1.0 Concept Selection
Mortality and mortality have been utilized as the primary traditional measures or indicator of health outcomes related to lifestyle illnesses such as diabetes (Wang & Sheih, 2001). When diabetes is detected in time in a patient, it becomes easier to diagnose and manage concomitant conditions. However, diabetic patients might exhibit side effects that can compromise the physical, social, and mental well-being of the patient. The concept of "well-being" is a complex construct that has been used in diverse scientific disciplines, including nursing. As a result, diversity and inconsistencies exist in the conceptualization of the term, particularly in the present literature. The ambiguity inherent in the use of the concept in nursing research can and is a considerable impediment to further development of knowledge and theory. A concept analysis of well-being is therefore justified by the need to understand competing viewpoints of the concept and create a clear distinction between it and other terms that are interchangeably used with it.
2.0 Aims and Purpose of the Analysis
As identified above, mortality and morbidity have been the major measures for health outcomes (Wang & Shein, 2001). Today, health practitioners and scholars have subjectively perceived well-being in the attempt to assess health outcomes (Wang & Shein, 2001 2; Diener, Scollon & Lucas, 2009). Despite the use of well-being in diverse field and documentation of the term in numerous research studies, its conceptualization across the different disciples are still unclear. In fact, there still inconsistencies and ambiguity in the use of the term across the various disciplines. For instance, well-being is still used interchangeably with related terms such as gratitude and happiness (Ryan & Deci, 2001; Deci & Ryan, 2008; Andrews & Withey, 2012; Ryff & Singer, 2013; Pinto, Fumincelli, Mazzo, Caldeira & Martins, 2016). Therefore, there is a justified need to develop the meaning and understanding of well-being and to conceptualize the term from a nursing perspective.
3.0 Identification of all uses of well-being
Compressive review of existing literature on the concept of well-being reveals inconsistencies in meaning and variations in meaning of the term (Wang & Shein, 2001; Deci & Ryan, 2008; Diener, Scollon & Lucas, 2009; Pinto et al., 2016). Watsons Transpersonal Theory attempts to identify the diverse uses and purposes of well-being particular within the nursing discipline. Pinto et al. (2016) note that the concept of well-being exists not only in nursing theories but also in the mainstream health sciences theories as an essential construct in the assessment of patients. Orem's theory describes self-care as the activities people or health providers do for their benefits with the fundamental goal of maintaining life, health, and well-being (Pinto et al., 2016).
Moreover, Watsons theory, on the other hand, supports the need for nurses to shape a system of humanistic and altruistic values, instill faith and hope, and to recognize senses and feelings as guiding principles for developing working relationships between the caregiver and the patients, and for fostering well-being (Pinto et al., 2016). Wood, Froh & Geraghty (2010) explain the relevance of gratitude to the field of clinical psychology by asserting that it provides a strong explanatory power to comprehending well-being and the potential for enhancing well-being via promoting gratitude with simple exercises. These theories and insights present the uses and purposes of the concept of well-being, which are peculiar to the nursing profession.
4.0 Defining attributes of well-being
The application of well-being in many disciplines suggests that the concept has several defining attributes. According to the Oxford Dictionary, well-being is the state of being comfortable, healthy, and happy (Pinto et al., 2016). Three defining attributes of the concept can be identified from this definition comfort, happiness, and health. In the nursing and other scientific disciplines, well-being is related to a number of concepts, including happiness, satisfaction in ones life, fulfilling experiences, health (physical, mental, and social), prosperity; quality of life, gratitude; and pursuit of pleasure, engagement, and meaning (Ryan & Deci, 2001; Ryan & Deci, 2008; Diener, Scollon & Lucas, 2009; Schueller & Seligman, 2010; Wood, Froh & Geraghty, 2010; Pinto et al., 2016).
In light of Reeds Self-Transcendence Theory, well-being is equated to the sense of being whole and healthy based on an individuals view of wholeness and health (Reed, 2008). According to this theory, people perceive the concept of well-being differently since an individual is a product of its environment (Reed, 2008). Differences in cultures, complexities in life, social dogma, and other aspects of the environment an individual grows to explain the differences in the understanding of well-being.
