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1.
Int J Nurs Stud Adv ; 7: 100215, 2024 Dec.
Article in English | MEDLINE | ID: mdl-39005946

ABSTRACT

Background: Chronic illness diagnosis while living in low resourced communities creates ongoing adversity in the process of adaptation. Resilience is an important phenomenon of study to improve health outcomes. The subject in this particular population has been poorly studied. Objective: To conceptualize resilience of individuals with chronic illness who reside in low resource communities. Design: Concept analysis. Data sources: Seminal works and current studies were searched in PubMed (including Medline), Science Direct, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Google Scholar, OVID, Ebsco, and the Cochrane Database. Qualitative and quantitative studies that investigated individual resilience of adults in the setting of chronic illness who reside in low resource communities were included. Exclusions included children with chronic illness and resilience of communities and populations. Methods: Walker and Avant's method of concept analysis was utilized. The key elements for conceptualizing resilience in the setting of chronic illness who reside in low resource communities included defining attributes, antecedents and consequences of resilience identified from the literature search. Results: Analysis revealed three defining attributes: (1) reflection, contemplation, and the will to live despite adversity through hope; (2) personal transcendence through action; and (3) continuous personal transcendence and maintenance. Antecedents and consequences of resilience in the setting of chronic illness who reside in low resource communities were described and outlined. Conclusions: The conceptualization of resilience in the setting of chronic illness who reside in low resource communities is based on the defining attributes, antecedents, and consequences that resulted in a preliminary conceptual model. The model can be further tested in diverse populations to add to the existing knowledge on the subject, and develop interventions to foster resilience aimed to improve health outcomes and quality of life.

2.
Int J Qual Stud Health Well-being ; 19(1): 2378912, 2024 Dec.
Article in English | MEDLINE | ID: mdl-39007854

ABSTRACT

AIM: This review describes the ways in which individuals experience chronic illnesses in resource-limited settings; to define the concept and understand its attributes, antecedents and consequences. METHODS: A comprehensive analysis of the databases CINAHL, PubMed and Google Scholar was conducted. During literature search the following limits were applied: articles published in English with available full-text; articles that focused on living with chronic illness in adults from the patient's perspective. RESULTS: The following three attributes of chronic illness experience were identified: transformational experience, acceptance and self-management. Prominent predisposing factors (antecedents) were: genetic inheritance, malnutrition and poverty, high levels of stress and unhealthy lifestyle. The most dominant consequences were as follows: impact on quality of life; self-management burden; burden to others and economic stressors. CONCLUSIONS: The findings underscore the need for health-care professionals to understand the chronic illness experience in the context of resource-limited settings and its consequences. The greater insights into the concept of chronic illness experience in resource-limited settings will guide nurses to support people in the realities of chronic illness experience in resource-limited settings in developing countries. This knowledge can guide nurses in providing competent care to chronically ill individuals, including meeting their individual needs with such illnesses.


Subject(s)
Developing Countries , Health Resources , Poverty , Quality of Life , Humans , Chronic Disease , Stress, Psychological , Malnutrition , Self-Management , Cost of Illness , Adaptation, Psychological , Life Style , Adult , Resource-Limited Settings
3.
BMC Nurs ; 23(1): 466, 2024 Jul 09.
Article in English | MEDLINE | ID: mdl-38982439

ABSTRACT

BACKGROUND: Academic resilience is a crucial concept for nursing students to cope with academic challenges. Currently, there is significant variation in the description of the concept attributes of academic resilience among nursing students, which impedes the advancement of academic research. Therefore, it is essential to establish a clear definition of the concept of academic resilience for nursing students. PURPOSE: The purpose of this paper is to report the results of concept analysis of academic resilience of nursing students. METHODS: The Rodgers evolutionary concept analysis was employed to test the attributes, antecedents, consequences and related concepts of academic resilience of nursing students. Walker and Avant's method was utilized to construct a model case and provide empirical referents. RESULTS: The findings indicate that the attributes of nursing students' academic resilience include self-efficacy, self-regulation and recovery, and the antecedents include internal factors and external environmental factors. The consequences include adaptability, career maturity, adversity quotient level, probability of academic success, a sense of belonging to school and low levels of psychological distress. CONCLUSION: The systematic understanding of academic resilience among nursing students provides a pathway for nursing educators and students to enhance academic resilience, promote academic success, and establish a foundation for the training of more qualified nurses.

