Operationalizing Nursing Concepts PDF

Operationalizing Nursing Concepts Dua’ Y. Al-Maharma 13 October, 2024 1  Objectives Differentiate between theoretical and operational definitions Recognize the steps of operationalizing a concept Understand the...

Operationalizing Nursing Concepts Dua’ Y. Al-Maharma 13 October, 2024 1  Objectives Differentiate between theoretical and operational definitions Recognize the steps of operationalizing a concept Understand the steps to develop a theoretical definition 2 Operationalizing Nursing Concepts Concepts are the building blocks of nursing knowledge and research. Concepts must be clear and well-defined for effective measurement and use in research. 3  Exercise Read the attached article about perinatal grief and answer the following questions: – How is perinatal grief defined in the provided article? – Is the definition theoretical or operational? – Is the term perinatal grief used consistently across the literature? – Is the concept clearly defined, or does it require further refinement? – Is the concept of perinatal grief mature or immature? – What are the criteria that make a concept mature or immature? – What are the observable indicators of perinatal grief? 4  Mature vs. Immature Concepts Mature Concepts: – Clearly defined with distinct characteristics and boundaries. – Ready for use in research (e.g., pain, vital signs). Immature Concepts: – Vague or have multiple meanings. – Require further development before they can be effectively measured (e.g., trust, health). 5  What is a Concept? A concept is a word or term symbolizing an aspect of reality. Concepts represent ideas that can be communicated to others. They can be formed from observations or abstract experiences. 6  What is a Concept? Concepts describe phenomena (objects, attributes, events). They help differentiate one set of phenomena from others. – Example: The concept 'infection' can be differentiated from 'inflammation'. 7  What is a Concept? Concepts are shorthand symbols representing complex ideas. They link abstract thought with real-world experiences – e.g., Compassion is an emotional desire to alleviate suffering. Nurses show compassion by listening to patients, offering comfort, and taking extra care. 8  Concepts and Theories in Nursing Concepts are the basic building blocks of scientific theories. Theories consist of propositions that describe relationships between concepts. Propositions help explain, predict, and control nursing phenomena. 9  Conceptual Framework in Nursing A conceptual framework provides an organized way to approach nursing phenomena. It guides the development of specific nursing theories. Concepts and theories form the foundation for nursing research and practice. 10  Abstract Concepts vs. Observables Abstract Concepts Observables (Directly and Indirectly) Complex ideas (e.g., infection, trust) Directly observable properties (e.g., color, odor) or indirectly through devices Difficult to observe directly Can be sensed (e.g., skin color, wound odor) or measured indirectly (e.g., ECG detecting arrhythmias) Requires indirect methods or tools Examples: Skin color indicating to observe infection, ECG for arrhythmias, devices to detect non-visible properties 11  Observable Attributes and Indicators Observable attributes are used as indicators (empirical referents) of health concepts. – Redness, swelling, and foul odor discharge are indicators of infection. A given observable may be indicator for more than one Concept: – An infant’s cry can be an indicator of pain, hunger, or boredom. 12  Behavioral Concepts Behavioral concepts: refer to ideas that are relatively abstract but can be indicated by behaviors. – Direct behavioral observation: behaviors observed directly (e.g., Observing mother-infant interaction to assess parenting skills or attachment). – Indirect Behavioral Observation: Behaviors inferred through responses to questions or interviews (e.g., Patient reporting satisfaction with care or help-seeking behavior) – Qualitative Approaches: To understand complex concepts that then guide the identification of indicators. 13  What is Operationalization? Operationalization is the process of defining how a concept will be measured. It involves making a concept explicit by identifying observable indicators. This helps to turn abstract concepts into measurable elements. – E.g., a patient's note may show pre-surgery anxiety, operationalized by the provider through signs like restlessness, insomnia, and diarrhea complaints 14  What is Operationalization? Operationalization is essential for research, especially with quantitative methods. It helps ensure that abstract concepts are clearly measured. This process supports the testing of theories and answering research questions. 15  What is Operationalization? Tools like checklists, protocols, and guidelines ensure standardized patient assessment. Activities requiring precise operationalization include: – Evaluating the quality of care – Identifying patient outcomes – Judging the effectiveness of interventions – Assessing clinical performance 16  Nursing Concepts Nursing concepts vary widely and represent different phenomena: – Animate or inanimate objects (e.g., patient, needle, crutch). – Attributes or characteristics of objects or persons (e.g., size, color, intelligence). 17  Nursing Concepts Static characteristics (e.g., socioeconomic status) can be measured at a specific point in time. Dynamic processes (e.g., socialization, interaction) evolve over time and are harder to capture with a snapshot. Some concepts are both static and dynamic, like social support (given and received vs. an ongoing process). 18  Nursing Concepts Stable manifestations (e.g., trait anxiety) vs. situational ones (e.g., state anxiety). Concepts can refer to relationships between individuals (e.g., subordination, exchange) or groups (e.g., structure, pattern). Individual-level concepts (e.g., health) can also apply to larger groups (e.g., families, communities). 