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"documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Clin. 2020;30 Supl 3:1-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Family resilience minimizes post-traumatic stress disorder: A systematic review" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "5" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2055 "Ancho" => 2167 "Tamanyo" => 340591 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the study selection process.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Abdul Wakhid, Achir Yani S. Hamid" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Abdul" "apellidos" => "Wakhid" ] 1 => array:2 [ "nombre" => "Achir Yani S." "apellidos" => "Hamid" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862120300127?idApp=UINPBA00004N" "url" => "/11308621/00000030000000S3/v2_202004260744/S1130862120300127/v2_202004260744/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "titulo" => "A concept analysis: Aloneness in elderly with depression" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "6" "paginaFinal" => "9" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Thika Marliana, Budi Anna Keliat, Novy Helena C. Daulima, Tri Budi W. Rahardjo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Thika" "apellidos" => "Marliana" "email" => array:1 [ 0 => "perawathika@yahoo.co.id" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Budi Anna" "apellidos" => "Keliat" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Novy Helena C." "apellidos" => "Daulima" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Tri Budi W." "apellidos" => "Rahardjo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "School of Nursing, Health Science Faculty, University Respati of Indonesia, Jakarta, Indonesia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Nursing, Universitas Indonesia, Depok, Indonesia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Dentistry Faculty, Universitas Indonesia, Depok, Indonesia" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The elderly population in Indonesia has grown at an unprecedented rate during the period 1990–2020 and has experienced an increase in life expectancy from 66.7 to 70.5 years. The number of elderly (over 60 years) in Indonesia is expected to increase to 28.8 million (11% of the total population) in 2020, and 80 million (28.68%) in 2050.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> The longer a person's life, the more experienced physical, mental, spiritual, economic and social problems.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Depression is the most prevalent impairment of psychosocial function in older adulthood.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> Approximately 20% of older adults suffer from clinically significant symptoms of depression.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> The researcher's observations from clinical experience in psychiatric private practice suggest many individuals with depression describe feelings of being alone. The consequences of aloneness are multifaceted for elderly.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The concept of aloneness is examined in very few published materials.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> Hence, the concept of aloneness is meaningful within the literature relating to depression. In this situation, concept development is needed to clarify the concept, refine meaning and direct future applications. The concept of aloneness in the elderly is the basic building blocks in theory constructions so that anyone who sees the concept and its definition within the theory can understand exactly what is being described, explained, or predicted. This paper's aim was to examine the structure and function of an aloneness concept in the elderly with depression, using Walker and Avant model.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A concept is a mental image of phenomenon or experience, with a meaning that can be communicated to others and understood. A concept analysis is a deductive process that analyses the existing usage of a concept, identifying and refining shared meaning.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">5</span></a> In order for a concept to be analyzed, it needs to be broken down into simpler elements to establish its internal composition.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Walker and Avant<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> provide a model for undertaking this process, the goal of which is to bring to light the attributes of a particular concept and clarify its meaning.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> Walker and Avant's framework relies on literature-based evidence and ensures that the uses of the concept are not just limited to nursing literature, but facilitate sources such as dictionaries and research papers. This method is not without criticism, with some authors arguing that it does not add to the knowledge base, and is instead only an intellectual idea<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a>; others argue that it does not create a strong enough theoretical basis for further work.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> However, the Walker and Avant model has been selected for this paper because it is the most widely utilized within nursing research, and it has specifically been used in a mental health context to analyze concepts related to depression and aloneness. Overall, this method is deemed rigorous, logically structured and appropriate to the concept being analyzed.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Aloneness is a concept that is relatively new in the research and nursing literature, and one for which meaning has not fully coalesced. Using Walker and Avant's framework, this paper will explore what different authors mean by aloneness, to develop an accurate understanding of what is being discussed. This method involves using a series of eight steps (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The following search strategy was conducted:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0040" class="elsevierStylePara elsevierViewall">The following databases were used: Proquest, EBSCO, Science Direct, Willey Online Library, Scopus.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0045" class="elsevierStylePara elsevierViewall">The key term ‘aloneness’ was used in all databases. Databases were searched using the title keyword ‘aloneness’ rather than ‘loneliness’ because it was observed that many scholars tended to use ‘aloneness’ to imply ‘loneliness’.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0050" class="elsevierStylePara elsevierViewall">The search was limited to a study involving human subjects and articles published in English between 2015 and 2018.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0055" class="elsevierStylePara elsevierViewall">Full-text articles assessed for eligibility were 127 articles used PRISMA flow chart.</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Step 1: selection of a concept</span><p id="par0060" class="elsevierStylePara elsevierViewall">The first step of concept analysis is to decide which term should be selected. Walker and Avant<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> recommend analyzing concepts where the meaning unclear and not strictly defined. A brief review of the literature was undertaken to determine which term was used most consistently. On this basis, the concept of ‘aloneness’ has been selected for analysis.