As you reach the conclusion of this Assignment, take a minute to appreciate your achievement. Your theoretical foundation for research represents a significant milestone not just in this course, but also in your growth as a doctoral student and a nurse scientist. Whether you retain your focus on your selected phenomenon or adjust your plans as you move forward, you will be able to build on the skills you have honed in this course to develop your program of research in the future.
To prepare
- Ensure that your paper addresses the following:
- Your phenomenon of interest
- Concepts (definitions, attributes, antecedents, and consequences)
- Conceptual relationships
- Assumptions
- How an existing framework or theory could inform your work. (Explain how the framework/theory originated and what modifications you may need to make for it to be useful for your research.)
- Research questions or hypotheses
- Graphic model and narrative, as necessary, to support the model
Note: Please include your graphic model and narrative within the paper you submit.
Final Paper (due week 10 Sunday, November 8th) (called Assignment 1 again) (8-12 pages not including the title page or references – don’t worry about page limit – write and write succinctly)
Parts:
- Title page
- Introduction
- Phenomenon of interest
- Concept including definition, some ROL, antecedents, defining attributes, and consequences (you must have at least 2 citations for each defining attribute – if possible include a table starting with antecedents, then attributes, and finally consequences so you can see the flow)
- Relationships about concepts – antecedents and concept, antecedents and consequences (maybe), concept and consequences; concept and another concept (similar or opposite – hope and hopelessness, quality of life and well-being, etc.), direction of relationships – one direction or two, positive or negative; any other related concepts and their relationship with your concept (pull in text)
- you do NOT Have to include the model case and another case but if you want to you can but make sure you call out all the defining attributes in the model case and if you use a borderline case, talk about which defining attribute is missing – you can make up the case study and focus on your context (POI); you do NOT have to include empirical referents but if you want to, do so
- Assumptions (remember to keep them general)
- Theory or conceptual framework
- Research questions and/or hypotheses (research questions about concept and antecedents, concept and consequences, concept and other concepts or factors, one big global question) (remember to include the population of study and context)
- Graphic with a brief explanation of the graphic (make sure you have antecedents, defining attributes, and consequences as well as the theory – it is about the CONCEPT)
- Summary
- References (separate pages)
Analyzing a Health-Related Scenario #1
Area of Interest: Patient Medication Education
In the development of the theoretical foundation to investigate patient medication education, a researcher needs to evaluate the thesis title and the research problem (medication noncompliance), brainstorm elements for consideration as the critical variables, and conduct relevant review literature to know how other researchers have addressed the issue of a patient not complying with medication prescription due to lack of proper medication education.
During the theoretical foundation development, building framework or theories takes some phases in which the first step is examining the issues related to inadequate patient medication education. This research problem will form the basis for the entire study and from which research constructs theoretical framework (Hennink Hutter, & Bailey, 2020). Secondly, brainstorming what a researcher considers as the vital variables in the study becomes crucial. Questions concerning the elements contributing to patients not to take the medication after six months of post-surgery, get answered.
In the literature review of the issues that relate with the current research problem under the study, scholars and researchers who have solved or addressed medication noncompliance are sought through the analysis of their theories (literature review). In this process, the identification of the assumptions from which the scholars address the research problem is critical (Greenhalgh, Bidewell, Warland, Lambros, & Crisp, 2020). Also, the listing of the research constructs and variables such as nursing education vs rate of medication noncompliance during post-surgery is undertaken. The listing gets followed by the grouping of the variables into independent and dependent categories. In the framework development, a researcher outlines assumptions or propositions of the theory and highlight their relevance to the research. For instance, an assumption will be, patient medication education reduces the rate at which post-surgery patients abandons their drug prescription or medication.
The theoretical framework carries research concepts. Concepts of patient medication education are medication compliance that involves taking medication as prescribed, and education is given to gain knowledge on how to take drugs. So, the conceptual relationships account for how lack of medication education contributes to medication noncompliance among patients. The graph model to use on patient medication education is the state-of-the-art graph that will combine theoretic strategies with approaches to probability theory during the presentation of the research results (Greenhalgh et al., 2020).
In the research’s presentation of the conceptual relationship, both independent and dependent variables such as nurse educator lessons and incidences (rates) of not taking medication will get linked to illustrate how they influence each other and show the possible research outcome. For instance, variables on the left side and outcome (dependent variable) on the right side of the conceptual framework will get joined through the use of arrows. Dependent variable on the left side implies the medication compliance as an outcome of independent variables such as medication education provided.
