issues in research

Concept analysis as a method of

inquiry
Many researchers begin their studies without clearly
defined concepts. Moyra Ann Baldwin explains why
researchers need to consider what it is theyre researching
using concept analysis before starting work
key words

Concept Analysis

Models and Theories

Nursing: Philosophy
Nursing: Process

Introduction
Mathieson, in the editorial of the first issue of Nurse Researcher, said that
one purpose of the journal was to increase readers research awareness in
terms of different methods and their significance to practice to sort out
the good from the bad and to make informed decisions (Mathieson 1993).
This was an invitation for researchers to pursue all approaches to the design
of research and to consider that the foundation of any research is its design.
Concept analysis and clarification is one of those different methods of
research that I will explore in this article.

Concepts: what are they?

Nursing embraces many concepts, some of which have been exposed to the
process of analysis, such as advocacy (Baldwin 2003), dignity (Mairis 1994),
grief (Jacobs 1993), intimacy (Timmerman 1991) and presence (Gilje 1992).
Concepts are labels that describe phenomena and provide a concise sum-
mary of thoughts (Meleis 1991). If asked to describe a favourite chair, each
of us, I believe, would describe a chair but the shape, size and nature of
our specific chair would be quite different: it might be a rocking or gliding
chair, sofa, armchair or wheelchair. Nevertheless, we would be explaining

NURSERESEARCHER 2008, 15, 2 49

issues in research

the concept concisely. Meleis uses jet lag as an example of a concise label
that explains a complex phenomenon, and even those of us who have not
experienced jet lag have a fair idea of what it entails.

Purpose of research and the role of concept analysis

The purpose of research is an attempt to increase the sum of what is known,
usually referred to as a body of knowledge, by the discovery of new facts or
relationships through a process of systematic scientific enquiry, the research
process (Macleod-Clark and Hockey 1989). Concept analysis, as a method
of research, can be justified on the premise that the purpose of research is to
make a contribution to scientific knowledge (Hockey 2003). Concept analysis
is a method that can contribute to a body of knowledge, specifically about
concepts. Such a contribution is seen in the concept analysis conducted by
Bu and Jezewski, who clarify the idea of patient advocacy by positing a mid-
range theory of the concept (Bu and Jezewski 2007).
John Wilson, one of the early writers about concept analysis, notes that a
great many adults who are concerned with matters of general interest and
importance would do better to spend less time in simply accepting the
concepts of others uncritically and more time in learning how to analyse con-
cepts in general (Wilson 1963). Concept analysis can provide a knowledge
base for practice by offering clarity and enabling understanding, rather than
mere knowing. To understand a concept, the precise and rigorous process of
conceptual analysis is required. This, according to Wilson, involves asking a
number of questions.
Concept analysis, according to a number of theorists, brings about clarifica-
tion, identification and meaning of words (Hull 1981, Norris 1982, Walker
and Avant 1988, 1995). It is this third function, meaning, that Wilson
emphasises. While he acknowledges that his Socratic, questioning, method
may seem unnecessary and fussy, his method of analysing concepts draws
attention to the point that the question is about meaning (Wilson 1963).

Theoretical basis of concept analysis

Bearing in mind that the purpose of research is to contribute to scientific
knowledge (Burns and Grove 1999, Hockey 2003), it is worth exploring what

50 NURSERESEARCHER 2008, 15, 2

constitutes science and scientific knowledge. Dictionaries define knowledge
as the act or process of knowing. The Dictionary of Philosophy (Lacey 1986)
and Leddy and Pepper (1993) suggest that it is justified true belief but one
can argue that what counts as justification is open to interpretation (Lacey
1986). In relation to science, Richards believes it is best to think of it as an
investigation into how the world works and what it is like (Richards 1981).
Success with such an investigation increases the power to explain, predict
and control events (Carper 1978). One of the first three goals of concept
clarification involves describing, explaining and giving meaning to human
behaviour (Norris 1982). Therefore one can conclude that concept analysis
contributes to scientific knowledge. Since nurses have a responsibility to keep
their practice up-to-date as well as provide quality evidence-based care to
patients (Hamer and Collinson 2000), updating knowledge about concepts is
key to evidence-based practice.
Understanding of what constitutes knowledge owes much to elaboration
and criticism of the Ancient Greek concept. The Greeks discovered math-
ematics and the art of deductive reasoning, and reasoned deductively from
what appeared self-evident, not inductively from what had been observed
(Russell 1945). Russell considers this to be a one-sided approach, and says
replacing the Hellenic belief derived from philosophers precepts to the
scientific method, which seeks to reach principles inductively from observa-
tions of particular facts has been a slow process (Russell 1945). The idea
that knowledge concerns concepts derives from Plato (Leddy and Pepper
1993, Russell 1945). In contrast, Aristotle began by viewing Platonic ideas as
poetic metaphors (Taylor 1955) and tried to relate all objects of knowledge
to particular facts of sense perception. Science, for Aristotle, meant proved
knowledge. Things are known through their causes or reasons why (Taylor
1955). Aristotle, however, was unable to maintain a purely empirical theory
of knowledge and returned to Platonism because sense perception assures
one that a fact is so; it cannot explain the fact by showing its connection
with the rest of the system of facts (Taylor 1955).
The importance of distinguishing between matters of fact and rela-
tions of ideas in other words concepts was highlighted by the Scottish
Enlightenment philosopher, Hume (Macnabb 1962). Hume concluded that

