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Abstract: Cognitive reframing is a concept that has gained increasing popularity in nursing literature in recent years, but it has rarely been defined. Moreover, definitions vary among sources. This systematic evaluation of cognitive reframing is analyzed using Walker and Avant's classic framework for concept analysis. Diverse disciplines are reviewed including psychology, pastoral care, art and architecture, and nursing. The analysis provides an operational definition of the concept based on interdisciplinary literature and establishes four defining attributes of cognitive reframing: (1) sense of personal control; (2) altering or self-altering perceptions of negative, distorted, or self-defeating belief; (3) converting a negative, self-destructive idea into a positive, supportive idea; and (4) the goal for cognitive reframing is to change behavior and/or to improve well-being. This analysis provides the reader with a clear understanding of cognitive reframing within a nursing context.
Keywords: Behavioral change, cognitive reframing, cognitive restructuring, concept analysis
In the most recent edition of Nursing: Scope and Standards of Practice (2010), the American Nurses Association identifies five standards of practice for the registered nurse: assessment, diagnosis, outcomes identification, planning, and implementation of care. One barrier to change that nurses often encounter in the planning and implementation phases is the clients unwillingness to change because of perception or beliefs. Nurses can affect client outcomes by altering the clients viewpoint, or perspective, on an issue. While cognitive reframing is described in psychosocial nursing literature, it is ill defined and demands further investigation.
Framework for Concept Analysis
Simply defined, a concept analysis is a systematic exploration of a concept that determines what a concept is and what a concept is not (Walker & Avant, 2005). One of the most popular models used for concept analysis today, Walker and Avant's model streamlines Wilson's (1963) concept analysis procedure into eight steps. These eight steps include: concept selection, determining the aims or purposes of the analysis, gathering all uses and definitions available in interdisciplinary literature, identifying case studies to describe the concept, identifying antecedents and consequences, and defining empirical referents. Walker and Avant's eight step model will be used as the framework for this concept analysis of cognitive reframing.
Theoretical Context and Selection of Concept
This concept analysis was inspired by Nola Pender s Health Promotion Model ([HPM], revised) which seeks to...