Conceptual Relationships and Assumptions
Can you? Pick please ONE out repost statement from the article.
Then apply Walker and Avant (2019) chapter 11, statement analysis, to this statement:
Classify (existence, definition, relational)
If it is relational:
Type - is is causal, probabilistic, concurrent, conditional, time ordered, necessary, sufficient, etc. (see Gray et al. text too, page 145)
Sign - positive or negative
Symmetry
Logic
Testability
Walker, L. O., & Avant, K. C. (2019). Strategies for theory construction in nursing (6th ed.). Prentice Hall.
Week 5 Learning Resources
Gray, Grove, & Sutherland (2017)
Chapter 8 – see week 1
McEwen & Wills (2014)
Chapter 2 – see week 1
Chapter 4 – see week 1
Walker & Avant (2011)
Chapter 5 – statement derivation
· A declarative sentence in which a relationship is posited between 2 or more concepts
· Concepts share a common strength or content within the existing strategy for statement derivation
· Example: when X is reached, further Y leads to reduced Z
· We do this is there is not a lot of data, it currently is outdated, or existing data is not sufficient to capture the phenomenon
· Direct research to test them
Chapter 8 – statement synthesis
· Specify relationship between 2 or more concepts based on evidence
· 2 steps: 1) evidence results in inferences and 2) generalize from specific
· When to do a statement synthesis: 1) there is no conceptual or empirical work on the topic, 2) concepts and evidence are available so link them, or 3) research is published but it is not organized into a meaningful conclusion
· Qualitative, quantitative, or mixed methods
Chapter 11 – statement analysis
· Focus on classifying each concept, relationships between them, and the role the statement has in the whole picture
· If statements are nonrelational they exist or provide a definition
· If there is a relationship they could be causal, probabilistic, concurrent, conditional, time ordered, necessary, or sufficient
· Steps include select the statement, simplify it, classify it, examine the concepts, specify relationships, examine the logic, and determine testability
Chapter 13 – see week 3
Cowden & Cummings (2012)
· Employee job satisfaction is related to thinking about leaving which is related to turnover (3 concepts linked)
· Behavioral intentional statements have the strongest prediction
· The key concept is intent to stay – previous research has focused on cognitive behaviors not affective ones – we need both
· Many variables affect intent to stay including organizational commitment, job satisfaction, leadership practices, work environment, individual nurse characteristics, and career development opportunities
· A model was created a model with manager, organizational, work, and nursing characteristics as independent variables, cognitive and affective behaviors as mediators, and the outcome or dependent variable, intention to stay – this model can create evidence-based nurse retention strategies
· Future research should include desire to stay
DeGuzman & Kulbok (2012)
· Built environment – physical like sidewalks and social networks
· Outcomes of the built environment can be negative like obesity, HTN, and heart disease
· A framework to study this would be the social determinants of health and environmental health promotion
· The built environment influences our walkability which affects outcomes such s health behaviors, social integration, and social support
· Bottomline is that the built environment, mediated by physical activity and diet, affects health outcomes
Vanderheide, Moss, & Lee (2013)
· Workplace adversity is a burden of workplace environment and moral complexities
· Is workplace adversity ‘uninhabitable? – nurses stay or leave; a habitable environment can shape moral identity
· Authors followed a process: 1) concept map with 4 domains of moral climate, moral agency, moral distress, and more sensitivity followed by identification of relevant concepts and outcomes (both positive and negative); 2) integrative review of the literature using Kirkevolds’ quality appraisal
· A moral climate is an ethical climate
· A moral climate is tied to a moral agency
· A moral climate is related to moral distress
· A mismatch of values between people and the organization or organizational constraints that interfere with how we enact our values results in moral distress
· Moral stress is predicted by moral climate and or moral sensitivity but ethical sensitivity replaces moral sensitivity
· Ethical sensitivity is a big definition including intelligence and compassion, uncertainty, critical understanding, ethical codes, academics, learning, self-knowledge and other abilities to anticipate consequences and courage to act!!
