Assignment 1: Theoretical Foundation

Assignment 1: Theoretical Foundation

Assignment 1: Theoretical Foundation

As you reach the conclusion of this Assignment, take a minute to appreciate your achievement. Your theoretical foundation for research represents a significant milestone not just in this course, but also in your growth as a doctoral student and a nurse scientist. Whether you retain your focus on your selected phenomenon or adjust your plans as you move forward, you will be able to build on the skills you have honed in this course to develop your program of research in the future.


To prepare
  • Ensure that your paper addresses the following:
    • Your phenomenon of interest
    • Concepts (definitions, attributes, antecedents, and consequences)
    • Conceptual relationships
    • Assumptions
    • How an existing framework or theory could inform your work. (Explain how the framework/theory originated and what modifications you may need to make for it to be useful for your research.)
    • Research questions or hypotheses
    • Graphic model and narrative, as necessary, to support the model

Note: Please include your graphic model and narrative within the paper you submit.

Final Paper (due week 10 Sunday, November 8th) (called Assignment 1 again) (8-12 pages not including the title page or references – don’t worry about page limit – write and write succinctly)


  • Title page
  • Introduction
  • Phenomenon of interest
  • Concept including definition, some ROL, antecedents, defining attributes, and consequences (you must have at least 2 citations for each defining attribute – if possible include a table starting with antecedents, then attributes, and finally consequences so you can see the flow)
  • Relationships about concepts – antecedents and concept, antecedents and consequences (maybe), concept and consequences; concept and another concept (similar or opposite – hope and hopelessness, quality of life and well-being, etc.), direction of relationships – one direction or two, positive or negative; any other related concepts and their relationship with your concept (pull in text)
  • you do NOT Have to include the model case and another case but if you want to you can but make sure you call out all the defining attributes in the model case and if you use a borderline case, talk about which defining attribute is missing – you can make up the case study and focus on your context (POI); you do NOT have to include empirical referents but if you want to, do so
  • Assumptions (remember to keep them general)
  • Theory or conceptual framework
  • Research questions and/or hypotheses (research questions about concept and antecedents, concept and consequences, concept and other concepts or factors, one big global question) (remember to include the population of study and context)
  • Graphic with a brief explanation of the graphic (make sure you have antecedents, defining attributes, and consequences as well as the theory – it is about the CONCEPT)
  • Summary
  • References (separate pages)
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    Analyzing a Health-Related Scenario #1

    Area of Interest: Patient Medication Education

    In the development of the theoretical foundation to investigate patient medication education, a researcher needs to evaluate the thesis title and the research problem (medication noncompliance), brainstorm elements for consideration as the critical variables, and conduct relevant review literature to know how other researchers have addressed the issue of a patient not complying with medication prescription due to lack of proper medication education.

    During the theoretical foundation development, building framework or theories takes some phases in which the first step is examining the issues related to inadequate patient medication education. This research problem will form the basis for the entire study and from which research constructs theoretical framework (Hennink Hutter, & Bailey, 2020). Secondly, brainstorming what a researcher considers as the vital variables in the study becomes crucial. Questions concerning the elements contributing to patients not to take the medication after six months of post-surgery, get answered. Assignment 1: Theoretical Foundation

    In the literature review of the issues that relate with the current research problem under the study, scholars and researchers who have solved or addressed medication noncompliance are sought through the analysis of their theories (literature review). In this process, the identification of the assumptions from which the scholars address the research problem is critical (Greenhalgh, Bidewell, Warland, Lambros, & Crisp, 2020). Also, the listing of the research constructs and variables such as nursing education vs rate of medication noncompliance during post-surgery is undertaken. The listing gets followed by the grouping of the variables into independent and dependent categories. In the framework development, a researcher outlines assumptions or propositions of the theory and highlight their relevance to the research. For instance, an assumption will be, patient medication education reduces the rate at which post-surgery patients abandons their drug prescription or medication.

