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26 UNIT I Evolution of Nursing Theories

phenomena or facilitate thinking about phenomena in a relate the concepts to observable phenomena specify-
different way (Hage, 1972). Scholarly analysis of the con- ing empirical indicators. Table 3-5 provides examples
cepts in nursing theories is a critical beginning step in the of concepts with their theoretical and operational
process of theoretical inquiry. The concept process con- definitions. These linkages are vital to the logic of the
tinues to flourish with many examples in the nursing lit- theory, its observation, and its measurement.
erature. See Table 3-4 for references to analyses carried The concept-building process emerges from prac-
out using different approaches. tice, incorporating the literature and research findings
Concept analysis is an important beginning step in from multiple disciplines. Concepts are built into a
the process of theory development to develop a con- conceptual framework and are further refined. A
ceptual definition. It is crucial that concepts are clearly 10-phase process for concept building is described in
defined to reduce ambiguity in the given concept or the literature (Smith & Liehr, 2008; Smith & Liehr,
set of concepts. To eliminate perceived differences in 2012). The process of concept building is guided by
meaning, explicit definitions are necessary. As the patient stories. The 10 phases are as follows: (1) write a
theory develops, theoretical and operational defini- meaningful practice story; (2) name the central phe-
tions provide the theorist’s meaning of the concept nomenon in the practice story; (3) identify a theoretical
and the basis for the empirical indicators. For exam- lens for viewing the phenomenon; (4) link the phenom-
ple, McMahon and Fleury (2012) published a concept enon to existing literature; (5) gather a story from some-
analysis on wellness in older adults. Wellness in older one who has lived the phenomenon; (6) reconstruct the
adults was theoretically defined as wellness is a pur- shared story (from Phase 5) and create a mini-saga that
poseful process of individual growth, integration of captures its message; (7) identify the core qualities of
experience, and meaningful connection with others, the phenomenon; (8) use the core qualities to create a
reflecting personally valued goals and strengths, and definition; (9) create a model of the phenomenon; and
resulting in being well and living values. The concept (10) write a mini-synthesis that integrates the phe-
of wellness in older adults was operationalized as an nomenon with a population to suggest a research direc-
ever changing process of becoming, integrating, and tion. The process, which provides the scaffolding for
relating. beginning scholars to move from the familiarity of
Theories are tested in reality; therefore, the con- practice to the unfamiliarity of phenomena for research,
cepts must be linked to operational definitions that will be shared with brief examples that demonstrate

TABLE 3-4 Examples of Published Concept Analyses with Different Approaches
Concept Approach Author
Spirituality Chinn & Kramer Buck (2006)
Readiness to change Chinn & Kramer Dalton & Gottlieb (2003)
Acculturation Morse Baker (2011)
Ethical sensitivity Morse Weaver, Morse, & Mitcham (2008)
Disability and aging Rodgers Greco & Vincent (2011)
Moral distress in neuroscience nursing Rodgers Russell (2012)
Symptom perception Schwartz-Barcott & Kim Posey (2006)
Being sensitive Schwartz-Barcott & Kim Sayers, K., & de Vries, K. (2008)
Work engagement in nursing Walker & Avant Bargagliotti (2012)
Migration Walker & Avant Freeman, Baumann, Blythe, Fisher, & Akhtar-Danesh (2012)
Infant distress Wilson method Hatfield & Polomano (2012)
Social justice Wilson method Buettner-Schmidt & Lobo (2012)