Concept analysis of overcoming in nursing and healthcare

¶ … Antecedents

Defining Characteristics

Empirical Referents

The ability to help a person or a patient is often a complex affair that involves care on a much deeper level than simply treating symptoms. "Overcoming" is a concept that was chosen by the authors; this concept is multifaceted and includes many different aspects, but can be thought as roughly being able to overcome a personal challenge to meet a desired outcome (Brush, Kirk, Gultekin, & Baiardi, 2011). The concept of overcoming is interesting to me and I feel that I have had overcome many things in my life; although these challenges were on a different scale than the case studies provided. However, understanding what it takes to "overcome" could be a valuable concept to many people.

The significance of the concept in the profession can be largely thought of in terms of expanding the lexicon to include terms that might be more relevant to a larger population. The concept of overcoming seems to include many other concepts that are already well-defined. Although there may be subtle differences, I think the originality and contribution to this concept is that way that it organizes related concepts in a new way that might appeal to a broader audience and be more readily understood by some patients and/or professionals.

I chose this specific concept for the specific fact that the term, "overcoming" is widely used and generally not understood on a detailed level. Yet, at the same time, most people will have a basic understanding of the concept naturally. Because of this, I think it could be a useful concept to explore.

History Section

The concept of overcoming can be applied to many different situations in life and is not specific to nursing. However, the authors note that it appears in nursing and health disciplines to de-ne one's ability to work through or surmount an issue, problem, obstacle, or situation such as addictive behaviors (Brush, Kirk, Gultekin, & Baiardi, 2011).

My belief is that the concept of overcoming is so broad and included in popular culture, as well as generally includes an inspirational aspect to it, could appeal to make individuals who are undergoing treatment and would benefit from the inspirational nature of this concept.

The authors also describe the terms use in many different contexts. For example:

"The process of overcoming has also been popularized in songs of protest, activism, and/or spiritual awakening as well as in a host of self-help books from binge eating (Brush, Kirk, Gultekin, & Baiardi, 2011)"

Searches in the academic literature revealed the use of the concept of overcoming in a wide array of different disciplines -- including everything from law, marketing, psychology, sociology, and many more. For example, one study used the concept of overcoming in overcoming the challenges related to succession in a family business (Freire, Soares, Nakayama, & Spanhol, 2010). The concept of overcoming is largely devoted to cultural changes that occur in an organization as a result of succession. Another article applies the concept to a national perspective which tackles the issues related to a country losing highly qualified and skilled workers to foreign markets and opportunities, a concept known as "brain drain" (Levatino & Pecoud, 2012). However, the concept of overcoming seems to be largely everywhere in the literature and most cases appear to refer to the inspirations aspects inherent in the concept.

Antecedents

Understanding -- the individual who is attempting to overcome some obstacle or adversity, must first understand the situation to some extent. They need to recognize that there will undoubtedly have to be some form of behavior change to fulfill the concept.

Self-efficacy -- the individual needs to believe that they have the ability to make the needed changes to overcome whatever challenges or adversity that is present. Without a belief that overcoming is at least possible, the individual would be largely unmotivated to try to make a change in their behaviors.

Change -- change is also a critical component to overcoming for the simple fact that if the obstacle did not require change on some level, then it would be a routine act that could be considered as something in the way of a normal daily challenge and would not require one to "overcome." "

Planning -- the individual must construct some strategy to be able to make the needed changes in their behavior or situation to overcome. It can be thought of as a personal intervention strategy in which the individual recognizes that a change needs to be made and responds to this with a plan to do so.

Optimism -- the authors state that it is necessary to have optimism. However, of all the antecedents mentioned, this seems as if it's the weakest addition.

It is not completely clear that optimism must be an antecedent in overcoming. While it could improve the likelihood of success, overcoming does not seem to be dependent upon the individual maintaining a level of optimism.

Defining Characteristics

The authors do not dedicate a section on the defining characteristics of what overcoming entails. However, I do not personally feel like this detracts from the concept because many of the defining characteristics appear in the other sections; both before and after where one might expect to see this section.

Consequences

The authors first give the general definition of consequences as provided by Walker & Avant (2005) which states consequences are those events or incidents that can occur as a result of the occurrence of a concept and that can often stimulate new ideas or avenues for research pertaining to certain concepts. There are also consequences that are provided that relate to overcoming.

Quality of Life -- the result of overcoming will be a better quality of life in some regard

Finding Hope and Meaning in Life -- although this is somewhat relevant to the inspiration aspect of overcoming, it is not clear that things like hope and finding meaning in life are necessary consequences to overcoming.

Moving Beyond a Difficult Situation -- this seems reasonable and relevant to overcoming. The individual must overcome something difficult, as in out of the ordinary, to overcome

Positive Outcome -- the individual must achieve a positive outcome that was intended; or at least a more positive outcome relative to the conditions that were present before an individual began the overcoming process.

Again, things included in the concept of overcoming may not necessarily need to include items like optimism, hope, and especially finding meaning in life. While these items may be related to overcoming in many cases, I do not feel that overcoming necessarily needs such items to be achieved.

Empirical Referents

The empirical referents section precedes the cases in the article and will be provided here in the same order. This section is well organized and utilizes measures of related constructs to devise a strategy to measure overcoming since there is no direct measure available. The empirical referents for categories of the related phenomena of resiliency, hope, optimism, self-ef-cacy, and perceived social support on the process of overcoming are provided (Brush, Kirk, Gultekin, & Baiardi, 2011). These constructs are chosen based on the population that is selected for the case studies. Resiliency deals with the ability to bounce back or recover from some adverse event. Hope is the belief that some positive outcome will manifest in the future which is also closely related to optimism which is something of a belief that the positive outcome can and will be achieved. Self-efficacy is the belief that the individual has the power to achieve the objective. And social support consists of members of the individuals friends and family who are willing to provide assistance in the achievement of the intended outcome.

• for this section stat if the empirical referents are in the article and how they use ( ex -- the author included -- empirical referents and explain them)

Cases

The cases that are present are based on actual cases from the authors' experience working with homeless individuals. Three cases are provided. Two of these case illustrate overcoming adversity on different levels. For instance, one case features a homeless pregnant woman who clearly overcomes adversity while another case represents a pregnant homeless woman who also overcomes adversity, but to a lesser degree. The contrary case features a homeless mother who is unable to overcome the adversities present in her life.

The cases are good and clearly illustrate some of the factors that can be thought of in regards to overcoming. Yet, as previously mentioned, some of the factors associated with the overcoming that are mentioned earlier in the article, especially finding a meaning in life, are not clearly presented in the cases. Personally, it leads me to believe that though these concepts may be related in some manner, that they are not necessary for one to achieve overcoming. Thus I believe the concept of overcoming present could be simplified and such factors excluded from being characteristics of this concept.