4.
JMIR Aging ; 7: e51987, 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38959053

ABSTRACT

BACKGROUND: Usability is a key indicator of the quality of technology products. In tandem with technological advancements, potential use by individuals with dementia is increasing. However, defining the usability of technology for individuals with dementia remains an ongoing challenge. The diverse and progressive nature of dementia adds complexity to the creation of universal usability criteria, highlighting the need for focused deliberations. Technological interventions offer potential benefits for people living with dementia and caregivers. Amid COVID-19, technology's role in health care access is growing, especially among older adults. Enabling the diverse population of people living with dementia to enjoy the benefits of technologies requires particular attention to their needs, desires, capabilities, and vulnerabilities to potential harm from technologies. Successful technological interventions for dementia require meticulous consideration of technology usability. OBJECTIVE: This concept analysis aims to examine the usability of technology in the context of individuals living with dementia to establish a clear definition for usability within this specific demographic. METHODS: The framework by Walker and Avant was used to guide this concept analysis. We conducted a literature review spanning 1984 to 2024, exploring technology usability for people with dementia through the PubMed, Web of Science, and Google Scholar databases using the keywords "technology usability" and "dementia." We also incorporated clinical definitions and integrated interview data from 29 dyads comprising individuals with mild Alzheimer dementia and their respective care partners, resulting in a total of 58 older adults. This approach aimed to offer a more comprehensive portrayal of the usability needs of individuals living with dementia, emphasizing practical application. RESULTS: The evidence from the literature review unveiled that usability encompasses attributes such as acceptable learnability, efficiency, and satisfaction. The clinical perspective on dementia stages, subtypes, and symptoms underscores the importance of tailored technology usability assessment. Feedback from 29 dyads also emphasized the value of simplicity, clear navigation, age-sensitive design, personalized features, and audio support. Thus, design should prioritize personalized assistance for individuals living with dementia, moving away from standardized technological approaches. Synthesized from various sources, the defined usability attributes for individuals living with dementia not only encompass the general usability properties of effectiveness, efficiency, and satisfaction but also include other key factors: adaptability, personalization, intuitiveness, and simplicity, to ensure that technology is supportive and yields tangible benefits for this demographic. CONCLUSIONS: Usability is crucial for people living with dementia when designing technological interventions. It necessitates an understanding of user characteristics, dementia stages, symptoms, needs, and tasks, as well as consideration of varied physical requirements, potential sensory loss, and age-related changes. Disease progression requires adapting to evolving symptoms. Recommendations include versatile, multifunctional technology designs; accommodating diverse needs; and adjusting software functionalities for personalization. Product feature classification can be flexible based on user conditions.


Subject(s)
COVID-19 , Dementia , Humans , Dementia/psychology , Dementia/therapy , COVID-19/epidemiology , Aged , Female , Male , Caregivers/psychology , Aged, 80 and over
5.
Belitung Nurs J ; 10(3): 252-260, 2024.
Article in English | MEDLINE | ID: mdl-38947301

ABSTRACT

Background: The concept of concordance and its usage are indicative of patient-centered healthcare, which encourages an equitable collaboration between patients and clinicians. However, there is a lack of clarity in understanding concordance, and an analysis of this concept is warranted. Objective: This paper seeks to explore the essence of the concordance concept in the healthcare context. Methods: Walker and Avant's eight-step method of concept analysis was applied. A literature search was conducted using concordance AND concord as keywords on CINAHL, MEDLINE, PubMed, ProQuest, Cochrane database, and ScienceDirect databases, published between 2006 and 2022. Results: The attributes of concordance include communication process, therapeutic partnership, and agreement on treatment regimens. Antecedents of concordance comprise provider-patient relationship, patients' beliefs, healthcare providers' characteristics, and complexity of treatment plans. Consequences are improved adherence and compliance, improved clinical outcomes, and better quality of life. Conclusion: This paper offers clarification of concordance by presenting its antecedents, attributes, and consequences. The findings serve as a basis for developing assessments and nursing interventions to promote patient concordance. Nurses can use the findings to encourage concordance by establishing a trusty relationship during health encounters that respects patients' beliefs and effectively communicating to improve patients' understanding in dealing with complex treatment plans.