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Step 2: determine the aims of analysis</span><p id="par0065" class="elsevierStylePara elsevierViewall">The lack of a clear definition of aloneness in the elderly with depression.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> Awareness of aloneness from the perspective of the elderly with depression, nurses working in gerontology areas, community health settings, and clinics can promote not only quality of care,<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5,11</span></a> but also the quality of life for those elderly.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Step 3: identify all uses of the concept</span><p id="par0070" class="elsevierStylePara elsevierViewall">Once the concept has been selected and the purpose of the analysis defines,<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> the concept is broken down so that the individual words ‘aloneness’ can be examined separately, then re-joined to provide a single definition. The analysis progresses to examine how the concept as a whole is currently used in the literature.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Step 4: determine the defining attributes</span><p id="par0075" class="elsevierStylePara elsevierViewall">Defining or critical attributes, characteristics indicative of the concept, are aggregates associated with the word aloneness. This section is based on the authors’ previous work. When the elderly were depressed, they viewed aloneness as being vulnerable,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> fearful,<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> and helpless,<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> and as having a loss of control of self<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> and identity confusion.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> As the elderly progressed in their recovery from depression, they viewed aloneness as being self-reliant,<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> hopeful,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> and resourceful<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> and having self-determination<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> and self-reflection.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> This two-staged experience of aloneness was represented by the loss of control of self and identity confusion followed by self-determination and self-reflection.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Defining the concept of aloneness is with qualitative data, as suggested difficult. Lin<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> stated being alone can occur in a physical sense. For instance, an individual can be alone in a house. However, being alone can also occur in the sense of an individual standing alone in a given situation. An example is a son who stands alone, apart from other siblings in the family, in the decision-making process of nursing home placement for a father. Individuals can feel alone, but not in the sense of being lonely. All literature showed five paired themes as gained clarity and insight into experiencing depression and recovery in the elderly with depression. The attributes of aloneness were delineated.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Steps 5 and 6: constructing a model case, borderline case, and contrary case</span><p id="par0085" class="elsevierStylePara elsevierViewall">A model case is constructed to illustrate the concept of aloneness. The model case includes all off the defining attributes and no other attributes.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">A borderline case is an instance containing some of the defining attributes of the concept being examined.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> The borderline case of criteria established by Walker and Avant showed all the defining attributes are not represented.</p><p id="par0095" class="elsevierStylePara elsevierViewall">A contrary case is clear examples of what the concept is not.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> The elderly described did move from depression into a state of recovery. Their life only became stabilized with external help, as a result of being alone.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Step 7: antecedent condition and consequences</span><p id="par0100" class="elsevierStylePara elsevierViewall">Antecedent conditions are necessary circumstances that must occur before the aloneness process begins. The elderly described being by one's self as a “necessity” to monitor and attend to their varying needs for time alone.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> For these elderly, it did not seem to matter if being alone was self-imposed or otherwise forced—the results were the same. One of these elderly captured the essence of aloneness when she said, “It will make you a better person if you just try to take a little time for yourself”. Aloneness was defined as vacuous and imposing when the elderly were depressed. The elderly were worried about what was “going to happen” to them.</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">Aloneness does not necessarily imply feelings of unhappiness. Stahl notes that “loneliness is defined as lack of companions and often connotes painful awareness of being alone”,<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> loneliness also implies solitude, which is a state of being alone or remote from others when there is a desire for companionship<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> noted that loneliness is associated with a number of physical and psychological pathologies for elderly.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Psychosocial and health care related databases were searched for the concept of aloneness. Loneliness is depicted as the perceived subjective condition that may or may not co-occur with being alone.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> In contrast, aloneness is described as a perceived objective experience of being separate from others. This subtle, but important, the distinction is critical in determining varying aspects of aloneness associated with health or loneliness, and possibly depression.</p><p id="par0115" class="elsevierStylePara elsevierViewall">They felt frightened, helpless, and out of control. They seemed to lack the ability to form connections with others. The elderly described, in terms of life cycle development, an inability to stabilize their internal state of chaos. They depicted their environment as devoid of meaning, when depressed. The elderly's burgeoning recovery was unique and vicissitude. It paralleled the changes of the seasons without a calendar to clearly mark the transition from aloneness in depression to aloneness in recovery.</p><p id="par0120" class="elsevierStylePara elsevierViewall">After the depression started to abate, these elderly were able to view aloneness as an opportunity—a blank canvas to be colored with their own unique thoughts, needs, and experiences. Aloneness now meant they were now able to:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">a.</span><p id="par0125" class="elsevierStylePara elsevierViewall">Make decisions.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">b.</span><p id="par0130" class="elsevierStylePara elsevierViewall">Regain a sense of hope.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">c.</span><p id="par0135" class="elsevierStylePara elsevierViewall">Be resourceful.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">d.