Conectar
Exploring the concept of patient agitation in the intensive care unit.
Patient agitation in the intensive care unit is of widespread concern and linked to negative outcomes for patients, staff, and family members. There is currently no consensus on what constitutes agitation in the intensive care context, hindering effective and tailored prevention and management.
Concept Analysis.
Walker and Avant's eight-step concept analysis approach.
A comprehensive search was carried out in the databases MEDLINE, PsychINFO and CINAHL. A total of 32 papers published between 1992 and 2023 were included, reviewed, and analysed to explore definitions, attributes, antecedents and consequences of patient agitation.
Patient agitation in the intensive care unit is characterised by excessive motor activity, emotional tension, cognitive impairment, and disruption of care, often accompanied by aggression and changes in vital signs. Antecedents encompass critical illness, pharmacological agents and other drugs, physical and emotional discomfort, patient-specific characteristics and uncaring staff behaviours. Consequences of agitation range from treatment interruptions and poor patient outcomes to the psychological impact on patients, families, and staff.
Agitation in the intensive care unit is a complex issue which significantly impacts patient treatment and clinical outcomes. For healthcare professionals, patient agitation can contribute to high workloads and job dissatisfaction. Due to the complex nature of agitation, clinicians must consider multifaceted strategies and not rely on medication alone. Further research is needed to fully understand patient agitation in the ICU. Such understanding will support the development of improved strategies for preventing and managing the behaviours.
A clearer understanding of patient agitation supports the development of tailored interventions that improve patient care, guide ICU training, and inform future research.
This concept analysis was developed with input from a patient representative.
To analyse the dimensions of the omission of nursing care in emergency departments, including its attributes, antecedents, and consequences, using Walker & Avant's concept analysis method.
Methods: Walker and Avant's eight-step method defined attributes, antecedents, and consequences of the omission of nursing care in emergency departments.
A comprehensive literature review was conducted using CINAHL, MEDLINE, Embase, Health Management Database, and Cochrane Library, covering publications from 2001 to 2024. The search was conducted in August 2024.
Key attributes were delayed, incomplete, or interrupted care, mostly due to insufficient staffing or unpredictable patient volumes. Antecedents included high workloads, inadequate skill mixes, and understaffing. Consequences were increased patient morbidity and mortality, nurse burnout, and job dissatisfaction. A research gap exists in paediatric-specific measurement tools.
Identifying dimensions of omitted nursing care in emergency departments informs interventions to improve patient safety and care quality. Developing paediatric-specific measurement tools is essential.
The findings emphasise the need for improved staffing and resource allocation policies, reducing risks to patients and enhancing nurse satisfaction.
This study addressed the gap in understanding omitted nursing care specifically in emergency departments. Findings highlight systemic issues impacting patient outcomes and nurse well-being. The results will guide organisational improvements and future research globally.
This study adhered to EQUATOR guidelines, following Walker and Avant's method for concept analysis.
This study did not include patient or public involvement.
This study underscores the critical impact of the omission of nursing care (ONC) in emergency departments (EDs) on patient safety, nurse well-being, and healthcare efficiency. ONC contributes to increased morbidity, mortality, and adverse events, highlighting the urgent need for improved staffing models and resource allocation. Training programmes should equip emergency nurses with prioritisation strategies to mitigate care omissions. Policymakers must recognise ONC as a key quality indicator, ensuring adequate workforce support. Additionally, this study identifies a gap in measuring ONC in paediatric EDs, calling for the development of tailored assessment tools and further research on intervention strategies.
To define and clarify the concept of emotional intelligence in healthcare leadership.
Walker and Avant's concept analysis model.
The study was conducted using Walker and Avant's concept analysis model. In the search of the relevant literature, the Joanna Briggs Institute's methodology and search protocol for scoping reviews were applied. Searches were conducted in May 2023 with no time or geographical limits on Scopus, CINAHL, ProQuest, the Web of Science, Medic and Mednar and 42 studies were included. The data were analysed using narrative synthesis by categorising results using the steps of concept analysis.
Concept analysis identified defining attributes of emotional intelligence in healthcare leadership, including leadership qualities, management competencies, and sets of leadership styles which were related to supportive and transformational leadership behaviour. The antecedents were socio-demographic factors, well-being, and workplace resources. Finally, employee-, manager-, organisation- and patient-related consequences were identified, such as the well-being of both employees and managers, organisational performance and patient care quality.
