Home About us Contact
|
Home About us Contact | ||
|
|
||
Diagnostic Concept (diagnostic + concept)
Selected AbstractsVictims of Domestic Violence: A Proposal for a Community Diagnosis Based on One of Two Domains of NANDA Taxonomy IIINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Patricia Serpa de Souza Batista PURPOSE To explore and identify diagnostic components to amplify NANDA nursing diagnoses by modifying the root violence. Whereas violence is nondebatable as a diagnostic concept in nursing, other alternatives have not been identified in the two existing diagnoses. METHODS Using the case study method, this qualitative study sought to identify commonalties in a population of women who were "donnas da casa" (homemakers) in a small rural community of approximately 100 families, typical of the Brazilian northeast. The sample of 7 women was identified through a larger study that had been based on health needs of the community. Data were obtained through observation during a home visit and a semistructured interview based on NANDA Taxonomy II. Observations were focused on hygiene, manner of dress, home environment, and physical and emotional state. Data were analyzed by content and clustered into major categories. From these a profile of the women and another of the partners emerged. FINDINGS Subjects ranged in age from 33 to 43 years, and number of children between 3 and 7. One of the 7 women was literate; 5 were underweight; all were slovenly attired. They appeared sad and older than their age. The majority seemed relieved to unburden themselves to the interviewers as they went through a gamut of emotions such as sadness, anguish, and irritability expressed through crying, restlessness, changes in body language, and tone of voice. The shortage of beds was supplemented by hammocks and mats or cardboard. The women spoke of being confined to their home and of male partners who drank on weekends, thus leaving them with little money for necessities of life. There were accounts of beatings when the partner returned home after drinking, overt nonacceptance of children from previous marriages, and general destruction of the family environment. New children were regarded as just another mouth to feed. DISCUSSION The profiles pointed to the necessity of identifying a new nursing diagnosis that would be linked, only tangentially, by the root violence to the two diagnoses in NANDA Taxonomies I and II. This insight led us to consider that a new method of listing NANDA diagnoses, by root only, is imperative in the evolution of Taxonomy II. Proposed descriptors, Victims of (Axis 3) and Domestic (Axis 6) would be identified by Axes, thereby facilitating the process of classifying in the Domains and Classes. The two existing NANDA diagnoses, risk for other-directed violence and risk for self-directed violence, are proposed for classification in Class 3, Violence, in Domain 11 of Taxonomy II. Safety/Protection could, by virtue of their modification power, find anchor in another domain such as Domain 6, Self-Perception. CONCLUSIONS Although Safety/Protection seems the most logical domain for classification by root, the axes, dimensions of human responses, could pull the diagnosis in another direction, thereby dictating other nursing interventions and nursing outcomes [source] Aetiology of autism: findings and questions,JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 4 2005M. Rutter Abstract Background Although there is good evidence that autism is a multifactorial disorder, an adequate understanding of the genetic and non-genetic causes has yet to be achieved. Methods Empirical research findings and conceptual reviews are reviewed with respect to evidence on possible causal influences. Results Much the strongest evidence concerns the importance of susceptibility genes, but such genes have yet to be identified. Specific somatic conditions (such as tuberous sclerosis and the fragile X anomaly) account for a small proportion of cases. Over recent decades there has been a major rise in the rate of diagnosed autism. The main explanation for this rise is to be found in better ascertainment and a broadening of the diagnostic concept. Nevertheless, some degree of true rise cannot be firmly excluded. However, the epidemiological evidence on the main hypothesized environmental explanation, namely the measles-mumps-rubella vaccine, is consistently negative. Conclusion Progress on the elucidation of the causes of autism will be crucially dependent on the combination of epidemiology with more basic science laboratory studies. [source] Annotation: PANDAS: a model for human autoimmune diseaseTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 3 2005Susan E. Swedo Background:, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus infections (PANDAS) is a recently recognized syndrome in which pre-adolescent children have abrupt onsets of tics and/or obsessive-compulsive symptoms, a recurring and remitting course of illness temporally related to streptococcal infections, and associated neurologic findings including adventitious movements, hyperactivity and emotional lability. Methods:, Inspired by observations of similar symptoms in children with Sydenham's chorea, a search was undertaken for clinical and laboratory evidence in support of the new syndrome. Results:, Consistent and predictable clinical findings have been described in a large case series. Magnetic resonance imaging has supported the postulated pathobiology of the syndrome with evidence of inflammatory changes in basal ganglia. Antibasal ganglia antibodies have been found in some acute cases, mimicking streptococcal antigen epitopes. Conclusions:, While PANDAS remains a controversial diagnostic concept, it has stimulated new research endeavors into the possible links between bacterial pathogens, autoimmune reactions, and neuropsychiatric symptoms. [source] Incidence of