous term often used in literature to discuss PTSD-associated consequences, intervention response, and symptom progression. An evolutionary concept analysis was conducted to clarify understanding of psychological functioning in veterans with combat-related PTSD. Rodgers' method for an evolutionary concept analysis was used to examine the concept of psychosocial functioning. A literature search using the Cumulative Index to Nursing and Allied Health Literature and SCOPUS databases and subsequent screening yielded twenty articles meeting established criteria for analysis. The analysis highlights significant attributes, antecedents, consequences, and implications for future concept development. Psychosocial functioning environment/domain, social support, and engagement in treatment were distinguishing attributes identified. Combat exposure and various PTSD symptoms are related antecedents. Consequences such as decreased intimacy, decreased work function, low parenting satisfaction, and inadequate productivity in educational settings are all components of this concept. The concept of psychosocial functioning is meaningful in the everyday lives of US combat veterans with PTSD and requires special consideration in treatment planning by healthcare providers.

Health-related decision-making is a complex process given the variability of treatment options, conflicting treatment plans, time constraints and variable outcomes. This complexity may result in patients experiencing decisional regret following decision-making. Nonetheless, literature on decisional regret in the healthcare context indicates inconsistent characterization and operationalization of this concept. To conceptually define the phenomenon of decisional regret and synthesize the state of science on patients' experiences with decisional regret. A concept analysis. Rodgers' evolutionary method guided the conceptualization of this review. An interdisciplinary literature search was conducted from 2003 until 2023 using five databases, PubMed, CINAHL, Embase, PsycINFO and Web of Science. The search informed how the concept manifested across health-related literature. We used PRISMA-ScR checklist to guide the reporting of this review. Based on the analysis of 25 included articles, a conceptual definition of decisional regret was proposed. Three defining attributes underscored the negative cognitive-emotional nature of this concept, post-decisional experience relating to the decision-making process, treatment option and/or treatment outcome and an immediate or delayed occurrence. Antecedents preceding decisional regret comprised initial psychological or emotional status, sociodemographic determinants, impaired decision-making process, role regret, conflicting treatment plans and adverse treatment outcomes. Consequences of this concept included positive and negative outcomes influencing quality of life, health expectations, patient-provider relationship and healthcare experience appraisal. A conceptual model was developed to summarize the concept's characteristics. The current knowledge on decisional regret is expected to evolve with further exploration of this concept, particularly for the temporal dimension of regret experience. This review identified research, clinical and policy gaps informing our nursing recommendations for the concept's evolution. This concept analysis examines existing literature and does not require patient-related data collection. The methodological approach does not necessitate collaboration with the public.

As the number of healthy older adults increases, robustness has emerged as an important concept to describe individual differences in adaptability and health outcomes. However, the concept remains inconsistently defined across healthcare disciplines, necessitating conceptual clarification. This study aims to conduct an evolutionary concept analysis of robustness in older adults. An evolutionary concept analysis method was conducted. Four healthcare databases (PubMed, CINAHL Complete, EMBASE, Scopus) and Google Scholar were systematically searched without publication year restrictions, excluding gray literature. Data were extracted and analyzed to identify attributes, antecedents, consequences, and related terms. Analysis of 31 studies revealed three attributes: multidimensional vitality, resilient stability, and functional autonomy. Antecedents include socioeconomic resources, beneficial lifestyle behaviors, and supportive social networks, while consequences encompass enhanced quality of life, reduced healthcare needs, and decreased mortality. Comparison with related terms confirmed robustness as distinct from successful aging, non-frailty, intrinsic capacity, and resilience. This study established conceptual boundaries for robustness, enabling healthcare professionals to move beyond age-based approaches toward individualized assessment and care strategies, providing a theoretical framework for developing measurement tools and implementing personalized interventions.

