Concept Analysis Intro

NURSERESEARCHER 2008, 15, 2 49

issues in research

Concept analysis as a method of inquiryMany researchers begin their studies without clearly defined concepts. Moyra Ann Baldwin explains why researchers need to consider what it is they’re researching using concept analysis before starting work

Introduction

Mathieson, in the editorial of the first issue of Nurse Researcher, said that

one purpose of the journal was to increase readers’ research awareness in

terms “of different methods and their significance to practice… to sort out

‘the good from the bad’ and to make informed decisions” (Mathieson 1993).

This was an invitation for researchers to pursue all approaches to the design

of research and to consider that the foundation of any research is its design.

Concept analysis and clarification is one of those “different methods” of

research that I will explore in this article.

Concepts: what are they?

Nursing embraces many concepts, some of which have been exposed to the

process of analysis, such as advocacy (Baldwin 2003), dignity (Mairis 1994),

grief (Jacobs 1993), intimacy (Timmerman 1991) and presence (Gilje 1992).

Concepts are labels that describe phenomena and provide a “concise sum-

mary of thoughts” (Meleis 1991). If asked to describe a favourite chair, each

of us, I believe, would describe a chair but the shape, size and nature of

our specific chair would be quite different: it might be a rocking or gliding

chair, sofa, armchair or wheelchair. Nevertheless, we would be explaining

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Concept AnalysisModels and TheoriesNursing: Philosophy Nursing: Process

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50 NURSERESEARCHER 2008, 15, 2

issues in research

the concept concisely. Meleis uses jet lag as an example of a concise label

that explains a complex phenomenon, and even those of us who have not

experienced jet lag have a fair idea of what it entails.

Purpose of research and the role of concept analysis

The purpose of research is “an attempt to increase the sum of what is known,

usually referred to as ‘a body of knowledge’, by the discovery of new facts or

relationships through a process of systematic scientific enquiry, the research

process” (Macleod-Clark and Hockey 1989). Concept analysis, as a method

of research, can be justified on the premise that the purpose of research is to

make a contribution to scientific knowledge (Hockey 2003). Concept analysis

is a method that can contribute to a body of knowledge, specifically about

concepts. Such a contribution is seen in the concept analysis conducted by

Bu and Jezewski, who clarify the idea of patient advocacy by positing a mid-

range theory of the concept (Bu and Jezewski 2007).

John Wilson, one of the early writers about concept analysis, notes that “a

great many adults who are concerned with matters of general interest and

importance… would do better to spend less time in simply accepting the

concepts of others uncritically and more time in learning how to analyse con-

cepts in general” (Wilson 1963). Concept analysis can provide a knowledge

base for practice by offering clarity and enabling understanding, rather than

mere knowing. To understand a concept, the precise and rigorous process of

conceptual analysis is required. This, according to Wilson, involves asking a

number of questions.

Concept analysis, according to a number of theorists, brings about clarifica-

tion, identification and meaning of words (Hull 1981, Norris 1982, Walker

and Avant 1988, 1995). It is this third function, meaning, that Wilson

emphasises. While he acknowledges that his Socratic, questioning, method

“may seem unnecessary and fussy”, his method of analysing concepts “draws

attention to the point that the question is about meaning” (Wilson 1963).

Theoretical basis of concept analysis

Bearing in mind that the purpose of research is to contribute to scientific

knowledge (Burns and Grove 1999, Hockey 2003), it is worth exploring what


constitutes science and scientific knowledge. Dictionaries define knowledge

as the act or process of knowing. The Dictionary of Philosophy (Lacey 1986)

and Leddy and Pepper (1993) suggest that it is “justified true belief” but one

can argue that what counts as justification is open to interpretation (Lacey

1986). In relation to science, Richards believes it is best to think of it as an

investigation into how the world works and what it is like (Richards 1981).

Success with such an investigation increases the power to explain, predict

and control events (Carper 1978). One of the first three goals of concept

clarification involves describing, explaining and giving meaning to human

behaviour (Norris 1982). Therefore one can conclude that concept analysis

contributes to scientific knowledge. Since nurses have a responsibility to keep

their practice up-to-date as well as provide quality evidence-based care to

patients (Hamer and Collinson 2000), updating knowledge about concepts is

key to evidence-based practice.

Understanding of what constitutes knowledge owes much to elaboration

and criticism of the Ancient Greek concept. The Greeks discovered math-

ematics and the art of deductive reasoning, and “reasoned deductively from

what appeared self-evident, not inductively from what had been observed”

(Russell 1945). Russell considers this to be a one-sided approach, and says

replacing the Hellenic belief derived from philosophers’ precepts to the

“scientific method, which seeks to reach principles inductively from observa-

tions of particular facts” has been a slow process (Russell 1945). The idea

that knowledge concerns concepts derives from Plato (Leddy and Pepper

1993, Russell 1945). In contrast, Aristotle began by viewing Platonic ideas as

“poetic metaphors” (Taylor 1955) and tried to relate all objects of knowledge

to particular facts of sense perception. Science, for Aristotle, meant proved

knowledge. Things are known “through their causes or reasons why” (Taylor

1955). Aristotle, however, was unable to maintain a purely empirical theory

of knowledge and returned to Platonism because sense perception assures

one that “a fact is so; it cannot explain the fact by showing its connection

with the rest of the system of facts” (Taylor 1955).