autism spectrum disorders: Changes over time and their meaning,ACTA PAEDIATRICA, Issue 1 2005M. Rutter Abstract Aim: Several reviews have noted a huge increase in the rate of diagnosed autism spectrum disorders. The main aims of this paper are: 1) to use published empirical findings to consider whether the rise reflects a true increase in incidence, as distinct from the consequences of better ascertainment and a broadening of the diagnostic concept; and 2) to consider how epidemiological data may be used to test hypotheses about possible causal influences, using MMR and thimerosal as examples. Methods: Search of the literature for studies with a large epidemiological base population, systematic standardized screening, a focus on an age group for which diagnostic assessments are reliable and valid, and diagnosis by trained professionals using high-quality research assessments. Also, search of a broader literature to consider the evidence from all epidemiological studies with respect to the hypothesized causal effect of MMR and thimerosal on autism spectrum disorders. Results: The true incidence of autism spectrum disorders is likely to be within the range of 30,60 cases per 10,000, a huge increase over the original estimate 40 years ago of 4 per 10,000. The increase is largely a consequence of improved ascertainment and a considerable broadening of the diagnostic concept. However, a true risk due to some, as yet to be identified, environmental risk factor cannot be ruled out. There is no support for the hypothesis for a role of either MMR or thimerosal in causation, but the evidence on the latter is more limited. Conclusion: Progress in testing environmental risk hypotheses will require the integration of epidemiological and biological studies. [source] The development of a research agenda for substance use disorders diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)ADDICTION, Issue 2006John B. Saunders ABSTRACT Aims This paper describes the background to the establishment of the Substance Use Disorders Workgroup, which was charged with developing the research agenda for the development of the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It summarizes 18 articles that were commissioned to inform that process. Methods A preliminary list of research topics, developed at the DSM-V Launch Conference in 2004, led to the identification of subjects that were subject to formal presentations and detailed discussion at the Substance Use Disorders Conference in February 2005. Results The 18 articles presented in this supplement examine: (1) categorical versus dimensional diagnoses; (2) the neurobiological basis of substance use disorders; (3) social and cultural perspectives; (4) the crosswalk between DSM-IV and the International Classification of Diseases Tenth Revision (ICD-10); (5) comorbidity of substance use disorders and mental health disorders; (6) subtypes of disorders; (7) issues in adolescence; (8) substance-specific criteria; (9) the place of non-substance addictive disorders; and (10) the available research resources. Conclusions In the final paper a broadly based research agenda for the development of diagnostic concepts and criteria for substance use disorders is presented. [source] The Changing Epidemiology of AutismJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2005Eric Fombonne This article reviews epidemiological studies of autism and related disorders. Study designs and sample characteristics are summarized. Currently, conservative prevalence estimates are: 13/10000 for autistic disorder, 21/10000 for pervasive developmental disorders not otherwise specified, 2.6/10000 for Asperger disorder, and 2/100000 for childhood disintegrative disorder. Newer surveys suggest that the best estimate for the prevalence of all autistic spectrum disorders is close to 0.6%. A detailed analysis of time trends in rates of pervasive developmental disorders in then provided. It is concluded that most of the increase is accounted for by changes in diagnostic concepts and criteria, and by improved identification. Whether or not there is, in addition to these factors, a true increase in the incidence of the disorder cannot be examined from available data. [source] The neurotic versus delusional subtype of taijin-kyofu-sho: Their DSM diagnosesPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 6 2002KEI NAKAMURA Abstract The main purpose of the present study was to investigate the diagnostic concepts of taijin-kyofu-sho (TKS) and social phobia, by comparing the clinical diagnosis of TKS and the operational diagnosis of Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised; DSM-III-R). Three evaluators conducted semistructured interview for DSM-III-R (SCID axis I and II, the Japanese version) to 88 outpatients who visited Jikei University Daisan Hospital, Japan, over a period of 1 year, requesting Morita therapy. The patients were also independently diagnosed by three psychiatrists to identify TKS. A total of 65.8% of 38 cases of TKS were diagnosed as social phobia. Among the neurotic TKS cases, the percentage was high at 81.5%, while among the delusional TKS cases it was 27.3%. A total of 42.1% of the TKS cases were diagnosed as mood disorder; 60.5% of the TKS cases presented some axis II disorders, among which avoidant personality disorder was the most prevalent (31.6%). There was no significant difference between the neurotic and delusional subtypes of TKS, regarding comorbidity with axis I diagnoses. As for axis II diagnoses, delusional TKS patients had a higher rate of comorbidity with paranoid personality disorder, although they demonstrated very similar trends in comorbidity with all other personality disorders. In the diagnostic system of DSM-III-R, it is highly likely that the neurotic and delusional subtypes of TKS will be seen to correspond to different diagnostic categories. [source] | ||||||||||