Concept Analysis Using Walker and Avant Method

Pain stands for the most common and prevailing problem and recurring nursing diagnosis for which patient in the clinical environment look for help. Briefly, pain stands for a bad, distressful and uncomfortable feeling, which negatively influences life quality and relationships, causing negative emotional and physical effects. In accordance to Walker and Avant, concept analysis provides nursing scholars with a possibility to analyze concepts characteristics and attributes. The main objective of utilizing concept analysis concerns distinguishing between determinative and incongruous attributes of a concept.

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Concept Uses

The concept is used in general, professionals, and sociological spheres. The nursing usage of pain depends on a holistic approach in regards to the clinical environment. This is a case when pain concept is used to outline individual experiences, which are characterized by uncomfortable sensations and severe discomfort. In professional field, McCafferys definition is most often utilized, outlining the concept as whatever the experiencing individual reports it is in whatever location, which is stated by this individual. In addition, Virginia Hendersons need theory outlines 14 components of health in connection to the pain management implications. In regards to sociological viewpoint of the concept usage, it concerns cultural inheritance, as it is outlined as not merely the automatic reaction and pain sensation but as specific associated feeling condition as well. This is explained by the fact that pain reactions appear typically on behavioral and emotional levels, while peculiar social situations and culture background influences individuals understanding and reaction to pain. The general usage of the concept of pain has four different meanings, including the feeling, which individual experiences when hurt; suffering and distress, which can be viewed as opposite to pleasure; grief and sorrow; and trouble, when the accomplishment of something difficult is required. Thus, the usages of the concept depend on the sphere, where it is utilized.

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Defining Attributes

Defining attributes concern the features, which are correlated and connected to the concept of pain. Due to the fact that any concept analysis will incorporate more than one defining attribute, it is important to define the attributes, which are relevant and are pertinent for the analysis objective. Thus, the significant attributes of pain will include six elements. The first one stands for distressful and irritating experiences, which originate from physical perceptions and might have both positive and negative individual denotations. The second element concern subjective human experiences. The third one stands for a feeling condition, expressed in perceptional, emotional, and behavioral constituents. The fourth element incorporates physical and psychological reactions to the inducements. The fifth one stands for the pain functions, encompassing defensive and prevention signals. The final attribute demonstrates that pain reactions are acquired and impacted by individuality, setting, emotions, society, and culture.

Model Case

A model case should be a paradigmatic sample and incorporate all concept attributes. A young attractive 35-year-old married female recovers after mastectomy. When a nurse comes to the room to change her dressing, she finds female silently crying, avoiding eye contact. The nurse notices that female is tense and diaphoretic, while her heart rate and pressure are elevated. This stimulates the nurse to ask whether the woman is in pain. Female explains that she cannot properly characterize her feelings, as she actually feels terrible in general, because of the overall chest pain, the fear of her husbands reaction, and low self-esteem, because of perceiving herself as ugly. This model case incorporates all above-mentioned determining attributes of the concept of pain.

The current concept allows utilizing only borderline and contrary cases for further analysis of the phenomenon.

Borderline Case

The borderline case incorporates several analogous crucial concept attributes, but not all of them or differ solidly in one attribute. A 55-years-old man was diagnosed with renal cancer, while cancer cells have metastasized to the right femoral bone. A nurse took care of a man, who never confessed having pain or openly asked for painkillers. Nevertheless, patients heart rate and blood pressure were slightly elevated. Moreover, metastases in bone typically result in solid pain, making patients ask for pain medication. After discussing this issue with the patient, the nurse was explained that the man does not want to show that he is weak, as this will cause more pain and suffering for all other family members. Thus, the example demonstrates that even despite the fact hat the patient have not expressed pain in a verbal or emotional manner, the behavioral signs of pain were visible.


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Contrary Case

A contrary case stands for a sample, which reveals not the concept. A 4-years-old girl was brought by her parents to the clinic for the general immunization several weeks ago. Nevertheless, when her mother brought the child to the clinic again for a standard routine check, the girl started crying when she saw the nurses. The girl was constantly crying asking to go home because of the concept of fear and not pain, as pain is actually absent in the current situation .

Antecedents and Consequences

Antecedents stand for the events or incidents, which appear prior to the existent concept. Individual, cultural, and environmental values operate in a form of antecedents in regards to the pain as the concept. In addition, above-mentioned antecedents appear to be interconnected. Thus, environment is connected to the event, which triggers or stimulates pain. In fact, the body and mind of an individual appear to be influences by this event, which provokes virtual or possible tissue injuries or damages for the individual. In addition, the knowledge, cognizance, and attitude of an individual connected to this event perform a crucial function as well. Such cognizance and attitudes, including former pain experience, might affect the ways, in which individual abides and receive pain. In addition, it will actually later impact the ways, which individual uses to cope with pain. The individual issues incorporate the individual’s present emotional and physical state, individuality, gender and socio-economic class. The physical state concerns sleeping patterns, the degree and level of muscle tension, and whether the person is able to perceive the inducements and stimuli. Moreover, the personality of an individual will impact the ways, in which he/she apprehends pain as well. For example, women have tendency to be more sensitive while perceiving pain and are permitted to demonstrate their pain more frequently on contrary to men. This also typically depends on culture, meaning that pain together with its perception can be viewed as culturally shaped. Nevertheless, pain acceptance and expectancy usually demonstrate the personalized attitude towards pain. Moreover, it is also highly important to mention that family performs a crucial function in impacting the personal reaction to pain.

On the other hand, consequences stand for the incidents or occasions, which appear in a form of concept outcome. In fact, the consequences of pain appear to be connected to both: pain reactions and the persons individual apprehending the general meaning of pain as such. It is important to mention that pain reaction typically has a more solid biological and physical concentration and can be observed and apprehended as a specific pain conduct. Another pain consequence stands for the fact that individuals might evolve a specific meaning regarding the actual time pain experiencing and practice. The facts demonstrate that people might shift their pain experiences, while providing some specific positive or negative sense and meaning to pain experiences. It is also important to mention that this is a case when pain repulses individualized coping mechanisms applied when the person has to deal with their pain.

Empirical References

The last step of the current concept analysis method concerns empirical references, which demonstrate the ways to measure and observe the concept. The previous analysis of attributes reveals that patients verbalizations can be viewed as the most dependable pain indications. Nevertheless, the complete reliance on this methods cannot be considered as highly adequate. It will require additional pain measurements in form of viewing intensity, location, and pain quality/capacity. Additional signals can also be taken into account, including the assessment of movement avoidance, muscle tone changes, restlessness, and crying. Thus, Hendersons 14 needs outlined in the need theory can used to analyze and measure the pain. Thus, for example, respiratory rate has a tendency to elevate with unrelieved pain, elevated pain causes poor appetite, movements are restricted because of pain levels, sleep and rest are inhibited or interrupted by pain, etc.


This concept has been chosen for the analysis, as it is acknowledged as a solid issue for both healthcare professionals and patients. The analysis will help in obtaining enhanced understanding of the concept, allowing implementing relevant nursing activities in relieving patients pain.