Critique of a concept analysis Essay

A Critique of Manias’ Concept Analysis on Medication Communication Running Head: Critique of Manias’ Concept Analysis

This is a critique of a concept analysis by Elizabeth.Manias (2009) on medication communication. The author used Walker & Avant’s (2005) method to explore this concept. This method consists of eight steps that guide the researcher to form a thorough definition and understanding of a concept. The following critique is structured according to these eight steps, just as Manias‘ analysis is structured. The first step is to select a concept.

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Manias chose to analyze the concept of medication communication. The purpose of this, which is the second step, is to, as the author claims, create an understanding about the concept, see how it is applied, and then identify what is yet to be understood. The third step in this concept analysis is to examine current uses of the concept of medication communication. Manias describes four ways in which the concept is used. One way involves the processes used to help ensure the patient is prescribed the correct medicine and then takes the medicine as prescribed.

Another use centers around the pharmacist: the pharmacist coordinates with the healthcare provider in assessing the patient, determining a plan of care, and evaluating the effectiveness of any medication treatment. A third use focuses on healthcare providers and pharmacists working together to meet the needs of the patient. The patient plays an active role in any medication decisions, and also helps to evaluate its effectiveness. The fourth and final way involves all the healthcare professionals associated with his or her medication treatment.

The next step in the concept analysis is to determine the defining characteristics of medication communication. Manias names and explains six attributes. First, there is a speaker and the others linked to the encounter. Sometimes, however, the patient or the others involved choose to remain silent during the encounter; this is the second attribute. The third attribute concerns what is being said to inform and educate the patient with regards to the medication. The actual words that are used is another attribute; the health care worker may use technical jargon or may instead use words that are easy for the patient to understand. The body language during the interaction constitutes the fifth attribute. The final attribute revolves around the patient, their choices, and the main goals of care.

The author, following the Avant & Walker (2005) method, next constructs a model case of medication communication. Manias uses a dialogue to present her model case. It includes all of the six critical attributes of the concept. The patient, accompanied by her husband, is in her hospital room surrounded by those involved in her care: the physician, pharmacist, bedside nurse, charge nurse, and physiotherapist. The health care professionals discuss the plan of care, allowing each person to provide input regarding the patient’s goal, which is to be discharged soon. The patient and her husband are active participants in the conversation and are allowed to voice their concerns. The healthcare workers use language that is clear and on a level the patient can understand. This model case keeps the focus always on the patient while everyone works as a team and communicates information that is relevant to the goal.

Next, the author fabricates additional cases that are borderline, related, contrary, or illegitimate (Walker & Avant, 2005). Manias identifies both a borderline case and a contrary case. Again, a dialogue at the patient’s bedside is used to illustrate the cases. The borderline case has some, but not all, of the characteristics of the concept. First, not every health care professional involved is present to provide input. Also, the patient is not encouraged by those present to voice her thoughts or feelings about the plan of care. The communication is not as focused on the patient and her goals as in the model case.

The contrary case depicts a hurried physician asking closed-ended questions, accompanied only by the nurse. The communication is physician-centered, not patient-centered; the patient is not given the opportunity to be an active participant. This case has none of the six attributes of the concept.

The seventh step in the concept analysis is to identify antecedents and consequences. Manias recognizes environmental influences as antecedents to medication communication. The environment may be structured or not, either quiet or plagued by distractions. The author also points out that there are sociocultural antecedents as well. This includes things such as the language that is spoken by the patient, or their socioeconomic background. Consequences occur as a result of the concept: Manias states that the consequences of medication communication are its outcomes. An outcome, for example, may be the patient taking the medicine as prescribed. The final step in the concept analysis it to determine empirical referents. Manias was unable to find one for medication communication that included all the characteristics of the concept. The author, in her step-by-step approach, meets the criteria for a concept analysis. Each step is thoroughly described and researched. The dialogues presented for each case are clear and definitive. A kink, however, exists in Manias’ choice of defining attributes.

All are based within the nursing and healthcare realm; none are taken from colloquial use. I am left wondering why the concept of medication communication has these chosen attributes and not others. The meaning of a word, after all, is its use in the language, and not every bit of medication communication occurs only between patients and healthcare providers. Despite this, I do have a better understanding of a concept analysis now that I have thoroughly written about one. I am familiar now with how a concept analysis should be structured using the Walker and Avant method of analysis, and now understand better the purpose of each step.

References
Manias, E. (2009). Medication communication: a concept analysis. Journal of Advanced Nursing 66(4), 933-943. doi: 10.1111/j.1365-2648.2009.05225.x Walker, L.O. & Avant, K.C. (2005). Strategies forTheory Construction in Nursing (4th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

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