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 concept of professional commitment is being widely studied at present. However, although it is considered an indicator for the most human part of nursing care, there is no clear definition for it, and different descriptors are being used indiscriminately to reference it. The aim of this study is to clarify the concept of professional commitment in nursing through the Rodgers' evolutionary concept analysis process. Systematic search using English and Spanish descriptors and concept analysis. Studies published between 2009 and June 2015, front-to-back analysis of the Nursing Ethics journal and manual check of articles cited in studies related to the Nijmegen Professionalism Scale. The procedure of concept analysis developed by Rodgers was used. Although the topic was not labeled as sensitive and subject to ethical approval, its realization was approved by the Ethical Committee of Clinical Research of Aragon (CEICA) approved the study on 18 March 2015 and also careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. A total of 17 published studies. A clear definition of the concept was made, and surrogate terms, concept dimension, differential factors related to the concept, sociocultural variations and consequences for nursing practice were identified. There is a need for continuous advancement in the development of the concept, specific actions to encourage this and the improvement of evaluation methods for its study.

To offer a clear understanding of the definition, attributes, antecedents, and consequences of undergraduate nursing students' clinical judgment in the nursing education context. Clinical judgment is a concept with broad uses among healthcare professionals. Its definitions and attributes vary across contexts. There is no established understanding of clinical judgment in nursing students. This concept analysis was performed using the eight steps of Walker and Avant's framework. A literature search was conducted using search engines and included peer-reviewed articles related to clinical judgment in nursing students. Clinical judgment in nursing students was defined as the cognitive process exhibited via a nursing action by observation, patient assessment, interpreting, and prioritizing data that lead to responding using the appropriate nursing practice with the patient. Reflection was used to evaluate nursing students' clinical judgment to revise nursing practice. Antecedents included nursing education curriculum, student's knowledge, previous clinical experience, critical thinking, and clinical reasoning. The consequences of clinical judgment were clinical judgment ability, safe nursing practice, nursing care quality, and patient safety. This concept analysis gives clear insights into the definition, attributes, antecedents, and consequences of undergraduate nursing student's clinical judgment.

Resilience is a complex concept that is extensively drawn upon in higher education, nursing included. The objective is to examine the concept of resilience and its use within nursing education. Rodgers' evolutionary concept analysis was used to explore this concept. The current focus on fostering resilience in undergraduate nursing education predominantly focuses on educational interventions to support one's ability to self-care continues to be pervasive within the nursing literature. More recent dialogue encourages a more holistic approach that examine interventions from both individual and structural perspectives. Recommendations for future research are to examine the synergy between individual, contextual, and structural factors to support resilience in nursing students. Based on the concept analysis, resilience is contextual. Therefore, nurse educators may support and foster nursing students' resilience by having increased awareness of both individual and structural perspectives of resilience.

BackgroundMoral sensitivity is an essential criterion for nurses' professional competence, and it is effective in professional performance and the development of communication between nurse and patient. According to several definitions of moral sensitivity in nursing texts, each of them has examined moral sensitivity from a different aspect, and there are still uncertainties in the field of moral sensitivity of nursing students. Therefore, to clarify the characteristics and dimensions of the concept of moral sensitivity of nursing students, we used the method of concept analysis.GoalTo clarify and define moral sensitivity of nursing students.MethodFor this systematic review, ten databases (PubMed, Scopus, Science Direct, Emerald, Springer, Proquest (open access), ERIC, SID, Irandoc, Magiran) were searched. They were published between 1990 and 2020. Inclusion criteria were having access to the full text of the article, types of studies (quantitative, qualitative, concept analysis, systematic review, and meta-analysis) related to the attributes, antecedents, and consequences of nursing students' moral sensitivity, medical students' moral sensitivity and Ethics education, articles being published in scientific journals in English or Persian language, texts published in non-peer-reviewed journals and letters to the editor were excluded from the data analysis. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool 2018 and Prisma ScR Checklist 2020. Rodger's evolutionary concept analysis was used to conduct this study.ResultsFrom 361 articles, 38 were included. The results showed moral sensitivity in nursing students improves through specialized ethical knowledge and presence in educational and professional settings. The attributes consist of honest and benevolent communication, compassionate professional practice, intuitive perceiving moral challenges, awareness of the responsibilities and moral consequences of decisions. The moral sensitivity of nursing students improves the quality of nursing care and the effective management of ethical challenges.ConclusionResults can help develop nursing education theories and programs, design appropriate tools to evaluate this concept, and increase the quality of care and management of moral challenges in society and health systems.LimitationThis research has only examined Persian and English texts; also, accessing all the international databases was impossible, and more investigation in this field is required.

