Home About us Contact
|
Home About us Contact | ||
|
|
||
Findings
Kinds of Findings Terms modified by Findings Selected AbstractsFINDING AND FOSTERING THE PHILOSOPHICAL IMPULSE IN YOUNG PEOPLE: A TRIBUTE TO THE WORK OF GARETH B. MATTHEWSMETAPHILOSOPHY, Issue 1 2008SARA GOERING Abstract: This article highlights Gareth Matthews's contributions to the field of philosophy for young children, noting especially the inventiveness of his style of engagement with children and his confidence in children's ability to analyze perplexing issues, from cosmology to death and dying. I relate here my experiences in introducing philosophical topics to adolescents, to show how Matthews's work can be successfully extended to older students, and I recommend taking philosophy outside the university as a way to foster critical thinking in young students and to improve the public status of the profession. [source] MANAGEMENT OF OBSCURE GASTROINTESTINAL BLEEDING BASED ON THE CLASSIFICATION OF CAPSULE ENDOSCOPIC BLEEDING FINDINGSDIGESTIVE ENDOSCOPY, Issue 3 2010Mitsunori Maeda Background:, Double-balloon endoscopy (DBE) and capsule endoscopy (CE) have been useful in managing obscure gastrointestinal bleeding (OGIB). However, DBE is invasive, complex and time-consuming, therefore indications should probably be selective. The aim of this study was to evaluate the usefulness of the classification of the CE bleeding findings for determining the indications and timing of DBE in patients with OGIB. Methods:, From February 2003 to January 2009, 123 patients with OGIB who underwent CE were included in this study. These CE findings were classified based on the bleeding source. Type CE-I, II, III, IV and 0 indicate active bleeding, previous bleeding, lesions without active bleeding, a lesion outside of the small bowel, and no findings, respectively. We compared diagnostic yield and outcome between the classification and the findings of DBE or enteroclysis. Results:, Comparisons of the positive findings rate with DBE or enteroclysis, the treatment rate and the rebleeding rate with the classification showed: CE-Ia, 100% (6/6), 50% (3/6), 33.3% (2/6); Ib, 66.7% (4/6), 0% (0/6), 16.7% (1/6); IIa, 33.3% (1/3), 33.3% (1/3), 33.3% (1/3); IIb, 53.8% (7/13),15.4% (2/13), 30.8% (4/13); III, 100% (84/84), 9.5% (8/84), 8.3% (7/84); IV, 100% (2/2), 50% (1/2), 0% (0/2); and 0, 0% (0/9), 0% (0/9), 0% (0/9), respectively. Conclusions:, The proportion of patients requiring treatment, the positive findings rate with DBE or enteroclysis and the rebleeding rates tended to be higher in the higher ranked classification types (CE-I > II > III > IV > 0). These findings suggest that the classification can provide useful information on determining the indications and timing of DBE. [source] AORTO-DUODENAL FISTULA: MULTIDETECTOR COMPUTED TOMOGRAPHY AND GASTRODUODENOSCOPY FINDINGS OF A RARE CAUSE OF UPPER GASTROINTESTINAL HEMORRHAGEDIGESTIVE ENDOSCOPY, Issue 3 2007Massimo De Filippo An aorto-enteric fistula is a serious complication of abdominal aortic aneurysm. Acute upper gastrointestinal bleeding may be a life-threatening condition that calls for immediate diagnosis and action. Morbidity and mortality remain high despite progress in diagnosis and therapeutic procedures. In the literature, the aorto-enteric fistula diagnostic suspicion by multidetector computed tomography scan is assumed on the basis of the interruption of the aortic wall, with the presence of duodenal gas situated to tightened contact with the aorta. We report a patient with an aorto-duodenal fistula associated with inflammatory abdominal aortic aneurysm detected by gastro-duodenoscopy and multidetector computed tomography scan, with gas found in the lumen of the abdominal aorta, between the aneurysm wall and the thrombus. [source] INFLUENCE OF MENSTRUAL CYCLE PHASE ON SMOKING CESSATION TREATMENT OUTCOME: A HYPOTHESIS REGARDING THE DISCORDANT FINDINGS IN THE LITERATUREADDICTION, Issue 11 2009TERESA R. FRANKLIN No abstract is available for this article. [source] DO RECENT FINDINGS IN PLANT MITOCHONDRIAL MOLECULAR AND POPULATION GENETICS HAVE IMPLICATIONS FOR THE STUDY OF GYNODIOECY AND CYTONUCLEAR CONFLICT?EVOLUTION, Issue 5 2008David E. McCauley The coexistence of females and hermaphrodites in plant populations, or gynodioecy, is a puzzle recognized by Darwin. Correns identified cytoplasmic inheritance of one component of sex expression, now known as cytoplasmic male sterility (CMS). Lewis established cytonuclear inheritance of gynodioecy as an example of genetic conflict. Although biologists have since developed an understanding of the mechanisms allowing the joint maintenance of CMS and nuclear male fertility restorer genes, puzzles remain concerning the inheritance of sex expression and mechanisms governing the origination of CMS. Much of the theory of gynodioecy rests on the assumption of maternal inheritance of the mitochondrial genome. Here we review recent studies of the genetics of plant mitochondria, and their implications for the evolution and transmission of CMS. New studies of intragenomic