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25 March 2018, Volume 2 Issue 1 Previous Issue   
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EditorialComment of Walker and Avant’s method of concept analysis
Liu Hui, Ling Dong-Lan, Su Irene
TMR Integrative Nursing. 2018, 2 (1): 1-3.   https://doi.org/10.12032/TMRIN20180307
Abstract ( 72 )   HTML ( 2 )     PDF (234KB) ( 43 )  
Concept Analysis
Self-management A concept analysis of self-management for cancer patients’ home-basedrehabilitation
Ling Dong-Lan, Yu Hong-Jing
TMR Integrative Nursing. 2018, 2 (1): 4-11.   https://doi.org/10.12032/TMRIN20180308
Abstract ( 103 )   HTML ( 1 )     PDF (376KB) ( 36 )  

Objective: To explore and clarify the concept of self-management in the context of cancer patients’ home-based rehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to develop self-management strategies and enables them to improve their ability in symptom self-management of home-based rehabilitation. Method: Walker and Avant’s framework (2011) was used to analyse the concept of self-management. Results: Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation, problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge and social support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes and quality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Management scale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether this instrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thus further research is needed. Conclusion: According to the concept analysis, nurses should encourage cancer patients to involve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management of home-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.

Adherence-A concept analysis in the context of cardiac rehabilitation
Liu Hui, Tian Xu
TMR Integrative Nursing. 2018, 2 (1): 12-17.   https://doi.org/10.12032/TMRIN20180309
Abstract ( 96 )   HTML ( 2 )     PDF (303KB) ( 35 )  

Objective: To explore and identify the concept of adherence in the context of cardiac rehabilitation. This concept analysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence to cardiac rehabilitation programme. Method: Walker and Avant’s framework was used to analysis the concept of adherence. Results: Adherence is defined as patients collaboration with health care provider, active involvement in the treatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributes of adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents of adherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors. Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standard instrument to measure adherence. Conclusion:Based on the concept analysis, in order to improve patients’ adherence to cardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan and promote patients’ self-efficacy and prevention relapse.

ICU Delirium: A concept analysis
Lian-Lian Tang
TMR Integrative Nursing. 2018, 2 (1): 18-26.   https://doi.org/10.12032/TMRIN20180310
Abstract ( 38 )     PDF (448KB) ( 25 )  

Objective: To explore and analyze the concept of intensive care unit (ICU) delirium. Method: Walker and Avant’s strategy of analysis was adopted to this research. Results: ICU delirium is defined as the presence of an acute cognitive impairment, accompanied by a disturbance of consciousness with fluctuating inattention, and the array of dysfunctions only developed for a short period of time in ICU. The antecedents of ICU delirium include (1) the high severity of illness, (2) pain, (3) sedative use, (4) immobilization, (5) sleep deprivation and (6) unpleasant awareness. The consequences involve (1) promoting the risks of self-extubation and unplanned removal of catheters, (2) prolonging the length of ICU stay, (3) increasing the mortality of critical patients and (4) highly distressing the patients’ family members and caregivers. Some different ICU delirium assessment instruments are gathered. Confusion Assessment Method for Intensive Care Unit assessment tool (CAM-ICU) was the most popular diagnostic tool used by nurses. Conclusion: Concept analysis as an extension and development of nursing theory can create a linkage between practice and theory. It will create a knowledge foundation of ICU delirium and provide a theoretical basis to construct nursing theory. This study can help ICU nurses to understand and recognize ICU delirium. ICU nurses will be enlightened to develop effective interventions of ICU delirium to improve critical patients’ clinical outcomes.

Concept Analysis
Coping: a concept analysis in the cancer context
Yang Hua
TMR Integrative Nursing. 2018, 2 (1): 27-33.   https://doi.org/10.12032/TMRIN20180311
Abstract ( 50 )   HTML ( 1 )     PDF (368KB) ( 41 )  

Objectives: The aim of this paper is to analyse the concept of coping in the cancer context. This concept analysis will provide a theoretical framework for oncology nurses to help patients cope with the influences of cancer and adapt to their new situations. Methods: The concept analysis of coping was conducted according to Walker and Avant's method. Results: Coping is defined as a process of dealing with stressful events by means of cognitive appraisal, purposeful efforts, and use of available supports and resources in order to achieve physiological and psychological adjustment. Antecedents to coping involve stressful events, individual personality, individual experience, and available supports and resources. Different coping strategies based on patients’ responses to suffering from cancer bring about positive or negative results. Effective coping means being well-adapted, which is conducive to patients’ health and optimum quality of life. Roy’s middle range theory of coping and adaptation processing provides a theoretical framework for the study of coping.The Mental Adjustment to Cancer scale and the 15-item Coping and Adaptation Processing Scale are considered practical and effectual instruments to measure coping in the cancer context. Conclusions: This concept analysis contributes to understanding the process of coping with cancer. Oncology nurses should identify cancer patients’ coping patterns, provide timely and proper professional support and educate effective coping strategies in order to help patients adapt to their new situations both physiologically and psychologically.

Quality of life in head and neck cancer survivors: A concept analysis
Zeng Qiao-Miao, Liao Yao, Chen Wen-Feng
TMR Integrative Nursing. 2018, 2 (1): 34-41.   https://doi.org/10.12032/TMRIN20180312
Abstract ( 65 )   HTML ( 0 )     PDF (345KB) ( 50 )  

Objective: To identify and clarify the existing definitions of quality of life in head and neck cancer survivors. This concept analysis will inform healthcare professionals of promoting nursing care for head and neck cancer survivors and eventually improve their quality of life. Method: Concept analysis based on Walker and Avant’s framework. Results: Quality of life is a subjective and personally derived cognitive evaluation of global well-being by perceiving a feeling of overall life satisfaction in his/her own value, happiness, and the independence to manage daily activities and life experience. Three defining attributes for quality of life were identified: a feeling of overall life satisfaction in his/her value, global personal well-being, and independence. An improvement of quality of life means an improvement of clinical outcome. However, the variety of instruments for measuring life quality makes it difficult for healthcare professionals to select a standard one for head and neck cancer survivors. Conclusion: By proposing a comprehensive definition of the concept, this analysis contributes to the advancement of knowledge about quality of life in the context of head and neck cancer survivorship. Through a sound understanding of the phenomenon, healthcare professions will recognize or measure head and neck cancer survivors’ life conditions in a more accurate way and to implement intervention where necessary, eventually, improve patients’ life quality in survivorship.