NURSERESEARCHER 2008, 15, 2 51

issues in research

the only elements which can be known are perceptions and resolve them-
selves into two distinct kinds impressions and ideas (Macnabb 1962).
It is evident that there have been two distinct approaches to gaining
knowledge: the way of pure reason exemplified by Plato and subsequent phi-
losophers such as Descartes; and the way of empiricists, such as Hume, who
declare that all ideas must originate in sense perception. Whatever way ideas
are gained, the process of concept analysis and clarification highlights the
consistency and coherence of the ideas with the existing body of knowledge
and the evidence upon which those ideas were constructed.
Identifying the elements of fever and distinguishing facts from misconcep-
tions, Thompsons analysis directs one toward recognising fever as an adap-
tive response (Thompson 2005). Thus the ability to explain fever is present.
The ability to predict and control events (Carper 1974, Richards 1981) is
present, too, as healthcare professionals recognising fever can instigate appro-
priate intervention and withhold inappropriate measures in an attempt to
reduce temperature (Thompson 2005).
Concept clarification is essential in critically analysing claims of knowledge
gained through reason or experience: Concept analysis gives framework and
purposiveness to thinking that might otherwise meander indefinitely and pur-
poselessly among the vast marshes of intellect and culture (Wilson 1963).
This captures Mulhalls guidance for a successful research endeavour in that
the design assists with the purpose of the inquiry (Mulhall 1992) .

Methods of concept analysis

Examination of the methods of concept analysis reveals an array of systems
much of which refers to the work of Wilson (1963) and Walker and Avant
(1983), the latter having adapted Wilsons approach to the study of con-
cepts that are of significance to nursing (see Table 1). Norris enumerates
and describes ten methods of concept clarification, one of which is Wilsons
technique (Norris 1982). Much of the literature in which the purpose of the
study is to examine a specific concept uses the methods advanced by Wilson,
Walker and Avant, or a combination of both (see Table 2). A Wilsonian
approach was adopted by Thompson when analysing the concept of fever
Thompson (2005). Purdy likewise used this approach to analyse the concept

52 NURSERESEARCHER 2008, 15, 2

 Table 1. Stages of concept analyses

Wilson 1971 Walker and Avant 1983

Isolating questions of concept Select a concept

Right answers associated closely with Determine the aims or purpose of analysis
the question of concept

Model cases Identify all uses of the concept that you

can discover

Contrary cases Determine the defining attributes

Related cases Construct a model case

Borderline cases Construct borderline, related contrary,

invented and illegitimate cases

Invented cases Identify antecedents and consequences

Social context Define empirical referents (for critical

attributes)

Underlying anxiety associated closely

with social context

Practical results

Results in language

of vulnerable (Purdy 2005). Shattells concept analysis of risk followed

Walker and Avants method and Baldwin used an eclectic approach to clarify
the concept of advocacy (Shattell 2005, Baldwin 2003).
Wilsons method of concept analysis involves posing questions he claims
are neither the meaning of words nor questions of fact or value. Instead, they
concern the uses or possible uses of words. But that means the context and
purpose are important, which I suggest means the questions are exactly to
do with the meaning of words. In this vein, Hook has analysed the concept
of partnership in the context of healthcare provider-patient relationship, and
advocacy has been analysed in the context of nursing by Baldwin (Hook
2006, Baldwin 2003).
The first step in Wilsons method of concept analysis is to isolate ques-