recombination provide a plausible origin for the chimeric ORFs that characterize CMS. Moreover, evidence suggests that nonmaternal inheritance of mitochondria may be more common than once believed. These findings may have consequences for the maintenance of cytonuclear polymorphism, mitochondrial recombination, generation of gynomonoecious phenotypes, and interpretation of experimental crosses. Finally we point out that CMS can alter the nature of the cytonuclear conflict that may have originally selected for uniparental inheritance. [source] Victims 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] Fatigued Elderly Patients With Chronic Heart FailureINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Anna Ehrenberg PURPOSE To compare descriptions of fatigue based on the NANDA characteristics from interviews with elderly people with congestive heart failure (CHF) and data recorded by nurses at a Swedish outpatient heart failure clinic. METHODS Patients were screened for moderate to severe CHF. A total of 158 patients were interviewed using a revised form of the Fatigue Interview Schedule (FIS) based on the NANDA characteristics. Of these patients, half (n= 79) were offered visits at a nurse-monitored heart failure clinic. Nursing documentation of fatigue at the heart failure clinic was reviewed based on the NANDA characteristics and compared with the content in the patient interviews. FINDINGS Tiredness was documented in 43 (75%) records and indicated in 36 patients based on patient scores on the FIS (X,= 5.5; range 1,9). The most frequently recorded observation related to fatigue was the symptom emotionally labile or irritable, followed by notes on lack of energy and decreased performance. Patients' descriptions of their fatigue were expressed as a decreased ability to perform and a perceived need for additional energy. Results indicated poor concordance in patients' descriptions and record content concerning fatigue. Whereas patients emphasized the physical characteristics of fatigue, nurses emphasised the emotional features. Decreased libido was linked to fatigue according to the patients but not according to the nurses' records. Whereas cognitive characteristics of fatigue occurred rarely in the records, they were more frequent in the patient interviews. DISCUSSION Symptoms such as irritability and accident-proneness may be seen as manifestations of the patients' experiencing the need for more energy or a feeling of decreased performance. These consequences of being fatigued, rather than the different dimensions of fatigue, seemed to have been easy for the nurses to observe and document. Earlier studies indicate that poor observation, medication, and diet in patients with heart failure might partly be explained by cognitive impairment. CONCLUSIONS Findings of this study highlight the need for nurses to pay attention to the experience of fatigue in patients who suffer from CHF, and to validate their observations with the patients own expressions. Using the patients' words and expressions and the diagnostic characteristics of fatigue in recording can support the nurses in developing both understanding of patients living with CHF and strategies to help patients cope with their restricted ability in daily life. [source] Evaluation of Interventions Proposed for Altered Tissue Perfusion: Cardiopulmonary in Patients Hospitalized With Acute Myocardial InfarctionINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Ivanise Maria Gomes PURPOSE To evaluate the effectiveness and efficacy of the interventions proposed for patients with altered tissue perfusion: cardiopulmonary, according to NIC and NOC taxonomies. METHODS Prospective and descriptive study carried out in the cardiology unit of a school hospital with patients under clinical treatment followed from admission until discharge. Patient data were collected using the unit's assessment tool and nursing diagnoses were established. Daily activities were proposed for these patients based on NIC interventions "cardiac care: acute,""cardiac care," and "cardiac care: rehabilitative." Results were evaluated according to indicators selected from NOC's Tissue Perfusion: Cardiac. FINDINGS The sample comprised 25 patients (12 males, 13 females), age range 39 to 83 years. Days hospitalized averaged 3.5 in the coronary unit and 3.5 in the cardiology infirmary, for a total of 7 hospital days. The nursing diagnosis was made based on defining characteristics: enzymatic and ECG changes were found in 100% of the patients, chest pain (96%), diaphoresis (80%), and nausea (72%). The related factor in evidence for 100% of the sample was coronary arterial flow interruption. Patients were evaluated according to NOC outcomes both before starting activities and daily, with the following results: chest pain , 64% of patients initially presented pain with score 1, most (72%) presented scores 4 and 5 on day 2; on days 3, 5, 6, and 7 of hospitalization, all patients reported absence of pain (score 5). On day 4 only, 4% of patients reported pain with intensity 7 (score 