Application of Concept Analysis to Clinical Practice

Application of Concept Analysis to Clinical Practice

Monareng, (2012) is of the opinion that concept analysis refers to a process of establishing meanings of vaguely used terminologies in clinical practice. In nursing sciences, concept analysis is a fundamental process given the need to determine the meaning of the various nursing concepts. As such, concept analysis is not new in the field of nursing because of this reason. In essence, this paper aims at scrutinizing a peer-reviewed concept analysis article on spiritual nursing care. An analysis of this kind will operationalize the definition as well as nature of the concept and enhance further understanding of the methodological approach used to achieve this purpose. Additionally, it will identify the steps employed in the concept analysis process adopted in the article and provide results of each stage. Lastly, this discussion will illustrate the application of the spiritual nursing care concept to a clinical practice situation.

Method for Analysis

Primarily, the peer-reviewed article utilizes the Walker and Avant’s model of concept analysis as a framework to conceptualize spiritual nursing care. Walker and Avant came up with 8 steps that would facilitate the determination of the operation definition of concepts used in nursing (McEwen, & Wills, 2014).

Steps of Analysis and Results

Selection of the Concept

Walker and Avant categorically stated the selected should be fascinating to the researcher. Also, characteristic to the selected concepts is that they have many definitions from different professionals that make them vague (Walker, 2014).

The article directs its efforts at analyzing the concept of spiritual nursing care. That is the case given the observation of the mechanical treatment of patients with no consideration of the spiritual needs (Monareng, 2012).

Purpose of the Concept Analysis

According to Nuopponen, (2010), the second step in Walker and Avant’s framework focuses on stating the purpose of the review. In this case, the objective of the analysis was the establishment of the defining attributes, antecedents and consequences of spiritual nursing care as well as the assessment of its possible implications for nursing practice, research and education (Monareng, 2012).

Uses of the Concept

In this step, one considers all definitions of the word through the scrutiny of resources such as dictionaries, colleagues, available literature and thesaurus (McEwen, & Wills, 2014). Primarily this article identifies several definitions of spiritual nursing care, which demonstrate its various uses as a concept. A case in point it defines spiritual nursing care as a process that starts from the perspective of being with the patient in love and dialogue, which may result in therapeutic interventions directed by patient’s religious or spiritual reality (Monareng, 2012).

Secondly, it depicts spiritual nursing care as holistic care, which empowers the patients to search meaning and purpose. Another use is evident in the definition that spiritual nursing care refers to activities that promote a healthy balance between the bio-psychosocial and spiritual needs of an individual to facilitate a sense of wholeness and wellbeing. Finally, the article also envisions spiritual nursing as care devoted to determining spiritual needs and concerns of a person alongside his/her family and quickly intervening based on the assessment of the circumstance (Monareng, 2012).

Defining Attributes

As encapsulated by Walker and Avant explanation of defining attributes to be characteristics repeatedly observed in literature when dealing with a certain concept, this article identifies various defining characteristics for spiritual nursing care. They include caring presence, a search of meaning and purpose, spiritual dialogue, transcendence and harmonious connectedness. The data analyzed identifies caring presence as the primary variable from which all other defining characteristics emerge (Monareng, 2012).

Model Case

In this step, Walker and Avant recommend the provision of model cases that represent real life examples of situation depicting the utilization of the concept. The real-life situation must demonstrate all the critical attributes of the concept (McEwen, & Wills, 2014).

The article highlighted a case in which Nurse A is attending to a middle-aged patient involved in a car accident secondary to alcohol intoxication. Nurse A exemplifies all the identified defining attributes of spiritual nursing care. That is the case since she provides a caring presence to the patient by attending to his needs. She also engages in the search for meaning and purpose by listening attentively without interruption what the patient has to say about the situation. Spiritual dialogue is also evident in this case given the nurse sets aside time to talk to the patient about spiritual issues. Transcendence is also manifest when the nurse encourages the patient to put trust in God and His ability to forgive sins. Lastly, harmonious connectedness also comes to the fore when Nurse A allows the patient to take his time to make the decision on whether he should engage in the prayer session. As such, she does not impose her beliefs on the patient but respects the autonomy of the patient (Monareng, 2012).

