Moral distress in midwifery practice: A concept analysis

2021 ◽  
pp. 096973302110239
Author(s):  
Wendy Foster ◽  
Lois McKellar ◽  
Julie Fleet ◽  
Linda Sweet
Keyword(s):  
Moral Distress ◽  
Ethical Decision Making ◽  
Concept Analysis ◽  
Moral Awareness ◽  
Model Case ◽  
Midwifery Practice ◽  
Moral Uncertainty ◽  
Sequential Mixed Methods ◽  
Antecedents And Consequences ◽  
Definition Of

Research suggests that the incidence of moral distress experienced by health professionals is significant and increasing, yet the concept lacks clarity and remains largely misunderstood. Currently, there is limited understanding of moral distress in the context of midwifery practice. The term moral distress was first used to label the psychological distress experienced following complex ethical decision-making and moral constraint in nursing. The term is now used across multiple health professions including midwifery, nursing, pharmacy and medicine, yet is used cautiously due to confusion regarding its theoretical and contextual basis. The aim of this study is to understand the concept of moral distress in the context of midwifery practice, describing the attributes, antecedents and consequences. This concept analysis uses Rodgers’ evolutionary framework and is the first stage of a sequential mixed-methods study. A literature search was conducted using multiple databases resulting in eight articles for review. Data were analysed using NVivo12©. Three core attributes were identified: moral actions and inactions, conflicting needs and negative feelings/emotions. The antecedents of clinical situations, moral awareness, uncertainty and constraint were identified. Consequences of moral distress include adverse personal professional and organisational outcomes. A model case depicting these aspects is presented. A midwifery focused definition of moral distress is offered as ‘a psychological suffering following clinical situations of moral uncertainty and/or constraint, which result in an experience of personal powerlessness where the midwife perceives an inability to preserve all competing moral commitments’. This concept analysis affirms the presence of moral distress in midwifery practice and provides evidence to move towards a consistent definition of moral distress.

Usability of mobile applications: A Concept Analysis to be used in health promotion (Preprint)

2021 ◽  
Author(s):  
Po-Jen Kung ◽  
Ching-Min Chen
Keyword(s):  
Health Promotion ◽  
Information And Communication Technologies ◽  
User Experience ◽  
Mobile Applications ◽  
User Satisfaction ◽  
Concept Analysis ◽  
Mobile App ◽  
Model Case ◽  
Antecedents And Consequences ◽  
Definition Of

BACKGROUND Following the rise of health awareness in modern societies, health promotion has attracted progressively more attention in both academia and industry. This, along with the evolution of information and communication technologies, has resulted in the development of several mobile applications used in health promotion. Unfortunately, users of the applications have not achieved their goals, since many applications have not provided a smooth user experience. OBJECTIVE To clearly identify the defining attributes of mobile app usability in the context of health promotion in order to guide the design of apps which provide smooth user experience. METHODS It is thus first necessary to conduct an exploration into app usability, for which this study applies the concept analysis method by Walker and Avant, which includes: (1) identifying the use of the concept, (2) determining the defining attributes, (3) constructing a model case, (4) constructing model, contrary, borderline, and related cases, (5) identifying antecedents and consequences, and (6) defining empirical referents. RESULTS We then derive a unified definition of usability from the healthcare perspective—that the defining attributes of "usability of mobile application" are: efficiency, user satisfaction, and learnability. CONCLUSIONS It is concluded that mobile applications with these attributes could achieve their designed goals and reach maximal efficacy, since users would continue using the app on a regular basis, and would recommend it to others.