The importance of distinguishing between matters of fact and rela-

tions of ideas – in other words concepts – was highlighted by the Scottish

Enlightenment philosopher, Hume (Macnabb 1962). Hume concluded that


issues in research

the only elements which can be known are perceptions and “resolve them-

selves into two distinct kinds… impressions and ideas” (Macnabb 1962).

It is evident that there have been two distinct approaches to gaining

knowledge: the way of pure reason exemplified by Plato and subsequent phi-

losophers such as Descartes; and the way of empiricists, such as Hume, who

declare that all ideas must originate in sense perception. Whatever way ideas

are gained, the process of concept analysis and clarification highlights the

consistency and coherence of the ideas with the existing body of knowledge

and the evidence upon which those ideas were constructed.

Identifying the elements of fever and distinguishing facts from misconcep-

tions, Thompson’s analysis directs one toward recognising fever as an adap-

tive response (Thompson 2005). Thus the ability to explain fever is present.

The ability to predict and control events (Carper 1974, Richards 1981) is

present, too, as healthcare professionals recognising fever can instigate appro-

priate intervention and withhold inappropriate measures in an attempt to

reduce temperature (Thompson 2005).

Concept clarification is essential in critically analysing claims of knowledge

gained through reason or experience: “Concept analysis gives framework and

purposiveness to thinking that might otherwise meander indefinitely and pur-

poselessly among the vast marshes of intellect and culture” (Wilson 1963).

This captures Mulhall’s guidance for a successful research endeavour in that

the design assists with the purpose of the inquiry (Mulhall 1992) .

Methods of concept analysis

Examination of the methods of concept analysis reveals an array of systems

much of which refers to the work of Wilson (1963) and Walker and Avant

(1983), the latter having adapted Wilson’s approach to the study of con-

cepts that are of significance to nursing (see Table 1). Norris enumerates

and describes ten methods of concept clarification, one of which is Wilson’s

technique (Norris 1982). Much of the literature in which the purpose of the

study is to examine a specific concept uses the methods advanced by Wilson,

Walker and Avant, or a combination of both (see Table 2). A Wilsonian

approach was adopted by Thompson when analysing the concept of ‘fever’

Thompson (2005). Purdy likewise used this approach to analyse the concept


of ‘vulnerable’ (Purdy 2005). Shattell’s concept analysis of risk followed

Walker and Avant’s method and Baldwin used an eclectic approach to clarify

the concept of advocacy (Shattell 2005, Baldwin 2003).

Wilson’s method of concept analysis involves posing questions he claims

are neither the meaning of words nor questions of fact or value. Instead, they

concern the uses or possible uses of words. But that means the context and

purpose are important, which I suggest means the questions are exactly to

do with the meaning of words. In this vein, Hook has analysed the concept

of partnership in the context of healthcare provider-patient relationship, and

advocacy has been analysed in the context of nursing by Baldwin (Hook

2006, Baldwin 2003).

The first step in Wilson’s method of concept analysis is to isolate “ques-

Table 1. Stages of concept analyses

Wilson 1971 Walker and Avant 1983

Isolating questions of concept Select a concept

Right answers – associated closely with

the question of concept

Determine the aims or purpose of analysis

Model cases Identify all uses of the concept that you

can discover

Contrary cases Determine the defining attributes

Related cases Construct a model case

Borderline cases Construct borderline, related contrary,

invented and illegitimate cases

Invented cases Identify antecedents and consequences

Social context Define empirical referents (for critical

attributes)

Underlying anxiety – associated closely

with social context

Practical results

Results in language


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tions of concept” (see Table 1). A model case of the concept is a good place

to start. He suggests it can then be followed by contrary, related, borderline

and invented cases. It is necessary, according to Wilson, to examine the social

context, underlying anxiety and practical results. He completes his technique

with a stage entitled “results in language”. Not all the steps are equally useful

in all cases but taking each stage in order might be a wise method.

Rodgers criticises a method such as Wilson’s because its reductionist approach

to isolating conditions and boundaries represents a static view (Rodgers 1989).

I believe Wilson guards against such claims: his “questions of concepts” relate

to uses of words. This is worth considering as nursing is practised in a dynamic

system of healthcare delivery. Rodgers’ exploration of the philosophical

foundation of concept analysis also identified two views of concepts, namely

“entity” and “dispositional”. These views respectively focus on the concept as

an entity in itself and on an individual’s ability to perform specific behaviours.

