Overcoming: A concept Analysis

Assignment:
Complete a concept analysis on one of the following topics. Utilize the Overcoming concept analysis as an example. This part of the assignment should be at least 1000 words and contain the following parts: Introduction, Definition, and Uses of the Concept, Defining Attributes, Antecedents, Consequences, Model Case, Borderline Case, Contrary Case, and Implications for Nursing Practice.

Your chosen defining attributes should be clearly identified in each of the three cases.
Hope
Caring
Trust
Teamwork
Appraise ways in which your nursing practice (patient care, education, research, administration, etc.) has been influenced by nursing (or borrowed) theory.
The assignment should be between 1500 and 2000 words in length and contain at least two scholarly sources, in addition to the textbook and provided material. Please submit your assignment in one APA formatted document.

Tappen chapter 3
Brush, B. L., Kirk, K., Gultekin, L., & Baiardi, J. M. (2011). Overcoming: A concept analysis. Nursing Forum 46(3), 160-168.
Tappen chapter 3

SOLUTION

Overcoming: A concept Analysis
Introduction
This paper describes an operational description of overcoming as a prerequisite step in the systematic analysis of the concept. Walker & Avant (2005) described a method that examines the attributes and characteristics of overcoming. In addition, the authors made an attempt to relate the practical and theoretical application of overcoming in the nursing practice.

Nursing practice often involves encounters with unwell patients either emotionally, mentally or even physically. Some even present to the hospital with social problems. Nurses have the responsibility to improve their health using their nursing knowledge. This interaction is destined with disturbance and approaches that are different between patients and nurses.

A research by Gulteken, Brush, Baiardi, kirk, & Lapides (2010) which included homeless mothers with an aim of establishing how to improve their lives. The participant often describes overcoming their situation as there much needed outcome. Education, establishment of permanent housing and acquisition of land were some of the issues which came up in the discussion in order to achieve the outcome.

However, the perception of the needs between the providers and the homeless mothers were different. In essence, the homeless women identified their own priorities, needs, barriers or obstacles they faced that was completely different from what the providers understood. Therefore, the definition of overcoming in the literature by the oxford dictionary as “Succeed in dealing with a problem or difficulty” is vague and has different meaning.

This is because the participants in the study, homeless women, had their own expectations; rising above their current situations, better education for their children and better housing. The term overcoming is synonymous and often used interchangeably with adaptation, resilience, survival and resourcefulness. Overcoming, when used in nursing as concept, there is a dire need to systematically explore it.

By use of the concept analysis method that was described by Walker and Avant (2005), the paper serves to dissect the definition of overcoming and scrutinize its attributes and characteristics. For purposes of illustration, the case study on homeless mothers helps to understand the concept and come up with an operational definition. Implication of this in nursing is crucial in application of the concept theoretically or practically in nursing practice.

Definitions and Uses of the Concept
The term overcoming was derived from an old English word, oftercuman which means to get better of: to defeat another a person in a competition, prevail, conquer, surmount or overpower or overwhelm (American Heritage dictionary, 2009). The term is synonymous with words like survive, beat, best, conquer and hurdle. Antonyms of give in, surrender, yield and relapse. Overcoming paints a picture of victory over failure, a process of emerging victorious over defeat, a process of surmounting rather than succumbing to.

Individuals like Keller have effectively symbolized the concept of overcoming and become an embodiment of inspiration to others. Hellen Keller being physically challenged that seem insurmountable later became a prominent author and a human rights activists. Hellen is the author of “All the World is full of suffering. It is also full of overcoming of it.”

In the same vein, Keller’s success despite blindness and deafness has inspired people to overcome vital social barriers like poverty and personal adversity to achieve their desired outcomes, access to better health and ensured survival.
In addition, the concept of overcoming has been made famous in songs that are usually sang during protest, activisms and spiritual awakening.

The key anthem of civil rights movement:” We shall overcome” indicates the barriers that they need to overcome to abolish racial discrimination. The song’s lyrics were adopted from Charles Tindley, a gospel song “I’ll overcome someday,” which defines the temptations and the” thousands of snares set for me” through prayer and faith. Tindley’s believe in prayer was inspired by a bible verse in the New Testament.

The musician through his song sheds a light on the willpower and internal strength that a person requires to overcomes challenges in life.
The term overcoming has been used extensively in the health sector to indicate a person’s ability to surmount an issue, health condition, addiction or a situation, physical and mental illness , traumatic events(Bush, 2002; Joseph & Linley, 2005) ad barriers to healthcare access .

The term overcoming has also been used in pharmacology to denote methods of surpassing resistance and potentiate the drug effect on specific disease
Defining Attributes
Signs and symptoms are similar to defining attributes as they are vital properties that help distinguish one concept from another with close relationship and make clear its meaning (Walker & Avant, 2005).

For the concept of overcoming, three defining attributes have been identified:
1. The instincts to acknowledge and appreciate a situation, behaviour, event, or problem exists and is unpleasant, undesirable and unhealthy.
2. Demonstration through an act of the readiness the will power and internal strength to change the situation and surmount the problems
3. Belief that the effort targeted at changing the situation, behaviour or surmounting the problem will lead to an improvement of the person’s future.
From the above attributes, overcoming can be defined as a well-planned and highly thought process of altering or surmounting a perceived problematic situation, behaviour or adversity with the purpose of living a healthy life and improving one’s future.

