Janice M. Morse
THE PROTOTYPICAL METHOD
Q: How many people of a certain classification does it take to screw in a lightbulb?
A: More than one.
Recall the definition of a behavioral concept: It is a representation of a collection of behaviors that have been given a name.
It is the shared agreement of these labels and what they represent that enables communication. However, reality is messy, and we often find that behavioral concepts are a poor fit, and sometimes there is no concept label for what we are interested in. In these instances, we communicate using description, analogies, metaphors, and so forth. On the other hand, we may find several concepts fitting, or competing for, the same phenomena, or, alternatively, a range of phenomena or examples fitting the same concept label (Figure 16.1a and 16.1b). In these cases it is important to determine the actual differences between the concepts or the phenomena. (These techniques are discussed when we need to compare concepts in Chapter 19.) Importantly, sometimes we find a situation or phenomenon that fits the concept label exactly—a perfect exemplar (Figure 16.1c). It is this last type of exemplar that we analyze in the first part of the prototypical method for concept development.
THE PROTOTYPICAL METHOD
What level of concept is most suited for analysis or development using the prototypical method? The best are lay concepts that are well established in the lexicon but have not been well developed. Their definition in the literature may be clear, but the attributes have not been identified. In the literature, there may be some descriptive qualitative studies available, and even some quantitative, but these studies are not explanatory—they do not help us understand the nature of the concept. Thus, the concept that you are interested in may be classified as being in the upper level of immature, bordering on partially mature. It may be commonly used, and even considered important in nursing care.
As we learned from our analysis of compathy, once a concept is identified, it is easy to see it everywhere. The concept suddenly appears obvious or commonplace.
Using the Prototypical Method
The prototypical method of concept identification and development consists of two stages: (a) an inductive phase, the identification and analysis of the exemplar and the concept, and (b) a deductive phase, exploring the presence of the concept in other situations, of confirmation of the concept as a concept.
Phase 1: The Identification and Analysis of the Exemplar
The prototypical analysis usually starts with the investigator’s analysis in a particular concept, followed by a rather frustrating and unfruitful literature review. Then, in desperation, the investigator may find a documentary movie or a short biographical story that seems to be an excellent example of the phenomenon of interest. If it is a story presented as an oral history, one should be certain to audiotape it, as the story must be in a form suitable for analysis. Remember, this is your primary data for developing the concept.
Next, listen carefully to the story or watch the video several times. Make notes on the course of events and the nature of the phenomena. You must be able to sort out the dross—the irrelevant incidents or events—from those events associated with the concept. Some early important features will be those that set up the concept, that is, the preconditions. Strong characteristics are probably attributes; weaker characteristics may also be attributes, but are those that are not dominant in this form of the concept. Alternatively, they may be attributes that are shared with allied concepts. Or, they may even be just noise, coincidental events that may be disregarded.1
If your story is complete (i.e., not an ongoing episode), events that occur at the end of the story are probably outcomes. Spend time examining these outcomes, and the transition or boundary that just precedes the outcome.
Now develop the attributes. These events/incidents or descriptive features should be described as cleanly as possible. Preferably, give them a name that is not too colloquial—that is, select a label that is general and descriptive, and is possibly a concept name that is already used in the literature. Do not choose an emic label; that is, one that uses the words of the participants, for these are too local. Remember you are developing a concept and contributing to the literature. These labels will, hopefully, be used by others.
Delineating the Concept
Next, work on the attributes. Write a description of each and select a reasonable name for each. Each must be distinct from the names from other concepts. Usually, the attributes all may co-occur and are not ordered—that is, one occurring before another. If an attribute does precede another (i.e., is sequenced), you will find that you are developing a model, albeit primitive.
Phase 2: Exploring the Presence of the Concept in Other Situations
At this point you have developed a concept from a single case. It is possible that your concept is right, but we must ensure that is it correct and generalizable, and not some local phenomenon.
The first step is to find other sources of data that may be used to confirm the attributes. In the example of hope (that follows in this chapter), it used other data sets—data collected for other purposes, but in which hope was likely to be present. Examine these sets of data using your knowledge about the concepts deductively. Look for the attributes—are they all present? Does the description hold?
One should note that concepts appear in different forms in different contexts—later in the chapter we discuss different types of hope. Each type of hope has all of the attributes, but in some forms of hope some attributes are stronger, more dominant, than others, and others are weaker. They are still present, but have been backgrounded. And this pattern varies with the type of hope. Therefore, in your data, some of the variations that you see may be from different forms of the concept, but it is still the same concept. In the hope example, we have diagrammed the different forms of hope.
Near the boundaries, the concept becomes weaker, as it interfaces with allied concepts. Look to see where the boundaries are: When the concept no longer becomes an example of the phenomenon, that is the point where the boundary lies.2
Finally, check the antecedents and the consequences. Do the conditions to setting up the concept and the outcomes still hold?
And one final step: Visit the library and check that the concept you have just delineated has not been developed by someone else. If it has, check for similarities and dissimilarities. Look at their context; check their definitions. If their conceptualization is very close to yours, adopt their terms. They identified it first; so acknowledge that. As it is highly unlikely that their concept description will be exactly the same as yours, yes, you have done original work, and will be acknowledged for it. But do make it simple for the rest of the world, and link your findings with theirs.
THE CASE OF HOPE3
In the early 1990s much had been written about hope, but the literature was not clear: hope, as a concept, had not yet been delineated. Although hope was defined in the dictionary, the attributes were not explicated. We needed to identify the antecedents and we needed to identify the outcomes. Neither had the boundaries been identified. Importantly, we wanted to know if the many forms of hope were pertaining to one malleable concept as the strengths of attributes changed, or to many allied concepts that appeared as the patient’s condition changed or as the prognosis was confirmed.
Some years earlier, I worked with a student, Sharon Laskiwski, to conduct an ethnography in a spinal cord unit exploring the role of hope in the early stages of a spinal cord injury. From those data, we documented the changing nature of hope—this was the first study that viewed hope as a dynamic concept, capable of changing form as the phenomenon changes—in this case, the prognosis of the spinal cord patient changed as the injury was assessed and realized in the days following injury (Laskiwski & Morse, 1993).
At this time, why was hope to be considered a phenomenon and not a concept? As noted, hope was defined in the dictionary, but was poorly developed, and had not reached the developmental stage of a concept. Hope was considered an emotion, a collection of behaviors that roughly occurred together, but these emotions or behaviors had not been described in detail and had not been delineated. In the research presented in this section, we first described hope in detail (Laskiwski & Morse, 1993) and then developed the attributes of the concept of hope (Morse & Doberneck, 1995) using the prototypical method of concept development. Once completed, and recognizing that the types of hope were a single concept, we used these attributes to develop an assessment guide, so that clinicians could support or modify the development of hope (Penrod & Morse, 1997). This is described later in Chapter 23. Later in the research program, we linked hope to emotional suffering (Morse & Penrod, 1999) in the process of developing the mid-range theory, the Praxis Theory of Suffering (Morse, 2001, 2011), described in Chapter 35. Such was the usefulness of the concept to the progression of the research program.
But we are getting ahead of ourselves.
The first descriptive study of hope showed that hope was a malleable concept, changing over time. All parties involved with the patient who had a spinal cord injury—the patient, the family members, and the staff—changed what they were hoping for, very quickly, as they received and were able to accept new information (Laskiwski & Morse, 1993, p. 152).
But such a descriptive study is only the beginning. To develop hope as a concept, we need to identify a context and a phenomenon that will lead to hope (the precursors or antecedents of hope), conditions of which we may be reasonably certain.