A concept analysis of postpartum contraception

2019 ◽  
Vol 13 (4) ◽  
pp. 1-11
Author(s):  
Esnath Kapito ◽  
Ellen Chirwa ◽  
Clara Haruzivishe ◽  
Betty Sakala ◽  
Ruth Mwale ◽  
...  
Keyword(s):  
Traditional Method ◽  
Concept Analysis ◽  
Neonatal Health ◽  
Postpartum Contraception ◽  
Midwifery Practice ◽  
Client Care ◽  
Maternal And Neonatal Outcomes ◽  
Maternal And Neonatal Health ◽  
Antecedents And Consequences ◽  
Definition Of

Postpartum contraception has some ambiguities in terms of its definition and period. The purpose of this concept analysis is to clarify postpartum contraception in terms of its attributes, antecedents, consequences and empirical referents. This can be used in the development of a model for care that promotes the use of postpartum contraception Walker and Avant's (2011) traditional method of concept analysis was used here. A theoretical definition of postpartum contraception was formulated and six defining attributes of postpartum contraception were identified through the process of induction. The antecedents and consequences of postpartum contraception are presented Defining postpartum contraception helps highlight important elements that can be applied in client care in order to improve maternal and neonatal outcomes. Further insights to this concept are required for the development of a model, which can be used to improve midwifery practice and maternal and neonatal health.

Institutional betrayal in nursing: A concept analysis

2021 ◽  
pp. 096973302199244
Author(s):  
Katherine C Brewer
Keyword(s):  
Organizational Behavior ◽  
Moral Distress ◽  
Well Being ◽  
Concept Analysis ◽  
Ethical Culture ◽  
Negative Events ◽  
Moral Standards ◽  
Conceptual Clarity ◽  
Definition Of ◽  
Conceptual Relationships

Background: Ethical relationships are important among many participants in healthcare, including the ethical relationship between nurse and employer. One aspect of organizational behavior that can impact ethical culture and moral well-being is institutional betrayal. Research aim: The purpose of this concept analysis is to develop a conceptual understanding of institutional betrayal in nursing by defining the concept and differentiating it from other forms of betrayal. Design: This analysis uses the method developed by Walker and Avant. Research context: Studies were reviewed using health literature databases with no date restrictions. Ethical considerations: Analysis was conducted using established guidelines for ethical research. Findings: Although institutional betrayal is a concept applied in the literature, there was a paucity of studies exploring the concept within nursing. Examples of the concept in the literature include violation of trust between organization (i.e. employer) and nurse, such as provision of inadequate workplace protections, ineffective or hostile management, and gaslighting of those who experience negative events. Examples of institutional betrayal have become more visible during the COVID-19 pandemic. Discussion: A conceptual definition of institutional betrayal is a deep violation of trust or confidence or violation of moral standards committed by an institution toward a nurse. This definition incorporates experiences and issues suggested by the literature. Outcomes are likely negative, including impacts on nurse psychological and workplace well-being. This concept likely fits within a framework of ethical workplaces and has conceptual relationships with moral distress and moral resilience. Further studies can help qualitatively explore and empirically measure this concept. Conclusion: In the pursuit of improving the ethical culture of healthcare workplaces, this concept can provide meaningful insight into organizational behavior and its consequences. Naming and describing the concept can promote conceptual clarity and equip researchers, nurses, and leaders to identify and mitigate the issue.

Moral competence among nurses in Malawi: A concept analysis approach

2018 ◽  
Vol 26 (5) ◽  
pp. 1361-1372 ◽  
Author(s):  
Veronica Mary Maluwa ◽  
Elizabeth Gwaza ◽  
Betty Sakala ◽  
Esnath Kapito ◽  
Ruth Mwale ◽  
...  
Keyword(s):  
Nursing Practice ◽  
Ethical Decision Making ◽  
Code Of Ethics ◽  
Concept Analysis ◽  
Team Work ◽  
Moral Competence ◽  
Training Environment ◽  
Positive Attitudes ◽  
Antecedents And Consequences ◽  
Improved Performance

Background: Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. Objective: The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Method: Analysis of moral competence concept was done using Walker and Avant's strategy of concept analysis. Results: Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Conclusion: Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi.