    The theoretical framework carries research concepts. Concepts of patient medication education are medication compliance that involves taking medication as prescribed, and education is given to gain knowledge on how to take drugs. So, the conceptual relationships account for how lack of medication education contributes to medication noncompliance among patients. The graph model to use on patient medication education is the state-of-the-art graph that will combine theoretic strategies with approaches to probability theory during the presentation of the research results (Greenhalgh et al., 2020).

    In the research’s presentation of the conceptual relationship, both independent and dependent variables such as nurse educator lessons and incidences (rates) of not taking medication will get linked to illustrate how they influence each other and show the possible research outcome. For instance, variables on the left side and outcome (dependent variable) on the right side of the conceptual framework will get joined through the use of arrows. Dependent variable on the left side implies the medication compliance as an outcome of independent variables such as medication education provided. Assignment 1: Theoretical Foundation


    Greenhalgh, T. M., Bidewell, J., Warland, J., Lambros, A., & Crisp, E. (2020). Understanding research methods for evidence-based practice in health. John Wiley & Sons.

    Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods. SAGE Publications Limited.

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    Adults                                                                                                                                          Concepts, Conceptual Relationships, Frameworks/Theories, and Graphic Models

    The frameworks/theories of individualized patient medication education are critical elements of research. According to Jason, Stevens, Ram, Miller, Beasley, and Gleason (2016), these frameworks/theories give guidance for developing research questions and testable hypotheses on how the effectiveness of providing individualized patient medication education for older adults to reduce incidences of medication non-compliance among older patients. In general, frameworks will give a broad description of individualized patient medication education for older adults and inform a researcher of the types of elements classified as critical avenues of studying (McEwin & Wills, 2019). Also, the frameworks or theories play a crucial role in informing research methods and designs. Furthermore, the theories give overall guidance on what components of patient education to research. If theories get founded within frameworks, then frameworks are nested within interest phenomena, patient medication education for older adults (Jason et al., 2016). However, the theories fail to provide specific predictions regarding the relationship between medication compliance and medication patient education among older adults.

    The main concepts in research will be individualized medication education and medication compliance. Sticking to these two concepts will result in attaining valid findings that answer the research question. On the other hand, conceptual relationships will involve semantic connections or links between two or more specialized concepts, medication education, and rates, or medication compliance incidences. For instance, if the healthcare facilities (hospitals) fail to educate discharged older patients on how to take drugs, such patients are likely to abandon the dose before they can finish their dose. This abandonment threatens medication compliance and may bring other complicated health issues leading to 30-day readmission. Under conceptual relationships, a researcher will develop a conceptual framework that illustrates the relationships between independent and dependent variables being studied. For instance, in the study, the independent variable will include medication education lessons, and the dependent variable becomes the rates of compliance.

    The relationship between the independent and dependent variables is that when a nurse educator does not teach or educate patients on how to use medicine while under a home-based care program, such a patient will take wrong doses. So, the independent variable influences the dependent variable’s variation in the conceptual relationships (Hennink, Hutter, & Bailey, 2020). In the representation of the relationship, for instance, variables on the left side and outcome (dependent variables are put on the right side (outcomes) while independent on the left side and their facilitating elements or factors. Assignment 1: Theoretical Foundation

    The best graphic model for use in studying individualized patient medication education is the Gaussian Graphical Model. This model will help a researcher visualize the relationship between variables. Since the model is probabilistic-based, the relationship is that when individualized patient education for older patients is provided, the positive outcome is medication compliance (Gray, 2017). In contrast, if education is not given, the negative outcome that is non-compliance will probably occur. According to McEwin & Wills (2019), the development of the theoretical elements is vital because it will make a researcher aware of the assumptions that inform the research design, showing the rationale behind them.


    Gray, J. R. (2017). Frameworks. J. R. Gray, S. K. Grove, & Sutherland, S. (Eds.). Burns and Grove’s the practice of nursing research (pp. 138-156). Elsevier.

    Greenhalgh, T. M., Bidewell, J., Warland, J., Lambros, A., & Crisp, E. (2020). Understanding research methods for evidence-based practice in health. John Wiley & Sons.

    Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods. SAGE Publications Limited.