6.
Nurs Outlook ; 72(5): 102224, 2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38905740

ABSTRACT

BACKGROUND: Previous concept analyses have not conceptualized an evidence-based definition of the concept of dementia literacy. METHODS: Rodger's evolutionary method was used to conceptualize dementia literacy among informal caregivers of persons living with dementia (PLWD) in the United States. A comprehensive search across four databases and a thorough review process resulted in 22 relevant articles between 2011 and 2023. DISCUSSION: Dementia literacy is defined as the ability to acquire dementia-related knowledge to inform decision-making, self-identify gaps in caregiving support, and secure access to necessary resources to enable long-term care, all while maintaining relationships with an interdisciplinary team of specialized providers. CONCLUSION: The nursing profession can promote dementia literacy by recognizing the needs of racial and ethnic groups, the complexity of culture and language, and being mindful of potential implicit bias toward informal caregivers who are working diligently to be prepared and proactive for PLWD.

7.
J Adv Nurs ; 2024 Jun 28.
Article in English | MEDLINE | ID: mdl-38943338

ABSTRACT

AIMS: This article aimed to examine the concept of safeguarding adults and establish an operational definition for application to practice, research and policy. DESIGN: Rodgers' evolutionary and inductive method of concept analysis was used. DATA SOURCES: A systematic search was conducted across four electronic databases, CINAHL, PsycINFO, Scopus and PubMed, covering the period from January 2014 to May 2023. This systematic database search aimed to gather a broad spectrum of research and scholarly literature to inform and support the concept analysis. A total of 10 peer-reviewed articles were reviewed using a data chart to identify the context, definitions, antecedents, attributes and consequences of safeguarding adults. RESULTS: The analysis of the included articles helped to develop a better understanding of safeguarding adults by offering a practical operational definition tailored to the specific needs of practising nurses. The implications for practice, research and policy are discussed, highlighting the potential for improving the quality of care and ensuring the well-being of adults at risk of abuse. CONCLUSION: By employing Rogers' evolutionary concept analysis method, we developed a deeper insight into safeguarding adults in health care. A synthesis of literature revealed the intricate layers and adaptations within safeguarding practices. This concept analysis lays the groundwork for future research, policy development and educational initiatives, enhancing the well-being and safety of adults at risk of abuse within care. IMPACT: By undertaking a concept analysis of the term safeguarding adults' nurses can be more prepared to engage in and reinforce the key principles of safeguarding adults, providing guidance to ensure the protection and well-being of adults at risk of abuse. PATIENT OR PUBLIC CONTRIBUTION: Not applicable. WHAT THIS PAPER CONTRIBUTES TO THE WIDER BODY OF KNOWLEDGE: This concept analysis helps to define and clarify the conceptual term 'safeguarding adults' promoting a shared understanding of the key components of adult protection and providing a comprehensive framework for assessment and management of adults at risk of abuse in this field of practice.

8.
Clin Nurs Res ; : 10547738241258509, 2024 Jun 12.
Article in English | MEDLINE | ID: mdl-38867492

ABSTRACT

To investigate and define the concept of perioperative sleep disturbance (PSD) among surgical patients, with the goal of aiding clinical practice and research. Walker and Avant's eight-step approach of concept analysis was applied. A systematic search of English literature was conducted in the following databases: PubMed, Web of Science, and CINAHL, with a time restriction from 2010 to August 2023. Based on the 54 eligible studies, the attributes of PSD in surgical patients were identified as individualized symptom manifestation, difficulty initiating and/or maintaining sleep, and altered sleep patterns. The antecedents included poor psychological state, inaccurate perception, surgery and/or anesthesia-related physiological changes, and environmental interference. PSD in surgical patients was found to result in physical discomfort, psychological disorder, impaired neurocognitive function, and prolonged recovery. A clearly defined and distinguishable concept of PSD in surgical patients was achieved through concept analysis, which provides a conceptual basis for future development in both clinical practice and related research.