References
Greenhalgh, T. M., Bidewell, J., Warland, J., Lambros, A., & Crisp, E. (2020). Understanding research methods for evidence-based practice in health. John Wiley & Sons.
Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods. SAGE Publications Limited.
Adults Concepts, Conceptual Relationships, Frameworks/Theories, and Graphic Models
The frameworks/theories of individualized patient medication education are critical elements of research. According to Jason, Stevens, Ram, Miller, Beasley, and Gleason (2016), these frameworks/theories give guidance for developing research questions and testable hypotheses on how the effectiveness of providing individualized patient medication education for older adults to reduce incidences of medication non-compliance among older patients. In general, frameworks will give a broad description of individualized patient medication education for older adults and inform a researcher of the types of elements classified as critical avenues of studying (McEwin & Wills, 2019). Also, the frameworks or theories play a crucial role in informing research methods and designs. Furthermore, the theories give overall guidance on what components of patient education to research. If theories get founded within frameworks, then frameworks are nested within interest phenomena, patient medication education for older adults (Jason et al., 2016). However, the theories fail to provide specific predictions regarding the relationship between medication compliance and medication patient education among older adults.
The main concepts in research will be individualized medication education and medication compliance. Sticking to these two concepts will result in attaining valid findings that answer the research question. On the other hand, conceptual relationships will involve semantic connections or links between two or more specialized concepts, medication education, and rates, or medication compliance incidences. For instance, if the healthcare facilities (hospitals) fail to educate discharged older patients on how to take drugs, such patients are likely to abandon the dose before they can finish their dose. This abandonment threatens medication compliance and may bring other complicated health issues leading to 30-day readmission. Under conceptual relationships, a researcher will develop a conceptual framework that illustrates the relationships between independent and dependent variables being studied. For instance, in the study, the independent variable will include medication education lessons, and the dependent variable becomes the rates of compliance.
The relationship between the independent and dependent variables is that when a nurse educator does not teach or educate patients on how to use medicine while under a home-based care program, such a patient will take wrong doses. So, the independent variable influences the dependent variable’s variation in the conceptual relationships (Hennink, Hutter, & Bailey, 2020). In the representation of the relationship, for instance, variables on the left side and outcome (dependent variables are put on the right side (outcomes) while independent on the left side and their facilitating elements or factors.
The best graphic model for use in studying individualized patient medication education is the Gaussian Graphical Model. This model will help a researcher visualize the relationship between variables. Since the model is probabilistic-based, the relationship is that when individualized patient education for older patients is provided, the positive outcome is medication compliance (Gray, 2017). In contrast, if education is not given, the negative outcome that is non-compliance will probably occur. According to McEwin & Wills (2019), the development of the theoretical elements is vital because it will make a researcher aware of the assumptions that inform the research design, showing the rationale behind them.
References
Gray, J. R. (2017). Frameworks. J. R. Gray, S. K. Grove, & Sutherland, S. (Eds.). Burns and Grove’s the practice of nursing research (pp. 138-156). Elsevier.
Greenhalgh, T. M., Bidewell, J., Warland, J., Lambros, A., & Crisp, E. (2020). Understanding research methods for evidence-based practice in health. John Wiley & Sons.
Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods. SAGE Publications Limited.
Jason, L.A., Stevens, E., Ram, D., Miller, S.A., Beasley, C.R., & Gleason, K. (2016). Theories in the field of community psychology. Global Journal of Community Psychology Practice, 2(3), 23-35
McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Philadelphia, PA: Wolters Kluwer Health.
Work Engagement
In the nursing field, the concept of work engagement implies involving all healthcare workers when addressing nursing-related issues. The concept builds a harmonious work environment since everyone gets consulted when solving arising job-related disputes or conflicts that undermine the delivery of quality work. In general, work engagement in professional nursing practices focuses on personal strengths, rather than limitations in service delivery. So, it is vital to engage others in solving problems of care systems, involving negative impact of clinical shortage and pressures to minimize health care expenditure.
This concept is relevant and critical in the nursing profession because the current changing multiple setting of healthcare. Without nurses’ effort, the achievement of the set goals is not impossible. As a result, nurse leaders or nurse executives need to emphasize on keeping close contact with nurses to enable them to perform the work. In a wide perspective, work engagement leads to inspiration and motivation. For instance, burnout happens in case of clinical staff shortage while work engagement occurs when resources are high. So, engaging each nurse can motivate and inspire, thereby minimizing the chances of burnout at the workplace (Antoinette Bargagliotti, 2012). Hospital management can balance act between care service demand and resources to determine the level at which healthcare workers get engaged.
