Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Nursing Image: An Evolutionary Concept Analysis

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Nursing Image: An Evolutionary Concept Analysis

Article excerpt

Currently, there are 14 million nurses worldwide and it is nurses who are the core of the health-care system (World-Health-Organization, 2007). One of the many challenges that nursing has had to overcome is the concept of image of nurses and the nursing profession. As early as the 19th century, the issue of image was a key issue. For example, the deplorable working conditions and the unsanitary clothing of Sairy Gamp and Betsy Prig so keenly described by Charles Dickens in the book Martin Chuzzlewit (Dickens, 1987), represents the 'dark age of nursing' in England in middle to late 1800s (cited in Wallace, 2007). In addition, studies showed that the nursing image (NI) is a significant concept to the discipline because it is associated with the decision to enter nursing, remain in it and/or suggesting it to others as a career choice (Emeghebo, 2006; Zarea, Negarandeh, Dehghan-Nayeri, & Rezaei-Adaryani, 2009). Moreover, allocating social resources, funding for nursing education, research and practice, and nurses' quality of working life are related to NI (Kazis & Schwendimann, 2009).

Despite the importance of NI, there is a paucity of data on the concept and factors affecting it (Donelan, Buerhaus, DesRoches, Dittus, & Dutwin, 2008). A majority of the studies which have explored NI, have highlighted the need to implement strategies to facilitate improvement of the image (Auker, 2004). However, before engaging in any image-improving effort, there is a need to scrutinize and clarify the concept. An extensive literature review, revealed a dearth of systematic and integrated data about the concept, its significance to the profession, factors affecting it, and its consequences. We searched the scientific databases for the concept of NI; however, despite its importance, the concept has not yet been investigated in-depth. Clarification of the concept will increase nurses' awareness of the concept and its antecedents and consequences. Moreover, nurses may be able to identify the challenges, which exist in relation to NI. With these challenges in mind, we conducted this evolutionary concept analysis.


The aim of this study was to analyze the concept of NI, i.e., clarifying its attributes, antecedents, consequences, and implications.


As our aim was to analyze the concept of NI in terms of its attributes, antecedents, consequences, and implications, we employed the Rodgers' evolutionary concept analysis approach (Rodgers, 2000). The inductive, non-sequential, and descriptive nature of the Rodgers' model guarantees the analytic rigor of the approach and provides a systematic approach for analyzing the concept in terms of its attributes, antecedents, consequences, and implications. Rodgers' model involves five specific steps to conduct a concept analysis:

* Identifying the concept of interest and associated expressions;

* Identifying and selecting an appropriate setting and sample for data collection;

* Collecting the relevant data to identify the attributes and contextual bases of the concept;

* Analyzing data to identify characteristics;

* Identifying a model case (an exemplar);

* Identifying implications and hypotheses for further development of the concept.

Below we describe the application of the Rodgers' model to the concept of NI.

Step 1: The concept of interest and associated expressions

The concept of interest in this study was the NI. To provide a wider scope of this concept, we also included other terms such as image, professional image, professional identity, public image, public perception, public understanding, and impression.

Step 2 and 3: Setting, sample, and data collection process

A comprehensive internet-based review of literature was performed to retrieve relevant literature published over the last 30 years (1980-2011). We chose this 30-year period to include a sufficient number of recent publications in the study. …

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