9.
Pain Manag Nurs ; 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38849234

ABSTRACT

BACKGROUND: Chronic pain resilience is a concept that is frequently used in research but lacks theoretical clarity. Understanding chronic pain resilience is germane to developing interventions to improve it and the overall quality of life among individuals with chronic pain. AIMS: To uncover and clarify the unique characteristics of the concept of chronic pain resilience. DESIGN: A concept analysis using Rodgers' evolutionary method. METHODS: Full-text articles published after 2000 in English were used to inform the concept analysis. Scopus, PubMed, PsychINFO, Embase, and CINAHL Plus with Full Text were utilized for literature searches. Rodgers' evolutionary approach was used to clarify the attributes, antecedents, and consequences. RESULTS: The search yielded 31 articles that were used in the analysis. The key attributes of chronic pain resilience included engagement in meaningful activities despite pain, maintaining positive psychological homeostasis, buffering against negative mental outcomes, seeking support, and self-empowerment. After considering surrogate terms, antecedents, attributes, and consequences, chronic pain resilience may be defined as the development of the capacity to successfully adapt to chronic pain. This adaptation results in a move toward optimal social, physical, mental, and behavioral functioning by balancing negative and positive psychosocial factors, despite the additional challenges brought about by living with chronic pain.

10.
J Hum Lact ; : 8903344241254345, 2024 Jun 10.
Article in English | MEDLINE | ID: mdl-38855823

ABSTRACT

BACKGROUND: Donor human milk is recommended when infants are unable to be fed their mother's own milk or require supplementation. For-profit companies use technologies to create human milk products for infants in the neonatal intensive care setting without consistent guidelines and regulatory frameworks in place. This commercialization of human milk is inadequately conceptualized and ill-defined. RESEARCH AIMS: The aim of this study is to conceptualize and define the commercialization of human milk and discuss the need for policy guidelines and regulations. METHOD: Using a concept analysis framework, we reviewed the literature on the commercialization of human milk, analyzed the antecedents and potential consequences of the industry, and developed a conceptual definition. The literature review resulted in 13 relevant articles. RESULTS: There has been a surge in the development and availability of human milk products for vulnerable infants developed by for-profit companies. Commercialized human milk can be defined as the packaging and sale of human milk and human milk components for financial gain. Factors contributing to the commercialization of human milk include an increased demand for human milk, and consequences include potential undermining of breastfeeding. The lack of guidelines and regulations raises concerns of equity, ethics, and safety. CONCLUSION: The industry is rapidly growing, resulting in an urgent need for consistent guidelines and regulatory frameworks. If left unaddressed, there could be potential risks for donor milk banking, the future of breastfeeding, and infant and maternal health.

11.
Behav Sci (Basel) ; 14(6)2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38920817

ABSTRACT

Post-traumatic stress disorder (PTSD) occurs when an individual experiences a traumatic event that exceeds the limits of psychological endurance. Many veterans experience PTSD. PTSD can negatively impact veterans' quality of life, functioning, life satisfaction, and overall well-being. It is important to analyze the concept of PTSD in the veteran population. This concept analysis aimed to investigate the defining attributes, a model case, antecedents, consequences, and empirical referents related to the concept of PTSD among veterans. Walker and Avant's method was used to guide this concept analysis of PTSD. The results showed that three attributes were determined from the analysis: intrusive memories of traumatic events, feelings of isolation and estrangement, and negative cognitions. PTSD is conceptualized as a collection of symptoms that arise from highly traumatic experiences. The military environment predisposes veterans to traumatic events that should be identified or acknowledged. A better understanding of the concept of PTSD can facilitate the development of effective interventions for the veteran population and enhance their mental health.

