Concept Analysis in the Literature Essay.

Strategies for Concept Development and Analysis
This week examines concept development and analysis, which, along with theory, is a critical aspect of nursing research.
Whether a concept (also called phenomena) is abstract or more concrete, it exists within a particular context and may be interpreted in multiple ways. Clarifying or generating a shared understanding of what a particular concept is or means is therefore vitally important. As such, you will apply this approach to a research topic relevant to your nursing practice, and evaluate the steps in this process as demonstrated in a research article.Concept Analysis in the Literature Essay.

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Students will:
• Apply concept analysis to a practice problem
• Analyze the steps in concept development and analysis as demonstrated in a research article

Assignment: Concept Analysis in the Literature
Review of research literature is a beneficial strategy that can be employed for concept analysis. In undertaking this strategy, you seek to understand how others have defined a particular concept, including the steps that have been utilized to arrive at this definition. As members of the nursing field engage in multiple concept analyses, they can begin to develop consensus for concept definitions and/or revise them as necessary.Concept Analysis in the Literature Essay.
Note: The concept and practice problem you select will be your focus next week as well, when you explore the relationship between concept analysis and theory development.
To prepare:
• Select a concept related to a practice problem of interest to you. You may use the concept and practice problem you selected for the Discussion.
• Using the Walden Library, find and read at least two articles that demonstrate concept analysis for your selected practice problem.
Then:
Write a 2- to 3-page paper that summarizes the steps of the concept analysis process utilized in each article. Include in your summary the following information for each article:
• What is the definition of the concept?
• How could or does the definition differ from its use in nursing and health care versus in other disciplines?
• What characteristics define the concept? How do these apply to nursing and clinical practice?Concept Analysis in the Literature Essay.

Required Readings
McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing. (5th ed.) Philadelphia, PA: Wolters Kluwer Health.
• Chapter 3, \”Concept Development: Clarifying Meaning of Terms\”
Chapter 3 explains the process of concept development and discusses its application to theory development and research.Concept Analysis in the Literature Essay.

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.
• Chapter 8, \”Frameworks\”
Chapter 8 examines concepts and relational statements, how theories relate to concepts, and how to use conceptual maps to visually illustrate the interrelationships between concepts and statements.

Cronin, P., Ryan, F., & Coughlan, M. (2010). Concept analysis in healthcare research. International Journal of Therapy & Rehabilitation, 17(2), 62-68.
The theoretical and philosophical underpinnings of concept analysis are described in this article. In addition, methods used for concept analysis are discussed.Concept Analysis in the Literature Essay.

Ekeland, E., Heian, F., Hagen, K., Abbott, H., & Nordheim, L. (2008). Exercise to improve self-esteem in children and young people. Cochrane Database of Systematic Reviews, (1).
This systematic review examines the influence of exercise on the self-esteem of children and young adults.

Parse, R. R. (2006). Concept inventing: Continuing clarification. Nursing Science Quarterly, 19(4), 289.
This article provides an overview of concept inventing and describes the process as a nonlinear multidimensional approach that requires simultaneous analysis and synthesis.Concept Analysis in the Literature Essay.

Penrod, J. (2007). Living with uncertainty: concept advancement. Journal of Advanced Nursing, 57(6), 658-667.
This article provides an analysis of a phenomenological study on the concept of uncertainty among family caregivers.

Optional Resources
Brown, C., Wickline, M., Ecoff, L., & Glaser, D. (2009). Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center. Journal of Advanced Nursing, 65(2), 371–3 81.

Risjord, M. (2009). Rethinking concept analysis. Journal of Advanced Nursing, 65(3), 684–691.

The concept of concordance represents an evolution in terminology from and confusion (unfortunately) with the terms compliance and adherence. Adherence and compliance relate to the psychiatric patient’s ability or capacity to stick to medication regimens and to take the prescribed medications as and when it is required. A review of literature related to terms adherence, compliance, and concordance reveals that there is considerable confusion as to the meaning of each term, with different professionals at time using the three terms interchangeably and erroneously. Concept Analysis in the Literature Essay.

According to Weiss and Britten (2009), concordance is not the same as compliance or adherence and differs with these two in two ways. First, concordance is concerned with collective decision-making between the clinician/ nurse and the patient. Second, concordance is focused not on the behavior of the patient with regard to sticking to medication regimes; but on the very process of consultation between the clinician and the patient (Weiss & Britten, 2009). Concept Analysis in the Literature Essay. The practice problem considered in this paper is that of the lack of concordance between psychiatric-mental health nurse practitioners (PMHNPs) and patents with mental illness. This fact makes the treatment of these patients with mental illness expensive and wasteful of resources (as in the instance where the patient occupies two beds – one in the normal unit and another set aside in the psychiatric unit just in case). This paper summarizes the content of two papers on analysis of the concept of concordance with focus on this clinical problem. Concept Analysis in the Literature Essay.

Snowmen et al. (2014)

Definition of the Concept

The definition of the concept of concordance by Snowden et al. (2014) is that it is a patient-centered approach to achieving medication and therapy adherence/ compliance by involving the patient in decision-making about their treatment. It shifts the balance of power in the clinician-patient relationship to the patient by relying on mutual understanding in place of paternalism.

