Janice M. Morse

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CONCEPT CLARIFICATION: THE USE OF PRAGMATIC UTILITY¹

                Words … should be discarded as soon as they begin to conceal what they ought to illuminate. Our terminology should be flexible in order to bring more and more human experience into the range of our theory.

—Goldenburg (1990, p. 215)

Concepts are dynamic. As our world changes and develops, so do concepts emerge, change, and develop. Consider how many concepts have developed with the coming of the digital age—with cell phones, computers, and online music, books, movies, and information.

In order to understand concepts pertinent to nursing practice and research, it is helpful to examine how they have been used and developed in nursing research. At least it seems to be an approach that would please the Wizard (Coté, 2005, p. 167), for concepts are by their very nature subjective, created perspectives of reality, which are shared and that allow us to communicate. If we can determine what everyone agrees on, what they are, and what they represent, then we are one step closer to developing the theoretical basis of nursing. In Chapter 12, we discussed how to elicit lay concepts that are implicit and undeveloped, but nevertheless a part of our reality. Here, we start one level above this, examining concepts that are partially developed, and that have been used in research and discussed in our literature. Using the concept of caring as an example, we explore how various authors have used this lay concept, how they defined it, and considered its scope and its attributes. If there is some variation in its presentation and use, we examine the agreements and disagreements about the concept, and the different assumptions and perspectives as presented in the literature.

Recall this method of analysis is for lay concepts, not scientific concepts: there should be agreement about scientific concepts, and their components clearly presented when they were introduced. As they have, by definition, been introduced into research as mature concepts, there is no reason to conduct a concept analysis or be concerned with concept development.

However, the fact that a concept may not be developed to the state of maturity does not deter researchers from using the concept in research. In fact, in qualitative inquiry, where the goal is to develop theory and concepts, concept maturity is not often reached, even as an outcome of the study. In quantitative inquiry, where the majority of the major concepts used are scientific concepts, lay concepts, with all their limitations, are also used. Rarely however, are immature lay concepts used in quantitative research, although we do find them in qualitative inquiry.

Therefore, the goal of pragmatic utility is the development of partially mature concepts by using the literature as data. Pragmatic utility is a metaanalytic technique that, rather than synthesizing the literature, moves inquiry forward by examining or appraising the way the lay concept has been used by other researchers and authors in their publications. When conducting pragmatic utility, the researcher systematically examines the definitions, attributes, and uses of partially mature concepts as described by each author, and asks analytic questions about the components of authors’ conceptualizations of the concept, then comparing, contrasting, and synthesizing that data. In this way, the researcher may identify the implied and the explicit assumptions, overt and inferred meanings, and implicit and explicit conceptual components. Thus, the commonalities and the differences of the use of the lay concept may be identified, the different perspectives or usages of the lay concept described, and the degree to which the lay concept has been operationalized can be determined.

Note that pragmatic utility is mainly used for lay concepts, for eliciting hidden meanings. The technique may not be very useful for scientific concepts, as scientific concepts have been purposefully developed, and should in the process of development be published as a mature concept, so that there is nothing “hidden” to reveal. But there is an exception: sometimes scientific concepts, as they are used in research by various researchers, are subtly, consciously, or unconsciously changed, and these changes become significant, yet remain covert. In Chapter 19, we discuss one such example, social support, and Hupcey’s (1998a, 1998b) analysis of the changes that occurred over time.

Pragmatic utility is not a literature review, in which all of the research pertaining to a particular topic is summarized. It differs from a critical analysis, in which the researcher criticizes or challenges the ideas of other authors. It differs from a research review or critique, in which the researcher synthesizes the major contributions to research in a particular area and attempts to identify what is known and where the gaps in the research are or to identify the next logical step, hypotheses, or research questions to be tackled in order to continue inquiry. And it is more than a meta-analysis, in which the perspectives of various authors are synthesized and compared, and even a new model created.

Using procedures that differ from other types of literature summaries and syntheses, pragmatic utility is a method that explores concepts as determined by critically appraising the literature and the role they play in inquiry. Pragmatic utility provides a method to compare attributes of a concept suggested by various authors, to elicit the underlying assumptions of their perspectives, to identify the attributes of the concept, and its application or use in practice. Pragmatic utility may be used to compare, to clarify, or to develop lay concepts (Morse, 2000). It may be used to explore various forms of a particular concept or the relationship of a concept to its allied or competing concepts. It is an important method that moves knowledge forward.

