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Attitude: A Concept Analysis

Article in Nursing Forum · July 2008

DOI: 10.1111/j.1744-6198.2008.00106.x · Source: PubMed

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Attitude: A Concept Analysis
ORIGINAL
Blackwell
Malden,
Nursing
NUF
XXX
1744-6198
0029-6473
Forum
USA
Attitude: ARTICLES
APublishing
Concept Inc
Analysis

Tanya K. Altmann, RN, MSN, PhD

This paper presents a concept analysis conducted Tanya K. Altmann, RN, MSN, PhD, is Assistant
Professor, Division of Nursing, Sacramento State
as a beginning step to developing research on University, Sacramento, CA.

nurses’ attitudes toward advancing formal

education. A literature review, conducted by the
author, confirmed that the term attitude is used
prolifically in nursing research; however, the
findings were inconclusive as to a definition and
the attributes of an “attitude.” Often this concept
was either not defined or vaguely defined. Few
operational definitions, required for accurate
measurement of a concept, were found.
An adequate definition and understanding
of a concept is required for critical reflection
and utilization of the term and development
of measurement procedures.
Search terms: Attitude, concept analysis
W alker and Avant (1995) describe concept analysis
as “a formal, linguistic exercise to determine those
defining attributes. The analysis itself must be rigorous
and precise but the end product is always tentative”
(p. 37). There are many steps in concept analysis that
may occur simultaneously, sequentially, or randomly
and with the possibility of returning to steps previously
completed. Walker and Avant describe the following
eight steps: (a) select a concept, (b) determine the aims
or purpose of analysis, (c) identify all uses of the con-
cept that you can discover, (d) determine the defining
attributes, (e) construct a model case, (f) construct
borderline, related, contrary, invented, and/or illegiti-
mate cases, (g) identify antecedents and consequences,
and (h) define empirical referents (p. 39).
As stated in the abstract, the concept of “attitude” is
vaguely defined in the literature. Simply conducting a
literature search for the term using the Cumulative
Index to Nursing and Allied Health Literature (CINAHL)
resulted in 40,553 possible articles, supporting interest
in the concept. However, in order to accurately study
and measure the concept, a more precise definition
must be formed. This is the purpose of this analysis.
The concept of “attitude” is vaguely defined

in the literature.

Definitions and Uses of the Concept

This step is accomplished by identifying as many uses

of the concept as possible without limiting the search
to only one aspect of the concept. It is important to consider