2). Profuse diaphoresis was found in 80% of the sample on day 1 of hospitalization, and that disappeared in the course of the remaining days. Nausea was found in 44% of the population with score 1 on day 1 of hospitalization, and disappeared subsequently. Most the patients (84%) did not present with vomiting. Also, no evidence was found of vital sign changes in most of the sample. ECG presented score 1 in 72% of the sample on day 1, greatly decreasing from day 2. Cardiac enzymes appeared in 100% of the sample, decreasing in subsequent days. Heart ejection fraction, pulmonary artery pressure, heart rate, and myocardial scanning indicators were not measured. CONCLUSIONS Indicators evaluated achieved score 5 (no compromise) on hospital discharge in 100% of patients, which evidences effectiveness of the interventions performed. [source] Nursing-Sensitive Outcome Implementation and Reliability Testing in a Tertiary Care SettingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Julia G. Behrenbeck PURPOSE To describe the NOC outcomes most relevant for specialty nursing practice and in selected field sites representing the continuum of care; to assess the adequacy of measures (reliability, validity, sensitivity, specificity, practicality); and to describe the linkages among nursing diagnoses, interventions, and outcomes in clinical decision making. METHODS Data were collected on 434 patients during the 12-month data collection period at a tertiary care center: cardiac surgery intensive care (n= 76), cardiac transplant unit (n= 153), and medical unit (n= 205). Medical diagnoses of patients on the two cardiac units were related to cardiac disease. Medical diagnoses of patients on the medical unit were extremely varied (ranging from e.g., gout to pneumonia). Data were collected on 65 separate outcome labels for a total of 633 ratings. FINDINGS In the cardiac transplant ICU, data were collected on 42 outcomes: 30 had an average interrater reliability of ,85%, and 16 had an absolute agreement interrater reliability of ,85%. In the cardiac surgery ICU, data were collected on 30 outcomes: 25 had an average interrater reliabilty of ,85%, 6 had an absolute agreement interrater of ,85%. In the medical unit, data were collected on 45 outcomes: 41 had an average interrater reliability of ,85%, 14 had an absolute agreement interrater reliability of ,85%. Four outcomes have been implemented into the documentation system for all patients: Tissue Integrity: Skin and Mucous Membranes, Mobility Level, Knowledge: Disease Process, and Coping. CONCLUSIONS Overall, nursing staff were very positive about having the opportunity to participate in nursing research. Staff were able to think about the relative status of their patient and how nursing care contributes to the patient's recovery. They appreciated the opportunity to discuss this with a colleague during the interrater exercise. Increased familiarity with NOC allows staff members to determine which outcomes comprise core nursing-sensitive outcomes for their clinical setting. [source] Nursing Diagnoses in Psychiatric Acute Wards in Switzerland and AustriaINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Harald Stefan PURPOSE To examine the frequency and quality of documented nursing diagnoses and to compare the diagnoses regarding ward and patient characteristics. METHODS The following data were collected from 11 acute care wards in five psychiatric hospitals in Switzerland and Austria: documented nursing diagnoses, demographic characteristics of an unselected sample of 30 consecutively discharged patients in each ward, ward data, and data from three randomly selected complete charts from each ward. Free-text diagnoses were recoded into NANDA terminology. Frequencies were calculated and compared across settings and regarding patient and ward characteristics. Diagnoses were examined for quality and structure of the diagnostic statements. FINDINGS Mean age of patients was 40 ± 13 years, and the main psychiatric diagnoses were schizophrenia, mood disorders, substance abuse, and neurotic and personality disorders. Of the 664 nursing diagnoses located in 330 nursing records, 635 were proper nursing diagnoses; 83% of patients had at least 1 nursing diagnosis (X,= 2). The number of diagnoses correlated weakly with patient length of stay. Of the nursing diagnoses, 20% were made on admission day, and the majority of nursing diagnoses was active at discharge. Ninety percent of the diagnoses were formulated using NANDA terminology. The most frequently used categories were coping-related diagnoses,disturbed thought processes and self-care deficits. Numerous problem,etiology,symptom (PES)formatted diagnoses had diagnostic labels nested within the etiology. Countryand setting-specific similarities and differences were found with a significantly higher number of nursing diagnoses in Austria where use is mandated. In Austria, more somatic nursing diagnoses were found. The most frequent nursing diagnoses were similar in both countries. DISCUSSION The number of diagnoses corresponds to results