Difference in Definition from its Use in Nursing versus Other Disciplines

Usage of the concept of concordance in various disciplines indeed differs from how it is defined and used in nursing and healthcare. According to Snowden et al. (2014), concordance in literature refers to a list that contains all the words that an author has used in a piece of literary work. Geneticists apply the definition of the concept of concordance to mean the occurrence of a genetic trait in both identical twins. Of course the converse of this or the absence of the trait in one of the twins (as it shows in the other) would be discordance in this context. For statisticians, concordance is a numerical coefficient of accord. Even in healthcare, some use concordance in the clinical context to refer to the fact that one has followed particular guidelines. Concept Analysis in the Literature Essay.

The Characteristics that Define the Concept

The concept of concordance is, as has been discussed above, all about shifting focus on the patient in all matters concerning their treatment. It is a patient –centered approach to therapy that places great emphasis on the bioethical principle of autonomy. This is the principle that states that the patient should always retain the power to decide the course of their treatment and what is done to them (Haswell, 2019). Autonomy is based on informed consent and mutual agreement (Entwistle, 2019). It is patient-centered in the real sense of the word.  In concordance, the power to comply with treatment is placed squarely in the hands of the patient. There is no paternalism or coercion but just mutual agreement between the nurse/ clinician and the patient on the way forward in treatment compliance. Concordance avoids focus on the patient but focuses more on the process of consultation, making it as patient-centered as possible. Concept Analysis in the Literature Essay.

These characteristics apply to nursing and clinical practice in that when the concept of concordance is applied, better patent outcomes are achieved. Concordance, which focuses on the consultation process rather than patient behavior results in better medication adherence/ compliance by the mental health patient. Concept Analysis in the Literature Essay.

Bissonnette (2008)

Bissonnette (2008) analyzed the concept of adherence and made it clear that in that context, it was synonymous with adherence and concordance. Of course that is not the case, as has been discussed above. These were early days and concordance was considered as a change of terminology from compliance and adherence. This is why it is included here as an analysis of the concordance concept. Concept Analysis in the Literature Essay.

Concept Definition

The author defines the concept of adherence (which they consider – erroneously – as an earlier terminology to concordance) as congruence between patient behavior and clinician advice, the ability to follow clinician instructions, and a collaborative clinician-patient relationship that is voluntary and mutual in nature (Bissonnette, 2008). Concept Analysis in the Literature Essay.

Difference in Definition from its Use in Nursing versus Other Disciplines

In other disciplines, this concept would mean different things depending on the concept. The author in this case does not explicitly detail these, but the inference is implicit in the discussion of the analysis by Roger’s model. In all the instances, however, there is a clear abscence of patient-centeredness and an imbalance of power in favor of the clinician who exercises paternalism. The patient is seen as a passive recipient of instructions that are meant to be followed regardless of their own views. Concept Analysis in the Literature Essay.

The Characteristics that Define the Concept

The characteristics of the concept of adherence (which was considered synonymous – erroneously – with concordance in the context of the article) included that the clinician was the decision maker; the patient was a passive receptacle for instructions; and the balance of power was in favor of the issuer of treatment instructions. Application to nursing and clinical practice is in appreciating the difference in meaning between the concepts of concordance on the one hand, and compliance or adherence on the other. Evidence-based practice would favor application of the concordance concept for better clinical outcomes in mental health.  Concept Analysis in the Literature Essay.

The concept chosen for this discussion is the Concordance Concept which very is a concept that is very applicable to nursing to my nursing practice problem.  Nursing is rooted in patient-centered care and assumed partnership with patients, as is concordance. The discipline of nursing has many patient-centered theories and practices that support the constructs of concordance (McEwen & Wills, 2019). The inpatient mental health is currently in transition to more of a mental health/ medical ward. This decision is due to patients having to be sent to a medical ward for minor medical complaints that have more of a mental health concern. These situations have caused an increase use of staff, because when they placed on a medical unit, they must be on a 1:1 observation. The patient will also have two beds; one would be on hold on the mental health unit and the bed they are currently occupying, causing another patient not having the ability to be seen. This situation shows the need for “concordance” in healthcare in nursing practice. Concept Analysis in the Literature Essay.

Concept Analysis and Research Topic

Concordance appears to offer an alternative approach consistent with person-centered approaches to decision-making. Evidence supports the concept that effectiveness and implementation of a patient’s prescribed therapeutic regimen correlates to the value of the patient and healthcare provider’s relationship (Lehman, 2020). Generally, when patients are being placed on other units within the hospital, their therapeutic regimen is thrown off. They are not being seen for regular mental health therapy, which breaks the provider’s relationship and often are being discharged from the hospital without getting their mental health concerns address. This has been creating an increase readmission rate to the mental health units. With all the challenges in health care, concordance in nursing care is important to help bridge this gap in care. Concept Analysis in the Literature Essay.

Concept and Research Topic to Nursing Practice

Reviewing the concept of concordance shows how important discipline come to together to provide patient- centered care and how each discipline play an important role in this care.  The concept of concordance and the role of the healthcare provider were evaluated using the guidelines and steps of Walker and Avant’s method of concept analysis (Weiner &Shwartz, 2016). Mental Health has come a long way and has been a unique form of health care. The concept analysis theory suggests all disciplines are integrated and applied within the care. During the expansion of the mental health unit, we now have providers, such as; Advanced Practice Registered Nurse, Physician Assistant, Psychologist and Physician all working together to provide comprehensive care on the unit. After the reconstruction on the unit, there will be medical beds available to care for patients so they can be treated for their medical concurrentlywith their mental health conditions. This is plan was developed after multiple health concerns were not being address on the mental health unit and vice versa. With the new construction, it is evident that mental health will move toward the concordance in nursing care practice. Concept Analysis in the Literature Essay.