19  Nursing Concepts Nursing concepts vary in complexity: some use single indicators, while others use multiple. Concrete concepts (e.g., syringe) are observable; abstract ones (e.g., mother-infant attachment) need inferential steps. – Abstract concepts are built from less abstract ones, requiring clear definition and measurement. Some concepts, like functional status, are borrowed from other disciplines to guide nursing research and practice. 20  Theoretical and Operational Definitions Theoretical Definition: Provides meaning by defining a concept using other concepts. Operational Definition: defining concept in terms of observations and/or activities that measure it. – It includes the empirical indicators and any procedures (such as instruments, specific settings, or protocols) used to measure the concept. 21  Example Fatigue Theoretical Definition: “A subjective feeling of tiredness influenced by circadian rhythms, varying in unpleasantness, duration, and intensity.” (Piper, Lindsey, & Dodd, 1987) Operational Definition: Measured using the 22-item Piper Fatigue Scale, which has 4 dimensions: Behavioral, Sensory, Cognitive, and Affective (Stewart & Lynn, 2009) 22  Theoretical and Operational Definitions Theoretical definitions can come from common usage, existing theories, literature, or field observations. Definitions should align with their disciplinary use. Borrowing definitions from other fields can be inadequate because meanings are often specific to context and discipline.. Concepts may be defined by theory terms or used without formal definition if an agreed meaning exists 23  Theoretical and Operational Definitions Operationalization may not fully capture the concept's theoretical meaning. Qualitative research, through concept analysis and sequential studies, clarifies concept meanings, enhancing their research use by revealing their depth and richness, grounded in real-world observations and literature. 24  Operationalizing Nursing Concepts Steps in Operationalizing a Concept: 1. Develop the theoretical definition. 2. Specify variables derived from the theoretical definition. 3. Identify observable indicators. 4. Develop measurement methods for the indicators. 5. Evaluate the adequacy of the operational definition 25  Developing the Theoretical Definition To convey a concept clearly for theory, research, or practice by turning an informal definition into a precise, clear, and context- appropriate theoretical definition. Steps Involved: 1. Develop a preliminary definition. 2. Review literature. 3. Identify exemplars or examples. 4. Map the concept's meaning. 5. State the theoretical definition. 26 Developing the Theoretical Definition Conceptualization involves deep understanding and should not be bypassed by using dictionary definitions or shortcuts. Common definitions may be too broad or imprecise for scientific use. Scientific definitions must be validated by research and fit the specific context. Borrowing definitions can be appropriate if they convey the essential meaning and fit within the study’s context. 27  The preliminary definition Starting point by writing down key ideas and synonyms. Derived from clinical observation, experience, or literature. Determine the Purpose: – Testing a theory. – Conducting research on a health-related phenomenon. – Developing/testing instruments for patient assessment. – Documenting nursing interventions. – Identifying characteristics of a new nursing diagnosis 28  The preliminary definition key steps to prepare for concept definition: – Translate ideas into words: Clearly express the concept to highlight important aspects for refinement. – Set boundaries: Define limits, excluding irrelevant meanings based on context. – Identify context-specific meanings: Adapt the concept’s meaning according to different fields (e.g., "reaction" in chemistry vs. psychology). – Clarify the perspective: Determine the worldview and assumptions that will influence how the concept is defined. 29  Literature review Examine current knowledge through a review of relevant literature in nursing and related fields. Search databases across multiple disciplines, not just nursing. Interpret literature from other fields carefully, recognizing limitations in understanding. Use exemplars and cases from literature to enhance understanding. Engage with scholars from the parent discipline for input and clarification 30  Literature review Choice of literature to review should be guided by: – The purpose of the concept being developed. – The unit of analysis (e.g., individual, group, society). – The theoretical framework used. Include both recent and older literature to track the historical evolution of the concept. 31  Literature review Techniques for Constructing Theoretical Definitions: 1. List all definitions: – Gather all definitions (explicit and implicit) from the literature. – Identify common elements and differences. – Focus on critical attributes that define the concept. 2. List synonyms and their definitions: – Identify related terms to differentiate subtle differences in meaning. 32  Literature review 3. List examples or instances: – Use real-world or fictitious examples to illustrate the concept. – Employ cases like model case (clear example), contrary case (opposite example), or related case (similar example). 4. Analyze related or opposite concepts: – Compare multiple similar or opposite concepts simultaneously to enrich the analysis. – This can involve a consensus group (several experts) for validation. 33  Mapping the Meaning A concept's meaning space (content domain): refers to the range or domain of meanings, attributes, and dimensions that make up the full understanding of a concept. – For example, if you take the concept of “health,” its meaning space would include physical health, mental health, emotional well- being, social health, and environmental factors. Each of these aspects represents part of the broader "space" or "area" that contributes to the full definition of health. 