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Introduction
Concept analysis is a crucial process of theory construction in nursing. McEwen and Wills (2019) define concepts as the primary building blocks of theory. Concept analysis helps to understand essential features of the concept of interest and distinguish between similar concepts (Walker & Avant, 2019). The present paper aims at analyzing the concept of “prevention” which was defined as the primary concept of the “dialysis prevention.”
Phenomenon of Interest
My phenomenon of interest is dialysis prevention which belongs to the focus area of population health. In particular, I am interested in dialysis prevention among US patients with chronic and end-stage kidney diseases.
Primary Concept
The primary concept under analysis is “prevention,” which is a broad term that encompasses many meanings. Oxford dictionary defines prevention as “the act of stopping something bad from happening” (Oxford, n.d.). National Cancer Institute (NCI, n.d.) defines prevention in medicine as “action taken to decrease the chance of getting a disease or condition” (para. 1). However, Starfield et al. (2008) state that the concept of prevention has expanded to include risk factors, as the definition of primary, secondary, tertiary, and quaternary prevention emerged. The primary concept will be analyzed in the context of healthcare.
Synopsis
Concept analysis was conducted following the steps provided by Walker and Avant (2019). First, the concept was selected from the phenomenon of interest, which was dialysis prevention. Second, the purpose of the analysis was defined as developing the operational definition of the concept to use in my future research, as suggested as one of the possible purposes for concept analysis by Walker and Avant (2019). Third, several definitions were assessed from different sources to overview different meanings of the concept. Three of the definitions are provided in the previous section. After that, attributes were defined, two model cases were identified, additional cases were provided, referents were described, and implications were discussed.
Literature Review Results
A brief literature review concerning the concept of prevention led to several conclusions. Starfield et al. (2008) conducted an analysis of the concept and arrived at the conclusion that the concept of prevention has lost all practical meaning due to the rapid expansion of the definition. However, it is unclear if elevated blood pressure prevention (BP) or dialysis prevention are viable combinations of words, as neither high elevated BP nor dialysis are diseases. Czeresnia (1999) stated that prevention and promotion are two concepts close in meaning; however, promotion is a broader term that applies to health in general rather than to certain diseases. Today’s literature states that prevention is more important than treatment (Firdaus et al., 2021). The concept of prevention is used in a wide variety of disciplines and sphere. Table 1 below provides a brief overview of definitions of the concept.
Table 1. Definitions of prevention.
Antecedents, Attributes, and Consequences
Two antecedents were identified for the concept of prevention. According to Orem’s theory of self-care deficiency, any disease is a result of insufficient self-care (Orem, 1991). According to Awoke et al. (2019), patient education can improve adherence to self-care practices. This implies that both self-care and patient education are antecedents of prevention. In other sphere, antecedents are usually development of protocols or list of instructions that can help to prevent fires, crime, workplace accidents, and equipment damage, as can be seen from definitions from Table 1. The consequence of prevention is the absence of a disease, a risk factor, or something else negative, as can be derived from the provided definition. The attributes of prevention include timeliness, sufficiency, theoretical justification, evidence justification, and relevancy (Starfield et al., 2008; Firdaus et al., 2021). The antecedents, attributes and consequences are summarized in Table 2 below.
Table 2. Antecedents, attributes, and consequences.
Model Case
One of the examples of the following is the prevention of kidney failure described in Kalantar-Zadeh (2013). The article described how food consumption counseling could decrease the chance of kidney failure. The patients were unable to maintain a balance of phosphorus, which is a crucial predictor of kidney failure. This implies that they did not perform needed self-care practices. A patient education intervention (food counseling) contributed to the prevention of kidney failure, which resulted in a decreased chance of patients being diagnosed with kidney failure in one year’s time. Another example is conducting a patient education intervention that promotes exercising for controlling high blood pressure. In this case, patient education leads to improved self-care practices (exercising), which prevents high blood pressure. As a result, patients have a decreased chance of being diagnosed with the condition.
Empirical Referents
Empirical referents of a concept are classes of phenomena that, by their existence, demonstrate the occurrence of the concept (Walker & Avant, 2019). One of the empirical referents of prevention is the recommendations provided by the Centers for Disease Control and Prevention (CDC). The recommendations are always theory- and evidence-driven and describe the best timeframe for the prevention practice.
Implications
There are several implications of the analysis. First, prevention needs to be theory- and evidence-driven. Second, the time for the prevention initiatives should be selected carefully. Third, prevention measures should target self-care practices. Finally, patient education can promote prevention.
Influence on Perception
The analysis of the concept has broadened my understanding of the concept. Additionally, it made my knowledge of the concept more specific. I will use the results of the analysis when planning future prevention interventions. I will ensure that provided patient education is evidence- and theory-driven, timely, and targets self-care.
Summary
The present paper provided an in-depth analysis of the concept of prevention using Orem’s theory of self-care deficiency and the concept analysis framework provided by Walker and Avant (2019). The analysis described attributes, antecedents, consequences, and empirical referents of the concept. Additionally, two model examples were given, and implications were discussed.
References
Awoke, M. S., Baptiste, D. L., Davidson, P., Roberts, A., & Dennison-Himmelfarb, C. (2019). A quasi-experimental study examining a nurse-led education program to improve knowledge, self-care, and reduce readmission for individuals with heart failure. Contemporary Nurse, 55(1), 15-26.
Czeresnia, D. (1999). The concept of health and the difference between prevention and promotion. Cadernos de Saúde Pública, 15(4), 701-709.
Firdaus, S., Anwar, A. I., Khan, A. A., & Ahmed, Z. (2021). Concept of life style diseases and its prevention through Unani system of medicine-A review. International Journal of Unani and Integrative Medicine, 5(2): 20-23.
Kalantar-Zadeh, K. (2013). Patient education for phosphorus management in chronic kidney disease. Patient Preference and Adherence, 7, 379- 390.
McEwen, M., & Wills, E.M. (2019). Theoretical basis for nursing (5th ed.). Walters Kluwer.
National Cancer Institute. (n.d.). Prevention. Cancer.gov. Web.
Orem, D.E. (1991). Nursing: concepts of practice (4th ed.). Mosby.
Oxford. (n.d.). Prevention. In Oxford Learner’s Dictionary. Web.
Raken. (n.d.). Preventing equipment damage. Web.
Safeopedia. (2019). Fire prevention. Web.
Starfield, B., Hyde, J., Gérvas, J., & Heath, I. (2008). The concept of prevention: a good idea gone astray?. Journal of Epidemiology & Community Health, 62(7), 580-583.
United Nations. (n.d.). Crime prevention.UNODC. Web.
Walker, L.O., & Avant, K.C. (2019). Strategies for theory construction in nursing (6th ed.). Pearson.
Workplace Testing (n.d.). Accident prevention.Web.
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