    Jason, L.A., Stevens, E., Ram, D., Miller, S.A., Beasley, C.R., & Gleason, K. (2016). Theories in the field of community psychology. Global Journal of Community Psychology Practice, 2(3), 23-35

    McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Philadelphia, PA: Wolters Kluwer Health.

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    Work Engagement

    In the nursing field, the concept of work engagement implies involving all healthcare workers when addressing nursing-related issues. The concept builds a harmonious work environment since everyone gets consulted when solving arising job-related disputes or conflicts that undermine the delivery of quality work. In general, work engagement in professional nursing practices focuses on personal strengths, rather than limitations in service delivery. So, it is vital to engage others in solving problems of care systems, involving negative impact of clinical shortage and pressures to minimize health care expenditure.

    This concept is relevant and critical in the nursing profession because the current changing multiple setting of healthcare. Without nurses’ effort, the achievement of the set goals is not impossible. As a result, nurse leaders or nurse executives need to emphasize on keeping close contact with nurses to enable them to perform the work. In a wide perspective, work engagement leads to inspiration and motivation. For instance, burnout happens in case of clinical staff shortage while work engagement occurs when resources are high. So, engaging each nurse can motivate and inspire, thereby minimizing the chances of burnout at the workplace (Antoinette Bargagliotti, 2012). Hospital management can balance act between care service demand and resources to determine the level at which healthcare workers get engaged.

    In developing, executing, and implement new nursing policies, policymakers need to concentrate on clinical engagement to make the proposed policies acceptable to all people impacted. The 21st healthcare setting is undergoing various changes and trends which force the hospital to keep changing the policies to fit the new environment to become effective and efficient. As a result, the concept of engaging all involved parties boost organization or person interactions and tie the commitments of each nurse to overall organizational objectives. Most of the hospital view work engagement as a tool for creating positive, fulfilling job-based state of mind in which all workers hold meaningful work values for high performance.

    In terms of maintaining employee relations, work-engagement is among the best approaches to use. Through nurse-leader engagement, a nurse perceives such an engagement as a form of the intrinsic reward of seeing social support from other healthcare practitioners, patient recover, and energy (Antoinette Bargagliotti, 2012). Most importantly, work engagement in nursing practice and healthcare setting has helped in retaining the workforce. The exiting relationship between work engagement and leaving the job is inversely related. For instance, in hospitals where engagement is highly maintained, labor turnover is low compared to where nurses are not engaged in making or deciding nursing issues that impact nurses at their place of work. Based on the above summary of article information, it directly reflects my definition of the concept of work engagement in nursing professional practice.


    Antoinette Bargagliotti, L. (2012). Work engagement in nursing: a concept analysis. Journal of advanced nursing, 68(6), 1414-1428.

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    Concept: Motivation

    Motivation is attributed willingness to attain or achieve something though goal-directed behavior. In simple terms, motivation encompasses processes that consider a person’s intensity, direction, and persistence of effort toward meeting a goal or objective. The three vital aspects of a person’s willingness are intensity, direction, and persistence. With the intensity aspect, it implies the level at which an employee works to attain the goal. On the other hand, it directly benefits the organization as persistence determines how long a worker maintains his efforts or commitments. Under the context of Maslow’s Pyramid, meeting needs such as physiological needs (sex, hunger, and thirst), a person’s safety, social (friendship, acceptance, and affection), esteem (self-respect and autonomy), and self-actualization (self-fulfillment), trigger motivation. Assignment 1: Theoretical Foundation

    Synopsis of Analysis


    The research paper explains and presents the concept analysis of motivation.

    Background: The current healthcare system is dynamic and requires accurate adjustment to ensure positive general organizational performance. Challenges of attending to the aging population, high demand for care services, patients with severe diseases such as cancer, and limited resources to solve future care issues demoralize healthcare providers’ efforts. With increasing demands for healthcare services, nurse leaders and nurse executives are forced to set specific goals that their team members should work to achieve them. Without motivation, it becomes challenging to attain such goals; thus, the organization’s performance decreases. Primarily, motivation is an internal process that triggers and makes a person move toward improving the quality of services provided.