Laureate Education
· Concepts interact with one another
· Look for gaps
· Proposed relationships lead to assumptions which include outcomes (ex. We assume participates will answer questionnaires truthfully)
· Tools should be reliable and valid and measure the concept
DISCUSSION (5 parts)
· Post a synopsis of an article that features conceptual relationships related to your phenomenon of interest
· Explain insights you gained from applying Walker and Avant’s steps for statement analysis
· Compare information in the article with your current thinking about theoretical foundation for research, including relationships and assumptions
· Describe implications of the metaparadigms for your theoretical foundation
I copy and attached one of my colegue post as sample for you.
Synopsis
Medication Adherence is the phenomenon of interest for this post; The theoretical framework is based on the Theory of Self-care of Chronic Illness. Concepts utilized are medication adherence, self-care maintenance, self-care monitoring, self-care management, behaviors, and perspective. The Middle-Range Theory of Self-Care of Chronic Illness has been used widely since it was first published in 2012 (Riegel, Jarrsma, & Lee, 2019). They now propose a revision of the theory, which includes symptoms integrated with the self-care behaviors of self-care maintenance, monitoring, and management (Riegel, Jarrsma, & Lee, 2019). This article states symptoms interact most directly with self-care monitoring and self-care management (Riegel, Jarrsma, & Lee, 2019).
Symptoms are both an antecedent and a consequence of self-care (Riegel, Jarrsma, & Lee, 2019). The article states the experience of having symptoms can build skills in self-care maintenance, monitoring, and management (Riegel, Jarrsma, & Lee, 2019). As an antecedent, symptoms often motivate individuals to engage in self-care behaviors (Riegel, Jarrsma, & Lee, 2019). Other antecedents include experience, skill, and self-care confidence or self-efficacy influenced by the symptom experience (Riegel, Jarrsma, & Lee, 2019).
The article states that the consequences of self-care are illness stability, health, well-being, quality of life, and perceived control (Riegel, Jarrsma, & Lee, 2019). Perceived health, well-being, and quality of life are primarily a function of symptoms (Riegel, Jarrsma, & Lee, 2019). Although many people with chronic illness tolerate symptoms, severe symptoms were associated with poor quality of life (Riegel, Jarrsma, & Lee, 2019). In another sample, symptoms were the primary reason patients sought acute care (Riegel, Jarrsma, & Lee, 2019).
In conclusion, the article stated the perspectives-self-care and symptoms are clearly related (Riegel, Jarrsma, & Lee, 2019). By integrating the two, the authors hope for further development of symptoms theory to self-care theory, and the ability of self-care to mitigate symptoms will be appreciated (Riegel, Jarrsma, & Lee, 2019). Both perspectives are central to a holistic approach to patient care (Riegel, Jarrsma, & Lee, 2019).
Statement analysis
Select the statement –Behaviors taught for self-care, observation taught for recognizing changes in signs and symptoms, and teaching how to respond if changes occur will result in adherence to a medication regimen. Medication adherence results in three concepts that consist of self-care maintenance., self-care monitoring, self-care management.
Clarify statement – none required
Classify the statement -This statement is classified as a relational statement because it specifics relationships between concepts (McEwen & Willis, 2019).
Examine concepts within the statement for definition and validity - Medication adherence is the extent to which a patient continues an agreed-on treatment mode without close supervision ( Medical -Dictionary-Adherence, 2020). ). Behaviors to maintain physical and emotional stability are utilized in self-care maintenance (Riegel, Jaarsma, & Stromberg, 2012). Self-care monitoring involves observing changes in signs and symptoms (Riegel, Jaarsma, & Stromberg, 2012). If changes occur, then the response to signs and symptoms is known as self-care management (Riegel, Jaarsma, & Stromberg, 2012). Behavior is the way in which someone conducts oneself (Behavior, 2020). Perspective is the capacity to view things in their true relations or relative importance (Perspective, 2020). The ontological approach of the nature of truth can be divided into two parts. Realism is a verifiable reality outside of the research (Burkholder, Cox, & Crawford, 2016). The assumptions are that there is one truth, the perception and nature of objects are independent of the researcher's perception, and truth corresponds to observable and knowable facts (Burkholder, Cox, & Crawford, 2016). Relativism (antirealism) is a nontraditional interpretive method of knowing (Burkholder, Cox, & Crawford, 2016). The assumptions are that knowledge is determined by historical, subjective, cultural, or institutional circumstances. There are no objective viewpoints to evaluate truth, and reality is from a person's particular perspective (Burkholder, Cox, & Crawford, 2016). Truth is subjective and is created through individuals' interactions (Burkholder, Cox, & Crawford, 2016).