12.
BMC Nurs ; 23(1): 306, 2024 May 03.
Article in English | MEDLINE | ID: mdl-38702690

ABSTRACT

BACKGROUND: Nurses are on the frontline for managing epidemic diseases. Different aspects of clinical nursing competencies during epidemics are important issues that need investigation. OBJECTIVES: The aim of this study was to determine the required clinical competencies for nurses during epidemics. Understanding these competencies could provide valuable information for health care services and nursing education organizations to prepare nurses for future epidemics. METHODS: The qualitative conventional content analysis study was conducted using semi-structured interviews with 12 nurses that were actively engaged in providing patient care during COVID-19 pandemic in Shahid Beheshti hospital in Kashan/Iran, from October 2022 to March 2023. The data analysis process was conducted according to 5 steps suggested by Graneheim and Lundman. RESULTS: After analysis, the 159 competencies were derived from interviews that were categorized to 11 subcategories, and three categories of clinical nursing skills in epidemics, knowledge of epidemics, and soft skills for nurses in epidemics. CONCLUSION: Nurses need wide range of competencies to address the professional expectations regarding providing acceptable care during epidemics. Knowing these competencies can help nursing managers to prepare nurses for crisis such as what world experienced during COVID-19 pandemic.

13.
Iran J Nurs Midwifery Res ; 29(2): 238-244, 2024.
Article in English | MEDLINE | ID: mdl-38721245

ABSTRACT

Background: "Interprofessional Collaboration" is associated with improving the quality of care. The objective of this study was the analysis of the concept of "Interprofessional Collaboration" using a hybrid model. Materials and Methods: A hybrid model was used in order to analyze the concept of "Interprofessional Collaboration." The first phase was the scientific search of texts in all valid electronic databases. The second phase includes fieldwork in which medical, pharmaceutical, and nursing staff were interviewed. Data were collected, reviewed, and analyzed in the third phase. Results: The four main themes extracted in the theoretical phase included: "attributes of individual, team, organizational, and system." In the fieldwork phase, three themes and seven sub-themes were identified: "Dynamism/effectiveness of collaboration, uncertain boundaries of collaboration, advanced organizational culture." In the final phase, with the combination of the results of two previous phases, the final definition of the concept was presented: "A process that brings together systems, organizations and individuals from various professions to achieve common interests and goals. Achieving common goals and interests is influenced by individual, team, organizational, and system attributes." Conclusions: Defining the concept of interprofessional collaboration and identifying its various aspects can be a practical guide for creating and evaluating it in educational and clinical settings.

14.
J Adv Nurs ; 2024 May 13.
Article in English | MEDLINE | ID: mdl-38738562

ABSTRACT

AIM: To clarify the concept of fear of childbirth among pregnant women and to examine its current measure tools. BACKGROUND: Fear of childbirth is a psychological symptom, prevalent among pregnant women, which negatively impacts women's health and well-being. It has become an increasingly concerning issue in perinatal mental health. However, due to its poor conceptualization, it presents difficulty in conducting reliable assessments and identifying risk factors. METHODS: The Walker and Avant approach to concept analysis guided this review. Six bibliographic databases were systematically searched for published research from their inception date to May 2023. Additional records were identified by manually searching the reference lists of relevant studies. Quantitative and qualitative studies investigating fear of childbirth in pregnant women were included. RESULTS: Three critical attributes have been identified: cognitive impairments, affective disorders and somatic symptoms. Antecedents include perceived a real or anticipated threat of pregnancy or its outcomes, low perceived self-coping ability and unmet social support needs. Consequences include processing and avoiding behaviours. This study also identified the dimensions of fear of childbirth, including 6 primary categories and 14 subcategories. The content of five scales was analysed and none covered all domains. CONCLUSIONS: The current analysis provides healthcare providers with a more comprehensive framework to assess and identify fear of childbirth. Further research is needed to develop a suitable instrument that covers all the attributes and dimensions of this concept and assesses its severity. IMPACT: This conceptual analysis provides a comprehensive insight into the phenomenon of fear of childbirth. This will help family members, healthcare providers and policymakers to identify the psychological needs of pregnant women and improve the quality of antenatal care. PATIENT OR PUBLIC CONTRIBUTION: Not applicable as no new data were generated.