Spirituality in Psychiatric Nursing: A Concept Analysis

2020 ◽  
Vol 27 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Michelle Clark ◽  
Amanda Emerson
Keyword(s):  
Nursing Care ◽  
Concept Analysis ◽  
Psychiatric Nursing ◽  
Spiritual Needs ◽  
Mental Health Nurses ◽  
Clinical Confidence ◽  
Nursing Literature ◽  
Antecedents And Consequences ◽  
Negative Coping ◽  
Definition Of

BACKGROUND: There is robust literature on spirituality in nursing. Despite the unique needs of those with serious mental illness, there has been little exploration of spirituality in the context of nursing care for this population. Lacking a well-defined concept of spirituality in psychiatric care, mental health nurses often struggle to provide optimal, holistic care. AIMS: The aim of this concept analysis was to review definitions and descriptions of spirituality in the psychiatric nursing literature to synthesize a usable definition to inform practice and provide a basis for future study. METHOD: Beth Rodgers’s evolutionary concept analysis method was followed to inductively derive a definition of spirituality in psychiatric nursing care. Steps included identification of the concept, setting, and sample; synthesis of key attributes, antecedents, and consequences from the literature; and a discussion of implications. A search in the psychiatric nursing literature (1998-2019) included literature reviews, case studies, concept analyses, qualitative interview studies, and quantitative survey research. RESULTS: Spirituality in psychiatric nursing was defined by attributes of a search for life meaning and purpose and a sense of connectedness. Spirituality in the practice of psychiatric nursing was a result of value-influenced thinking and a capability for interaction with others. Consequences included consolation and positive or negative coping. CONCLUSIONS: A clearly defined concept of spirituality in psychiatric nursing can provide a basis for clinical confidence for nurses in identifying patient spiritual needs and choosing appropriate interventions to support those needs.

scholarly journals Leadership in Digital Health Services: Protocol for a Concept Analysis (Preprint)

2020 ◽  
Author(s):  
Elina Laukka ◽  
Tarja Pölkki ◽  
Tarja Heponiemi ◽  
Anu-Marja Kaihlanen ◽  
Outi Kanste
Keyword(s):  
Health Services ◽  
Digital Health ◽  
Relevant Literature ◽  
Concept Analysis ◽  
Intersectoral Collaboration ◽  
Analysis Model ◽  
Model Case ◽  
Scoping Reviews ◽  
Antecedents And Consequences

BACKGROUND Due to the rapid digitalization of health care, leadership is becoming more complex. Leadership in digital health services is a term that has been used in the literature with various meanings. Conceptualization of leadership in digital health services is needed to deliver higher quality digital health services, update existing leadership practices, and advance research. OBJECTIVE The aim of this study is to outline a concept analysis that aims to clarify and define the concept of leadership in digital health services. METHODS The concept analysis will be performed using the Walker and Avant model, which involves eight steps: concept selection, determination of aims, identification of uses, determination of defining attributes, construction of a model case, construction of additional cases, identification of antecedents and consequences, and definition of empirical referents. A scoping literature search will be performed following the search protocol for scoping reviews by the Joanna Briggs Institute to identify all relevant literature on leadership in digital health services. Searches will be conducted in 6 scientific databases (CINAHL, MEDLINE, Scopus, ProQuest, Web of Science, and the Finnish database Medic), and unpublished studies and gray literature will be searched using Google Scholar, EBSCO Open Dissertations, and MedNar. RESULTS An initial limited search of MEDLINE was undertaken on October 19, 2020, resulting in 883 records. The results of the concept analysis will be submitted for publication by July 2021. CONCLUSIONS A robust conceptualization of leadership in digital health services is needed to support research, leadership, and education. The concept analysis model of Walker and Avant will be used to meet this need. As leadership in digital health services appears to be an interprofessional and intersectoral collaboration, defining this concept may also facilitate collaboration between professionals and sectors. The concept analysis to be conducted will also expand our understanding of leadership in digital health services. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/25495

Best Interests: a Concept Analysis and Its Implications for Ethical Decision-Making in Nursing

1995 ◽  
Vol 2 (2) ◽  
pp. 149-160 ◽  
Author(s):  
Pat Rose
Keyword(s):  
Decision Making ◽  
Patient Autonomy ◽  
Ethical Decision ◽  
Nursing Practice ◽  
Ethical Decision Making ◽  
Concept Analysis ◽  
Nurse Education ◽  
Best Interests ◽  
Best Interest ◽  
Antecedents And Consequences