Antecedents
According to Walker and Avant (2005) antecedents are events or attributes that come up before a concept’s occurrence. In the process of overcoming a problematic circumstance, an individual must first identify the existence and the need of changing a current behaviour, situation, event or a problem. The behaviour change is a function of one’s expectations on the results of perpetuating the behaviour and the expectation about one ability to adopt a new behaviour.

Self-efficacy has a vital role in overcoming. Individuals need to believe in their inner will and internal strength to change a particular behaviour about a situation. It is generally apparent that individuals with low self-efficacy are less likely to overcome their unhealthy behaviors like addiction that those with high efficacy who tend to achieve much success in overcoming their undesired situations.

Consequences
Consequences are events that arise after a concept has occurred and often result in development of new ideas or opportunities for research on certain concepts (Walker and Avant, 2005). The probable consequences that can occur as a result of overcoming could include improved health, more stable and quality life, hope, trust and teamwork. Similarly, a more fulfilling future. In essence, “consequences describe a positive process that result in positive outcomes.”

Empirical Referents
Empirical referents refer to methods that can be measured to illustrate the occurrence of the concept (Walker &Avant, 2005). However, there are no measure of overcoming. But there exist measurements of related constructs that help to quantify the process and the outcomes. For instance, empirical referents on resiliency can be measured using Connor-Davidson Resilience Scale, hope can be measured using the optimism, and self-efficiency measured multiple bandura models, perceived social support and quality of life.

Model Case
A.B is 40-year-old male American with type two diabetes. On his previous visit to the doctor he was diagnosed with type 2 diabetes mellitus. He leads a sedentary lifestyle, physically inactive, eats junk food, a smoker and an alcoholic for the past 15 years. The attending physicians advises him on the appropriate measures to take in order to keep diabetes in control. A.B was adamant to stop his junk food, cigar rete and alcohol.

Four months later he presents with acute complications of diabetes. This made him acknowledge the importance of doctor’s advice. He understood that the undesired complications of diabetes could be controlled if he follows doctors’ advice: regular exercise and stopping junk food alcohol and cigarrete. A.B started attending diabetes education on diabetes self-management.

A month later his symptoms regressed and he lives life free of complications. AB recognized the need to follow his doctor’s instructions; stop taking alcohol and smoking as this was the undesirable behaviour. He had the willpower and the self-efficiency that leading a healthy lifestyle would make him healthier.

Borderline Case
D.A a 55-year-old male with poorly controlled diabetes mellitus lives alone in Alabama. He lives a sedentary lifestyle and has not been keen on his medication. He has also not stopped smoking and his junky food despite the numerous counselling from the doctor. D.A developed visual complications where he complains he could not see properly.

This made him to start heed the doctor’s advice about compliance with his medication and the life style changes. However, D.A did not take personal commitment as he waited for his doctor to remind him of the medication and he never cared to attend the diabetes self-management education. His diabetes was controlled owing to his doctor’s efforts to ensure he takes medications and fully adheres to the lifestyle changes.

This case study presents partial attributes only. D.A realized the need to start leading a healthy life style so as to achieve a better control of his sugars hence a healthy life. However, D.A fails to demonstrate the Will through action as his doctor kept reminding him.

Contrary Case Analysis
G.A is a 61-year-old male with type 2 diabetes. He has been advised accordingly on importance of complying with his medications, lifestyle changes including diet changes. G.A was not keen on his medication and at one time he could take foods high in sugars. Consequently, he develops painful peripheral neuropathy that progressed to an ulcer and eventually a gangrenous foot.

The only option was a below knee amputation. During the routine self-help meetings, he did not share the reason why his diabetes went out of control resulting in an amputation. Instead he laments how his future is doomed. He spoke of unsympathetic doctors, the difficulty of being on diet and the frequent medications he takes are stressful; reason why he has not been compliant.

This case study presents a situation where the defining attributes cannot be outlined. The patient did not recognize the need to change his behaviour. Also, he doesn’t have the will as he only kept lamenting. In addition, he doesn’t believe that compliance of medications will make him healthier.

Implications for Nursing
Overcoming in nursing is a phenomenon that still requires much study in nursing practice as it has not been extensively explored. Concept analysis on overcoming enables nurses to come up with clinical interventions that promote the process. This has an impact of contributing to positive outcomes either physically or psychosocially.

Additionally, promoting the process of overwhelming leads to positive environmental health outcomes. Nurses working with specific population such as geriatrics with diabetes will find overcoming and its attributes significant in assessment and interventions.

References
Walker, L. O., & Avant, K. C. (2005). Strategies for theory construction in nursing.
Joseph, S., & Linley, P. A. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of general psychology, 9(3), 262.
Bush, G. W. (2002). The national security strategy of the United States of America. EXECUTIVE OFFICE OF THE PRESIDENT WASHINGTON DC.
Brush, B. L., Kirk, K., Gultekin, L., & Baiardi, J. M. (2011, July). Overcoming: a concept analysis. In Nursing forum (Vol. 46, No. 3, pp. 160-168). Blackwell Publishing Inc.

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