Nowadays, nurses have to work hard and learn from different sources in order to meet all professional expectations and personal demands. Wills and McEwen (2014) underline that experienced nurses should know how to focus on the practical application of their evidence-based knowledge and demonstrate high skills in generalizing and solving different problems. One of the main steps in a learning process is the possibility to understand and analyze concepts. The article was written by Firth, Smith, Sakallaris, Bellanti, Crawford, and Avant (2015) is a good example of how one nursing concept, it is healing in this case, has to be approached and used in practice. Concepts may be of different types and gain many characteristics, and the task of a nurse is to know how to use them and achieve positive results. The aim of this paper is to review how Firth et al. (2015) investigate the concept of healing through the Walker and Avant method of concept analysis. This article shows how a comprehensive definition of healing can be developed, operationalized, and measured to clarify all attributes of healing that may be important in nursing practice.
Methods of Analysis
The choice of method of analysis in the article under discussion depends on the connection of the concept to one particular framework. Firth et al. (2015) discover that patient care and treatment have to be offered in the optimal healing environment (OHE) where people can find a compromise in their relationships, health promotion, and behaviors. Regarding healing as a part of the OHE framework, the authors suggest using concept analysis methodology and investigating its elements and meaning from different perspectives. The Walker and Avant method of concept analysis are one of the most frequently used methods to bring clarification and meaning to all concepts through analysis and synthesis (Firth et al., 2015; Wills & McEwen, 2014). Though this method is highly criticized because of the lack of integration between its steps, the improvements offered during the process turn out to be a significant contribution to the application of this analysis to nursing clinical practice.
Processes and Results
According to the Walker and Avant methodology, researchers have to take nine steps and finish with a strong and effective definition of a concept. Though the analysis process may not be linear, its interactivity has to be mentioned. Still, in the article under consideration, the authors follow their own order and make sure every specific goal is achieved. The first step requires the selection of the concept for analysis (Firth et al., 2015; Wills & McEwen, 2014). In this case, healing is a concept for evaluation and analysis. The second step aims at determining the aim of the study. In this article, the authors underline their intention to develop “an operational definition of healing in order to study the OHE framework” (Firth et al., 2015, p. 45). The third step should help to identify all possible ways to use the chosen concept. The study is limited to healing offered to humans only.
To succeed in taking the next step of the analysis, it is necessary to work with different sources, gather enough data, and organize meetings during which the examination of related concepts may be developed. The main achievement at this step is the recognition of healing as “a holistic transformative process”, “personal”, “innate or naturally occurring”, “multidimensional;”, and the one that involves “repair and recovery of mind, body, and spirit” (Firth et al., 2015, p. 46). The fifth step is the identification of a model case. The authors introduce a case of a gay male, Jorge Morales, a representative of a growing Mexican immigrant community that is located in America, who neglects the risks of having HIV and does not pay much attention to the signs of this disease (Firth et al., 2015). With time, he becomes broken physically and emotionally. The only solution is to start a healing process and find meaning in everything around. Two constructed cases are introduced: a borderline case of healing of Jimmy and his multiple sclerosis diagnosis and a contrary case of healing of Ron and his failure to make up after multiple physical injuries.
The next stage is the identification of antecedents and consequences. Two main antecedents are given, including brokenness and the necessity to establish relationships with oneself and different people around. Positive change, a chance to find meaning, and an understanding of personal wholeness are the consequences of the chosen cases with the help of which it is possible to achieve the last but one stage of the analysis that is the determination of empirical referents which may support the validity of the concept and measure it. Regarding the fact that several categories may be used to measure human behavior such as change of feelings, cognitive reframing, and value improvements, healing may have several referents depending on the context. The measurement process occurs through the established metrics for repair and recovery regarding qualitative information and readiness to change and finding meanings (Firth et al., 2015). The authors make all necessary clarifications.
Finally, the aim of the study is achieved, and a clear definition of the concept of healing can be given. Firth et al. (2015) introduce healing as “a holistic, transformative process of repair and recovery in mind, body, and spirit resulting in positive change, finding meaning, and movement toward self-realization of wholeness, regardless of the presence or absence of disease” (p. 49). This definition proves the importance of each stage taken in this study.
Application of the Concept to Nursing Practice
Taking into account the results achieved by the authors of the chosen article, it is possible to say that the concept of healing considerably fulfills nursing practice. On the one hand, it has to be applied because of the possibility to guide a nurse and understand the boundaries of nursing actions. It is not enough to help a patient physically. It is important to promote the recovery of the human mind and spirit through the recognition of meanings in all activities and the promotion of positive changes (Firth et al., 2015). On the other hand, this concept informs about possible negative outcomes of treatment to prepare nurses for such challenges as the inability to support personal wholeness or stay connected with the world. Healing has multiple sides, and nurses should learn all of them to help patients and their families under different conditions.
In general, the achievements made by the authors of the article play an important role in understanding nursing practice and recognition of nurse responsibilities. If treatment may be pharmacological or non-pharmacological only, healing may vary, and its development depends on how well nurses learn theory and develop their practical skills. The Walker and Avant method is properly implemented in Firth et al.’s article and resulted in the creation of a working and well-grounded definition of healing.
Firth, K., Smith, K., Sakallaris, B. R., Bellanti, D. M., Crawford, C., & Avant, K. C. (2015). Healing, a concept analysis. Global Advances in Health and Medicine, 4(6), 44-50.
Wills, E. M., & McEwen, M. (2014). Concept development: Clarifying meaning of terms. In M. McEwen & E. M. Wills (Eds.), Theoretical basis for nursing (4th ed.) (pp. 49-71). Philadelphia, PA: Lippincott Williams & Wilkins.