    Data Sources

    A literature search will be critical in exploring the motivation concept. Sources such as electronic literature indexes, textbooks, Internet search engines, and scholarly research articles can provide evidence-based information concerning motivation. Mostly, literature not older than five years will give more evident findings to study motivation.


    Eight concept-analysis steps of Walker and Avant (2019) to carry out a motivation analysis related to work engagement in healthcare.

    Findings from Review of The Literature

    In Ethiopia, motivation is attached to job satisfaction among healthcare providers in public hospitals. In research by Ayalew et al. (2019), the findings show that resources’ availability determines the level of job motivation. Poor working conditions and limited resources demoralize nurses, thus reducing the level of their job satisfaction. However, this issue of decreased motivation is prevalent in developing countries and continues to negatively impact the quality of care. Among female nurses, job satisfaction is higher compare to their male counterparts. Female nurses attribute their motivation at the workplace with recognition, remuneration (equitable salary and fringe benefit), work experience, career development opportunities, and job features.

    Furthermore, adequate competent clinical staff motivates nurses since incidences of burnout are zero since the tasks assigned to every nurse are manageable within the official eight working hours. Across the world, there is a problem of critical shortage of nurses. Nurse are migrating to other countries looking for better pay and working conditions, career development, and personal safety (Freeman, Baumann, Blythe, Fisher, & Akhtar‐Danesh, 2012). The reason behind shortage and migration is due to lack of motivation, so the hospitals cannot retain nurses for long time.  According to Riahi (2011), role stress is a major problem among physicians and has led to increased distress contributing to burnout in the nursing profession. It is crucial to analyze role stress concept and its impact on nurses’ motivation.

    A 2016-2025 strategic plan launched by the Federal Ministry of Health of Ethiopia aimed to enhance the country’s commitments for developing, recruiting, deploying, and motiving healthcare workers. Ayalew, Kibwana, Shawula, Misganaw, Abosse, Van Roosmalen, & Mariam, 2019). Intrinsic and extrinsic motivation factors mainly drive overall job satisfaction. For instance, the researchers found that intrinsic motivation elements such as recognition for good performance, features of the job itself, and personal career development enhance job satisfaction and motivation. On the other hand, polices and administration, working conditions, salary, promotions, supervisions, and job security are extrinsic motivational factors of job satisfaction.

    In Iran, the concept of motivation among nurses is anchored based on encouragement. According to Esfahani & Afshin (2019), work engagement makes nurses feel motivated to give empathetic and safe healthcare services in a complex healthcare setting. Among Iranian healthcare centers, nursing work motivation among nurses and physicians is between medium to high. A s a result, hospital management, through their nurse managers and policymakers, need to focus on serious attraction to improve the job motivation that will make nurses achieve greater performance. Assignment 1: Theoretical Foundation

    The motivation of nurses and performance outcomes are directly related. The level of motivation affects satisfaction, retention, organizational performance, commitment, wellbeing, and engagement. In the perspective of wellbeing, nurses gain a feeling of happiness, also called an advanced psychological experience of individuals. In research conducted by Baljoon, Banjar, & Banakhar (2018), motivation is the product of interactions between people, their work setting, the match between these interactions, and the social context. Extrinsically motivated nurses find their work interesting, fun and challenging (Baljoon et al., 2018). The extent to which nurses are happy relies on how well they get motivated and the availability of personal sources of happiness.

    The connection between motivation and burnout is crucial when determining the level of emotional, physical, and mental tiredness resulting from long-term engagement in the work environment that appears to be emotionally demanding. In a Baljoon et al., (2018) study, motivation relates to work holism, work engagement, and burnout. Burned-out nurses do not view their work activities as satisfying and enjoyable. The findings showed that the encouragement of autonomous motivation contributes to increased job engagement and a decline in work holism and burnout. In Canada, among healthcare providers, burnout negatively impacts commitment and their work performance. Assignment 1: Theoretical Foundation

    Work motivation is essential for healthcare specialists’ performance. It has been established that it influences work performance among nurses. For instance, in quantitative research that examined the link between motivation and performance among healthcare providers employed at European Gaza Hospital, the most motivated care workers attain excellent performance outcomes compared to low-motivated care providers (Baljoon et al., 2018). This research findings raise the need for ensuring adequate training programs and an equitable working schedule to improve motivation and improve job performance. Further, the research findings indicated that highly-motivated nurses smile and initiate friendly discussions with patients and residents.