15.
Int J Nurs Stud Adv ; 6: 100174, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38746797

ABSTRACT

Background and Aim: Qualitative research plays an important role in improving nursing knowledge. Understanding the concept of saturation is essential to conducting rigorous qualitative research that contributes to evidence-based practice. The purpose of this study is to clarify the concept of saturation in qualitative research. Method: Evolutionary concept analysis was performed. A literature search was conducted using a variety of online databases for the years 2005- 2023. In total, 33 articles and books were analyzed using thematic analysis to identify the attributes, antecedents and consequences of saturation. The validity of the data was obtained by examining the analysis process by two independent researchers. Results: Saturation in qualitative research is a context-dependent, subjective process that requires detailed systematic analysis. Saturation is used in four ways in qualitative research: theoretical saturation, data saturation, code or thematic saturation, and meaning saturation. The antecedents of saturation were classified into two categories: study related factors and researcher related factors. The consequences of saturation were identified as: ensuring credibility and quality in qualitative research and time, energy and budget saving. Conclusion: This concept analysis serves to enhance the understanding of the concept of saturation, thereby offering valuable resources for qualitative researchers. By gaining a profound comprehension of saturation and its various types, researchers can ensure the validity of their studies while also optimizing time and resource allocation by avoiding redundant data collection. Future investigation warranted to elucidate how factors associated with reaching saturation impact estimations sample size.

16.
Nurse Educ Today ; 139: 106232, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38703536

ABSTRACT

OBJECTIVES: To analyze and define the concept of nurses' media competency. DESIGN: Concept analysis. DATA SOURCES: We conducted a literature search in PubMed, CINAHL, PsycInfo, and RISS International, as well as a hand-search, for relevant articles published between January 1990 and April 2023. A total of 57 articles related to nurses' media competency, published in English or Korean, were included in this study. REVIEW METHODS: We used Walker and Avant's method of concept analysis to identify the defining attributes, antecedents, and consequences of the concept. RESULTS: The seven defining attributes of nurses' media competency were networking with members of the media, selecting the appropriate media platform, considering that the target audience is the public, creating one's own media products, delivering intended messages through the media, monitoring and responding to the media, and maintaining professional dignity. Antecedents of the concept included cultivation of desirable nursing professionalism, critical evaluation of policies and issues, recognition of media influence, establishment of education and guidelines for media use, and having facilities and availability of technologies for media use. Consequences of the concept were improved influence of individual nurses, enhanced public awareness of the nursing profession, stronger networks and collaboration among professionals, and contributions to the promotion of public health. CONCLUSIONS: This concept analysis presents a theoretical definition of nurses' media competency that can provide guidance on how to educate nurses to develop media competency and how to measure nurses' media competency.


Subject(s)
Concept Formation , Humans , Nurses/psychology , Mass Media , Professional Competence/standards , Professionalism/standards
17.
BMC Oral Health ; 24(1): 594, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38778380

ABSTRACT

BACKGROUND: Oral frailty has become a worldwide problem among older adults. Although researchers have conducted various studies on oral frailty, its definition remains controversial. PURPOSE: To clarify the concept of oral frailty. METHODS: Online databases PubMed, Web of Science, CINAHL, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database were searched from inception to September 20, 2023. The reference lists of relevant studies were searched manually. Eligible articles, theses, and books were analyzed using Walker & Avant's concept analysis model. RESULTS: The attributes of oral frailty were abnormal oral structure and/or decline in multi-faceted oral function and coexisting decline in physical, cognitive and social functions. Its antecedents were aging, social frailty, and severe periodontitis, whereas its consequences were decline in physical health and mental health, social withdrawal, lower quality of life and systemic frailty. CONCLUSION: Oral frailty could result in worse conditions among older adults physically, psychologically and socially. Tools based on the concept analysis need to be developed to comprehensively assess oral frailty.


