Concept Analysis:Confidence/Self-confidence

Concept Analysis:Confidence/Self-confidence
nuf_230  218..230
Patricia Perry, MSN, RN, CNS, CNE
Patricia Perry, MSN, RN, CNS, CNE, is a Doctoral Student at the University of Hawaii at Manoa, School of Nursing and
Dental Hygiene, Honolulu, Hawaii, and an Assistant Professor at the Azusa Pacific University, School of Nursing, Azusa,
California, USA.
Concept analysis, confidence,
self-confidence, self-efficacy, nurse
Patricia Perry, MSN, RN, CNS,
Azusa Pacific University, School of
Nursing, P.O. Box 7000, Azusa, CA
91702, USA.
Confidence and self-confidence are crucial practice ele-
ments in nursing education and practice. Nurse educators should have
an understanding of the concept of confidence in order to assist in the
accomplishment of nursing students and their learning of technical and
nontechnical skills. With the aim of facilitating trusted care of patients in
the healthcare setting, nursing professionals must exhibit confidence,
and, as such, clarification and analysis of its meaning is necessary.
The purpose of this analysis is to provide clarity to the
meaning of the concept confidence/self-confidence, while gaining a
more comprehensive understanding of its attributes, antecedents, and
Walker and Avant’s eight-step method of concept analysis was
utilized for the framework of the analysis process with model, contrary,
borderline, and related cases presented along with attributes, antecedents,
consequences, and empirical referents identified.
Understanding both the individualized development of
confidence among prelicensure nursing students and the role of the
nurse educator in the development of confident nursing practice, nurse
educators can assist students in the development of confidence and
competency. Future research surrounding the nature and development of
confidence/self-confidence in the prelicensure nursing student experi-
encing human patient simulation sessions would assist to help educators
further promote the development of confidence.
Concepts are defined as “a word or phrase that
summarizes ideas, observations and experiences. They
are tools that provide mental images than can facilitate
communication about and understanding of phenom-
ena” (Fawcett, 2005, p. 4). Creating conceptual mean-
ings is vital to the advancement of nursing theory.
Conceptual analysis conveys a mental image of what
the phenomenon is and how it is perceived in human
experience (Chinn & Kramer, 2008; Walker & Avant,
2005). Concept analysis is a strategy to further develop
previously defined concepts and advance them to the
next level of development (Meleis, 2007). The analysis
process helps to identify the meaning of the abstract
concept and to explore the uncertainty surrounding
the concept (Rodgers, 1989). Therefore, concept
analysis is a significant undertaking.
Confidence and self-confidence are crucial practice
elements  in  prelicensure  nursing  education  and
nursing practice. Nursing is a service profession, and
those in its care must feel safe and reassured. Low
self-confidence makes others uncomfortable (Kröner
& Biermann, 2007) of trusted experts when receiving
their service, especially in the context of health care.
“When we listen to the answers of a mechanic, a
physician or any other expert and feel that they are
not confident, we also tend to fear that they do not
© 2011 Wiley Periodicals, Inc.
Nursing Forum  Volume 46, No. 4, October-December 2011
know what they are talking about” (Kröner & Bier-
mann, p. 589). How can nurse educators facilitate the
nurturing and development of self-confidence in the
prelicensure nursing student?
The purpose of this analysis is to provide a concep-
tual understanding of confidence/self-confidence. In
this paper, the terms confidence and self-confidence
will be used interchangeably. Analysis will be guided by
the eight-step process, modified and simplified from
Wilson’s original 11-step process as explicated by
Walker and Avant’s (2005) classic concept analysis
method. The aim of this analysis is to provide clarity
regarding  the  meaning  of  the  concept  of  self-
confidence, while gaining a more comprehensive
understanding of its attributes, antecedents, conse-
quences, and their application to practice.
Walker and Avant (2005) modified the Wilsonian
method of concept analysis by refining and simplifying
the original method. The method includes eight steps:
(a) select a concept; (b) determine the aims or purposes
of analysis; (c) identify all uses of the concept that you
can discover; (d) determine the defining attributes; (e)
identify a model case; (f) identify borderline, related,
contrary, invented, and illegitimate cases; (g) identify
antecedents and consequences; and (h) define empiri-
cal referents (Walker & Avant, 2005, p. 65).
Utilizing the Walker and Avant method as a struc-
tured iterative process allows for revisions of the
analysis in all steps. Confidence can be perceived as
subjective in nature, and ebbs and flows within the
tide of contextual situations. The selected method
is appropriate for analyzing self-confidence, as this
conceptual characteristic trait is a dynamic and evolv-
ing quality in the prelicensure nursing student.
Method of Concept Analysis and Application
Select a Concept
The identified concept of interest is confidence/self-
Webster’s New World Dictionary
defines self-
confidence as “firm belief; trust; reliance” (Neufeldt
& Guralnik, 1991). Merriam-Webster Online (2010b)
has a more contemporary definition and cites self-
confidence as “the belief in oneself and in one’s
powers and abilities.” Self-confidence is a person’s
belief that he or she can succeed. Self-confidence is
context-specific to particular tasks and some people
seem to display this characteristic through a wide
range of activities. Self-confidence can be related to
self-efficacy theory.
According to Bandura’s (1986) self-efficacy theory,
self-efficacy is enhanced by four main factors: success-
ful performances (competence), vicarious experience,
verbal persuasion (including praise and encourage-
ment), and arousal. Self-confidence is simply a self-
perceived measure of one’s belief in one’s own
abilities, dependent upon contextual background and
This concept analysis is based on a literature review.
Inclusion criteria included published works in English
from the United States, Canada, and the United
Kingdom. The decision to include studies from other
countries was based on the fact that constructs of
confidence/self-confidence in nursing education are
discussed in many countries. Further search inclusion
criteria limited years of publication to the past decade
(2000 to present). The time frame correlates with the
more recent development of high-fidelity simulation
in nursing education. The references on each of the
retained articles were reviewed for notable consisten-
cies among cited references.
Initial  searches  using  the  term  “confidence”
through PubMed, EBSCO, CINAHL, Academic Search
Premier, PSYCArticles, PSYCInfo, ERIC, as well as
several  incidental  finds  through  the  National
League for Nursing (NLN) publications, Simulation
Innovation Resource Center (SIRC), and research
journals yielded more than 92,000 articles. Using the
terms “confidence” and “self-confidence” resulted in

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