Concept Analysis Assignment Paper

Select one of the four concepts for your paper: trust, hope, suffering, or uncertainty.
Determine the aim or purpose of your analysis; what do you want to accomplish by conducting this concept analysis? Answer the questions, “Why am I doing this?” and “Why is this relevant to nursing knowledge and nursing science?”
Conduct your literature review by identifying all uses of the term that you can discover. Answer, “What are the known conceptualizations?\”
Locate and use a minimum of 3 dictionary definitions, 1 thesaurus entry, and 5 scholarly references from the nursing literature (you may use non-nursing literature, if necessary). Combined, these references will be the basis for identifying and defining attributes of your selected concept.
Determine the critical or defining attributes of the concept by identifying what each instance or use of the term has in common with the other uses. The more scholarly references you locate and use, the easier it is to determine critical attributes of a concept.
Create 4 cases using the critical attributes:
Construct a model case or a real-life scenario that uses the concept and includes all critical attributes of the concept. Explain how you use each critical attribute. This case should be an accurate representation or model of your concept.
Construct a contrary case or one that is opposite of the concept. Support the claims you make by explaining how and why the contrary case does not contain any of the critical attributes of your concept.
Construct a borderline case or one that is related to the concept but is not actually an example of the concept. Support the claims you make by explaining how and why the borderline case differs from the model and contrary cases (i.e., does not contain all of the critical attributes of your concept, etc.)
Construct an invented case or fictitious scenario that uses the concept and includes all of the critical attributes. Explain how you use each of the critical attributes.

Concept Analysis

Aim/purpose of the analysis

Trust is a pervasive and important nursing concept that is considered from two perspectives. Firstly, clinical perspective the focuses on the relationship between nurses and patients. Secondly, management/organizational perspective that focuses on effectiveness in terms of levels and outcomes. Although a pervasive concept, nursing literature that discusses trust has presented vague conceptualizations that largely borrow definitions and understandings from other disciplines. The absence of a clear trust conceptualization that is unique to nursing presents a concern for nursing research, especially with regards to organizational and clinical settings (Stanhope & Lancaster, 2014). Given this awareness, the present paper conducts a concept analysis of trust with a focus on presenting a conceptualization that are specific to nursing.

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Dictionary definitions and literature review

Trust is a term that is generally understood as belief in something, custody and responsibility (Thesaurus, 2020). Merriam-Webster (2020) defines trust as giving a responsibility, duty or task to another party. Lexico (2020) defines trust as a firm belief in the ability and reliability of something or someone. Cambridge Dictionary (2020) defines trust as the belief that someone is honest and good and will not cause harm. Farlex (2020) defines trust, in the context of nursing, as a concept involving reliance and confidence with the vulnerable patients being dependent on the motivations and intentions of nurses. It is clear that there are different definitions offered for the term trust.  Concept Analysis Assignment Paper

Trust is a term that has long being synonymous with nursing. It is considered as a valuable social capital that is important for creating dependable relationships that help in realizing healthy communities. Key in the definition of trust is the reference to willingness to be vulnerable so that one individual places trust in others with the optimism that the trust would be protected by caring for their interests. Trust can occur at the individual or systems level with the expectation of competence and integrity in pursing the agreed upon goals (Hutchinson, 2018). Manion (2015) adds to the discussion by explaining that nursing is all about leadership in health care matters, and this requires trust to facilitate the leadership efforts. Nurses must be leaders and patients become followers in order to achieve the nursing care objectives, and this can only be achieved when trust is leveraged to build healthy and positive relationships (Manion, 2015). Okello and Gilson (2015) explain that trust enables cooperation between nurses and other stakeholders, such as patients and medical personnel. This occurs by facilitating respectful interactions and fair treatment. This literature review makes it clear that there is no clear definition for trust in the health care environment.