reported in the international literature suggesting the justification for international comparison. Ten categories represent 60% of nursing diagnoses. Approximately 50% of nursing diagnoses were made in the first days after hospitalization, rendering their use practicable. A minority of nursing diagnoses were discontinued, possibly suggesting that some problems are difficult to solve or evaluate. The PES format and the NANDA terminology are used quite extensively even when not mandatory. NANDA terminology is deemed useful and practical, but problems occur when nursing diagnoses CONCLUSIONS Nursing diagnoses represent the main areas of nursing, but cultural differences exist regarding the diagnostic process. Thus, research is needed to test the appropriateness of nursing diagnoses to characterize nursing populations. [source] NANDA and NIC: Mediators to Describe Irish Intellectual Disability NursingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Fintan Sheerin PURPOSE To identify the foci of interest specific to nursing interventions within residential, intellectual disability nursing through the use of the terms and meanings presented in NANDA and NIC. METHODS Data were collected using a Delphi approach involving a purposive sample of 8 individuals with relevant expertise, followed up by the conduct of three focus groups held with a total sample of 17 intellectual disability nurses working in three Irish service settings: traditional residential, community residential, and nurse education. Data were examined for contextual meaning as well as consensus of perceptions. FINDINGS Many potential interventions and diagnoses were identified for the field of residential learning disability nursing. Interventions that elicited a >50% consensus among participants across groups were examined for contextual meaning, based on the taped and noted responses, and potentially related NIC interventional labels were then applied. These led, through a reverse NIC-NANDA linkage exercise, to the identification of 8 potentially related interventions. The contextual aspect directed the analysis process to identify the nursing diagnoses associated with the interventions to be used, and 21 resultant diagnoses were identified. DISCUSSION Further analysis and study are needed to verify the relevance of these diagnoses and interventions to residential learning disability. A quick comparison of the results with those of studies carried out in other countries demonstrates that certain diagnoses have been identified by one or more authors in their studies. CONCLUSIONS This study identified a number of foci that have achieved various levels of consensus among the study participants. The ongoing study plan will further examine nurses' and managers' perceptions while also looking at these within the context of current service philosophy. [source] An Internet-Based Survey of Icelandic Nurses on Their Use of and Attitudes Toward NANDA, NIC, and NOCINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Gyda Bjornsdottir PURPOSE To gain understanding of how Icelandic nurses can be supported during a mandated change to the use of NANDA and NIC in clinical documentation practices. METHODS All members of the Icelandic Nurses Association of working age were invited to participate in an Internet-based survey. Each nurse was assigned a unique password mailed to his/her home along with information on how to access the survey Web site. Each nurse could submit answers only once. On submission, data were automatically coded and saved in a database under encrypted numerical identifiers. FINDINGS A total of 463 nurses (18% response rate) participated by submitting answers. The sample was representative of the population in terms of demographic characteristics. Information resources most valued when planning nursing care included text-based progress notes (77%), nursing care plans (52%), doctor's orders (49%), verbal information (48%), and documented nursing diagnoses (37%). Of the participants, 58% said NANDA was used in their workplace; 28% said no standardized nursing documentation was used; 19% reported using NIC always or sometimes when documenting nursing interventions; and 20% never used NIC. NOC use was reported only by researchers. Of the sample, 86% reported that it is important or necessary for nurses to standardize documentation practices; 30% found NANDA useful in education; 56% found it useful for clinical work; 17% for research; and 7% found it not useful at all. Nine percent believed that NANDA diagnoses were not descriptive enough of patients' problems, and 23% found their wording problematic. No statistically significant differences were found between reported use of or attitudes toward NANDA and NIC when comparing nurses who use electronic patient record systems that support NANDA and NIC documentation and those who use paper documentation only. DISCUSSION The sample may have been somewhat biased toward computer use and classification system use for standardized and computerized documentation. However, results indicate that although