Background:Despite the importance and prominent role as a clinical, theoretical, and research approach in nursing practice, humanistic care nature and boundaries are not explicit and challenging for nurses to understand. This study was conducted to clarify the concept of humanistic care in nursing.Materials and Methods:Based on Rogers's evolutionary concept analysis, keywords such as “humanistic car *,” “caring behave *,” “humanistic nurs *,” “humanistic model of care,” were searched in PubMed, SCOPUS, Science Direct, Web of Science, WILEY, Springer, SAGE, ProQuest, SID, Iranmedex without time limit until November 2018. Sixty-five documents in nursing and ten documents in the medical discipline were finalized for thematic analysis.Results:Nine attributes of the humanistic care, including “excellence in clinical literacy,” “creating a healing environment,” “a comprehensive and unique viewpoint,” “contribution to clients' adaptation and flourishing of their talents,” “unrequited love and affection,” “preservation of human dignity,” “real presence,” “constructive dynamic interaction,” and “nurse's self-care,” were recognized. Assessing the historical and evolutionary course of the concept's semantic tendency revealed three periods: The focus in first, second, and third was on the nurse-patient relationship, quantitative tendency/measurement, and metaphysics/spiritual humanism, respectively. The comparison of interdisciplinary differences indicated greater semantic comprehensiveness and depth in the nursing discipline.Conclusions:Clear and practical definition and identification of humanistic care in nursing can be helpful in the further development of existing knowledge, instrumentation, designing guidelines, clinical interventions, knowledge translation, and correction of concept misuse. The identified antecedents and consequences can be in various aspects of clinical management.

Reform in the South African healthcare and educational system were characterized by the ideals that the country needs to produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. The objective of this study was to explore and describe clinical judgement through various data sources and review of literature to clarify the meaning and promote a common understanding through formulating the characteristics and developing a connotative (theoretical) definition of the concept. An explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search strategies were used, for the time frame 1982—2013. A concept analysis was used to arrive at a theoretical definition of the concept of ‘clinical judgement’ as a complex cognitive skill to evaluate patient needs, adaption of current treatment protocols as well as new treatment strategies, prevention of adverse side effects through being proactive rather than reactive within the clinical nursing environment. The findings emphasized clinical judgement as skill within the clinical nursing environment, thereby improving autonomous and accountable nursing care. These findings will assist nurse leaders and clinical nurse educators in developing a teaching-learning strategy to promote clinical judgement in undergraduate nursing students, thereby contributing to the quality of nursing care.

The formation of everyday ethical comportment is an essential part of nursing education in the 21st century, but the concept is more abstract and confusing than the dominant bioethical models frequently used in nursing education. The purpose of this analysis is to explore the concept of everyday ethical comportment and determine whether the concept remains viable for nursing as a discipline. Rodgers' method of evolutionary concept analysis guided a systematic literature review. Following PRISMA guidelines, 32 articles containing the keywords everyday ethical comportment were identified, and 20 are included in this study. The analysis identified four critical attributes of everyday ethical comportment (embodiment, skilled relational know-how, caring, and salience). The concept's surrogate and related terms, antecedents, and consequences were also identified. Everyday ethical comportment is underrepresented in the literature. Although it remains viable for nursing as a discipline, the concept's future sustainability is questionable. [J Nurs Educ. 2018;57(8):460-468.].