5.1 Introduction
The findings of phase 1 of the study were discussed in the previous chapter. This chapter focuses on phase two (2) of the study, which is comprised of concept analysis, programme development as well as its validation. Concept analysis was guided by the steps as outlined by Walker and Avant (2011). The findings of concept analysis led to development of a transition support programme, which was based on: (1) Conceptual framework of ADDIE’s model for training and instructional design, of which the steps are: Analysis, Design, Development, Implementation and Evaluation (Cutler et al., 2012); and (2) Stages of transition theory by (Duchscher, 2009) as follows: the stage of doing, stage of being and stage of knowing. A quantitative approach was used to validate whether the developed transition support programme would be able to serve as an effective tool for supporting newly graduated midwives during their transition period. The validation process was based on a framework for programme evaluation in public health by CDC. This chapter is congruent to objectives 4 and 5, which state:
• To develop a transition support programme to enhance effective support of newly graduated midwives during their transition period
• To validate a developed transition support programme for effective support of
CHAPTER 5 | 5.2 Concept Analysis
5.2 Concept Analysis
According to Mouton (2010), concept analysis refers to clarification and analysis of the lay concepts in the study in the way in which one’s research is integrated into the body of existing theory and research. Walker and Avant (2011) defined concept analysis as an integrated part of terminology work, because concept is considered as a central element in terminological theory. Concept analysis was done based on Walker and Avant’s (2011) method, in order to clarify meaning and promote mutual understanding of the readers, regarding the major concept ‘effective transition support’
that emerged from the findings of the study. Analysis of the concept ‘effective transition support’ was guided by the following steps as described by Walker and Avant (2011):
1. Select a concept
2. Aims of analysis
3. Identify uses, characteristics or connotations of the concept 4. Determine defining attributes
5. Construction of a model case
6. Identify antecedents and consequences 7. Define empirical referents
5.2.1 Select a Concept
Empirical findings revealed that newly graduated midwives viewed labour ward as a traumatic environment as it was very busy and with a serious shortage of staff.
Graduates also expressed a professional nurse’s role as stressful as it demands a high level of responsibility and accountability which they did not have, and
CHAPTER 5 | 5.2.2 Determine the Aims or Purposes of Analysis
experienced midwives being so unsupportive. Newly graduated midwives felt that the support they received from experienced midwives was ineffective, as they were neither mentored nor properly supervised and the environment was not conducive for learning. Reality shock experienced by newly graduated midwives, coupled with poor relationship with experienced midwives and poor learning opportunities frustrated graduates and made them lose the little confidence they had. The findings also revealed that graduates failed to meet experienced midwives’ expectations as they were unable to function independently, resulting in failure to reduce the workload.
Newly graduated midwives recommended that their placement in maternity ward be extended from a period of six months to a year in order for them to build confidence in midwifery practice. Based on the findings, ineffective transition support of newly graduated midwives during their transition period, was found to be the central idea or event and all other categories and attributes revolved around it. The identified transition support gaps then raised a question in the mind of the researcher as to
“What then constitutes ‘effective transition support’?” Hence, the researcher identified
‘effective transition support’ as a core concept to be analysed. The section that follows aims at determining the aims or purposes of concept analysis.
5.2.2 Determine the Aims or Purposes of Analysis
In order to achieve the aims of analysis, a researcher conducted an extensive literature search. Based on Walker and Avant (2011), the main aim of concept analysis was to provide a definition and clarity to the meaning of ‘effective transition support’
that contributed to understanding its use within the context of provision of midwifery services by newly graduated midwives, during their transition period in Limpopo Province. Concept analysis was done in order to have a better understanding of how the term ‘effective transition support’ is perceived.
CHAPTER 5 | 5.2.3 Identify Uses, Characteristics or Connotations of the Concept
Definitions were sought from various sources, including English dictionaries;
psychology; sociology and health sciences literature. As this is a three-word concept, the words ‘effective transition support’ were explored independently. Based on Smeltzer (2008), the critical attributes of ‘effective transition support’ as both the process and product were identified and differences between ‘connotation’ and
‘reference’ distinguished. The analysis determined the meaning of the concept
‘effective transition support’ and its usefulness, applicability and effectiveness as key concepts for transition support. Moreover, concept analysis was used to define a term for subsequent research or to examine how a concept was used within the current literature or in actual clinical practice (Chinn and Kramer, 1999). Discussion about the uses as well as characteristics or connotations of the concept were analyzed in the next step.
5.2.3 Identify Uses, Characteristics or Connotations of the Concept
To identify and explore basic information about the concept “effective transition support”, dictionaries, thesauruses and available literature were used. Extensive literature review was done and the ultimate choices of the defining attributes were based on such review of literature.5.2.3.1 Definitions 5.2.3.1.1 Effective
Effective means producing the desired or intended results (Merriam Webster Dictionary, 1991). Barry et al. (2013) defined effective as an extent to which planned outcomes, goals, or objectives are achieved as a result of an activity, strategy, intervention or initiative intended to achieve the desired effect, under ordinary circumstances.
CHAPTER 5 | 5.2.3.1.2 Transition