Icelandic nurses give free-text progress notes and verbal information a higher priority than nursing diagnoses as an information resource for care planning, they have a positive attitude toward NANDA. NANDA and NIC are still used inconsistently in clinical practice, and 28% of participants claimed not to use any form of standardized documentation. CONCLUSIONS In an effort to standardize clinical documentation among nurses, Icelandic health authorities must follow their documentation mandates with educational and technologic support to facilitate the use of NANDA, NIC, and (after its translation) NOC in nursing documentation practices. Electronic patient record system developers must find ways to further facilitate standardized nursing documentation because currently there seems to be no difference between users and nonusers in terms of how they use NANDA and NIC in their documentation practices. [source] Estimated Time and Educational Requirements to Perform NIC InterventionsINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Gloria M. Bulechek PURPOSE To estimate the time to perform and type of personnel to deliver each of the 486 interventions listed and described in the third edition of NIC. METHODS Small groups of research team members rated selected interventions in their area of expertise on education and time needed for each intervention. Education needed was defined as the minimal educational level necessary to perform the intervention in most cases in most states. Rating categories were (a) nursing assistant (NA/LPN/LVN/technician), (b) RN (basic education whether baccalaureate, associate degree, or diploma), or (c) RN with post-basic education or certification. Time needed was defined as the average time needed to perform the intervention. Raters selected one of five possible time estimates: (a) <15 minutes, (b) 16,30 minutes, (c) 31,45 minutes, (d) 46,60 minutes, or (e) >1 hour. All ratings were reviewed across groups to ensure overall consistency. FINDINGS Results of this exercise provide beginning estimates of the time and education needed for 486 NIC interventions. Twenty percent required <15 minutes, 30% required 16,30 minutes, 17% required 31,45 minutes, 12% required 46,60 minutes, and 21% required >1 hour. More than 70% of the interventions were judged as needing basic RN education to perform. Raters judged RN post-basic education to be required to performi 16% of the interventions, and 14% were deemed appropriate for personnel with NA/LPN education to perform. A monograph, Estimated Time and Educational Requirements to Perform 486 Nursing Interventions, available from http://www.nursing@uiowa.ed/cnc, includes lists of interventions appropriate for each time and education category, as well as time and education ratings according to NIC domains and classes. DISCUSSION The estimates of time and education provided by expert ratings provide a good beginning for cost estimates, resource planning, and reimbursement. The results of this study add to the small but growing body of literature that demonstrates that estimates of time to perform interventions by nurses who are familiar with the interventions is an accurate and efficient method to determine time values. A description of how this information can be used in a costing model is in the July/August 2001 issue of Nursing Economics. CONCLUSIONS NIC has identified the interventions that nurses perform. This study of time to perform and type of personnel to deliver each of the NIC interventions can help nurse leaders make better-informed decisions about cost-effective nursing care. [source] Standardized Care Planning: Evaluation of ICNP Beta in the Areas of Nutrition and Skin Care in a Practice SettingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Jan Florin PURPOSE To evaluate completeness, granularity, multiple axial content, and clinical utility of the beta version of the International Classification of Nursing Practice (ICNP®). METHODS Standardized care plans were developed based on research in the areas of nutrition and skin care and clinically tested in a 35-bed infectious disease unit at a Swedish university hospital. A convenience sample of 56 computerized and manual patient records were content analyzed and mapped to the terms in ICNP® beta. FINDINGS A total of 1,771 phrases were identified. Approximately 60% of the record content describing nursing phenomena and about one third of the nursing interventions in the areas of nutrition and skin care could be expressed satisfactorily using the terminology of ICNP® beta. For about 25% of the content describing both nursing phenomena and interventions, no corresponding term was found. The most common deficiencies were focus terms for stating patient perspective or collaboration, nonhuman focus, normal findings, more qualitative judgments, and different expressions for stating duration. Some terms are available in the ICNP beta as a whole, but the organization of axes impedes or restricts the use of terms beyond the ICNP categories. Terms needed to express nursing phenomena could