Related and Contrary Cases

As the sixth step of the analysis, the framework requires one to examine additional cases of utilizing the concept. During this stage, related, invented, borderline and illegitimate cases are in the spotlight to illuminate further the appropriate scenario for the use of the concept (Nuopponen, 2010).

In this case, the article brings to light a related case that depicts Nurse B who only engages in a spiritual dialogue but fails to demonstrate the other major attributes of spiritual nursing care such as offering a caring presence (Monareng, 2012).

Contrary to the model and related cases is another scenario of Nurse C who exhibits a flat, spiritless attitude by not taking into consideration the spiritual needs of the patient. She is more concerned on task completion rather than promoting the patient’s wellbeing (Monareng, 2012).

Antecedents and Consequences

The seventh step of the model focuses on identifying antecedents and consequences. According to pioneers of this model, antecedents are events that that resulted in the occurrence of the concept while consequences are incidents that arose after the initiation of a concept (Monareng, 2012).

The antecedents noted by the study include spiritual discomfort, self-awareness and transcendent awareness of the nurse, spiritual sensitivity, caring presence disposition of the nurse, trusting relationship and spiritual competency (Monareng, 2012).

On the contrary, the consequences of the occurrence of spiritual nursing care present in the reviewed literature included spiritual integrity, spiritual health and a heightened sense of wellbeing (Monareng, 2012).

Define Empirical Referents

Lastly, one connects the critical attributes and their empirical referents in the real world as the last step. Empirical referents are significant in nursing as they provide the nurses with physical phenomena that they can utilize to measure the existence of the concept (Nuopponen, 2010).

The article in this step highlights the empirical referents that medical personnel can also use to gauge the existence of the utilization of the defining attributes of spiritual nursing care concept. For instance, caring presence is observable through devotion to helping patients to face their spiritual pain, distress, and guilt. As for the attribute of searching for meaning and purpose, one ought to look for a person’s focus on the ontological significance of life.  On the other hand, spiritual dialogue and transcendence are evident in the use of spiritual language and provision of a quiet space for mediation, reflection or praying respectively. Finally, harmonious connectedness is measurable through forgiveness of self and others (Monareng, 2012).

Application of Concept in Clinical Practice Situation

Based on this analysis, spiritual nursing care use in clinical practice is very practical in various situations. A befitting example of clinical practice case that nurses and other medical personnel can utilize the concept is during a health history taking session. According to Phelps, (2012), the spiritual needs assessment is central to a comprehensive patient’s health history. As such, when taking the patient’s history in clinical practice, one can apply the concept of spiritual nursing care by seeking to establish the spiritual needs of the patient and sparking a conversation that will depict his/her spiritual status. Lastly, one can also apply this concept in a clinical practice situation by setting time apart to lead an individual to spiritual truths if he/she is a non-believer and willing to know them.


Concisely, this paper aimed at scrutinizing a peer-reviewed article conceptualizing spiritual nursing care. Moreover, it projected at identifying and describing the adopted method for analysis as well as the various steps involved and their results. Finally, this discussion also targeted at demonstrating the application of the spiritual nursing care concept to a clinical practice situation. Precisely, this review has managed to attain all these objectives. The implication drawn from this concept analysis exercise is that nurses should play a lead role in implementing plans of care that are holistic and tailored to patient’s need. Central to the holistic care are the spiritual requirements of the patient, which are not an option when nurses target to enhance the wellbeing of their patients. As such, going into the future, nurses ought to factor in an individual’s spiritual needs into their plan of care if they are to obtain better outcomes such as high patient satisfaction levels.




McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing.Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins

Monareng, L. V. (2012). Spiritual nursing care: A concept analysis. curationis35(1), 1-9.

Nuopponen, A. (2010). Methods of concept analysis-towards systematic concept analysis (part 2 of 3). LSP Journal-Language for special purposes, professional communication, knowledge management and cognition1(2).

Phelps, A. (2012). The Spiritual Retrieved 23 April 2017, from

Walker, L. O. (2014). Strategies for theory construction in nursing. Pearson.



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