Emotional intelligence in healthcare leadership contributes to better performing organisations, as emotionally capable leaders can inspire and empower their employees. Holistic management of organisational duties and people-oriented leadership is a crucial resource in healthcare organisations. Well-being and workplace resources can be vitally important for leaders to manifest emotional intelligence in their work.
Emotional intelligence can contribute to efficient leadership behaviour and have positive outcomes at the employee, manager, organisation and patient levels. Therefore, emotional intelligence should be addressed in leadership education, training programmes and recruitment procedures. Finally, policymakers should be encouraged to acknowledge the role of sufficient resources in health care to ensure effective leadership.
Emotional intelligence is a widely studied concept in the healthcare field. However, thorough conceptualisation regarding emotional intelligence in healthcare leadership has been lacking. Conceptualising this phenomenon was therefore outlined, providing a deeper understanding of the concept. The findings can be utilised in healthcare leadership development and research.
N/A.
No patient or public contribution.
To describe the latest information on types of psychosocial interventions and their effectiveness on loneliness reduction among older adults in community and residential care settings, and the experience with these interventions.
Umbrella review.
The Joanna Briggs Institute methodology for umbrella reviews.
Cochrane Database of Systematic Reviews; Cumulative Index of Nursing and Allied Health Literature; Medline; Embase; Emcare; PsycINFO; ProQuest Dissertation & Thesis Global; Ovid Nursing Database; MedRxvi.
Twenty-two reviews were included. Seven major types of psychosocial intervention were identified: (1) social facilitation interventions, (2) psychological therapies, (3) health and social care provision, (4) animal-assisted interventions, (5) befriending interventions, (6) leisure and skill development, and (7) other interventions. Social facilitation interventions that provide synchronised interaction, psychological therapies, health and social care provision, and animal (−assisted) interventions demonstrated positive effects while leisure/skill development and befriending interventions warrant more rigorous evidence. Group settings, synchronised interaction and purpose-driven are identified as facilitators, whereas technological issues and safety issues are barriers to participation.
Seven types of psychosocial interventions are currently available for loneliness among community-dwelling older adults, and a positive effect in reducing loneliness was demonstrated in some types. Facilitators and barriers to their participation were synthesised. Two future research directions are suggested: (1) reviews on meaning-centred interventions to provide a comprehensive understanding and (2) implementation studies employing community-based paraprofessionals to promote programme scalability and accessibility.
Health and social care practitioners (e.g., nurses), researchers and policymakers are recommended to employ social facilitation interventions with synchronised interaction, psychological therapies, health and social care provision and animal-assisted interventions to address loneliness among community-dwelling older adults.
This review provided empirical information on available effective interventions to address loneliness among community-dwelling older adults. It also provided information for nurses to implement psychosocial interventions in the community.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
This study did not include patient or public involvement in its design, conduct or reporting.
PROSPERO CRD 42023482852, registered 25/11/2023
Analyse the concept of expertise among practicing clinical nurses in hospital settings.
The generational loss of expert clinical nurses was exacerbated globally by the novel coronavirus. This ongoing loss combined with the increased complexity of hospitalised patients has prompted an urgent need to understand expertise among clinical nurses who practice in hospital settings.
Walker and Avant's concept analysis method was used. PubMed, Medline, CINAHL and Access Medicine were searched (1982–2025) for research studies and literature reviews published in English that addressed clinical nursing expertise in hospitals.
Expertise is the knowledge and skills that are enculturated from immersion in a domain. Common attributes include obtaining salient information from different sources, interpreting patient situations rapidly and holistically, and performing actions that are individualised, immediate and appear instinctive. Common antecedents include deliberate accumulation of relevant experience and contextual connections within the hospital. Facilitating improved outcomes and facilitating improved outcomes are common consequences.
The attributes, antecedents and consequences of clinical nursing expertise are complementary and cross specialties. Experts' apparently instinctive actions are not intuitive but rather related to relevant past experiences, pattern recognition and skilled know-how. The requirements to develop expertise have evolved with the increased volume of available knowledge.
Expertise requires cultivating relevant experiences through active engagement with patients and creating contextual connections with others regarding hospital systems and processes. Experts should be formally included when developing processes and guidelines. Low-fidelity proxy measures like years of experience should be replaced with psychometrically validated instruments to measure expertise.
This concept analysis addresses the ambiguity of clinical nursing expertise by synthesising over 40 years of literature and provides insights for clinical nurses and researchers regarding the importance of context and the growing complexity of care delivery.