The entity view emphasises the meaning of a concept out of context. Rodgers

then asserts that entity theories have their foundations in the works of philoso-

phers advancing the logical positivist movement where something is known for

certain (Russell 1945). Dispositional theories on the other hand are not clearly

found in the work of any particular philosopher. Rodgers suggests that the later

writings of Wittgenstein contribute to a greater understanding of concepts from

Table 2. Methods used for specific concept analyses

Concept analysis method Concept Researcher

Wilson Fever Thompson 2005

Vulnerable Purdy 2005

Dilemma Sletteboe 1997

Grief Jacobs 1993

Wilson, Walker and Avant Advocacy Baldwin 2003

Presence Gilje 1992

Risk Shattell 2005

Dignity Mairis 1994

Rodgers Partnering Hook 2006


the dispositional approach to analysis (Rodgers 1994). Cash seems to support

this assertion, as he states that Wittgenstein argued “that words get their mean-

ing in use, rather than by having some inner meaning that is hooked into them,

and dissoluble from them” (Cash 1990). A dispositional view thus addresses

the meaning of concepts in use, by those who use them. An example of this

can be seen in the language of our electronic age which has brought its own

meaning to the concept of ‘mouse’.

Addressing her criticism of Wilson’s reductionist approach, Rodgers offers

an evolutionary cycle of concept development (Rodgers 1994). The devel-

opment of concepts, she claims, is influenced by three aspects. These are

“significance”, “use” and “application”. This approach to analysis and her

subsequent synthesis of a cycle of concept development appears to be in

accord with Becker, who states “the precise meaning of a concept is thus

dependent upon the context in which it is employed” (Becker 1983). This is

what I believe Wilson was also concerned with and is of importance to nurs-

ing. There are many words associated with nursing that are used in different

ways depending on the context, such as the concept of advocacy in relation

to adults, children and learning disability.

From exploring the philosophical foundations of concept analysis and the

development of the evolutionary view of concepts, Rodgers elicits a definition

different to those of Wilson and Walker and Avant (Rodgers 1994, Wilson

1963, Walker and Avant 1983, 1988). She advances a vibrant definition and

analysis of concepts and such analyses are temporary to the theorist. Rodgers

claims that “a concept is considered to be an abstraction that is expressed

in some form, either discursive or non-discursive. Through socialization and

repeated public interaction, a concept becomes associated with a particular

set of attributes that constitute the definition of the concept” (Rodgers 1994).

Analysis of the common use of a concept helps define the concept and pro-

vide clarification. True to Watson’s assertion of the dynamic nature of concepts

(Watson 1991), they are “continually subject to change” (Rodgers 1994).

Rodgers (1994) provides further evidence of the dispositional approach

and Wittgensteinian thinking when she describes the process of evaluating

“resemblance” to the initial concept when confronted with related phenom-

ena or situations (concepts). In Wittgenstein’s terms one would be search-


issues in research

ing for “family resemblances” in those words associated with the concept.

Rodgers’ concept development helps to identify the set of attributes associat-

ed with the term and subsequently these constitute its definition (Cash 1990,

Rodgers 1989). Two examples of defining attributes that clarify concepts with

which nurses commonly engage are those of Baldwin and Sletteboe (Baldwin

2003, Sletteboe 1997). The three attributes defining advocacy were valuing,

apprising and interceding (Baldwin 2003). Sletteboe identified five defining

attributes associated with the concept dilemma namely involvement, equally

unattractive alternatives, awareness of the alternatives, need to choose and

uncertainty of action (Sletteboe 1997).

Conclusion

The philosophical foundations to concept analysis have been explored.

Whether one engages with Rodgers’s (1989) approach to concept analysis or

Wilson’s (1963), both methods contribute to the body of knowledge that is

nursing. To examine a concept to determine its characteristics and the condi-

tions that differentiate it from other concepts will not necessarily produce new

empirical facts. It remains more in tune with the rational production of knowl-

edge idealised by Plato rather than the hypothetico-deductive model (Leddy

and Pepper 1993). Despite this limitation, the rational inquiry into the mean-

ing of concepts is a necessary first step that should precede the development

of hypotheses and any subsequent testing. Success with analyses of this kind is

to be found in the literature. Timmerman conducted an analysis in relation to

intimacy that enabled her to derive a theoretical definition for subsequent use

in research and that had the potential to develop theory (Timmerman 1991).

A more recent development in this regard is the “mid-range” theory developed

by Bu and Jezewski (Bu and Jezewski 2007). Concept analysis is a pragmatic

and rigorous approach to defining concepts that can make a significant contri-

bution to knowledge and by implication to nursing practice.

Moyra Ann Baldwin BSc(Hons), MMedSci, RN, RCNT, DipN(London), Cert Ed,

RNT DANS FHEA, is senior lecturer at the University of Chester, UK

This article has been subject to double-blind review


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Concept Analysis Intro