5.0 A model case
From the perspective of Walker & Avant (2005), a model case would be a real life example of the use of well-being that encompasses all its defining attributes. The concept of well-being has been used in promoting patients' physical, mental, social, and environmental aspects of health or way of living. In the nursing discipline, the practice of improving the well-being of patients and individuals is common. Donoso et al. (2015) conducted a diary study to determine if daily emotional demands nurses face bear positively impact their daily motivation and well-being at work and home, respectively. The researchers established that daily emotional workplace demands positively affect the participants vigor at the workplace and vitality at home (Donoso et al., 2015). The study further revealed that nurses with higher ability to control their emotions exhibit higher morale at work and well-being at home when they expect facing high emotional demands at their workplace. This study presents a real case use of the concept of well-being among nurses.
6.0 Borderline, related, and contrary cases
A borderline case would be the quality of life (QoL). The World Health Organization (WHO) defines QoL as peoples view of their position in life from the culture and value systems in which they lived and based on their individual goals, expectations, standards, and concerns (Pinto et al., 2016). This conceptualization of quality of life incorporates many critical attributes of well-being, such as an individual's physical and mental condition, the level of independence, culture and the environment. WHO presents QoL as a subjective and multifaceted construct encompassing the cultural, social and environmental aspects of an individual. Also, the definition reflects the overall condition of human life. However, several critical attributes of well-being are missing. Another borderline can be comfort the immediate state of an individual to feel strong by having the need relieve, ease, and transcend himself or herself holistically physically, psycho-spiritually, socio-culturally, and environmentally (Pinto et al., 2016).
Happiness can be a related case to well-being. Deci & Ryan (2008) relate well-being to optimal experience and functioning. They identify two general perspectives from which the concept of well-being is derived hedonic and eudaimonic approaches. The former concerns happiness and conceptualizes well-being from the point of attaining pleasure and avoiding pain, while the latter anchors on meaning and self-realization and views well-being as the degree to which a person is fully functioning (Ryan & Deci, 2001; Deci & Ryan, 2008). This assessment presents well-being and happiness as related concepts as they share several aspects like pleasure attainment, pain avoidance, and self-realization. A good example of a contrary case to the concept of well-being would be gratitude.
7.0 Antecedents and consequences of well-being
Wang and Shein (2001) identify several antecedents of the state of well-being, including life experience and self-appraisal. Review of current literature in nursing revealed several consequences of well-being. These included self-realization, pain avoidance, motivation at work, happiness, pleasure attainment, and comfort, among others (Ryan & Deci, 2001; Deci & Ryan, 2008; Schueller & Seligman, 2010; Doroso et al., 2015; Pinto et al., 2016). As identified in earlier in this analysis, most of these antecedents and consequences of well-being are related and coexist among each other.
8.0 Empirical referents
Just as the concept of well-being is multidimensional so are its empirical referents. One example is happiness, which Deci and Ryan (2008) generally defined as the existence of a positive affect and the absence of a negative affect. The state of happiness can infer well-ness. That is an individual or patient who exhibits happiness can be said to be in the state of well-being. On the same note, Diener, Scollon, and Lucas (2009) observe that the subjective well-being comprises several separable but somehow related variables such as positive and negative feelings and life satisfaction, which can be said to be empirical referents of well-being.
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Deci, E. L., & Ryan, R. M. (2008). Hedonia, eudaimonia, and well-being: An introduction. Journal of happiness studies, 9(1), 1-11.
Diener, E., Scollon, C. N., & Lucas, R. E. (2009). The evolving concept of subjective well-being: The multifaceted nature of happiness. In Assessing well-being (pp. 67-100). Springer Netherlands.
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Wood, A. M., Froh, J. J., & Geraghty, A. W. (2010). Gratitude and well-being: A review and theoretical integration. Clinical psychology review, 30(7), 890-905.
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