Subject(s)
Frailty , Oral Health , Aged , Humans , Aging/psychology , Aging/physiology , Frail Elderly , Frailty/complications , Quality of Life
18.
Disabil Rehabil ; : 1-11, 2024 May 31.
Article in English | MEDLINE | ID: mdl-38821140

ABSTRACT

PURPOSE: Rehabilitation plays a critical role in minimising disability after stroke, with the concept of "challenge" proposed to be essential to rehabilitation efficacy and outcomes. This review unpacks how challenge is conceptualised in stroke rehabilitation literature from the perspectives of physiotherapy, occupational therapy, speech-language therapy and people with stroke. A secondary purpose was to provide a definition of challenge that is applicable to stroke rehabilitation. METHODS: Principle-based concept analysis was utilised to examine challenge within the stroke rehabilitation literature. Forty-two papers were included. Data analysis involved immersion, analytical questioning, coding and synthesis to elicit the conceptual components of challenge. RESULTS: Challenge was understood as a multidimensional and dynamic concept with three facets: nominal, functional and perceived challenge. Functional and perceived challenge were integral to optimal challenge. Optimal challenge was central to enhancing the outcomes and experiences of people with stroke, in rehabilitation and everyday life. CONCLUSIONS: Challenge is a key concept which, when carefully optimised to the person's ability and experience, may positively influence their learning, recovery and engagement after stroke. This review lays a conceptual foundation for better understanding, operationalisation and advancement of challenge, offering important implications for addressing the growing burden of stroke disability, through rehabilitation.


Challenge involves a multifaceted, multidimensional and dynamic interaction between the task, the person's ability and their subjective experience.The therapist and the person's perspective should collectively shape the process of co-creating a challenge that is truly optimal for the person.Therapists should consider both functional and perceived approaches to operationalising challenge with the person.

19.
Healthcare (Basel) ; 12(10)2024 May 07.
Article in English | MEDLINE | ID: mdl-38786372

ABSTRACT

Spiritual distress, hopelessness, and depression are concepts that are often used in palliative care. A simultaneous concept analysis (SCA) of these concepts is needed to clarify the terminology used in palliative care. Therefore, the aim of this study is to conduct a SCA of spiritual distress, hopelessness, and depression in palliative care. A SCA was performed using the methodology of Haase's model. A literature search was conducted in March 2020 and updated in April 2022 and April 2024. The search was performed on the following online databases: CINAHL with Full-Text, MEDLINE with Full-Text, MedicLatina, LILACS, SciELO, and PubMed. The search was achieved without restrictions on the date of publication. A total of 84 articles were included in this study. The results highlight that the three concepts are different but also share some overlapping points. Spiritual distress is embedded in the rupture of their spiritual/religious belief systems, a lack of meaning in life, and existential issues. Hopelessness is a sense of giving up and an inability to control and fix the patient's situation. Finally, depression is a state of sadness with a multi-impaired situation. In conclusion, refining the three concepts in palliative care is essential since it promotes clarification and enhances knowledge development towards intervention.

20.
Sci Rep ; 14(1): 11202, 2024 05 16.
Article in English | MEDLINE | ID: mdl-38755262

ABSTRACT

Measuring the dynamics of microbial communities results in high-dimensional measurements of taxa abundances over time and space, which is difficult to analyze due to complex changes in taxonomic compositions. This paper presents a new method to investigate and visualize the intrinsic hierarchical community structure implied by the measurements. The basic idea is to identify significant intersection sets, which can be seen as sub-communities making up the measured communities. Using the subset relationship, the intersection sets together with the measurements form a hierarchical structure visualized as a Hasse diagram. Chemical organization theory (COT) is used to relate the hierarchy of the sets of taxa to potential taxa interactions and to their potential dynamical persistence. The approach is demonstrated on a data set of community data obtained from bacterial 16S rRNA gene sequencing for samples collected monthly from four groundwater wells over a nearly 3-year period (n = 114) along a hillslope area. The significance of the hierarchies derived from the data is evaluated by showing that they significantly deviate from a random model. Furthermore, it is demonstrated how the hierarchy is related to temporal and spatial factors; and how the idea of a core microbiome can be extended to a set of interrelated core microbiomes. Together the results suggest that the approach can support developing models of taxa interactions in the future.


Subject(s)
Bacteria , Microbiota , RNA, Ribosomal, 16S , Microbiota/genetics , RNA, Ribosomal, 16S/genetics , Bacteria/genetics , Bacteria/classification , Groundwater/microbiology
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