A concept analysis of confidence related to older people living with frailty

Abstract

Aim To describe and define a concept of confidence in the context of older people living with frailty, which is important to the worldwide healthy‐ageing agenda preventing decline in independence and well‐being. Design Concept analysis informed by Walker and Avant's eight‐stage approach. Methods Electronic databases (MEDLINE, CINAHL and PsychINFO) from 1994–2018 were searched. Published studies exploring confidence and excerpts of papers referencing older people, frailty and confidence informed the concept analysis. Extracted attributes informed model case and additional case development. Appraisal of antecedents, consequences and empirical referents informed the final concept's construction. Results Three overall defining attributes of confidence were identified in this concept analysis: physical, psychological and social. A central feature is personal control, influencing internal and external factors. These control factors can be enabling factors (positive factors) or dis‐enabling factors (negative factors), affecting the frail older persons overall physical health and mental well‐being.

The meaning of confidence from the perspective of older people living with frailty: a conceptual void within intermediate care services

“…The sample was ethnically homogeneous and participant voices came from just one region of the UK, thereby potentially limiting transferability. Finally and in line with previous confidence concept development publications [ 6 , 7 ], this study maintained the separation from Banura’s social construct of self-efficacy [ 28 ] on the grounds that Bandura viewed confidence as a ‘colloquial term’ [ 29 : 382], one not linked to self-efficacy in any way.…”

“…Rich narrative descriptions of confidence have allowed the dimensions of social connections, fear, independence and control to be identified as its essential themes. This new knowledge enhances the previously higher-level descriptions of a literary-based concept analysis [ 7 ] and provides a tangible construct to inform intermediate care practice and service response.…”

“…A concept of confidence existed, based on recent published literature exposing attributes and perspectives of older people living with frailty [ 7 ]. This concept analysis highlighted three interconnected attributes with a strong central control feature.…”

“…This phenomenological enquiry importantly introduced the voices of older people living with frailty to enrich a literature-based concept [ 7 ]. This has informed, changed and significantly strengthened understanding to enable the production of a practice-relevant conceptual framework, previously missing from national intermediate care policy and guidance.…”

“…The authors called for better clarity to inform practice through more research. A concept analysis of confidence that drew on a wider literature review was undertaken and developed the first concept of confidence in an attempt to try and close the gap between policy and evidence [ 7 ]. This highlighted three interconnected attributes of confidence: physical, psychological and social, with a strong central feature influencing them all, identified as personal control.…”