The purpose of this paper is to analyse the concept of 'best interest' in order to give nurses, who use it to justify their actions, a clear picture of what this means, and to identify the skills needed for doing so. The process for concept analysis developed by Walker and Avant was used in the analysis of data generated from the literature. Themes were identified from which the defining attributes, antecedents and consequences emerged. The congruence of the findings with current values in nursing, such as promotion of patient autonomy, and the nurse as advocate, are discussed, together with the underpinning ethics theory. The skills needed for nursing practice are identified and recommendations for nurse education are made.

scholarly journals Woman-centred care in childbirth: A concept analysis (Part 1)

Curationis ◽  
2013 ◽  
Vol 36 (1) ◽  
Author(s):  
Maria S. Maputle ◽  
Hiss Donavon
Keyword(s):  
Concept Analysis ◽  
Borderline Case ◽  
Mutual Respect ◽  
Collaborative Relationship ◽  
Open Communication ◽  
Model Case ◽  
Domain Specific ◽  
Conceptual Clarity ◽  
Antecedents And Consequences ◽  
Information Recognition

‘Woman-centred care’ in childbirth is a process in which a woman makes choices and is involved in and has control over her care and relationship with her midwife. The aim of this paper is to study the concept of woman-centred care through analysis in the context of childbirth. The attributes, antecedents and consequences of this concept are identified, and a model case, a borderline case and a contrary case constructed to achieve conceptual clarity. A concept analysis was undertaken as described by Walker and Avant (2011), with an extensive exploration of domain-specific literature and evidence from various disciplines.  It was established from the concept analysis that ‘woman-centred care’ was complex and experienced individualistically. The analysis indicated that mothers’ participation is supposed to be based on a more collaborative relationship and partnership. Participation is exhibited by open communication and the mother’s involvement in decision-making, consultation and collaboration with the attending midwife, further characterised by mutual respect and the midwife listening to the mother’s views. There is also an exchange of complete and unbiased information, recognition and honouring of cultural diversity and making of informed choices. Through an inductive discovery approach and drawing on inferences, attributes were clustered in an attempt to identify the apparent essence of the concept.From the results of the concept analysis described in this study, the researchers recommend the formulation of criteria that could facilitate implementation and evaluation of woman-centred care and its empirical referents in the context of the Batho Pele principles (Part 2). 

scholarly journals Concept Analysis of Empowerment From Survivor and Nurse Perspectives Within the Context of Cancer Survivorship

2013 ◽  
Vol 27 (3) ◽  
pp. 157-172 ◽  
Author(s):  
Teresa A. Jerofke
Keyword(s):  
Dimensional Analysis ◽  
Cancer Survivorship ◽  
Health Management ◽  
Theory Development ◽  
Analysis Data ◽  
Concept Analysis ◽  
Patient Centered ◽  
Centered Care ◽  
Antecedents And Consequences ◽  
Definition Of

The liberal usage of the concept of empowerment has led to the development of a broad and ambiguous term. In health care, empowerment is a core principle of patient-centered care that promotes patient engagement in health management. This is an analysis of the concept of empowerment within the context of cancer survivorship using both Rodgers’ evolutionary concept analysis and Caron and Bower’s dimensional analysis. The dimensional analysis followed the evolutionary concept analysis as the perspectives of patients and nurse providers emerged in the analysis. Data sources included a sample of 249 papers from multiple disciplines covering the period 2000–2013. Empowerment is defined as power-with that is actualized through a beneficial relationship of mutual trust and respect for autonomy that develops within a dynamic and patient-centered process. The attributes, along with the antecedents and consequences, provide a foundation for future theory development of empowerment in the context of cancer survivorship. This analysis demonstrated that although nurses and survivors may have a similar definition of the concept of empowerment, the uses and assumptions of that definition may differ. Future studies should be conducted measuring the effectiveness of an intervention that uses the components of the process of empowerment from survivors’ perspectives.

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