No patient or public involvement.
To examine and define the concept of moral distress among family caregivers by identifying its key attributes, antecedents and consequences.
Concept analysis.
This study was guided by Walker and Avant's concept analysis framework. A comprehensive literature search was conducted to identify relevant studies, with 12 articles included in this analysis.
PubMed, CINAHL, Scopus and PsycINFO databases were searched for articles published between February 2000 and May 2025.
Three defining attributes of moral distress in family caregivers were identified: self-directed negative emotions, internal conflict and feelings of powerlessness and helplessness. Antecedents included caregiving burden, role conflict, ethical dilemmas, complex decision-making and internal and external constraints. Consequences encompassed long-term health effects, social withdrawal, burnout and moral residue. These findings led to a conceptual definition of moral distress in family caregivers.
Moral distress in family caregivers is a significant and underrecognised issue that affects caregiver well-being and the quality of care they provide. This concept analysis offers a clear conceptual definition, providing a foundation for developing research instruments and interventions.
Healthcare professionals should recognise moral distress in family caregivers as a key factor impacting both caregiver well-being and patient care. Support through education, counselling and peer groups can reduce moral distress and foster more ethical, collaborative care environments.
This study addressed the lack of clarity surrounding moral distress in family caregivers. It identified key attributes, antecedents, and consequences, and developed a clear conceptual definition. These insights will inform research, practice and policy. The findings will benefit caregivers, improve patient care and support healthcare teams.
This study followed Walker and Avant's framework and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in article selection.
No patient or public involvement.
This review seeks to explore the illness narratives of children and young people focusing on their healthcare trajectories; the right to health; and the kind of stories told about them.
This scoping review adopts a narrative approach to analyse how the illness experience of Spinal Muscular Atrophy is represented in the literature, moving beyond biomedical descriptions to consider sociocultural and historical dimensions. We explore how global and local forces shape everyday life and therapeutic possibilities for people with this condition.
Four online databases were used to identify papers published between 2014 and 2024 in English and Spanish. The analysis process was guided by the PAGER Framework.
Twenty-one articles met the criteria for the review, mainly published in the Global North. Following organisation of Patterns, findings were categorised into three themes: (1) Parents as storytellers of young people's life trajectories; (2) Tropes about everyday life with Spinal Muscular Atrophy; and (3) The right to health as a narrative terrain. Findings show that access to medical treatment, information, and healthcare coverage poses difficulties when navigating the healthcare system with little institutional support.
The voices of individuals with Spinal Muscular Atrophy are rarely reported, often represented by their parents. There are opportunities to develop strategies that enhance the experiences of children and young people when seeking care, which should have a rights-based, intersectional, and family-centred approach.
This review highlights the need to listen to children and young people's voices, offer support to caregivers, and further explore the right to health in the Global South.
The interpretation of the findings was enriched by the involvement of patients, who participated as advisors for the research team. Their contributions ensured the research remained aligned with concerns and priorities informed by lived experience of the disease.
The purpose of this concept analysis is to clarify the meaning of digital health equity beyond a simplistic definition, obtaining a richer meaning that can guide the digital healthcare landscape.
With the growing spread of digital health, digital health equity should be at the center of healthcare. Health outcomes for equity-deserving groups may be compromised without a clear understanding of digital health equity. Although the concept of ‘health equity’ has been analysed before; no concept analysis has been completed for the concept of ‘digital health equity’.
Concept analysis using Walker and Avant's method.
Articles from PubMed, Scopus and Google Scholar with no limitation on the period of data collection.
Walker and Avant's concept analysis method was used to outline attributes, antecedents, consequences, and empirical referents of the concept digital health equity.
The main attribute of digital health equity is digital health technology that benefits everyone fairly. The antecedents include: (1) appropriate infrastructure; (2) cognitive abilities including digital literacy; (3) intersectionality of multiple vulnerabilities; (4) presence of the core ethical principles in healthcare; (5) digital accessibility with careful consideration of the social determinants of health; and (6) co-creation of digital health technologies. The main consequences are improved patient health outcomes and elimination of the digital divide.
This analysis explored the concept of digital health equity as a means to promote positive health outcomes for equity-deserving groups, highlighting the critical role of nursing practice and research in addressing digital health disparities.
