Tolerance: A Concept Analysis

Article excerpt

Abstract:

The concept of tolerance is analyzed using a method outlined by Walker and Avant. This analysis clarifies the meaning of tolerance in such diverse disciplines as nursing, medicine, social science, and theological education. Although tolerance subsumes respect, empathy, and acceptance, it implies unequal power relations and moral neutrality. Because tolarance exposes intolerance and indifference, the practice of inclusion may be more promising. Tolerance is revealed as a useful, but limited concept for nurses and other helping professionals.

Keywords: Concept analysis, culture, diversity, inclusion, tolerance

Ralph Waldo Emerson introduced the iconic phrase "melting pot" in his journals, which were published and circulated in 1912 (Luedtke, 1979). This term has been used to describe the multicultural society found in the U.S. From colonial times and centuries earlier, the U.S. was populated by immigrants from different cultures, leading to coexistence of people from diverse ethnic, religious, and political backgrounds. With this coexistence came the need for such concepts as tolerance. Some may question relevance of the concept, tolerance, to nursing and other helping professions. From caring for patients of diverse backgrounds to collaborating with the rest of the healthcare team, professional helpers must practice tolerance daily. The authors chose to analyze the concept of tolerance for two reasons. As a labor and delivery nurse at a busy county hospital, the first author had the privilege of caring for women and their families with diverse cultural backgrounds. She learned about the importance of being tolerant to these women and honoring their customs and traditions. As a professor of nursing, the second author prepares nursing students to be tolerant of patients they care for and individuals with whom they work. Cultural competence is often cited as an expectation of basic nutsing education and a requirement for registered nurses' continuing education (Fitzgerald, Cronin, & Campinha-Bacote, 2009; Sealey, Burnett, & Johnson, 2006). Yet, is it possible to be culturally competent, particularly when the culture is not one's own? Perhaps tolerance is a more attainable goal. If so, then a clear understanding of the concept is warranted.

Method

Concept or linguistic analysis is often used in theory development to clarify concepts or imprecisely defined terms. It enables researchers to carefully examine the structure and function of a concept by highlighting the attributes and characteristics that uniquely distinguish it from other concepts (Walker & Avant, 2005). In this article, the authors examine the concept of tolerance using a modification of Wilsons (1963) classic analytic procedure detailed by Walker and Avant (2005). The modified approach includes eight discrete steps: (1) selecting the concept, (2) determining the purpose of the analysis, (3) identifying the concept's uses, (4) specifying its defining attributes, (5) constructing cases, (6) identifying antecedents and consequences, (7) describing empirical referents, and (8) providing a workable definition of the concept.

Review of Literature

Tolerance is a complex concept with many meanings and definitions. For instance, in bridge building and agriculture, tolerance refers to the ability to withstand wind, gravity, drought and other challenges of nature. In manufacture of food and drugs, tolerance denotes the type and amount of contaminants permissible in the final product. Although the term tolerance appears in the literature of such diverse disciplines as engineering, manufactuting, and safety technologies, for the purpose of this analysis, the focus was narrowed to four disciplines: nursing, medicine, social science, and theological education.

Nursing

Activity tolerance refers to the type and amount of exercise a patient is able to perform without undue exertion or injury. …