Health assets: A concept analysis
Introduction
Traditionally, nursing care has focused on identifying patients’ actual or potential health problems and providing nursing interventions to solve, alleviate, or prevent those problems. From this perspective, the primary emphasis of problem-oriented care is on nursing observations and interventions on behalf of the patient, with little focus on enhancing patients’ strengths and capacities. Furthermore, problem-oriented care pays little attention to patients’ individual perspectives, preferences, and experiences (Adamsen and Tewes, 2000, Ehrenberg and Ehnfors, 2001, Karkkainen et al., 2005, Florin et al., 2005).
Both the World Health Organization (WHO) and the Positive Psychology movement have recently recognized health assets as the strengths and capacities inherent in individuals, and encouraged greater attention by researchers and health professionals, as a means to strengthen patients’ health and wellness (Peterson and Seligman, 2004, Worlds Health Organization, 2008). The core of the health concept is wellness, a quality that must be appraised and assessed from the patient's perspective and experience (Moore and Huerena, 2005, Worlds Health Organization, 2006). Wellness is based on the promotion and maintenance of health and capacities for living rather than on healing of poor health and solving problems (Carlson, 2003). Nursing care that focuses on patient health assets can thus be seen as an important means to help patients improve their wellness and health.
Health assets were first defined and used as a core concept in Schlotfeldt's nursing model, developed during the 1970s and 1980s (Glazer and Pressler, 1989, Schlotfeldt, 1978, Schlotfeldt, 1988). Schlotfeldt stated that nursing should focus mainly on people's strengths, rather than on problems and pathology (Glazer and Pressler, 1989). However, a clear and precise definition of health assets was not fully articulated in her work or others. Therefore, more research is needed to identify the components of health assets that contribute to the achievement of optimal health and wellness (Spilsbury and Meyer, 2001, Ejlertsson et al., 2002). A prerequisite for such research is a clear understanding and definition of the concept. Yet so far no comprehensive analysis of the concept has been found in the literature.
Therefore, the purpose of this paper was to: (a) examine the concept of health assets, including its underlying attributes, antecedents, consequences, relationships, and its evolution in a health care context and (b) propose a preliminary framework for health assets. Such a framework might help guide the research and theory development of health assets as well as the development of support tools for the concept, which are needed to ensure its usefulness in clinical practice and research.
For ease of reading we will first present our definition and the conceptual model of health assets, which was developed as a result of our inductive analysis. Thereafter we will describe how we arrived at this definition through identification of the core attributes, antecedents and consequences in the literature. In this paper we defined health assets as follows:
Health assets are the repertoire of potentials—internal and external strength qualities in the individual's possession, both innate and acquired—that mobilize positive health behaviors and optimal health/wellness outcomes.
This paper also proposes a conceptual model that illustrates the attributes, antecedents, and consequences of health assets (Fig. 1). The model is depicted below, followed by a discussion of its components and their relationships to each other later in this paper.
Section snippets
Concept analysis method
We used Rodgers's evolutionary method (Rodgers, 2000) to analyze the concept of health assets in a nursing care context. This method is inductive, non-sequential, and descriptive and includes an examination of the social, cultural, and political context of a concept over time. The analysis was, therefore, like other inductive methods—an ongoing, repetitive process that happened simultaneously with the literature retrieval until the conclusion of the work. The method comprises the identification
Evolution of the concept
First, the evolution of the concept health assets was analyzed. Over time, this concept has been used sporadically by different health disciplines. The first citation using “asset” in the health-related literature was found in psychiatry, with a focus on personality and personal assets as a foundation for managing change (Beiser, 1971). The health assets concept was introduced in 1983 in nursing research (McGuire, 2001, Barkauskas, 1983); the health assets nursing model by Schlotfeldt soon
Discussion and implications for nursing research and practice
This concept analysis of health assets identified core attributes, antecedents, and consequences of the concept that are common across disciplines. A conceptual model and a definition of health assets are proposed. Health assets represent a promising perspective for patient-centered nursing care as a means to improve patient's health behavior and health/wellness outcomes. The goal of this concept analysis of health assets was to contribute to a better understanding of the concept as a
Conclusion
Seeing health assets as the core of nursing was pioneered by Schlotfeldt in the 1970s. Since then, the concept of health assets has gained increased attention across many health disciplines. The definition and model of health assets outlined in this paper contribute to a clearer understanding of the concept's attributes, antecedents, and consequences. A health assets approach to nursing care puts the focus on people's strengths rather than just their problems and is the key to providing
References1 (107)
Adolescent resilience: an evolutionary concept analysis
Journal of Pediatric Nursing
(2006)- et al.
Social support and chronic kidney disease: an update
Advances in Chronic Kidney Disease
(2007) - et al.
Focus on wellness
Geriatric Nursing
(1983) - et al.
Adolescent binge/purge and weight loss behaviors: associations with developmental assets
Journal of Adolescent Health
(2001) - et al.
Family dinner meal frequency and adolescent development: relationships with developmental assets and high-risk behaviors
Journal of Adolescent Health
(2006) - et al.
Relationships of a brief measure of youth assets to health-promoting and risk behaviors
Journal of Adolescent Health
(2004) - et al.
In search of a contemporary theory for understanding mortality change
Social Science & Medicine
(1993) - et al.