In developing, executing, and implement new nursing policies, policymakers need to concentrate on clinical engagement to make the proposed policies acceptable to all people impacted. The 21st healthcare setting is undergoing various changes and trends which force the hospital to keep changing the policies to fit the new environment to become effective and efficient. As a result, the concept of engaging all involved parties boost organization or person interactions and tie the commitments of each nurse to overall organizational objectives. Most of the hospital view work engagement as a tool for creating positive, fulfilling job-based state of mind in which all workers hold meaningful work values for high performance.
In terms of maintaining employee relations, work-engagement is among the best approaches to use. Through nurse-leader engagement, a nurse perceives such an engagement as a form of the intrinsic reward of seeing social support from other healthcare practitioners, patient recover, and energy (Antoinette Bargagliotti, 2012). Most importantly, work engagement in nursing practice and healthcare setting has helped in retaining the workforce. The exiting relationship between work engagement and leaving the job is inversely related. For instance, in hospitals where engagement is highly maintained, labor turnover is low compared to where nurses are not engaged in making or deciding nursing issues that impact nurses at their place of work. Based on the above summary of article information, it directly reflects my definition of the concept of work engagement in nursing professional practice.
References
Antoinette Bargagliotti, L. (2012). Work engagement in nursing: a concept analysis. Journal of advanced nursing, 68(6), 1414-1428.
Concept: Motivation
Motivation is attributed willingness to attain or achieve something though goal-directed behavior. In simple terms, motivation encompasses processes that consider a person’s intensity, direction, and persistence of effort toward meeting a goal or objective. The three vital aspects of a person’s willingness are intensity, direction, and persistence. With the intensity aspect, it implies the level at which an employee works to attain the goal. On the other hand, it directly benefits the organization as persistence determines how long a worker maintains his efforts or commitments. Under the context of Maslow’s Pyramid, meeting needs such as physiological needs (sex, hunger, and thirst), a person’s safety, social (friendship, acceptance, and affection), esteem (self-respect and autonomy), and self-actualization (self-fulfillment), trigger motivation.
Synopsis of Analysis
Aim
The research paper explains and presents the concept analysis of motivation.
Background: The current healthcare system is dynamic and requires accurate adjustment to ensure positive general organizational performance. Challenges of attending to the aging population, high demand for care services, patients with severe diseases such as cancer, and limited resources to solve future care issues demoralize healthcare providers’ efforts. With increasing demands for healthcare services, nurse leaders and nurse executives are forced to set specific goals that their team members should work to achieve them. Without motivation, it becomes challenging to attain such goals; thus, the organization’s performance decreases. Primarily, motivation is an internal process that triggers and makes a person move toward improving the quality of services provided.
Data Sources
A literature search will be critical in exploring the motivation concept. Sources such as electronic literature indexes, textbooks, Internet search engines, and scholarly research articles can provide evidence-based information concerning motivation. Mostly, literature not older than five years will give more evident findings to study motivation.
Method
Eight concept-analysis steps of Walker and Avant (2019) to carry out a motivation analysis related to work engagement in healthcare.
Findings from Review of The Literature
In Ethiopia, motivation is attached to job satisfaction among healthcare providers in public hospitals. In research by Ayalew et al. (2019), the findings show that resources’ availability determines the level of job motivation. Poor working conditions and limited resources demoralize nurses, thus reducing the level of their job satisfaction. However, this issue of decreased motivation is prevalent in developing countries and continues to negatively impact the quality of care. Among female nurses, job satisfaction is higher compare to their male counterparts. Female nurses attribute their motivation at the workplace with recognition, remuneration (equitable salary and fringe benefit), work experience, career development opportunities, and job features.
Furthermore, adequate competent clinical staff motivates nurses since incidences of burnout are zero since the tasks assigned to every nurse are manageable within the official eight working hours. Across the world, there is a problem of critical shortage of nurses. Nurse are migrating to other countries looking for better pay and working conditions, career development, and personal safety (Freeman, Baumann, Blythe, Fisher, & Akhtar‐Danesh, 2012). The reason behind shortage and migration is due to lack of motivation, so the hospitals cannot retain nurses for long time. According to Riahi (2011), role stress is a major problem among physicians and has led to increased distress contributing to burnout in the nursing profession. It is crucial to analyze role stress concept and its impact on nurses’ motivation.
