Estudio del Corazón de Framinham

Although different designs for conducting a concept analysis exists in the literature, the researcher utilised the process of concept analysis proposed by Walker and Avant (2011) during the current analysis.

3.2.2.1 Selecting a concept

This step entails selecting words or phrases that best depicts the researcher’s unfolding understanding of the concept at any point during the analysis. This selection expresses the researcher’s central interest. Walker and Avant (2011:160) advise that the concept selected should be interesting to the analyst. Chapter 1 explicates the researcher’s interest in the concept of empowerment, as well as in the background to the study and the statement of the research problem.

3.2.2.2 Determining the aims of the concept analysis The general aims of a concept analysis are:

 To give direction, set boundaries and therefore help the researcher to maintain focus on the object of interest (research topic)

 To explore the way literature sources describe and clarify the concept of empowerment in the existing literature

 To generate items for inclusion in a self-designed questionnaire (Walker and Avant 2011:158)

During the current study, the researcher embarked on a concept analysis for precisely these reasons.

3.2.2.3 Identifying the different uses of the concept

The use of literature sources such as dictionaries, thesauruses, and discussions with colleagues can assist the researcher in identifying different applications (uses) of a

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concept. Apart from conversations with colleagues, these assisted the researcher in outlining the defining attributes of the concept of empowerment as well as to related attributes, antecedents, and consequences of the concept. Definitions from the literature are the fundamental sources of information about the meanings of a concept (Meleis 2007:173). Such definitions enable the researcher to clarify the meaning of a concept and its verbal usage. Literature sources such as dictionary definitions explain the meanings of concepts using everyday language or theoretical (scientific and academic) terminology. Theoretical definitions provide clarification in terms that go beyond colloquial language and indicate the concept’s usage in various disciplines and theories (Chinn & Kramer 2011:178). The challenge faced by the analyst is to evolve a useful and adequate meaning from a variety of sources and possibilities to define the concept (Walker & Avant 2005:67; Walker & Avant 2011:161). This challenge motivated the researcher to define the concept such that he could operationalise it, using measurable variables relating to the concept of interest – empowerment – in the context of NEIs and nurse educators in the Limpopo Province.

3.2.2.4 Determining the defining attributes of the concept

Determining the defining attributes of a concept necessitates analyses of the literature on a concept from different angels involving both synonyms (a word with similar meaning) and antonyms (words that mean the opposite) for the concept. Determining defining (critical) attributes as well as associated attributes and distinguishing between these are considered central in the concept analysis process. Synonyms enable the researcher to identify the defining attributes of a concept such as empowerment, while the antonyms are useful to develop contrary cases of empowerment by way of contrast and countermeasure. According to Walker and Avant (2011:162), determining the defining attributes is the essence of a concept analysis. Defining attributes are characteristics or criteria of a concept that distinguish a concept from a similar one and serve to prevent the ambiguous use of a concept. Nonetheless, attributes are not immutable because they might change as the process of analysis develops (Walker & Avant 2011:162).

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Walker and Avant (2011:163-169) suggest the construction of different cases of the concept on completion of the concept analysis to enable the researcher to distinguish between the typical and untypical features of a concept (Walker & Avant 2011:163) in context. Although the researcher alludes to these different cases in the section that follows, he constructed only a model case of the concept of empowerment as this suffices for the current research. The researcher presents this in the form of a definition of empowerment – a working “disposition” of empowerment.

 The model cases

A model case is a paradigmatic or pure example of the concept under study (Walker & Avant 2011:163). An exemplary or model case provides an accurate representation of a concept. A model case represents the essential characteristics of a concept. Thus, Walker and Avant (2011:163) define a “model case” as “If this is not an example of the concept, then nothing is.”

 Additional cases

In addition to the model case, additional cases, namely related, contrary, borderline, legitimate and invented cases, reflect some of the attributes of the model case, however, not all of them.

