Intention to avoid drugs is a term used frequently and is an important target used in drug abuse nursing. From the literature review, there is an unclear definition of the intention to avoid drugs. Hence, this concept is analysed to make it clearer. Conceptual analysis of the process was used as it is an accurate and easy analysis to apply.

Concept analysis is a judgment on the attributes of the concept. The structure and development of the concept may change over time or the facts related to the empirical evidence. In the process of analyzing the concept, there are eight steps: Step (1) select the concept, (2) determine the aims or the purpose of the analysis, (3) identify all uses of the concept, (4) determine the defining attributes, (5) construct the model case, (6) construct additional cases, (7) identify the antecedents and consequences, and (8) define empirical referents.

The conceptual analysis

The purpose of this study was to analyze the concept of intention to avoid drugs in adolescents to clarify definitions, attributes and limitations of the concepts, and the development of knowledge in nursing phenomena and addiction, and to develop tools further.

Firstly, the concept analysis of the intention to drug avoidance was taken by reviewing the literature related to the concept of intention. The aim of this was to explore the concept of intention and to determine the pre domains of intention. Studies related to intention were reviewed, and a concept analysis was performed using Walker and Avant (2005) as the guideline. The literature review covered empirical knowledge, and the studies related to the intention. Databases were searched to find out about the concept of intention, and this consisted of searching PubMed, Blackwell, Synergy, CINAHL, and Science Direct for full texts. Articles published from January 1996- January 2017 were selected in this phase. The terms of intention, behaviour intention, avoid, avoidance, desire, intention to drug avoidance were used as the key words for search.

Step 1: Select a concept

The intention to avoid drugs is a concept. There is a relationship of this concept with drug abuse nursing, nurse practitioners or those involved in drug-related nursing. Intention to avoid drugs needs to studied and understood to use in the care of patients. The intention to avoid drugs can be used to promote or prevent drug use in the general public. However, there is ambiguous confusion that exists in the literature over this concept. The results of the definitions and dimensions are few. There is hardly any proof of scope that is given in detail. This article shows the clearness of the word intention to avoid drugs. In the phenomenon of drug nursing, the concept of intention to avoid drugs is important for the development of substance abuse nursing knowledge, and it is useful for researching or developing theories in the future.

Step 2: Determine the aims or purposes of analysis

The goals of this analysis were to: (1) investigate the development and extent of intention to avoid drugs, (2) clarify understanding of the issue of intention to avoid drugs. (3) decide on the limit the concept of intention to avoid drugs, the critical features of drugs and examples of case studies, (4) identify the antecedents and the consequence and (5) define the measurement or the empirical measure.

Step 3: Identify all uses of the concept

For the avoidance concept is as the performance of protecting from or preventing, avoiding from [1,2] an action of emptying, vacating, or clearing away an escape from the consequences of a specific course of action through the use of legally acceptable means [3].

Avoidance learning is the means by which a person learns a behaviour or reaction to dodge an unpleasant or unsavoury circumstance. The behaviour is to avoid, or to remove oneself from, the situation. For drug avoidance in adolescence, adolescents need to learn which people, places, and things stimulate the desire for drugs and how to either avoid or cope with them.

From the review of the literature of drug avoidance in adolescence [4-11], the findings were composed of two components as follows; (1) to stay away from drugs, such as limit negative influences and stay in a drug -free environment, and (2) to not take drugs, such as just say “No,” set and work toward a goal, and manage stress and risk situations.

Step 4: Determine the defining attributes

The concept analysis and the literature review were integrated to determine the attributes of intention to avoid drug abuse which is as follows; (1) self-control and motivation to stay away from and not take drugs which includes, setting individual goals to avoid drugs, inspiration and knowing how to make goals to be successful and having the self-restraint to stay away from drugs and not taken drugs, (2) commitment to stay away from drugs and not taken drugs even in the difficult situation which includes, commitment to stay away from drugs and not taken drugs although there are high-risk situations, and commitment to manage drugs triggers, and (3) willingness to stay away from drugs and not taken includes, negative attitudes toward drugs/drug users, and having adequate knowledge related to drugs.

Step 5: Identify a model case

Model case: Mr. A, aged 17 years-old, graduated from high school. The results of the study were moderate and Mr. A's classmates, who were quite rude. This group of friends has secretly used amphetamines. They secretly used after school at the house of another friend. Mr. A was friends and used drugs regularly, but Mr. A was quick to deny this and told his friends he was looking forward to creating some other types of activities. He has set strict goals in that he will not take any drugs. His friend has threatened to take drugs several times. Mr. A used the method of refusing and not engaging with friends and trying to influence friends in groups to find a way to avoid using drugs, inviting friends to exercise, watching movies instead of using drugs, including talking about the danger of drugs with his friends’.

