Concept analysis

Answer

Introduction

Concept analysis refers to an exercise designed to familiarize a researcher with a concept while a concept refers to a word or two words that relay meaning and understanding among individuals within a given discipline (Dubois, Prade, 2012). Therefore, concept analysis can accurately be regarded as the first step in communicating meanings and understandings among individuals of the same discipline. A theory, on the other hand, refers to a set of assumptions or accepted facts that attempt to provide a rational explanations for an observed phenomenon (Badawy, 2011). Concept analysis is, therefore, critical to the development of a theory because it provides a common understanding and meaning of the concepts of a phenomenon within a given discipline. The understanding of the phenomenon's concepts translates into a full understanding of the phenomenon and the subsequent making of assumptions that seek to explain the phenomenon hence, theory development.

Adaptation is an evident concept in nursing practice that seeks to explain how the environment needs to adapt to meet the patient’s needs (Dinmohammadi, Peyrovi, Mehrdad, 2013). This paper will focus on the following sections; the explanation of the concept of adaptation, the concept of comparison, literature review, defining attributes, Antecedent and Consequence, Empirical Referents, model cases, alternative cases and the conclusion.

The Explanation of the Concept of Adaptation

Adaptation refers to how an organism can adjust to fit in a given ecosystem. In nursing context, the concept of adaptation seeks to explain how the environment needs adaptation to meet the patient's needs (Dinmohammadi, Peyrovi, Mehrdad, 2013). This concept posits that to meet the needs of the patients; the nurses should either adapt to patient's needs, help the patient to adapt to the environment, or work towards adapting the environment to the patient's needs. This concept was obtained from Roy's Theory of Adaptation that uses a model that regards the individual as a set of biological, psychological and social systems that are interrelated (Roy, 2011). Roy’s theory of adaptation argues that the individual strives to maintain a balance between biological, psychological and social systems and the outside world without any absolute balance.

The Concept of Comparison

Comparison refers to the finding out of the differences and similarities between two or more items. In mathematics, the concept of comparison is widely used in the Model Method from which all math models are derived (Ganter, Wille, 2012). For instance, mathematics teachers use concrete objects to promote a sense of the comparison concept among students by comparing two or more quantities. Once the students have visualized how much a quantity is smaller than or greater than the other quantity, they then proceed to depict this relationship in the pictorial representation of the math model concerned using rectangular bars.

 The concept of adaptation posit some similarities between nursing profession and teaching profession in that both profession involve helping individuals in focus (i.e. patients for nursing and students for teaching) to adapt to their environments in order to have their objectives met (Dinmohammadi, Peyrovi, Mehrdad, 2013). For instance, in the nursing profession, the nurses should either adapt to patient’s needs, help the patient to adapt to the environment, or work towards adapting the environment to the patient’s needs while in the teaching profession, adaptation of mathematics instruction is appropriate for all students. For example, math teachers handling students with learning disabilities must ensure that the learners’ needs are met by adapting the general education mathematics instruction to meet the needs of individual learners (Ganter, Wille, 2012). Simple changes in the nursing environment can significantly help the patients to adapt to the situation and promote better patient outcomes. Similarly, simple changes to the presentation of concepts in mathematics can significantly enable learners to adapt to the process of solving the given mathematical problem. However, the adaptation concept posits some differences between the nursing and teaching professions. Whereas in the nursing profession the concept focuses much on the biological, psychological and social environment of a patient, the focus of the concept of adaptation in the teaching profession lies much on the mental and academic environment of the learner.

Literature review

There are a substantial number of nursing literature reviews on the concept of adaptation. These literature reviews include; 

Roy, C. (2011). Research based on the Roy adaptation model last 25 years. Nursing Science Quarterly, 24(4), 312-320.

This resource explores how the concept of adaptation can be drawn from Roy’s adaptation theory and be applied in research. The article presents essential details of two areas that links Roy’s adaptation theory to research and holds that secondary analysis of Roy model-based research is critical in understanding a person’s cognitive recovery after a mild head injury.

Fawcett, J., & Desanto-Madeya, S. (2012). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. FA Davis.

            This article is a literature review that seeks to explain how the concept of adaptation can be drawn from Roy’s adaptation theory to explain the knowledge of adaptation. It focuses on the adaptation of organisms to their environments as these organisms evolved from one species to another. The article advocates for adaptation as a significant concept in understanding the evolution process of organisms and seek to incorporate other nursing theories to support the position of Roy’s adaptation theory about evolution.