144 © (2008), The Author

Journal Compilation © (2008), Wiley Periodicals, Inc.
all aspects and sources of the term (both in and out of
the discipline of the original theory), to consider both
implicit and explicit uses of the term, to review the
literature, and to use dictionaries, thesauri, and colleagues.
The term attitude is a French term that originated
from the Italian word attitudine and from the Late Latin
aptitüdø and aptitüdin- (American Heritage Dictionary of
the English Language, 2000; Venes, 2001). An Internet
search for the term attitude resulted in sites such as the
following: multiple motivational resources, clothing
and apparel lines, a wilderness survival site, a New
Zealand site for teenage depression, a gay lifestyle
magazine (produced in the United Kingdom), a Web
site maintenance company, music sites, and a site
with humor for adoptive mothers. These are a few
examples of instances where the term attitude is used
as a proper noun (a name of something) and, therefore,
does not result in definitions.
The term attitude is most often defined as a noun.
The following are definitions found in various dictionaries
and thesauri.
• “A settled opinion” and “behavior reflecting this”
(Abate, 1999, p. 44).
• “Behavior based on conscious or unconscious
mental views developed through cumulative
experience” (Venes, 2001, p. 189).
• “Aircraft attitude is used to mean two closely
related aspects of the situation of an aircraft in
flight” (Wikipedia, 2006a).
• “A pose in which the dancer stands on one leg, with
the other leg lifted behind (derriere) or in front
(en avant) of the body with the knee bent at approx-
imately 120-degree angle” (Wikipedia, 2006b).
• “1. (Paint. & Sculp.) The posture, action, or disposition
of a figure or a statue. 2. The posture or position of
a person or an animal, or the manner in which the
parts of his body are disposed; position assumed or
studied to serve a purpose . . . 3. Fig.: Position as indicat-
ing action, feeling, or mood . . .” (Zimmerman, 2001).
• “An enduring, learned predisposition to behave in a
consistent way toward a given class of objects, or a
Nursing Forum Volume 43, No. 3, July-September 2008
persistent mental and/or neural state of readiness to
react to a certain class of objects, not as they are but
as they are conceived to be” (Dark, 2005).
• “1. A position of the body or manner of carrying
oneself . . . 2a. A state of mind or a feeling; disposi-
tion . . . b. An arrogant or hostile state of mind or
disposition. 3. The orientation of an aircraft’s axes
relative to a reference line or plane, such as the
horizon. 4. The orientation of a spacecraft relative to
its direction of motion. 5. A position similar to an
arabesque in which a ballet dancer stands on one leg
with the other raised either in front or in back and
bent at the knee” (American Heritage Dictionary of
the English Language, 2000).
• “1. The position of the body and limbs; posture. 2. A
manner of acting. 3. A relatively stable and enduring
predisposition to behave or react in a characteristic way”
(American Heritage Stedman’s Medical Dictionary, 2001).
• “1. The arrangement of the parts of the body: Posture
2a: a mental position with regard to a fact or state; b: a
feeling or emotion toward a fact or state. 3: an organis-
mic [sic] state of readiness to respond in a characteristic
way to a stimulus (as an object, concept, or situation)”
(Merriam-Webster’s Medical Dictionary, 2002).
• “1. A complex mental state involving beliefs and
feelings and values and dispositions to act in certain
ways . . . 2. Position or arrangement of the body and
its limbs . . . 3. A theatrical pose created for effect . . .
4. Position of aircraft or spacecraft relative to a
frame of reference (the horizon or direction of
motion)” (WordNet 2.0, 2003).
Some synonyms to the term attitude include orienta-
tion, approach, outlook, manner, stance, position, feel-
ings, thoughts, mind-set, way of thinking, and way of
behaving. Some related words are opinion, point of
view, view, standpoint, line, posture, and pose.
Determining Attributes
According to Rodgers (2000), “identification of
the attributes of a concept represents the primary
145
Attitude: A Concept Analysis
accomplishment of a concept analysis” (p. 91) and will
form the real definition of the concept. The identification
of attributes is accomplished by reviewing and analyzing
the literature for recurrent categories, clues to the defin-
ing characteristics, and actual definitions of the concept
of interest. The lists of characteristics of the concept
that appear over and over again are called defining,
or critical attributes.
From the definitions in the previous section, the
aeronautical and ballet definitions have been omitted
from analysis as they are out of the usual/popular context
of the term. This was done in accordance with Walker
and Avant (1995), who state that sometimes a decision
must be made “regarding which [definitions] will be the
most useful and which will provide you the greatest
help in relation to the aims of your analysis” (p. 42).
The three characteristics that seemed most
obvious among the definitions analyzed
were that “attitudes” are (a) a mental state—
conscious or unconscious; (b) a value,
belief, or feeling; and (c) a predisposition to