Defining attributes

The defining attributes are the characteristics that have been repeatedly linked to the term trust in the definition. (Walker & Avant, 2011) In this case, four defining attributes have been identified to present nursing in the context of nursing: belief, responsibility, reliance, and confidence. Firstly, belief refers to the expectation of the goals being pursued and confidence/certainty that there are no hidden goals being pursued. There must be belief for trust to exist. For example, patients have the belief that nurses will always act in their best interests with regards to health and wellbeing. Secondly, responsibility is the duty, concern, obligation and accountability that comes from having a specific identity or holding a position. For instance, nurses have a professional responsibility to provide competent medical care to patients. Thirdly, reliance refers to the dependence that is associated with trust. For example, patients are reliant on nurses to offer them competent medical services. Finally, confidence refers to sureness that the decisions made and actions undertaken would focus on achieving the intended goals. For instance, patients have confidence that the decisions made by nurses are the best ones (Watt, 2018).

Cases based on the four attributes

A model case is one in which all the four attributes are presented to illustrate the concept of trust. In a nursing case, a patient comes in for a routine health check, but is informed that a tumor has been identified and there is a need for admission into hospital for closer analysis. The patient decides to stay in hospital as advised for additional analysis of the tumor. This is considered a model case with the four antecedents. Firstly, the patient has confidence that the nurse is making the right decision for achieving health and wellness. This indicates belief. Secondly, the nurse has a responsibility to provide medical care for the patient, thereby creating the present situation in which the patient comes in for a routine checkup but recommends further stay because of a newly discovered tumor. Thirdly, the patient is dependent on the nurse to identify and address health care concerns. This indicates reliance. Finally, the patient is sure that the decision made by the nurse is the right one. This indicates confidence. As such, the case presents the four attributes of trust thus making it a model case.

A contrary case is one in which trust is absent. An example of a contrary case is one in which an unconscious patient is brought into the emergency room and requires nursing care. It is a contrary case since none of the four attribute associated with trust are present. The patient is unconscious, unaware of what is happening and not involved in the decisions. The case lacks belief, responsibility, reliance and confidence as attributes of trust.

A borderline case is one in which at least one of the attributes is missing. An example can be seen in a case where a patient comes in for a medical checkup and a tumor is discovered. The patient is then advised to stay in the facility overnight for additional tests. The patient agrees to stay for the checkup but insists on having other medical personnel to provide additional advice on the case. The patient has belief in the health care personnel and is reliant on them to receive the required medical care. In addition, the medical personnel are shown to seriously take their responsibility of providing medical care as shown by the fact that a tumor was identified during a routine assessment and additional test ordered for an accurate diagnosis. However, the case shows a lack of confidence in the nurse as the patient calls for additional medical personnel to participate in the case. The case has belief, responsibility and reliance, but lacks confidence as attributes of trust.

An inverted case is one in which the concept is taken out of context such that the experience is changed. An example of an inverted case is one in which a patient comes in for a routine health assessment. The assessment identified a tumor that requires additional laboratory tests with the patient advised to stay overnight for additional the additional tests. However, the patient decides against the medical advice and goes home without the tests being conducted. The patient decides on this decision because of financial difficulties as the additional tests and overnight stay in hospital cost money that the patient is unable to pay. There is no question of trust in this case as the patient does not have the money to pay for medical services thus opting to go home instead of receiving the recommended medical care.

References

Cambridge Dictionary (2020). Trust. https://dictionary.cambridge.org/dictionary/english/trust

Farlex (2020). Trust. https://medical-dictionary.thefreedictionary.com/trust

Hutchinson, M. (2018). The crisis of public trust in governance and institutions: Implications for nursing leadership. Journal of Nursing Management, 26(2). https://doi.org/10.1111/jonm.12625

Manion, J. (2015). The leadership relationship, part 1: understanding trust. Journal of Perianesthesia Nursing, 20(2), P153-P156. https://doi.org/10.1016/j.jopan.2015.01.006

Merriam-Webster (2020). Thesaurus: Trust. https://www.merriam-webster.com/thesaurus/trust

Okello, D., & Gilson, L. (2015). Exploring the influence of trust relationships on motivation in the health sector: a systematic review. Human Resources for Health, 13(Article 16). https://doi.org/10.1186/s12960-015-0007-5

Stanhope, M., & Lancaster, J. (2014). Public Health Nursing: Population-Centered Health Care in the Community (8^th ed.). Mosby/Elsevier.

Thesaurus (2020). Trust. https://www.thesaurus.com/browse/trust

Watt, G. (2018). Trusts and Equity (8^th ed.). Oxford University Press.  Concept Analysis Assignment Paper