Outcome-asset impact model: linking outcomes and assets
Evaluation and Program Planning
(2001) - et al.
The role of developmental assets in predicting academic achievement: a longitudinal study
Journal of Adolescence
(2006) - et al.
The potential protective effects of youth assets from adolescent sexual risk behaviors
Journal of Adolescent Health
(2004)
The unrecognized paradigm shift in nursing: implications, problems, and possibilities
Nursing Outlook
Discrepancy between patients’ perspectives, staff's documentation and reflections on basic nursing care
Scandinavian Journal of Caring Sciences
Preparing students for more effective community interventions: assets assessment
Family & Community Health
Unraveling the Mystery of Health—How People Manage Stress and Stay Well
Adolescent tobacco use: the protective effects of developmental assets
American Journal of Health Promotion
Effectiveness of public health nurse home visits to primarous mothers and their infants
American Journal of Public Health
A study of personality assets in a rural community
Archives of General Psychiatry
Theoretical substruction illustrated by the Theory of Learned Resourcefulness
Research & Theory for Nursing Practice
Complementary Therapies and Wellness: Practice Essentials for Holistic Health Care
Religion in the health of migrant communities: asset or deficit?
Journal of Ethnic and Migration Studies
Social support and adolescent cancer survivors: a review of the literature
Psycho-Oncology
Subjective well-being: three decades of progress
Psychological Bulletin
A matched case–control study: investigating the relationship between youth assets and sexual intercourse among 13- to 14-year-olds
Child Care Health and Development
Coping with a possible breast cancer diagnosis: demographic factors and social support
Journal of Advanced Nursing
Resilience: a concept analysis
Nursing Forum
The accuracy of patient records in Swedish nursing homes: congruence of record content and nurses’ and patients’ descriptions
Scandinavian Journal of Caring Sciences
Predictors of positive health in disability pensioners: a population-based questionnaire study using Positive Odds Ratio
BMC. Public Health
Personal resources supporting living at home as described by older home care clients
International Journal of Nursing Practice
An exploration of the relationship between youth assets and engagement in risky sexual behaviors
Journal of Adolescent Health
Adolescent resilience: a framework for understanding healthy development in the face of risk
Annual Review of Public Health
Patients’ and nurses’ perceptions of nursing problems in an acute care setting
Journal of Advanced Nursing
Operationalisation of a demand/resource model of health: an explorative study
Journal of Epidemiology & Community Health
Promoting mental health in the United Kingdom: a case study in many parts
AeJAMH (Australian e-Journal for the Advancement of Mental Health)
Development of a theoretically derived model of resilience through concept analysis
Contemporary Nurse
Schlotfeldt's health seeking nursing model
The ethics of destroying irreplaceable assets
International Journal of Environmental Studies
Adolescent health: a rural community's approach
Rural and Remote Health
Life course health development: an integrated framework for developing health, policy, and research
Milbank Quarterly
From risk factors to health resources in medical practice
Medicine, Health Care and Philosophy
Men's self-assessed personal health resources: approaching patients’ strong points in general practice
Family Practice
Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review
Journal of Advanced Nursing
Applying Sen's capabilities framework to neighborhoods: using local asset maps to deepen our understanding of well-being
Review of Social Economy
Documentation of individualized patient care: a qualitative metasynthesis
Nursing Ethics
Relationships among youth assets and neighborhood and community resources
Health Education & Behavior
Confucian bioethics and cross-cultural considerations in health care decision-making
Journal of Nursing Law
Returning to work after the onset of illness: experiences of right hemisphere stroke survivors
Rehabilitation Counseling Bulletin
Co-producing health: professionals and communities build on assets
Health Forum Journal
Cited by (63)
Core components of best evidence OA care: management planning, education, supporting self-management and behavior change
2022, Osteoarthritis Health Professional Training ManualHealth education: A Rogerian concept analysis
2019, International Journal of Nursing StudiesCitation Excerpt :This conceptual progress has had an important impact on the nursing literature and clinical practice. Despite the notable theoretical paradigm shift over time, nurses still often associate health education as being only directed toward the alteration of illness, disease and disability states rather than a means to enable or maintain well-being and positive health states (Diaz-Valencia, 2012; Khoury et al., 2015; Piper, 2008; Rotegård et al., 2010; Salci et al., 2013). Consequently, it is widely reported that nurses often fail to understand the concept and practice of health education, considering it complex and ambiguous (Diaz-Valencia, 2012; Piper, 2008; Whitehead and Russell, 2004).
Intergenerational understandings of personal, social and community assets for health
2019, Health and PlaceCitation Excerpt :The term ‘health assets’ can be differentiated from the term ‘health resources’, with assets comprising resources, resources being external to the individual and resources as ‘used’ rather than leveraged and developed (Rotegård et al., 2010). For the purpose of this paper, we deploy the terms health assets and health resources interchangeably due to a lack of conceptual difference across disciplines (Rotegård et al., 2010). Critics of assets-based approaches frequently point to an over-emphasis on individual and collective psycho-social resources whilst highlighting a silence on material advantage and notions of power (Friedli, 2013, 2015; Lynch et al., 2000).
Prerequisites for a healthy and independent life among older people: A Delphi study
2021, Ageing and Society
- 1
Asterisks marks (*) of the references selected and used for the concept analysis.