A concept analysis of confidence related to older people living with frailty.
Frazer Underwood, Jos M Latour, Bridie Kent
PMID 32257261WHAT IT FOUND
Confidence in older people living with frailty was described as physical, psychological and social, shaped by perceived control.
The authors propose nurses use this framework for conversations, but it is not evidence that conversations improve outcomes.
Key findings
01Confidence was described as three dynamic domains, physical, psychological and social, with control influencing physical and mental well-being.
02Fear of falling often came before loss of confidence, and fear could also follow a fall and lead to activity avoidance and more confidence loss.
03Existing falls self-efficacy and balance confidence scales may help with fall-related confidence, but they do not capture all aspects of the concept.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a concept analysis of published articles, not a study of patients or an intervention trial, so it cannot show that confidence conversations or exercise classes improve outcomes. The search was limited to English and to specific terms for older people, frailty and confidence, so relevant papers may have been missed. It did not use the word confident or non-English sources, which could have added attributes. It deliberately set aside self-efficacy and balance-confidence scales, which may have changed the concept. No measurement tool for this concept exists yet.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read this as evidence that confidence-focused conversations improve health or reduce frailty. It is a concept analysis of published articles, and the authors did not test the framework or measure patient outcomes.