NURSERESEARCHER 2008, 15, 2 53

issues in research

Table 2. Methods used for specific concept analyses

Concept analysis method Concept Researcher

Wilson Fever Thompson 2005

Vulnerable Purdy 2005

Dilemma Sletteboe 1997

Grief Jacobs 1993

Wilson, Walker and Avant Advocacy Baldwin 2003

Presence Gilje 1992

Risk Shattell 2005

Dignity Mairis 1994

Rodgers Partnering Hook 2006

tions of concept (see Table 1). A model case of the concept is a good place
to start. He suggests it can then be followed by contrary, related, borderline
and invented cases. It is necessary, according to Wilson, to examine the social
context, underlying anxiety and practical results. He completes his technique
with a stage entitled results in language. Not all the steps are equally useful
in all cases but taking each stage in order might be a wise method.
Rodgers criticises a method such as Wilsons because its reductionist approach
to isolating conditions and boundaries represents a static view (Rodgers 1989).
I believe Wilson guards against such claims: his questions of concepts relate
to uses of words. This is worth considering as nursing is practised in a dynamic
system of healthcare delivery. Rodgers exploration of the philosophical
foundation of concept analysis also identified two views of concepts, namely
entity and dispositional. These views respectively focus on the concept as
an entity in itself and on an individuals ability to perform specific behaviours.
The entity view emphasises the meaning of a concept out of context. Rodgers
then asserts that entity theories have their foundations in the works of philoso-
phers advancing the logical positivist movement where something is known for
certain (Russell 1945). Dispositional theories on the other hand are not clearly
found in the work of any particular philosopher. Rodgers suggests that the later
writings of Wittgenstein contribute to a greater understanding of concepts from

54 NURSERESEARCHER 2008, 15, 2

the dispositional approach to analysis (Rodgers 1994). Cash seems to support
this assertion, as he states that Wittgenstein argued that words get their mean-
ing in use, rather than by having some inner meaning that is hooked into them,
and dissoluble from them (Cash 1990). A dispositional view thus addresses
the meaning of concepts in use, by those who use them. An example of this
can be seen in the language of our electronic age which has brought its own
meaning to the concept of mouse.
Addressing her criticism of Wilsons reductionist approach, Rodgers offers
an evolutionary cycle of concept development (Rodgers 1994). The devel-
opment of concepts, she claims, is influenced by three aspects. These are
significance, use and application. This approach to analysis and her
subsequent synthesis of a cycle of concept development appears to be in
accord with Becker, who states the precise meaning of a concept is thus
dependent upon the context in which it is employed (Becker 1983). This is
what I believe Wilson was also concerned with and is of importance to nurs-
ing. There are many words associated with nursing that are used in different
ways depending on the context, such as the concept of advocacy in relation
to adults, children and learning disability.
From exploring the philosophical foundations of concept analysis and the
development of the evolutionary view of concepts, Rodgers elicits a definition
different to those of Wilson and Walker and Avant (Rodgers 1994, Wilson
1963, Walker and Avant 1983, 1988). She advances a vibrant definition and
analysis of concepts and such analyses are temporary to the theorist. Rodgers
claims that a concept is considered to be an abstraction that is expressed
in some form, either discursive or non-discursive. Through socialization and
repeated public interaction, a concept becomes associated with a particular
set of attributes that constitute the definition of the concept (Rodgers 1994).
Analysis of the common use of a concept helps define the concept and pro-
vide clarification. True to Watsons assertion of the dynamic nature of concepts
(Watson 1991), they are continually subject to change (Rodgers 1994).
Rodgers (1994) provides further evidence of the dispositional approach
and Wittgensteinian thinking when she describes the process of evaluating
resemblance to the initial concept when confronted with related phenom-
ena or situations (concepts). In Wittgensteins terms one would be search-

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issues in research

ing for family resemblances in those words associated with the concept.
Rodgers concept development helps to identify the set of attributes associat-
ed with the term and subsequently these constitute its definition (Cash 1990,
Rodgers 1989). Two examples of defining attributes that clarify concepts with
which nurses commonly engage are those of Baldwin and Sletteboe (Baldwin
2003, Sletteboe 1997). The three attributes defining advocacy were valuing,
apprising and interceding (Baldwin 2003). Sletteboe identified five defining
attributes associated with the concept dilemma namely involvement, equally
unattractive alternatives, awareness of the alternatives, need to choose and
uncertainty of action (Sletteboe 1997).

Conclusion
The philosophical foundations to concept analysis have been explored.
Whether one engages with Rodgerss (1989) approach to concept analysis or
Wilsons (1963), both methods contribute to the body of knowledge that is
nursing. To examine a concept to determine its characteristics and the condi-
tions that differentiate it from other concepts will not necessarily produce new
empirical facts. It remains more in tune with the rational production of knowl-
edge idealised by Plato rather than the hypothetico-deductive model (Leddy
and Pepper 1993). Despite this limitation, the rational inquiry into the mean-
ing of concepts is a necessary first step that should precede the development
of hypotheses and any subsequent testing. Success with analyses of this kind is
to be found in the literature. Timmerman conducted an analysis in relation to
intimacy that enabled her to derive a theoretical definition for subsequent use
in research and that had the potential to develop theory (Timmerman 1991).
A more recent development in this regard is the mid-range theory developed
by Bu and Jezewski (Bu and Jezewski 2007). Concept analysis is a pragmatic
and rigorous approach to defining concepts that can make a significant contri-
bution to knowledge and by implication to nursing practice.

Moyra Ann Baldwin BSc(Hons), MMedSci, RN, RCNT, DipN(London), Cert Ed,
RNT DANS FHEA, is senior lecturer at the University of Chester, UK

This article has been subject to double-blind review

56 NURSERESEARCHER 2008, 15, 2

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