This paper can have an impact on nursing practice, education and wider social and economic issues. First, various barriers encountered by patients when utilising digital health technologies can be understood. Second, clinicians can be encouraged to assess digital health equity, improve interventions for equity-deserving groups, and evaluate the effectiveness of digital health interventions to ensure they are equitable. In the context of educational implications, the understanding of digital health equity can be used to facilitate the creation of appropriate education materials for clinicians. Finally, on a wider social and economic scale, understanding digital health equity can aid in the creation of policies to enable equitable digital health technologies.
No patient or public contribution because this paper is a concept analysis.
To clarify the concept of life space in community-dwelling older adults to provide a clear and standardised conceptual basis for further research.
Rogers' evolutionary approach was used to identify surrogate terms, related terms, attributes, antecedents and consequences.
Literature from 1936 to 2025 was searched from PubMed, CINAHL, ProQuest, Cochrane databases, Scopus, Web of Science and CNKI.
A total of 46 articles were included for further analysis and synthesis. The attributes of life space in community-dwelling older adults were dynamic variability, multidimensionality and interaction between intrinsic abilities and external environmental demands. Antecedents were classified into four categories, namely, individual, physical, psychological and social factors. Life space can bring positive consequences, promoting walking, assessing the risk of falling, predicting cognitive decline, facilitating rehabilitation and improving quality of life, as well as negative consequences, causing diminished subjective well-being, heightened loneliness, increased risks of hospital readmission and mortality.
Life space, as a spatial indicator of a person's range of mobility, reflects older adults' physical range of motion, the frequency of activity, their need for assistance and the level of social participation. Older adults with adequate life space in the community are more likely to engage in outdoor activities. In contrast, restricted life space can lead to adverse outcomes.
Surrogate terms, related terms, attributes, antecedents and consequences identified by the concept analysis approach will contribute to a greater understanding of life space. These analytical findings establish an essential conceptual framework for future research while offering evidence-based theoretical guidance to improve life space in community-dwelling older adults, ultimately enhancing health outcomes and quality of life.
No patient or public contribution.
To introduce a novel conceptual framework that differentiates peripheral intravenous catheters according to their dwell time and therapeutic purpose, in order to improve the suitability of material choice, safety and cost-effectiveness.
Concept based on clinical guidelines, expert consensus and recent peer-reviewed evidence.
A literature search was conducted in PubMed on November 25, 2024, using defined keywords related to peripheral intravenous catheters, device complications and duration of use. This search was supplemented by manual screening of references from relevant articles.
The analysis followed the SANRA quality criteria for narrative reviews. Evidence and recommendations from clinical guidelines, randomised trials and qualitative studies were synthesised using the Australian Clinical Care Standards to structure the proposed classification into ‘procedural’ and ‘therapy’ catheters.
Procedural catheters are used for less than 24 h, typically during procedures or short treatments, and are mainly linked to immediate risks like insertion failure and local trauma. Therapy catheters, defined as devices used beyond 24 h or expected to remain while the patient sleeps, carry cumulative risks, including delayed complications such as phlebitis, occlusion and infection. The framework supports more nuanced decisions on device choice, insertion site and maintenance.
This framework introduces a practical differentiation between short- and longer-term peripheral venous catheters, addressing a major oversight in existing guidelines and supporting context-sensitive vascular access decisions.
Tailoring catheter management to expected dwell time may reduce complications and costs, enhance workflow, and improve patient comfort.
By addressing the lack of temporal distinction in current practice, this framework offers a simple yet transformative tool applicable across care settings, with the potential to improve patient outcomes, resource utilisation and costs.
This project is a concept analyses; no patient or public contribution was necessary.
To clarify the concept of quiet quitting in nursing practice.
Concept analysis using Walker and Avant's concept analysis methodology.
The eight-step method by Walker and Avant guided the concept analysis.
A systematic literature search was conducted in CINAHL, PsycINFO, Scopus and MEDLINE without date restrictions, identifying 36 empirical and theoretical articles published in English.
Quiet quitting in nursing is defined by four key attributes: minimal compliance with job expectations, psychological and emotional detachment, withdrawal of discretionary effort and lingering in role despite dissatisfaction. Antecedents include unhealthy work environments, psychosocial strain (e.g., burnout, moral distress) and individual/demographic influences (e.g., age, coping strategies). Consequences include impaired team dynamics, reduced care quality and organisational decline and increased turnover intentions. Twenty-five studies used validated measurement tools, notably the Quiet Quitting Scale.
Quiet quitting is a subtle form of disengagement distinct from burnout and turnover. It reflects an adaptive coping response to sustained dissatisfaction and unmet expectations. It is both widespread and underrecognized, with implications for healthcare sustainability.