    Antecedents, Attributes, and Consequences

    Motivation antecedents are classified as intrinsic and extrinsic motivation. Like personal attributes, these two categories involve clinical experiments that relate to educational-creativity setting or work environment context. When a person is intrinsically motivated, he engages in an activity solely because he enjoys it and gets personally satisfied with it. Similarly, when he gets extrinsically motivated, he does something to receive or gain an external reward (Bakay & Huang, 2010). The self-determination level and capability, and features of the work itself are critical elements (concepts) of extrinsic motivation. In general, the main attribute of intrinsic motivation loves what you do. On the other hand, the work performance results and nature of the work allude to extrinsic motivation. However, the negative relationship existing between intrinsic and extrinsic motivation undermines intrinsic motivation. Within the creativity context, the combination of intrinsic and extrinsic enhances the overall performance.

    A Model Case

    According to Maslow’s five-model of the hierarchy of needs, motivation is a procedural process containing basic needs that must be met before proceeding to the next level of motivation. A nurse should first meet biological and physiological needs such as food, sleep, sex, shelter, and warmth before meeting safety needs. In the second stage of motivation and satisfaction, a nurse must have protection, stability, and security (Montag, Sindermann, Lester, & Davis, 2020). The third step of the model being belongingness and affection needs, requires a nurse to have a healthy relationship and teamwork. The fourth last need is esteem. A nurse has already built his image, status and achieved better results. The last need is self-actualization, the involves nurses’ need to seek career advancement opportunities to become motivated. Assignment 1: Theoretical Foundation

    Empirical Referent

    The empirical referents for motivation include decreased performance, higher employee turnover, engagement’s low levels, poor communication, inability to overcome adversity, and lack of apathy for the job are problems that proliferate and contribute to the workplace become a toxic environment. Unmotivated nurses do not seem to care if they have a job or not. Also, they are unlikely to accept challenges and changes and cannot stick with the problem to allow for finding a long-term solution.


    Motivation in the workplace will lead to increased productivity due to a high level of performance among employees. As a result, the implication of hospitals’ motivation is finding what triggers motivation, especially among frontline workers such as nurses. Instead of focusing on monetary motivation, hospitals can improve working conditions, hire enough staff, and provide adequate work resources.

    Influence of Motivation Concept Analysis

    From the above concept analysis, I have realized that the best motivation is not only based on giving attractive compensation packages but using non-monetary rewards. Previously, I perceived motivation to be an aspect that is not much important in determining workers’ and organizations’ performance in general. Now, based on the finding, I can justify that motivation is the backbone of workforce performance and increased productivity. I will use the findings to frame comprehensive research questions to research on broad motivation area of interest. Assignment 1: Theoretical Foundation


    Ayalew, F., Kibwana, S., Shawula, S., Misganaw, E., Abosse, Z., Van Roosmalen, J., … & Mariam, D. W. (2019). Understanding job satisfaction and motivation among nurses in public health facilities of Ethiopia: a cross-sectional study. BMC nursing, 18(1), 46.

    Bakay, A., & Huang, J. (2010). A conceptual model of motivational antecedents of job outcomes and how organizational culture moderates. Available at SSRN 1722048.

    Baljoon, R. A., Banjar, H. E., & Banakhar, M. A. (2018). Nurses’ work motivation and the factors affecting it: a scoping review. International Journal of Nursing & Clinical Practices, 2018.

    Esfahani, P., & Afshin, M. (2019). Job Motivation among Iranian Nurses; a Systematic Review and Meta-Analysis Study. Health Research Journal, 4(1), 30-37.

    Freeman, M., Baumann, A., Blythe, J., Fisher, A., & Akhtar‐Danesh, N. (2012). Migration: a concept analysis from a nursing perspective. Journal of advanced nursing, 68(5), 1176-1186.