A 2016-2025 strategic plan launched by the Federal Ministry of Health of Ethiopia aimed to enhance the country’s commitments for developing, recruiting, deploying, and motiving healthcare workers. Ayalew, Kibwana, Shawula, Misganaw, Abosse, Van Roosmalen, & Mariam, 2019). Intrinsic and extrinsic motivation factors mainly drive overall job satisfaction. For instance, the researchers found that intrinsic motivation elements such as recognition for good performance, features of the job itself, and personal career development enhance job satisfaction and motivation. On the other hand, polices and administration, working conditions, salary, promotions, supervisions, and job security are extrinsic motivational factors of job satisfaction.
In Iran, the concept of motivation among nurses is anchored based on encouragement. According to Esfahani & Afshin (2019), work engagement makes nurses feel motivated to give empathetic and safe healthcare services in a complex healthcare setting. Among Iranian healthcare centers, nursing work motivation among nurses and physicians is between medium to high. A s a result, hospital management, through their nurse managers and policymakers, need to focus on serious attraction to improve the job motivation that will make nurses achieve greater performance.
The motivation of nurses and performance outcomes are directly related. The level of motivation affects satisfaction, retention, organizational performance, commitment, wellbeing, and engagement. In the perspective of wellbeing, nurses gain a feeling of happiness, also called an advanced psychological experience of individuals. In research conducted by Baljoon, Banjar, & Banakhar (2018), motivation is the product of interactions between people, their work setting, the match between these interactions, and the social context. Extrinsically motivated nurses find their work interesting, fun and challenging (Baljoon et al., 2018). The extent to which nurses are happy relies on how well they get motivated and the availability of personal sources of happiness.
The connection between motivation and burnout is crucial when determining the level of emotional, physical, and mental tiredness resulting from long-term engagement in the work environment that appears to be emotionally demanding. In a Baljoon et al., (2018) study, motivation relates to work holism, work engagement, and burnout. Burned-out nurses do not view their work activities as satisfying and enjoyable. The findings showed that the encouragement of autonomous motivation contributes to increased job engagement and a decline in work holism and burnout. In Canada, among healthcare providers, burnout negatively impacts commitment and their work performance.
Work motivation is essential for healthcare specialists’ performance. It has been established that it influences work performance among nurses. For instance, in quantitative research that examined the link between motivation and performance among healthcare providers employed at European Gaza Hospital, the most motivated care workers attain excellent performance outcomes compared to low-motivated care providers (Baljoon et al., 2018). This research findings raise the need for ensuring adequate training programs and an equitable working schedule to improve motivation and improve job performance. Further, the research findings indicated that highly-motivated nurses smile and initiate friendly discussions with patients and residents.
Antecedents, Attributes, and Consequences
Motivation antecedents are classified as intrinsic and extrinsic motivation. Like personal attributes, these two categories involve clinical experiments that relate to educational-creativity setting or work environment context. When a person is intrinsically motivated, he engages in an activity solely because he enjoys it and gets personally satisfied with it. Similarly, when he gets extrinsically motivated, he does something to receive or gain an external reward (Bakay & Huang, 2010). The self-determination level and capability, and features of the work itself are critical elements (concepts) of extrinsic motivation. In general, the main attribute of intrinsic motivation loves what you do. On the other hand, the work performance results and nature of the work allude to extrinsic motivation. However, the negative relationship existing between intrinsic and extrinsic motivation undermines intrinsic motivation. Within the creativity context, the combination of intrinsic and extrinsic enhances the overall performance.
A Model Case
According to Maslow’s five-model of the hierarchy of needs, motivation is a procedural process containing basic needs that must be met before proceeding to the next level of motivation. A nurse should first meet biological and physiological needs such as food, sleep, sex, shelter, and warmth before meeting safety needs. In the second stage of motivation and satisfaction, a nurse must have protection, stability, and security (Montag, Sindermann, Lester, & Davis, 2020). The third step of the model being belongingness and affection needs, requires a nurse to have a healthy relationship and teamwork. The fourth last need is esteem. A nurse has already built his image, status and achieved better results. The last need is self-actualization, the involves nurses’ need to seek career advancement opportunities to become motivated.
Empirical Referent
The empirical referents for motivation include decreased performance, higher employee turnover, engagement’s low levels, poor communication, inability to overcome adversity, and lack of apathy for the job are problems that proliferate and contribute to the workplace become a toxic environment. Unmotivated nurses do not seem to care if they have a job or not. Also, they are unlikely to accept challenges and changes and cannot stick with the problem to allow for finding a long-term solution.
