Hua Rongyu, Bhatarasakoon Patraporn
Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
Int J Nurs Stud Adv. 2024 Nov 28;8:100272. doi: 10.1016/j.ijnsa.2024.100272. eCollection 2025 Jun.
Demoralization is a complex construct comprising of several clinical phenomena that has gained increasing interest in clinical practice and research; however, the concept needs to be sufficiently specified and clearly described. A concept analysis of demoralization is necessary to integrate previous research findings and establish the scientific foundation for future intervention research.
To analyze the concept of demoralization in terms of its antecedents, attributes, consequences, and empirical referents in health.
A concept analysis was performed using the Joanna Briggs Institute guidelines scoping review method and mapping information through the Walker and Avant concept analysis framework. Electronic databases, including PubMed, The Cochrane Library, Embase, PsycINFO, and Web of Science, were searched until September 15, 2024. The grey literature and other minor non-indexed publications were also reviewed.
A total of 106 articles were included in the review. Antecedents included medical illness, symptom burden, low social support and coping difficulties. Attributes were identified as follows: dysphoria, disheartenment, helplessness, hopelessness, loss of meaning and purpose, and sense of failure. Consequences included poor quality of life, depression, anxiety, suicidal ideation and desire to die. The concept of demoralization was illustrated through a model case, one exhibiting borderline criterion and another displaying challenge.
This scoping review clarifies the clinical definition of demoralization, distinguishing it from common language usage and from other emotional symptoms frequently experienced by patients.
The identified attributes of demoralization play vital roles in health assessments and should guide nurses in providing appropriate patient care early on. Interventions should address the concept's antecedents and consequences.
士气低落是一个复杂的概念，由多种临床现象组成，在临床实践和研究中越来越受到关注；然而，这一概念需要得到充分的明确和清晰的描述。对士气低落进行概念分析，有助于整合先前的研究结果，并为未来的干预研究奠定科学基础。
从健康领域中士气低落的前因、属性、后果及实证依据等方面对其概念进行分析。
采用乔安娜·布里格斯研究所循证综述方法进行概念分析，并通过沃克和阿万特概念分析框架梳理信息。检索了包括PubMed、考克兰图书馆、Embase、PsycINFO和科学网在内的电子数据库，检索截至2024年9月15日。还查阅了灰色文献和其他少量未被索引的出版物。
综述共纳入106篇文章。前因包括疾病、症状负担、社会支持不足和应对困难。确定的属性如下：烦躁不安、气馁、无助、绝望、失去意义和目标以及失败感。后果包括生活质量差、抑郁、焦虑、自杀意念和求死欲望。通过一个典型案例阐述了士气低落的概念，一个案例显示接近标准，另一个案例显示具有挑战性。
本循证综述明确了士气低落的临床定义，将其与日常用语以及患者经常经历的其他情绪症状区分开来。
确定的士气低落属性在健康评估中起着至关重要的作用，应指导护士尽早提供适当的患者护理。干预措施应针对该概念的前因和后果。