behavior or action.
From the remaining dictionary definitions, the three
characteristics that seemed most obvious among the
definitions analyzed were that “attitudes” are (a) a
mental state—conscious or unconscious; (b) a value,
belief, or feeling; and (c) a predisposition to behavior
or action. These characteristics fit into three domains.
This is supported by the literature. An attitude has a
cognitive (Beatty, 2000; Emerson, 1992; Melusky, 1998;
Nelson, 1983; Roche, 1990; Sanders, 1993; Small, 1995;
146
White-Taylor, 1992), affective (Dawson, 1992; Emerson;
Jerdan, 1993; Melusky; Nelson; Sanders; Small; White-
Taylor), and behavioral (Beatty; Carlson, 1992; Hayes
& Darkenwald, 1990; Melusky; Nelson; Roche; Sanders;
Small; White-Taylor) component.
“Theory and research in the social sciences indicate
that attitudes are multi-dimensional constructs” (Hayes
& Darkenwald, 1990, p. 158). A definition by Dawson
(1992) states that in social psychology “it [attitude]
refers to a disposition towards or against a specified
phenomenon, person or thing” (p. 473). This definition
provides two aspects of an attitude that are supported
in the literature. First, an attitude is bipolar; it can be
positive or negative, favorable or unfavorable (Jerdan,
1993; Nelson, 1983; Ochsner, 1996; Roche, 1990; Small,
1995). Second, an attitude is a response to a person, object,
or situation (Beatty, 2000; Carlson, 1992; Emerson,
1992; Nelson; Ochsner; Sanders, 1993; Small; White-
Taylor, 1992).
Model Case
“A model case is a ‘real life’ example of the use of
the concept that includes all the critical attributes of
the concept” (Walker & Avant, 1995, p. 42). The model
case can be constructed or an actual case. The critical
attributes of an “attitude” are that it has a cognitive,
affective, and behavioral component; it is bipolar; and
it is a response to a stimulus.
Case 1
The nurse was always searching for information on
the newest and greatest method of providing patient
care. She believed that it was important to keep current
and understand the latest research developments so
that she could change her practice accordingly.
Case 2
It was a very hot and sunny day but his wife wanted
the car washed. He was not willing to do it because he
Nursing Forum Volume 43, No. 3, July-September 2008
had been taught that washing a car in the sun would
cause the paint to peel. When the temperature dropped
below 80°F (26°C), he would be willing to wash the car.
Case 3
The more the boss spoke, the more he realized that
things had changed. What he understood from past
experiences could no longer be used in the future. He
would have to do everything differently if he wanted
to do it correctly.
In the first model case, the nurse believed what she
was taught in school; that lifelong learning was important
and, thus, acted on this belief. In the second case, the
husband had learned the deleterious affect of the sun
on paint and was motivated to act a certain way under
specific circumstances. The third case is an example of
the fluidity of an “attitude.” The man was learning
something and changing his perspective accordingly.
Borderline Case
“Borderline cases are those examples or instances
that contain some of the critical attributes of the
concept being examined but not all of them” (Walker
& Avant, 1995, p. 43). The purpose of the borderline
case is to help identify what the model case is not, and
to clarify thinking about the defining or critical attributes.
Case 1
The mathematician solved the equations as an example
for the students. This was a daily occurrence in his job.
It paid the bills.
Case 2
As she walked through the woods, she saw some-
thing move. When she realized it was a snake, she
began screaming hysterically. It was a harmless grass
snake.
Nursing Forum Volume 43, No. 3, July-September 2008
In the first case, the mathematician was using his
cognitive abilities to complete an action for the
students. There is no indication of affect behind this
action. In the second case, the woman was frightened
of the snake so much so that she was unable to ration-
alize that it could not harm her.
Related Case
A related case is similar to the main concept, related
to the concept, but does not contain the critical attributes.
It is used to show how the concept may fit into “the
big picture.” “It is through the critical examination of
the network of related concepts that the analyzer can
gain insight into which features of the study concept
are essential and which are not” (Avant, 2000, p. 60).
Case 1
He knew the institution had a mission statement
but gave it no thought. He did his job the best he could
regardless of the mission of the organization.
In this case, the intent was to imply that the man gave
no thought to the mission nor did he have any feeling
about it; he did not let it influence his behavior. It could
be argued that knowing of the mission statement uses the
cognitive domain or that his action was a result of an
attitude. It is very difficult to create a related case because
of how broad the critical attributes of an attitude are.
Contrary Case
To demonstrate an example of what the concept is not,
contrary cases are used. These cases must not meet
any of the critical attributes defined. “Contrary cases help