 Related cases

Related cases are instances that represent a different but similar concept. According to Walker and Avant (2011:165), the construction of related cases involves incorporating some of the typical and untypical features of the concept. It enables the researcher to determine which features are essential and which are not representative of the concept. Related cases are, in some way, connected to the central concept. The related cases share several criteria with the concept under scrutiny, but some of the critical attributes of the concept under scrutiny are lacking. Thus, related cases help in understanding how the central concept fits into the network of concepts surrounding it (Chinn & Kramer 1999:67; Walker & Avant 2005:71; Walker & Avant 2011:165). The researcher sees the concept of “autonomy” as a closely related concept to that of empowerment

60  Borderline cases

According to Walker and Avant (2011:164), borderline cases contain the most defining attributes of the concept under scrutiny but not all of them. Borderline cases are those instances of metaphoric or pseudo-applications of the concept. Borderline cases serve to clarify inconsistencies in the application of the concept. These cases may contain some of the critical attributes of a concept but may differ substantially in one of its attributes. Paradoxical cases are variants of borderline cases, and they embody the elements of the model as well as elements from contrary cases. They highlight the central meaning of the concept (Chinn & Kramer 1999:68; Walker & Avant 2005:70). Thus, this step entails selecting exemplars that have features or attributes of the concept as well as ambiguous attributes varying according to context. An example of such a case, relating to empowerment, would be the concept of authority

 Invented cases

This step entails the development of a situation that contains ideas outside the experiences of the analyst or researcher to exemplify typical features of the concept (Walker & Avant 2011:166). The method for analysing the case should be innovative since the exemplars must be out of the ordinary. The purpose of invented cases is to highlight the significant features of the concept by taking the concept out of its usual context (Walker & Avant 2011:166). For instance, giving a detailed explication of how one computer program (software) integrates and serves to activate other pieces of software and thereby executing its function in such a way that the program itself is enhanced or improved while operationalising the other programme.

• Contrary cases

Contrary cases represent “not an instance” of the concept under analysis (Chinn & Kramer 1999:67; Walker & Avant 2011:166) and might be antonymous to a concept. The attributes of the contrary cases in the current study would be opposite (antonyms) to the concept of empowerment. Contrary cases help the analyst to state clearly, what the concept is by indicating what it is not (Walker & Avant 1995:44; Walker & Avant 2011:166). In the researcher’s opinion, all the antonyms for

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the word empowerment discussed in this chapter serve as attributes of a contrary case of the concept of empowerment.

3.2.2.6 Identifying antecedents and consequences of the concept

This section describes the antecedent (causes or necessary conditions) and consequences (outcomes) of the concept under investigation.

 Antecedents

Antecedents are those events or incidents that should exist before the occurrence of the concept (Walker & Avant 2005:73; Walker & Avant 2011). In the current research, antecedents refer to conditions that precede empowerment of nurse educators in the Limpopo Province. These preceding conditions involve specific personal characteristics, attitudes, and knowledge, as well as existing organisational hierarchies, amongst others.

 Consequences

According to Walker and Avant (2011:167), consequences are those events or incidents that occur because of the occurrence of the phenomenon (including empirical referents) represented by the concept (Ellis-Stoll & Popkess-Vawtwer 1998:65; Walker & Avant 2011:168). Regarding empowerment and the apparent self-impregnation of empowerment, consequences or outcomes of empowerment might well be the bolstering of a belief or feeling of being empowered.

3.2.2.7 Describing the social contexts and underlying anxieties related to the concept

The social context to which a concept applies specifies who might use the concept, the reasons for its use and the way to use it. In the current study, the context is that of nurse educators at NEIs in the Limpopo Province – their perception of the concept of empowerment, their empowerment and the managerial or organisational- hierarchical context in which they work.

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According to Walker and Avant (2011:168), the determination of empirical referent is the last step in the concept analysis process. Empirical referents are classes or categories of actual phenomena that, by their felt of perceived existence, demonstrate the occurrence of the concept under analysis. In the current study empirical referents, or variables, were identified from the concept analysis and the literature review structured according to Laschinger’s Integrated Model of Nurse/Patient Empowerment and from Kanter’s Theory of Structural Power in Organisation and Spreitzer’s Psychological Empowerment Theory. The empirical referents were utilised to construct the questionnaire in the current study.

3.2.2.9 The practical applications of the concept

This step entails the application of the concept in a specific and pragmatic way by defining and explaining the practical applications of the concept. The researcher breaks down the essential elements of the concept and defines or operationalises their relationships to the practice setting (Walker & Avant 2011:172). In the current study, this practical application manifests in the operationalisation of the multi- dimensionality of the concept of empowerment via the self-constructed questionnaire and the measuring of respondents’ experiences or perceptions relating to