McCarthy, V. (2011). A new look at successful aging: exploring a mid-range nursing theory among older adults in a low-income retirement community. Journal of Theory Construction & Testing, 15(1), 17-23.

This resource is a literature review that explores Roy’ adaptation theory to demonstrate how older adults can adjust to the circumstances of old age. It posit that adaptation is critical for maintaining good health in older adults. The article advocates for improved ability to cope and adapt to the challenges of old age to ensure satisfaction by the elderly. According to the article, older adults enhance their ability to survive through adaptation.

McCrae, N. (2012). Whither Nursing Models? The value of nursing theory in the context of evidence‐based practice and multidisciplinary health care. Journal of advanced nursing, 68(1), 222-229.

This article posit that Roy’s theory of adaptation is critical in nursing evidence-based practice. The article uses Roy’s adaptation theory to advocates for embrace of theory-based practice in the evidence-based practice by nursing educators and practitioners.

Im, E. O., & Ju Chang, S. (2012). Current trends in nursing theories. Journal of Nursing Scholarship, 44(2), 156-164.

            This resource is an integrated literature review that explores current trends in nursing theories. The article holds that understanding of nursing research and practice in the context of Roy’s adaptation model is critical in linking research and nursing practice.

Jimenez, C., Navia‐Osorio, P. M., & Diaz, C. V. (2010). Stress and health in novice and experienced nursing students. Journal of Advanced Nursing, 66(2), 442-455.

This article is a literature review that seeks to explain how the concept of adaptation, in the context of Roy’s adaptation theory, relates to stress and health in nursing students. It focuses on the adaptation of nursing students to stressors associated with their profession and seek to explore interventions in the context of Roy’s theory of adaptation.

Defining attributes

An attribute refers to the element that identifies the characteristics of a concept. The concept of adaptation posit four major attributes that are critical for individual’s adaptability (Kolker, 2015). These include; confidence, tolerance, resilience and vision.

Confidence refers to belief in one's self and the trust in one's own judgment and resourcefulness. This attribute of adaptation is critical in enabling individuals to accept their health conditions and focus on the positive side of their living, hence, adapt to the situation at hand (Kolker, 2015).

Tolerance refers to the ability of individual to accept opinions and practices different from theirs (Kolker, 2015). This attribute is critical in determining the patient’s ability to adapt to new ways of living as dictated by their health conditions. For instance, type 2 diabetes patient will need to adjust his life style to manage his health. Thus, tolerance will enable the patient to adapt to this new way of life in order to manage his health.

Resilience refers to the ability of an individual to overcome setbacks, barriers, and limited resources. This attribute is important in ensuring the strong emotional status of individuals hence enables them to handle their health conditions with confidence (Kolker, 2015). The confidence is critical in promoting adaptability of individuals by accepting to face the situation as it is.

Vision refers to the ability of individuals to look at the future with a purpose thus, become creative and suggest alternative ways of containing a situation while focused on the future (Kolker, 2015). Vision is critical in developing hope and optimism among individuals who then seek to adapt to situations by seeking alternative ways to fit in the new circumstances.

Antecedent and Consequence

Antecedent refers to an identifiable occurrence that precedes adaptation while consequence refers to the result of adaptation (Credé, Niehorster, 2012). Adaptation is preceded by the ability of an individual to identify the existence of a problem and the need to change current behavior, event or situation to counter the problem. Notably, adaptation comes with consequences. For instance, it enables individuals to return to a more stable life of better quality through finding hope and meaning to life and overcoming difficult circumstances towards a more satisfactory and healthier future(Credé, Niehorster, 2012).

Empirical Referents

An empirical referent refers to measurable ways of determining the occurrence of adaptation as a nursing concept (Morgan, Yoder, 2012). The presence of adaptation cannot be measured but can be determined objectively using the following empirical referents of related constructs; Connor-Davidson Resilience scale and Scale of Perceived Social Support.

Connor-Davidson Resilience scale was created to address aspects of resilience in clinical practice. Resilience refers to the capacity to adapt to overcome a diversity (Scali, Gandubert, Ritchie, Soulier, Ancelin, Chaudieu, 2012).  Connor-Davidson Resilience Scale is a 25 item scale whose psychometric properties can be used to determine the presence of adaptation in clinical practice. This 25-item scale has generated two version; the 10-item version and the 2-item version of the instrument. The 10-item scale has a range of score from 0-40 with questions 1, 4, 6, 7, 8, 11, 14, 16, 17, and 19 from the original 25-item scale. The second version, the 10-item scale has 1 to 8 items of the original scale with a score of 0-8. These scales post objective means of measuring adaptability (Scali, Gandubert, Ritchie, Soulier, Ancelin, Chaudieu, 2012).