PROCEDURES: DOING PRAGMATIC UTILITY

Pragmatic utility represents serious scholarship, with lots of hard thinking. It has been criticized for the amount of work it entails, for the lack of clear guidelines, for the open-ended nature of the literature search, and for the lack of a clear end goal (Weaver & Mitcham, 2008). I address these criticisms as I describe the process and procedures. Certainly, pragmatic utility is not a trivial technique, but with concentrated effort, it can be accomplished in a semester, and the results sometimes result in seminal contributions (Paley, 2002).

Why does the method not include fieldwork (or a combination of analyzing the literature and fieldwork) as does the hybrid model of concept development (Schwartz-Barcott & Kim, 2000) and recommended by Fawcett (2008a)? Because pragmatic utility is used for partially mature concepts, some published research about the concept of interest is available, and this research contains descriptive data from qualitative fieldwork—interviews and observations. Therefore, some knowledge that may be gained from conducting fieldwork should be available in the literature, so let us use it, reflect on it, synthesize it, and analyze it. Fieldwork is appropriate for the identification and analysis of immature concepts, when the literature is not available or scarce, as we discussed in Chapter 13.

Be Clear About the Purpose of the Inquiry

Doing concept analysis as a class exercise is not an adequate reason for using pragmatic utility. Rather, the purpose of your inquiry will direct your approach, determine the way the literature is segregated, and guide the types of analytic questions you will be asking. While it appears simple, doing concept analysis is actually hard work! (see Figure 17.1). Granted, at the very beginning, before you have delved into the literature, you may not be very clear exactly why you are doing it. But some good reasons for using pragmatic utility are:

Each of these goals may be attained using pragmatic utility and be reflected in your research question. As with all research, it begins with a research question. This question arises from your open inquiring attitude as you read about the concept:

Note that while your question about a concept arises from a curiosity present at the beginning of the study, it may be reconceptualized in the process of reading the copious literature available on the topic. Indeed, you may not have been aware of the specifics or the problems or strengths in the concept before delving into the literature.

Be careful not to combine too many questions or purposes in one study. Each time data are “split,” the amount of data in each category is further reduced, and introduces a problem of thin data or an inadequate number of articles (data) available for analysis in each category. Moreover, your analysis may become confusing if you try to do too much at once.

The Research Question Dictates The Organization of Data

Researchers must always be aware of their rationale for asking a research question, and they should be able to see the project through to the expected completion (results) and be aware of the type of results that they intend to obtain. This is essential—research is not an exercise of fumbling in the dark, but there is a fine line between knowing what you are looking for, and violating the principles of induction. Always keep your research questions and your goal in mind, so that you do not become completely lost in your data.

The rationale for conducting the study remains a constant reminder of the overall desired goals. For instance, you may be interested in different disciplinary perspectives on the concept. Whereas the conceptual attributes remain the same, the various disciplinary contexts emphasize different attributes and de-emphasize others, resulting in different forms of the concept. Similarly, as authors or major schools of inquiry tend to cluster in disciplines (or even within disciplines, institutions, or geographic areas), the analysis may cluster by major contributors or researchers who tend to use the same conceptual definitions. Occasionally, one or two authors will have made significant contributions, and therefore, it may be pertinent to the research goals to sort the concept by definition: for example, to sort stress by articles using Selye’s (1976) definition versus “others.” Often such an excellent definition becomes influential, is cited (and used) frequently, and developed into a “school” of thought.

Another question that may be of interest to researchers, and influence design, is by method. By method, I do not mean research method (as in qualitative method), but rather how the concept is researched and described, for exploring this provides insight into how the concept or phenomenon has been perceived. For example, the phenomenon of nurses’ ability to assess the patient’s condition without the patient verbalizing complaints has been accounted for by the concepts of intuition, inference, sublimation, empathy, and insight (Morse, Miles, Clark, & Doberneck, 1994). Consider how the phenomena were researched: With each concept, did the researcher obtain information about the concepts by interviewing nurses or observing nurses assessing patients to describe the concepts used? Did the researcher interview nurses about unsuccessful as well as successful incidents when exploring nurses’ insights? As discussed later, these five concepts all have distinct attributes, and using different methods to examine the same phenomenon sheds light on how such concepts are perceived.

Identifying a Partially Mature Lay Concept

In order to achieve the interpretative and descriptive goals of pragmatic utility, you must have:

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