sometimes be found in nursing actions axes. CONCLUSIONS The ICNP® beta needs to be further developed to capture relevant data in nursing care. The axial structure needs to be evaluated, and completeness and granularity of terms need to be addressed further before ICNP beta can be used on a daily basis in the clinical setting. Terms need to be developed to express patient participation and preferences, normal conditions, qualitative dimensions and characteristics, nonhuman focuses as well as duration. Empirical studies covering the complexity of information in nursing care are needed. [source] Patient Response to the Fast-Track ExperienceINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Jane Flanagan PURPOSE To describe patients' functional health, symptom distress, and recovery at home across a fasttrack perioperative experience. METHODS A nonexperimental, descriptive, correlational design using pre/post test measures and openended questions captured the fast-tracking experience. A convenience sample included 77 patients entering the same-day surgery unit to undergo arthroscopy with general anesthesia and planned fast-track recovery. In the preadmission test area, patients were asked by a nurse to participate in the study. If they agreed and met selection criteria, a nurse completed a demographic sheet, the Foster and Jones Functional Health Pattern Assessment Screeing Tool (FHPAST), and the Symptom Distress Scale (SDS). On the evening of surgery, a nurse called the patient to review the SDS to be completed by phone. At 72 hours after surgery, the FHPAST, the SDS, and a 72-hour open-ended questionnaire were administered to understand the patient experience of fast-tracking. FINDINGS At 12 hours nurses reported patients were "euphoric" and it was difficult to imagine pain or other symptoms. Some patients complained of nausea and fatigue. Most patients had family present. At 72 hours patients described unmet expectations, fatigue, immobility, ineffective pain management, sleep disturbance, and nausea. Interventions included teaching, coaching, and reassurance. Some patients continued to have nursing problems at 72 hours and benefited from a telephone follow-up call. CONCLUSIONS Preliminary results suggest that nursing diagnoses, interventions, and outcomes can be used to describe patient responses to the fast-track experience. Results indicate a need for practice changes to include innovative models and further research to measure outcomes. Fast-tracking can be effective, but requires clinical reasoning by nurses to guide the individual's healing. A coaching intervention seems to enhance patient satisfaction and a sense of being cared for. [source] Using NIC to Describe the Role of the Nurse PractitionerINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Cindy S. Haugsdal PURPOSE To have nurse practitioners (NPs) identify the 20 most prevalent NIC interventions describing their nursing practice; to determine if the NIC is applicable to the NP role. METHODS The study used a descriptive survey design. NPs with prescriptive privileges in the state of Minnesota received a cover letter and survey that included a description of NIC and a list of the 486 intervention labels and their definitions from the NIC (3rd ed.). Each participant was asked to identify all interventions performed at least once per month in their practice and to provide basic demographic data, including identification of NP specialty. FINDINGS A total of 1,190 surveys were mailed with a return rate of 37%. NPs' average age was 45 years; the average number of years of NP practice was 9. Employment in a clinic represented the work setting of 72% of respondents followed by hospital practice (11%) and long-term care (10%). Specialty (certified) areas were family practice (27%), pediatrics (21%), adult (19%), women's health (16%), geriatrics (11%), psychiatric (5%), and oncology (1%). The educational level was primarily master's degree (73%). NPs identified an average of 120 interventions they performed at least once per month. These interventions reflected areas of patient education and support, as well as documentation and physician collaboration. The 20 most frequently selected interventions were reported by 71%, 90% of respondents. Four core interventions ,"documentation,""telephone consultation,""teaching: prescribed medication," and "emotional support", were used at least once per month by all specialties. DISCUSSION The level of consistency (70%) among responses validates the strong foundation that professional nursing, as described by NIC, provides NPs in their role. Four core interventions and the remaining 16 most frequently selected interventions that are more specific to each specialty practice indicates that NIC is comprehensive enough to meet the needs of a variety of NP practices. CONCLUSIONS NIC encompasses key areas of interventions (health screening, treatment and management, health promotion and education, psychosocial support, indirect activities) central to the role of NPs, but qualitative comments described the need