34  Mapping the Meaning Key factors guiding the mapping process: 1. Purpose and Context 2. Theoretical Framework 3. Review of Literature 4. Common Distinction within the concept, such as: Objective vs. Subjective aspects (e.g., quality of life) Stable vs. Transitory aspects (trait and state characteristics) 5. Multiple Domains (e.g., physical, psychological, social) 6. Tailored to Discipline and Population 7. Qualitative and Exploratory Studies provide rich insights for conceptualization. 35  Strategies for Mapping the Concept's Meaning Space 1. List Major Elements: Identify key elements and note similarities or differences. Combine or remove categories that are not relevant to the purpose. 2. Create an Outline: Organize the concept's meaning into key headings. Group related elements under each heading, summarizing where possible. 3. Ask Questions: Use questions derived from the theoretical framework and literature review to clarify the concept's meaning (e.g., "What is being sought?" or "What is the purpose?"). 36  Strategies for Mapping the Concept's Meaning Space 4. Create Diagrams: Use Venn diagrams or flowcharts to visually represent how different meanings overlap or relate. This helps to understand complex relationships within the concept. 5. Identify Structure and Variations: Once the structure or stages are identified, list possible variations within each category. This aids in defining the concept and prepares it for operationalization later on. 37  Stating the theoretical definition Define essential elements and dimensions of the concept. Integrate and synthesize key elements into a meaningful whole, reversing the breakdown of concept analysis. Ensure the definition is clear and understandable, capturing the core meaning, even if not fully comprehensive 38  Stating the theoretical definition Eliminate unrelated or inappropriate behaviors, focusing on goal- oriented actions. Use supplementary explanations for abstract concepts to bridge theory and real-world application. Prefer using existing definitions that accurately reflect the meaning and are applicable in context. 39 Specifying variable aspect of a concept Nursing concepts have variable dimensions, which are more significant in practice and research than the concept's definition. A well-developed theoretical definition can highlight important clues to salient dimensions of a concept Sometime variable dimensions of a concept are not easily derived from theoretical definition and require return to literature. 40  Specifying variable aspect of a concept Once possible variables are identified, the selection of those that ultimately will be included in the operationalization is determined by the purpose and context for use of the concept. 41  Specifying variable aspect of a concept Questions to ask when selecting variable aspects or dimensions for inclusion in an operationalization: 1. Which variables will provide the most useful information to nurses? 2. Which variables have others found to be most important in understanding the phenomenon? 3. Which variables have others found to be related to other concepts of interest or to help explain or predict occurrences of interest to nurses? 4. Which variables can be rendered observable and measurable, given our present state of knowledge and technology? 42  Identifying observable indicators Decide if the concept represents a fixed (either/or) state or one that varies Research and theoretical sources help identify potential indicators. Evaluate their fit for measuring the concept. Gather insights from real-world experiences of nurses, patients, and families to enrich indicator selection. Choose indicators that are practical, relevant, and aligned with real-world needs and common sense. 43  Developing approaches to measurement Specify how a particular indicator can be made observable and measurable. Set rules for assigning numbers to different levels or states of the indicator. Once the measurement method is decided, the operational definition explains how the concept will be measured in the specific context. 44  Evaluating theoretical and operational definitions Criteria for Evaluating Operationalization Clarity: Definition, indicators, and operations should be easily understood. Precision: Observations and operations must be explicit, with specific instructions or guidelines. Reliability: The ability to repeat or reproduce the observation and operations. Consistency: Terms must be used consistently, and logical reasoning should guide the selection of indicators. 45 Evaluating theoretical and operational definitions Meaning Adequacy: Ensure the concept and its indicators align meaningfully and cover all dimensions. Feasibility: Operations and indicators must be practical, considering subjects' age, culture, and cognitive status. Utility: Operationalization should be useful within the context of specific investigation or other activity and more generally to the discipline of nursing. Validity: Observations must accurately represent the concept. Consensus: Accepted by the scientific community through empirical evidence. 46 Understanding the latent variables 47  Latent Variable as the Presumed Cause of Item Values Latent variables are unobservable constructs inferred from observable items. They are considered the cause of item responses, meaning their strength influences item values. Since the true score of a latent variable can't be directly measured, item correlations are analyzed to infer its strength. 48  Path Diagrams Using the provided path diagram, answer the following questions. 49  Exercise Explain the Path Diagram? Write the Equation to Calculate X1and X5? Calculate Communalities h2? Calculate specific variance? Calculate proportion of Variance Explained (Factorial Determination)? Calculate the Correlation Matrix? 50  References Waltz, C. F., Strickland, O. L., & Lenz, E. R. (2017). Measurement in nursing and health research (5th ed.). Springer Publishing Company. DeVellis, R. F. (2022). Scale development: Theory and applications (5th ed.). SAGE Publications. 51