NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nurs Inq. 2020 Oct;27(4):e12353. doi: 10.1111/nin.12353. Epub 2020 May 11.
Nursing models of care show promise in addressing the needs of older adults facing serious illness through supporting inner strength. However, previous conceptual and theoretical models of inner strength are limited. This concept analysis used dimensional analysis methods to explore inner strength in people ageing with serious illness to address limitations by defining a pragmatic, data-driven model. This study analyzed published literature of adults with serious illness that describes inner strength. Thirty articles were selected after review. The result was an explanatory matrix that describes inner strength from the perspective of where have I been, where am I going? within the context of being a person who is living and dies and you have a serious illness. The conditions spotlighting by actors around me and taking stock of others and ideas lead to processes of looking in/looking out and seeing me as I'm seen. The final consequence of this process is meeting me. This updated concept analysis of inner strength improves upon previous models by providing a clinically relevant situation-specific model of inner strength for people with serious illness. Implications for nursing scholarship and practice are described including exploration of person-centered care, relational practice, and health communication.
护理关怀模式通过支持内在力量，有望满足面临严重疾病的老年人的需求。然而，以前的内在力量的概念和理论模型是有限的。本概念分析采用维度分析方法，通过定义一个实用的、数据驱动的模型，探索患有严重疾病的老年人的内在力量，以解决其局限性。本研究分析了描述成年人严重疾病内在力量的已发表文献。经过审查，选择了 30 篇文章。结果是一个解释性矩阵，从“我从哪里来，我要去哪里？”的角度描述内在力量，其背景是作为一个既生存又死亡且患有严重疾病的人。我周围的行动者强调的条件和对他人和想法的评估，导致了“内省/外察”的过程，并将我视为他人所看到的样子。这一过程的最终结果是遇到我自己。这种对内在力量的更新概念分析通过为患有严重疾病的人提供一个具体临床情境的内在力量模型，改进了以前的模型。描述了对护理学术和实践的影响，包括对以患者为中心的护理、关系实践和健康沟通的探索。