Scale of Perceived Social Support is a psychometric 12-itemed multidimensional scale that distinguishes perceived social support from three sources; friends, family and significant other. This scale has strong factorial validity (Tonsing, Zimet, Tse, 2012). It focuses on a 12-item self-report inventory to measure perceived social support from friends, family and significant other. The Scale of Perceived Social Support involves the use of a 7-point Likert-type scale by the respondents who either strongly disagree or strongly agree with the items presented (Tonsing, Zimet, Tse, 2012). The result obtained can then be used to objectively measure how much individuals adapted to the various situation through social support from family, friends and significant other.

Model Case

D.B is a 30-year-old black American woman, of African descent, with five years history of type 2 diabetes. Although she was diagnosed in 2010, she had displayed symptoms of hyperglycemia for two years before the diagnosis. She was advised to lose weight at the time of the diagnosis and has been referred by family physician to the diabetes specialty clinic. Upon examination at the clinic, she was found to have gained weight and had swollen and painful lower extremities. While under medical care at the diabetes specialty clinic, she engaged in continuous active physical activities that saw her weight drop by 10 pounds within the first six months. She was put on glyburide, 2.5 mg every morning and also takes atorvastatin, 10 mg daily, for hypercholesterolemia. She has tolerated these medications in complete adherence to the daily schedule. She has regular checks on her blood sugar at the facility and always stick to the advice of her care provider about healthy living. D.B’s health has improved over the years and she has become very active in different volunteer organizations.

This case model posits all the attributes of adaptation as D.B is seen to be resilient, tolerant, and confident with a vision to better her life by sticking to the medication program to ensure better future.

Borderline Case

J.C is a 30-year-old Hispanic female living with type 2 diabetes. She was diagnosed two years ago having complained of pain and swelling of her leg. She got enrolled for nursing home care with a diabetes specialty clinic. Upon examination, she was found to be overweight and was advised to work on her weight by losing at least 10 pounds. Her care provider committed her to 2.5 mg of Diabeta every morning and atorvastatin, 10 mg daily, for hypercholesterolemia. She continued with the medication program as she actively engaged in physical exercise for eight months before discontinuing the medication after her health improved. Her home care provider advised her to continue with the medication and the exercise but she felt that was unnecessary as she had already lost 20 pounds and her health was stable. Seven months later, her health condition and her weight began to worry her as she had put on weight and both of her legs were swelling and losing sensitivity. She returned to the diabetes specialty clinic and was put back on medication and regular exercise. Now she is under home care nurse who helps her manage her condition. However, she has no plans to maintain the health management program but hope to stop the medication when her condition improves.

This case study posit all the attributes of adaptation except the vision for her future. This is shown by her lack of plans to maintain health management program. This indicates that J.C does not have the vision to avoid a repeat of the episode tomorrow.

Contrary Case

J.N is a 28-year-old American female who has been living with type 2 diabetes for one year. She declined to share the circumstances around her health management but was only perplexed at the failure of the local health facility to help her improve her health condition. She spoke of the poor public relation by the care givers at the facility and the side effects of the diabetes management drugs that were recommended by her homecare nurse. She raised concern over the strict rules and regulations on her eating habits and, how to live a healthy lifestyle. Whenever her home care nurse visited she would complain about being tired of taking the medication. Notably, she never adhered to the medication schedule and usually disregarded the homecare nurse’s advice on matters pertaining to her health management. Her condition has worsened and she is now in tears most of the time and feel dejected. She has no plans for future improvement of her condition and is pessimistic about a bright future for herself.

This case model posit absence of all the attributes of adaptation as J.N recognized the problem but did not acknowledge the potential for a better health. She was intolerant and lacked vision for the future. She was always in tears due to lack of resilience to overcome the situation and had no self-confidence.

Conclusion

The analysis of the concept of adaptation is the first step in the development of Roy’s theory of adaptation. This concept analysis has identified the defining attributes, antecedents, and consequences of adaptation. Adaptation theoretically refers to a process whereby an individual acknowledges a behavior, situation or problem and the negative social or health impact of the problem, becomes willing to change the behavior, situation or problem with the hope that the changes will improve the quality of life. The development of the theory of adaptation for nursing is then taken to the next level that involves construction and testing of theoretical relationships between adaptation and outcome variables. The presence of adaptation in nursing practice can be measured through its constructs using empirical referents.

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