The case study sample of Mr. A illustrates the concept of drug avoidance. All the attributes of Mr. A are motivated to avoid drugs. It is a self-determined goal not to interfere with substance and to control him not to try drugs as a part of his commitment to avoiding drugs even in high-risk conditions. Mr. A had a friend who used drugs which would try and persuade him to use drugs. Mr. A dealt with the problem by not interfering with drugs and doing other activities, such as exercising, watching movies. He was willing to avoid drugs, and he even tried to talk to his friends about quitting.

Step 6: Identify borderline cases and contrary case

Borderline case: Ms. B aged 18 years-old, is a student studying in a private school. Her study results are good. She has set goals in her life not to interfere with substance abuse. Her family home is rich, and she has classmates who have not abused drugs. She has friends in her neighbourhood area using drugs, but she was not interested in using them. During the midterm examination, her boyfriend who she loves very much terminated their relationship, she was broken-hearted and depressed, and she did not know how to deal with these feelings. Friends around her neighbourhood invited her to use cannabis. At that time, she thought about the effect of it and thought that if she used marijuana, it could become a problem, but she used it anyway and suffered nausea, dizziness, and headaches. After one week her boyfriend came to see her for reconciliation. As a result, she has committed not to touch cannabis and drugs anymore, because she was not happy about it."

In the analysis of this case study, there are some clear features such as her motivation to avoid drugs, she had set a clear goal not to interfere with substances and made a commitment to avoid it, Ms. B used drugs as a way of coping with her sadness and inability to manage the situation after her boyfriend broke up with her’.

Contrary case: Mr. K, aged 16 years-old, with divorced parents, is living with relatives. He had financial problems, and was working as a construction labourer. He had friends who used amphetamine and his friends had been inviting him to use marijuana with them. The reason that they use is to feel happy, relaxed and to have fun. Mr. K knows that it is not good to use drugs, but he cannot refuse so Mr. K joins his friends because he does not want to end their friendships.

For this case study, Mr. K has not set any goals to avoid drugs. He has recognized the dangers of using drugs, but he does not manage his triggers for using drugs. He has no commitment or willingness to avoid drugs.

Step 7: Identify antecedents and consequences

Antecedents: From the concept analysis by the researcher, the antecedents of intention to drug avoidance are;

• Positive attitudes toward behaviours refers to an adolescent’s positive or negative feelings associated with if he/she believes that the performance of the behaviour will lead to mostly positive outcomes to stay far away from people, place and high-risk setting which were expected to lead to substance abuse.

• Perceived susceptibility, also called perceived vulnerability refers to the adolescent’s perception of the risk or the chances of substance use. (e.g., “I feel that I am at risk to use drugs").

• Peer Resistance Skills (PRS): Adolescents responding to situations in which either their best friend offers them to use substances to use, their self-ability to “say no,” to manage, and resist influence from members of one's peer group to use drugs.”

• Self-control, an aspect of inhibitory control, is the ability to regulate the adolescent's emotions, thoughts, and his/her performance in the expression of desire in high-risk situations with substances.

Consequences: The consequences of intention to drug avoidance are a drug the free person even in a stressful situation, a good quality of life, good person, good health, etc.

Step 8: Define empirical referents

Defining the empirical referents of the intention of avoiding drugs was to determine the measure of the attribute. The measurement of the intention to avoid drugs used a questionnaire to observe and focus groups on intention to avoid drugs.

The analysis of the concept by using the concept of Walker and Avant (2005) [12] is a process of examining the elements of the concept, to help to conceptualize the intention to avoid drugs. The results of the analysis based on the concept of the intention to avoid drugs show three attributes; (1) self-control and motivation to stay away from drugs and not taken includes, setting individual goals to avoid drugs, inspiration and knowledge how to set successful goals, self-restraint to stay away from drugs and not taken drugs, (2) commitment to stay away from drugs and not taken drugs even in difficult situations includes, commitment to stay away from drugs and not take drugs although there are high-risk situations and commitment to manage drug triggers, and (3) willingness to stay away from drugs and not take drugs include having negative attitudes toward drugs/ drug users, and adequate knowledge related to drugs, these three attributes outlined are useful in the development of a measurement tool for study, research or the development of a theory for the intention to avoid drug use in adolescents’.