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Concept Development and Analysis- Uncertainty among Caregivers

Concept analysis and development is an approach used to investigate ideas or phenomenon of interest in a particular discipline to determine their attributes and characteristics (Cronin et. al., 2010). In nursing, it is done to get more clarity about concepts that are commonly used in theory, research and practice. One such phenomenon that requires analysis is uncertainty among family caregivers. Penrod (2007) defines uncertainty as for the aspect of being in doubt or of not being sure despite the evidence available at the particular time. This issue often crops up when family caregivers are required to make difficult decisions concerning the course of treatment for their loved ones. Understanding this concept, its cause and the way it affects family caregivers will be useful in determining their goals and treatment choices.

To deconstruct this concept, Penrod (2007) uses Walker and Avants’ method of concept analysis as described by Cronin and colleagues in 2010. First, e defined the concept of uncertainty according to literature, which determined that uncertainty is a dynamic state where an individual is unable to identify outcomes due to specific decisions that lead to discomfort and unease. While this definition is used in other disciplines, it is not accurate in the context of health care since it does not achieve practical utility, and it does not agree with what is known about uncertainty among caregivers. For instance, in health care, the probability is not applicable to life experiences, yet caregivers still experience uncertainty, though it is hard to analyze regarding probability (Penrod, 2007).

The major attribute concerning uncertainty is that it is dynamic and dependent on an individual (Penrod, 2007). Unlike other concepts, how a person perceives and processes information will determine their level of confidence and the resulting uncertainty. It is also discomforting since it disrupts daily life. Based on this, people develop different mechanisms to deal with it with the aim of evading the trouble it causes. Earlier on, in 2001, Penrod had used Rogers evolutionary method of concept analysis to refine the idea of uncertainty. Using this approach, uncertainty was defined as the inability to assign probabilities for different outcomes. However, on comparing with literature from various disciplines, this definition is helpful since it gives an understanding of the complex decision-making process that involves the family of the patient. It is also useful in providing an understanding of the patterns of human health behavior (Penrod, 2001).

Unlike Walker and Avants’ method, Rogers model requires that the researcher collects data that will be used to define the concept. In this case, Penrod (2001) collected 83 articles from different disciplines such as psychology, anthropology, and medicine that were used to define the concept of uncertainty. The data gathered is then used to come up with the attributes of the concept, which gives an accurate definition (Cronin et. al., 2010). According to the paper, one characteristic of uncertainty is that it is hard to pin it down (Penrod, 2001). Unlike other phenomena, it is usually described as a feeling that may manifest various sensations in different people. For instance, it has been described as a feeling of being torn or churned up inside. As a result, it is a subjective concept dependent on the individuals’ perception and experience, agreeing with what was described by Penrod in 2007.

Another attribute of uncertainty is that it is not easily measurable due to its’ subjective nature. As mentioned earlier, it is a dynamic concept that fluctuates within and among individuals depending on different factors. The nursing approach of using numerical measures might not be a viable measurement tool, and it may be necessary to adopt verbal measures such as those used in anthropology (Penrod, 2001). Uncertainty can be managed through cognitive, behavioral or emotional strategies (Pernrod, 2001; Penrod, 2005). This is an important aspect of this concept since it can be used to develop strategies that may be useful in managing it. It is also possible for the nursing practice to explore non- conventional means of managing uncertainty such as spiritual means that may also be effective.

Understanding the issue of uncertainty and how it affects family caregivers is relevant to nursing and clinical practice. Nurses often work with carers who face some uncertainty concerning about the decisions they should make concerning the health of their loved ones. A concept analysis of the issue will help broaden the knowledge and understanding of the phenomena and how it affects the decision-making process. It is then possible to come up with evidence-based interventions that enable the carers to move from the discomfort caused by uncertainty to more appropriate responses (Parse, 2006). Despite the two different methods of concept analysis used, they both give the same definition of uncertainty. They are also useful in showing how it relates and differs from various disciplines such as psychology and anthropology. Concept analysis is a useful tool for describing the attributes of a particular phenomenon and coming up with a practical application of the concept in nursing practice.

References

Cronin, P., Ryan, F., & Coughlan, M. (2010). Concept analysis in healthcare research. International Journal of Therapy & Rehabilitation, 17(2), 62- 68.

Parse, R. R. (2006). Concept inventing: Continuing clarification. Nursing Science Quarterly, 19(4), 289-289.

Penrod, J. (2001). Refinement of the concept of uncertainty/ Journal of Advanced Nursing, 34(2), 238- 245.

Penrod, J. (2005). Advancing uncertainty: Untangling and discerning related concepts. International Journal of Qualitative Methods, 1(4), 1- 20.

Penrod, J. (2007). Living with uncertainty: Concept advancement. Journal of Advanced Nursing, 57(6), 658- 667.

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