Implications
Motivation in the workplace will lead to increased productivity due to a high level of performance among employees. As a result, the implication of hospitals’ motivation is finding what triggers motivation, especially among frontline workers such as nurses. Instead of focusing on monetary motivation, hospitals can improve working conditions, hire enough staff, and provide adequate work resources.
Influence of Motivation Concept Analysis
From the above concept analysis, I have realized that the best motivation is not only based on giving attractive compensation packages but using non-monetary rewards. Previously, I perceived motivation to be an aspect that is not much important in determining workers’ and organizations’ performance in general. Now, based on the finding, I can justify that motivation is the backbone of workforce performance and increased productivity. I will use the findings to frame comprehensive research questions to research on broad motivation area of interest.
References
Ayalew, F., Kibwana, S., Shawula, S., Misganaw, E., Abosse, Z., Van Roosmalen, J., … & Mariam, D. W. (2019). Understanding job satisfaction and motivation among nurses in public health facilities of Ethiopia: a cross-sectional study. BMC nursing, 18(1), 46.
Bakay, A., & Huang, J. (2010). A conceptual model of motivational antecedents of job outcomes and how organizational culture moderates. Available at SSRN 1722048.
Baljoon, R. A., Banjar, H. E., & Banakhar, M. A. (2018). Nurses’ work motivation and the factors affecting it: a scoping review. International Journal of Nursing & Clinical Practices, 2018.
Esfahani, P., & Afshin, M. (2019). Job Motivation among Iranian Nurses; a Systematic Review and Meta-Analysis Study. Health Research Journal, 4(1), 30-37.
Freeman, M., Baumann, A., Blythe, J., Fisher, A., & Akhtar‐Danesh, N. (2012). Migration: a concept analysis from a nursing perspective. Journal of advanced nursing, 68(5), 1176-1186.
Montag, C., Sindermann, C., Lester, D., & Davis, K. L. (2020). Linking individual differences in satisfaction with each of Maslow’s needs to the Big Five personality traits and Panksepp’s primary emotional systems. Heliyon, 6(7), e04325.
Riahi, S. (2011). Role stress amongst nurses at the workplace: concept analysis. Journal of nursing management, 19(6), 721-731.
REPLY QUOTE
Analysis and Evaluation of Frameworks and Theories
Phenomenon of Interest
There is a difference between framework and theory. A theory in research shows the relationship between concepts in the phenomenon of interest (POI) by explaining, predicting, and understanding the topic under the study. On the other hand, the framework is a research’s roadmap and support research theory. The framework relies on existing theory such as path-goal theory and Victor Vroom’s expectancy theory.
The POI is motivation leading to workers’ satisfaction. The analyzed frameworks of the POI are path-goal theory and Victor Vroom’s expectancy theory. Under the path-goal theory, healthcare workers get empowered and satisfied to become productive employees of the hospital (Farhan, 2018). With Victor Vroom’s expectancy theory, it has crucial implications for motivating hospital’s medical and nursing staff (De Simone, 2015). They get motivated if the hospital provides the resources and good working conditions and patients increase their satisfaction scores if their healthcare needs are met. Motivation is what makes nurses exert a high level of effort when providing healthcare services because they expect positive outcomes. There is a need for further research on why management’s lack of understanding demotivates employees.
Victor Vroom’s expectancy model aligns with the researcher’s questions on what can be done to motivate medical and nursing staff. The model is derived from the concepts of social psychology (social sciences) whereby a person’s performance depends on aspects such as knowledge, abilities, personality, and skills which influence the behavior of a person. The theory strengths are triggering a motivational process that enhances performance within a setting where goals are properly set (De Simone, 2015). Also, workers’ expectations get boosted by rewards and incentives. The weaknesses are that the model or theory cannot work in practice without active participation from nurse leaders or executives. It assumes that all elements are known; thus, leaders fail to find out employees recognize as rewards.
In the process of reviewing motivation in nursing practice, emerged consideration was how the hospital management providing specific motivations and rewards, but workers cannot recognize them, can get a remedy.
Questions
How can hospital management that provide specific motivations and rewards, but workers cannot recognize them, resolve the problem?
How do theories meet the researcher’s original thought regarding the developed research questions on motivation?
References
De Simone, S. (2015). Expectancy value theory: Motivating health care workers. American International Journal of Contemporary Research, 5(2), 19-23. http://www.aijcrnet.com/journals/Vol_5_No_2_April_2015/3.pdf
Farhan, B. Y. (2018). Application of path-goal leadership theory and learning theory in a learning organization. Journal of Applied Business Research (JABR), 34(1), 13-22.
What Students Are Saying About Us
.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"
.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."