</span><p id="par0140" class="elsevierStylePara elsevierViewall">Enjoy the freedom to come and go and do as they wanted.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">e.</span><p id="par0145" class="elsevierStylePara elsevierViewall">Explore their sense of self.</p></li></ul></p><p id="par0150" class="elsevierStylePara elsevierViewall">Consequences refer to outcomes of the aloneness process. Aloneness in depression was a sign of failure.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> After these elderly were in recovery from their depression, their aloneness was a signal of independence and autonomy. In Wang's<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> terms, these elderly in recovery from their depression felt aloneness not only helped them heal but also facilitated their overall health. Similar to the findings of Dao,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> once in recovery, aloneness moved this elderly toward a greater sense of psychosocial adjustment.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Clinical implications for nursing based on concept analysis results: defining ambiguous terms used in theory, practice, education, and research; providing operational and orientationally definitions with a clear theoretical base; understanding the underlying attributes of a concept; facilitating research instrument development; and, promoting the development of nursing diagnoses.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0160" class="elsevierStylePara elsevierViewall">A clear understanding of the concept is critical to be better underpin understanding and effectively evaluate the elderly's experiences with depression. Understanding what aloneness is and how it operates in the lives of the elderly with depression is fundamental for providing effective nursing interventions in geriatric settings.</p><p id="par0165" class="elsevierStylePara elsevierViewall">In clinical practice, gerontological nurses working with psychiatric clients must observe the subtle clues of aloneness using astute observational and listening skills. Perceived physical separation on the part of the client, as well as the sense of being alone in a situation, must be continually assessed. Additionally, the antecedent conditions, defining attributes, and consequences of aloneness must be assessed and reassessed over time by nurses who work with the elderly experiencing depression and recovering from depression.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1329587" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1225162" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 4 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Step 1: selection of a concept" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Step 2: determine the aims of analysis" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Step 3: identify all uses of the concept" ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Step 4: determine the defining attributes" ] 4 => array:2 [ "identificador" => "sec0040" "titulo" => "Steps 5 and 6: constructing a model case, borderline case, and contrary case" ] 5 => array:2 [ "identificador" => "sec0045" "titulo" => "Step 7: antecedent condition and consequences" ] ] ] 5 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflict of interest" ] 8 => array:2 [ "identificador" => "xack459107" "titulo" => "Acknowledgments" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-08-27" "fechaAceptado" => "2019-12-16" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1225162" "palabras" => array:4 [ 0 => "Aloneness" 1 => "Concept analysis" 2 => "Depression" 3 => "Elderly" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The objective was to examine the structure and function of an aloneness concept in the elderly with depression.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The concept analysis framework of Walker and Avant was used. Data sources were retrieved from the following databases: Proquest, EBSCO, Science Direct, Scopus, Willey Online Library which published between 2015 and 2018. From a literature review, the defining attributes were ascertained. The antecedents and consequences were then identified and empirical referents determined.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Findings this research was the apparent attributes of aloneness. The attributes characterizing aloneness in the elderly with depression were vulnerable, fearful, and helpless, and having a loss of control of self and identity confusion.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Concept of aloneness in the elderly is the basic building blocks in theory constructions so that anyone who sees the concept and its definition within the theory can understand exactly what is being described, explained, or predicted.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the International Conference of Indonesian National Nurses Association (ICINNA 2019). Full-text and the content of it is under responsibility of authors of the article.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Step \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Process \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Purpose \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Selection of a concept \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Define what is being analyzed \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determine the aims and purpose of the analysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identify why the analysis is useful \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identify all the uses of the concept \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Understand how the concept is currently used \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determine the defining attributes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Analyze what features lie behind the current usage \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Constructing a model case \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Create an exemplar of how the concept is currently used \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Constructing borderline, related, contrary, invented, and illegitimate cases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Demonstrate that the concept is narrow enough to exclude misuse \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Defining antecedents and consequences of the concept \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Explain what happens prior to and after the concept to make the usage valid \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Empirical referent \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Check the definition of the concept for external validity \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2279068.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Process of concept analysis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0085" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 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This research did not receive any specific grant from a publicly funded agency, commercial, or non-profit sector.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/11308621/00000030000000S3/v2_202004260744/S1130862120300140/v2_202004260744/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11308621/00000030000000S3/v2_202004260744/S1130862120300140/v2_202004260744/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862120300140?idApp=UINPBA00004N" ]
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