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ORIGINAL ARTICLES

Attitude: A Concept Analysis

Attitude: A Concept Analysis

Tanya K. Altmann, RN, MSN, PhD

This paper presents a concept analysis conducted

as a beginning step to developing research on

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

Tanya K. Altmann, RN, MSN, PhD, is Assistant Professor, Division of Nursing, Sacramento State University, Sacramento, CA.

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

Nursing Forum Volume 43, No. 3, July-September 2008 145

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

aptit

ü

d

ø

and

aptit

ü

din

– (

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

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

146 Nursing Forum Volume 43, No. 3, July-September 2008

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;

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 147

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.

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

148 Nursing Forum Volume 43, No. 3, July-September 2008

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).

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 149

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

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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Appendix. Summary of Concept Analysis

Concept: Attitude Definition: • Defining Attributes

1. Has a cognitive, affective, and behavioral component

2. Is bipolar 3. Is a response to a stimulus

• Antecedents The objects, concepts, situations, and opinions one encounters

• Consequences Too numerous and diverse to identify simplistically

• Empirical Referents 1. Cannot be directly measured 2. Measured by correlating results from measure-

ment of the critical attributes alone and/or in combination