Understanding and addressing quiet quitting is essential for safeguarding professional standards, promoting nurse engagement and ensuring high-quality patient care. Early identification and systemic reforms are critical to mitigating its impact.
This study addresses the emerging challenge of nurse quit quitting. Findings can inform leadership, education and policy development globally, particularly in healthcare settings facing workforce strain, moral distress and retention challenges.
This article adheres to the PRISMA-ScR reporting guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
To examine the concept of obstetric violence culture and establish a working definition for application to practice, research, and policy in perinatal care.
Concept analysis.
Rodgers' evolutionary method guided the analysis and data organisation into antecedents, attributes, and consequences.
A systematic search using the phrase ‘obstetric violence’ was conducted in CINAHL and PubMed databases. Articles published in English between November 1, 2020, and December 31, 2024, were included.
Sixty-two articles were included. Antecedents reflected the historical medicalisation of birth, professional hierarchies, and structural inequities. Attributes—disbelief of harm, victim blaming, revictimisation, and disempowerment—mirror those identified in rape culture. Consequences spanned birthing people, clinicians, and systems, including mistrust, moral distress, and institutional silence. The resulting definition frames obstetric violence culture as an embedded and normalised set of practices and beliefs that sustain mistreatment in perinatal care.
Obstetric violence culture is not an outlier, but a pervasive and institutionalised framework to be systematically dismantled.
Nurses have an ethical obligation to recognise and disrupt obstetric violence culture. Structural change, clinical education, and institutional accountability are necessary to uphold patient autonomy and dignity.
This study followed Rodgers' evolutionary method and adheres to relevant EQUATOR guidelines for conceptual research.
This study did not include patient or public involvement.
To conceptualise information distortion in Electronic Health Records (EHRs), with the goal of providing a theoretical foundation for improving documentation practices.
A concept analysis.
Walker and Avant's strategy for concept analysis was used. The defining attributes, antecedents and consequences were identified.
A comprehensive search was conducted across PubMed, Web of Science, Embase, CINAHL and Scopus from their inception to December 2024. Studies published in English that addressed information distortion in EHRs were included.
A total of 37 studies were included. The three defining attributes were: real-world health truth, representation of reality and mismatch relationship. Antecedents were divided into five categories: people-related factors, equipment factors, regulatory factors, working environment factors and management factors. The consequences of information distortion in EHRs included threats to patient safety, poor operational performance, eroded trust, compromised research quality and health inequity.
This concept analysis enhances the understanding of information distortion in EHRs and provides a foundation for further empirical validation. The findings may contribute to the development of measurement instruments and strategies to mitigate information distortion in healthcare settings.
By undertaking a concept analysis of information distortion in EHRs, healthcare professionals will be better equipped to recognise and assess this ethical phenomenon, thereby supporting the development of targeted interventions to mitigate potential harms to healthcare practices. In addition, the clarity of this concept could provide a new angle from which to analyse the origins of flawed EHR documentation and its ripple effects across healthcare systems.
No patient or public involvement.
To conduct a concept analysis of ‘safe mobility’, with specific application in hospitalised older adults, identifying its defining attributes, antecedents and consequences.
The promotion of safe mobility is essential for maintaining the functionality of hospitalised older adults. However, this idea is not yet clearly defined in the scientific literature, requiring a conceptual analysis for better understanding and applicability in nursing practice.
Concept analysis.
The concept analysis methodology of Walker and Avant was employed, consisting of eight steps. Sources from the scientific literature (BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Thesis and Dissertation Catalogue, as outlined in a scoping review previously published by the authors) and terminologies from dictionaries and nursing practice, such as SNOMED CT, ICNP, NANDA, NIC and NOC, were analysed.
The concept of ‘safe mobility’ does not have a consolidated definition but was identified through three defining attributes: active movement, prevention of fall-related harm and prevention of immobility-related harm. The antecedents include the older adults' conditions, adaptation of the hospital environment, training of the multidisciplinary team, patient behaviour and family involvement. The consequences involve the maintenance of functionality, improvement of quality of life, reduction of hospital length of stay and costs, as well as a decrease in rates of readmission, referrals to long-term care institutions and mortality.
The concept analysis revealed that safe mobility involves promoting active movement and preventing harm related to both immobility and falls.
Strategies based on this concept can improve the quality of life of older adults, reduce complications and optimise hospital costs.