to clarify the essential elements of the concept by focusing
on the opposite of it” (Avant & Abbott, 2000, p. 68).
Case 1
The infant, only days old, woke from a long nap in
the car. It had been hours since any food had been
147
Attitude: A Concept Analysis
ingested. The infant began to cry loudly and startled
everyone in the car.
Similar to creating a related case, making a contrary
case is difficult. In the example of a contrary case, it
could be argued that the infant was reacting to a
situation without any real cognition, or affect; it was
simply a physiologic response.
Illegitimate Case
An illegitimate case is an example of the concept
term used out of context. It is not always included in a
concept analysis. A definition that is found but
excluded in the beginning because it does not reflect
the attributes of the others may be used as an illegitimate
case. An example of an illegitimate use can be created
from the aeronautical and ballet definitions of an
attitude.
Case 1
As the plane continued toward its destination, the
pitch and roll were perfect. The pilot was skilled at
adjusting the controls in order to keep the aircraft on
course or turn or change altitude.
Case 2
I had never liked to watch ballet before but today I
was enjoying it. The dancer exhibited poise and grace.
At the end of the evening, she stood in perfect stance;
balancing on one leg with the other positioned
elegantly behind.
Antecedents and Consequences
The purpose of identifying antecedents and con-
sequences is to place the concept into a social context
in which the term is generally used. This step may also
help to further refine the critical attributes (Walker &
Avant, 1995).
148
An antecedent is a situation, incident, or event that
precedes an instance of the concept. In the case of an
attitude, it is widely thought that children are born
with an open mind; free of any thoughts, ideas, or
feelings. During their formative years, children will
gather information from their surroundings and
people to develop their attitudes. As new information
is learned, these attitudes may change or become
stronger. Antecedents to an attitude are the objects,
concepts, situations, and opinions one encounters.
A consequence is a situation, incident, or event
that happens as a result of the concept. Possible con-
sequences of an attitude are too numerous and diverse.
People do not always act according to an attitude but
they are predisposed to act in a certain manner.
Empirical Referents
Empirical referents provide an answer to the question
of how one measures the concept or determines its
existence in reality. “Empirical referents are classes or
categories of actual phenomena that by their existence
or presence demonstrate the occurrence of the concept
itself” (Walker & Avant, 1995, p. 46). Empirical referents
are most useful in instrument development providing
both content and construct validity.
An “attitude” has a cognitive, affective, and
behavioral component; it is bipolar; and
it is a response to a stimulus.
An “attitude” has a cognitive, affective, and behavioral
component; it is bipolar; and it is a response to a stimulus.
The empirical referent must measure these together.
Many authors argue that an “attitude” cannot be directly
measured; we can only infer information about an attitude
Nursing Forum Volume 43, No. 3, July-September 2008
based on actions and words (Dawson, 1992; Henerson,
Morris, & Fitz-Gibbon, 1987). The affective domain is
inferred from the cognitive and/or behavioral domain.
Furthermore, respondent bias, or the self-awareness of
the respondent, influences what is seen or heard.
“Attitudes, like all psychological constructs, are latent, we
cannot observe them directly. So all attitude measurement
depends on those attitudes being revealed in overt
responses” (Albarracin, Johnson, & Zanna, 2005, p. 22).
If it is not possible to directly measure an attitude, it
may be more appropriate to correlate the findings
from measurement of different combinations of the
critical attributes. This method may more accurately
support the inferences made regarding an attitude.
Conclusion
The critical attributes of an “attitude” are that it has
a cognitive, affective, and behavioral component; it is
bipolar; and it is a response to a stimulus. These attributes
extend to all aspects of intellect and behavior. The
extensiveness of these attributes makes it difficult to
create true related and/or contrary cases. The cases pre-
sented are therefore arguably not true to their definition.
The critical attributes of an “attitude” are
that it has a cognitive, affective, and
behavioral component; it is bipolar; and it is
a response to a stimulus.
It is strongly suggested that true measurement of an
attitude is not possible. An attitude may be beyond the
conscious acknowledgment of the individual or he or
she may not choose to reveal it (either in part, fully, or
honestly). If an attitude is inferred through measurement
Nursing Forum Volume 43, No. 3, July-September 2008
of its attributes, and the intent of research is under-
standing, measurement of individual attributes might
lead to identification of where to influence an attitude.
Author contact: altmannt@csus.edu, with a copy to the
Editor: nursingforum@gmail.com
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