Specify relationship among concepts by type sign and symmetry - The specific relationship among the concepts is a causal statement because one set of concepts causes the other set of concepts (McEwen & Willis, 2019). Patients who continue on an agreed-on treatment mode (medication adherence) develop behaviors to maintain stability (maintenance), observing changes in oneself (monitoring) and take action if changes occur (management).
Example logic - In examining the logic, the statement is inductive because its logic cannot be judged except by the amount of empirical support it has and by comparison to existing knowledge (Walker & Avant, 2019). After a literature review was completed, specific themes emerged with the concept of medication adherence. A patient who adheres to a medical regimen in certain studies produces certain behaviors that could be observed and assessed.
Determine testability - The statement can be tested with self-reporting tools (Walker & Avant, 2019). Medication adherence results in self-care maintenance, monitoring, and management. The hypothesis is if a patient is taught behaviors for self-care maintenance, how to observe for changes in signs and symptoms, and then how response if changes occur, then the patient will adhere to the medication regimen.
Compare article
This author believes it is behaviors and perspective that influences medication adherence. Symptoms may dictate when self-care will occur, but this author believes behaviors and perspective are the driving forces for medication adherence. The article frequently addressed the perception of symptoms (Riegel, Jarrsma, & Lee, 2019). The article states symptoms are based on the perception of the individual experiencing the symptoms and self-report (Riegel, Jarrsma, & Lee, 2019). The article defines the symptom experienced as the perception of the frequency, intensity, distress, and meaning of symptoms concerning interpreting bodily changes as symptoms (Riegel, Jarrsma, & Lee, 2019).
Relationships among concepts
If a patient is taught behaviors for self-care maintenance, how to observe for changes in signs and symptoms, and how to respond if changes occur, the patient will adhere to the medication regimen. Behaviors to maintain physical and emotional stability are utilized in self-care maintenance (Riegel, Jaarsma, & Stromberg, 2012). Self-care monitoring involves observing changes in signs and symptoms (Riegel, Jaarsma, & Stromberg, 2012). If changes occur, then the response to signs and symptoms is known as self-care management (Riegel, Jaarsma, & Stromberg, 2012).
Nursing metaparadigm
The nursing metaparadigm consists of four concepts (person, health, environment, and nursing) that serve as an organizing framework for conceptual development to proceed (McEwen & Willis, 2019)
Medication adherence and person- Medication adherence affects a person's well-being and perceived control.
Medication adherence and health- Medication adherence affects illness stability.
Medication adherence and environment- Medication adherence affects the quality of life.
Medication adherence and nursing – Medication adherence affects practice to enhance behaviors associated with medication adherence.
References
Behavior. (2020). Retrieved from Merriam-Webster: https://www.merriam-webster.com/dictionary/behavior
Burkholder, G., Cox, K., & Crawford, L. (2016). The scholar-practitioner's guide to research design. Laureate Publishing.
McEwen, M., & Willis, E. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer Health.
Perspective. (2020). Retrieved from Merriam-Webster: https://www.merriam-webster.com/dictionary/perspective
Riegel, B., Jarrsma, T., & Lee, C. (2019). Integrating Symptoms into the Middle-Range Theory of Self-Care of Chronic Illness. Advances in Nursing Science, 42, 206-215. doi:10.1097/ANS.0000000000000237
Riegel, B., Jaarsma, T., & Stromberg, A. (2012). A Middle-Range Theory of Self-Care on Chronic Illness. Advances in Nursing Science, 35(3), 194-204.
Walker, L., & Avant, K. (2019). Strategies for theory construction in nursing (6th ed.). Prentice Hall.