This concept analysis examines existing literature and does not require patient-related data collection. The methodological approach does not necessitate collaboration with the public.
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.
Fall prevention is crucial for older adults. Enhanced fall risk perception can encourage older adults to participate in fall prevention programs. However, there is still no unified definition of the concept of fall risk perception.
To explore the concept of fall risk perception in older adults.
A concept analysis.
The literature was searched using online databases including PubMed, Cochrane Library, Embase, CINAHL Complete, PsycINFO, Web of Science, China National Knowledge Infrastructure, WangFang and SinoMed. Searches were also conducted in Chinese and English dictionaries. The literature dates from the establishment of the database to April 2023.
The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of “fall risk perception” in older adults.
Eighteen publications were included eventually. The attributes were identified as: (1) dynamic change, with features of continuum and stage; (2) whether falls are taken seriously; (3) a self-assessment of the fall probability, which is driven by individual independence; and (4) involves multiple complex emotional responses. The antecedents were identified as: (1) demographic and disease factors; (2) psychological factors and (3) environmental factors. The consequences were identified as: (1) risk-taking behaviour; (2) risk compensation behaviour; (3) risk transfer behaviour; and (4) emotions.
A theoretical definition of fall risk perception was identified. A conceptual model was developed to demonstrate the theoretical relationships between antecedents, attributes and consequences. This is helpful for the development of relevant theories and the formulation of fall prevention measures based on fall risk perception as the intervention target.
This paper aims to inform nursing and other healthcare disciplines by clearly defining patient competence and the skills required to improve self-care behaviours.
Competence has been defined in education and leadership. However, competence in persons with chronic disease has not been expanded upon since one publication in 1983. Patient competence needs to be developed and defined so that healthcare disciplines can understand the attributes necessary for a patient to be deemed competent to promote self-care behaviours.
A concept derivation.
Walker and Avant's approach to concept derivation was used to identify a base concept (competence) that is well-defined in another field, define the concepts associated with the parent field, and transpose that definition to a new field to formulate a redefined concept. PsycINFO, Scopus, Web of Science and Medline were searched, and 21 articles were included.
Patient competence is defined as the ability of a person with a chronic illness to reach skill mastery, achieve knowledge, maintain a positive attitude and develop trust in themselves and in healthcare providers that will facilitate active engagement to improve self-care behaviours.
Defining patient competence is important in assisting nurses and other healthcare providers in understanding the attributes needed to deem a patient competent, especially those living with chronic illnesses requiring lifelong self-care behaviours. More research is needed to aid in the designing of a precise instrument for measuring this phenomenon.
Concept derivation of patient competence provides a framework for nurses and other members of the healthcare profession to understand the attributes needed to determine patient competence.
Vicarious trauma can significantly affect the physical and mental health of nurses, as well as their ability to provide quality of care. However, the concept of vicarious trauma has received limited attention and remains controversial in the nursing context.
The purpose of this study was to clarify and define the concept of vicarious trauma as it pertains to the nursing context.
The Schwartz and Kim's three-stage hybrid concept analysis method was used to define the concept. In the theoretical phase, PubMed, CINAHL, OVID, Medline, Embase, Web of Science, Scopus, ProQuest, PsycINFO, CNKI database, VIP database and Wanfang database were used using keywords “nurs*”and “vicarious trauma*”, resulting in a total of 25 papers. In the fieldwork phase, we conducted participatory observations in three hospitals and semi-structured in-depth interviews with 18 clinical nurses from seven cities. In the analysis phase, the results of the previous two phases were integrated to develop a comprehensive concept of vicarious trauma in nursing.
Based on the results of the theoretical and field phases, we propose the concept of vicarious trauma in nursing as follows: vicarious trauma is a psychological trauma impacting nurses' cognitive schema which they may experience in clinical settings or on social media, resulting from deeply empathize with the physical or emotional trauma of patients, family, or colleagues, such as patients' physical injuries or death, family's grieving feelings and colleagues' received threats and attacks. Positively, vicarious trauma can transform into vicarious post-trauma growth through repositioning and connection, nourishing nurses and promoting their personal and professional development.
The concept of vicarious trauma in nursing is multidimensional and holistic. This study clarifies the concept of vicarious trauma in nursing using the hybrid concept analysis, providing a framework for future research and practice on vicarious trauma in the nursing field.
Nurses contributed to the conduct of the study by participating in the data collection via interviews.
FreshRSS 