    Montag, C., Sindermann, C., Lester, D., & Davis, K. L. (2020). Linking individual differences in satisfaction with each of Maslow’s needs to the Big Five personality traits and Panksepp’s primary emotional systems. Heliyon, 6(7), e04325.

    Riahi, S. (2011). Role stress amongst nurses at the workplace: concept analysis. Journal of nursing management, 19(6), 721-731.



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    Nurses are essential people in our lives, and they ensure the safety of many individuals daily. It is, therefore, vital to ensure they are well taken care of in the best way possible. They experience several challenges like workplace problems and both physical and emotional harassment and bullying. Workplace hazards include exposure to injuries, cold, germs, bloodborne pathogens, among other work-related issues (Walton et al., 2017). On the other hand, bullying occurs when they interact with patients or sometimes their seniors. It can be informed of physical or verbal abuse, and sometimes the nurses are also assaulted (Cleary et al., 2010). The paper will focus on how workplace hazards and bullying affect nurses’ performance.

    Workplace hazards and bullying affects nurses immensely. These two concepts impact nurses negatively in several ways. It may affect their health, performance at work and also their productive nature at workplaces. The statement is classified as a relational statement since it outlines the relationship between concepts (Walker & Avant 2019). Moreover, Workplace hazards are aspects of work which causes health risk. While bullying occurs when nurses interact with the patients or their seniors, it may be as a result of stress or job demands. It may result in emotional distress. Assignment 1: Theoretical Foundation

    Relationship between Concepts

    Workplace hazards and bullying greatly affect the nurses’ performance and productivity in their workplaces. When the environment they get involved in is not conducive enough, it affects their general performance. It is, however, essential to create awareness to the nurses on bullying and harassment concerns and also about workplace dangers. According to Walker & Avant (2019), concepts enables us to classify experiences in a more meaningful manner to both ourselves and the others. In this context, the relationship the nurses have with the environment they work and how it affects them and others. When they get sick due to the unconducive environment, the situation affects both the patients and the nurses themselves.

    Nursing Metaparadigm

    They include health, environment, nurse, and also patient. Workplace hazards focus on the environment; the nurses are connected within their respective facilities. When they catch a cold and flu, it is obvious the patients will get infected, and both their health will be affected. So it is essential to keep the environment the nurses work in safer for them to protect themselves and other people in healthcare facilities. When we talk about bullying of the nurses, it directly impacts their health negatively. It also entails the bad surroundings, which leads to such situations like bullying or any harassment. They can even go into depression and anxiety. When the nurse is not in his/her mental state, it implies that the lives of the patients are equally at risk.

    The assumptions implicit in the study include how workplace hazards might contribute to poor performance and healthcare delivery by the nurses. They are not clearly stated by they are suggested that one factor may lead to another. Similarly, the explicit assumptions include; bullying and workplace dangers affect the health of the nurses significantly both physically and emotionally. This may lead to mental issues, depression, or anxiety in the workplace. It is evident that the environment that the nurses work in contributes significantly to their performance, and this may also increase their morale and productivity in the workplace.


    Workplace Hazards and Bullying  are among the significant issues affecting nurses today. So it is crucial for health personnel to look deeply into the matter to ensure they address the issue by developing specific policies.  They will, therefore, help protect the nurses from bullying or any form of harassment to guarantee their safety (Cleary et al., 2010). The environment in which they work should be thoroughly checked to ensure it is safe for human inhabitants to avoid getting diseases that the nurses will potentially spread to other healthcare facilities. Assignment 1: Theoretical Foundation


    Cleary, Michelle, Glenn E. Hunt, and Jan Horsfall. “Identifying and addressing bullying in nursing.” Issues in mental health nursing 31.5 (2010): 331-335.

    Walton, A. L., & Rogers, B. (2017). Workplace hazards faced by nursing assistants in the United States: a focused literature  review. International journal of environmental research and public health14(5), 544.

    Walker, L.O., & Avant, K. C. (2019). Strategies for theory construction in nursing (6th ed). Prentice Hall.

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