for more language within NIC to characterize the NP role related to the prescribing of medications and treatments. Some respondents found the definitions to be unclear as to whether they were performing or ordering/prescribing the intervention. This lack of clarity could be addressed by further development of the NIC definitions and activities so the advanced role of the NP is more fully described. Development of documentation systems using the core interventions identified by the various NP specialties is needed. Using standardized nursing language for documentation will enable NPs to build clinical databases that reflect and describe the role. Future research needs to be focused by NP specialty and to go beyond the NIC definition and include analysis at the activity level. [source] Validation of Priority NIC Interventions and Suggested NOC Outcomes for Fluid Volume ExcessINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Juliana de Lima Lopes PURPOSE To identify and evalutate NIC priority interventions performed by Brazilian nurses and the associated NOC outcomes for patients whose clinical conditions suggest fluid volume excess. METHODS An exploratory study was developed in two phases: (a) validation of the content of the priority NIC interventions and suggested NOC outcomes by seven expert nurses from a cardiology ward and the researcher, and (b) activities and indicators chosen were performed and evaluated daily for all patients admitted to the cardiology ward whose clinical conditions suggested fluid volume excess. FINDINGS Nurses chose 26 activities from the NIC categories of "fluid management," 23 from "fluid monitoring," and 28 from "hypervolemia management." Eighteen NOC outcomes were chosen from Fluid Balance, 11 from Hydration, and 13 from Electrolyte and Acid/Base Balance. CONCLUSIONS Nurses identified many NIC activities that are important to their practice, and they also agreed with many NOC indicators. The use of standardized languages for interventions and outcomes will allow them to develop the process of nursing care and to establish practice standards. [source] Evaluation of NOC Measures in Home Care Nursing PracticeINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Gail M. Keenan PURPOSE To evaluate the reliability, validity, usefulness, and sensitivity of 89 NOC outcomes in two Visiting Nurse Associations in Michigan. METHODS Of a total 190 NOC outcomes 89 were assigned for testing. Interrater reliability and criterion validity were assessed a total of 50 times per outcome (on 50 different patients) across the study units. The total number of times the reliability and validity were assessed for each of the 89 measures studied ranged from 5,45. Three RN research assistants (RNRAs) oversaw and participated in data collection with the help of 15 clinicians. Convenience sampling was used to identify subjects. A roster of outcomes to be studied was maintained and matched with patient conditions whenever possible until the quota of outcomes assigned had been evaluated. Clinicians and RNRAs independently rated the outcomes and indicators applicable to the patient. NANDA diagnoses, NIC interventions, and medical diagnoses were recorded. FINDINGS A total of 258 patients (mean age 62) enrolled; 60% were women, 23% were from minority groups, and 78% had no college degree. Thirty-six of the 89 NOC measures were designated "clinically useful." The 10 outcomes with the highest interrater reliability were Caregiver Home Care Readiness; Caregiver Stressors; Caregiving Endurance Potential; Infection Status; Mobility Level; Safety Status: Physical Injury; Self-Care: Activities of Daily Living; Self-Care: Bathing; Self-Care: Hygiene; and Wound Healing: Secondary Intention. Criterion measurement and repeated ratings provided evidence to support the validity and sensitivity of the NOC outcomes. Evidence also suggested that NOC label level ratings could be a feasible, reliable, and valid method of evaluating nursing outcomes under actual use. For some measures, adjustments in the scales and anchors are needed to enhance reliability. For others, it may be unrealistic to reliably score in one encounter, thus scoring should be deferred until the clinician has adequate knowledge of the patient. CONCLUSIONS Continued study and refinement that are coordinated and integrated systematically strongly recommended. Comprehensive study in an automated system with a controlled format will increase the efficiency of future studies. [source] Nursing Outcomes for Evaluations of Caregiver Outcomes in a Rural Alzheimer Demonstration ProjectINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Janet Specht PURPOSE To evaluate the effectiveness of the interventions of nurse care managers in the care of family members of people with dementia. METHODS Data were collected as part of a 3-year Administration on Aging,funded Alzheimer Demonstration Project to provide expanded in-home services to rural Iowans affected by Alzheimer disease and related disorders in 8 rural Iowa counties,randomly selected to have a nurse care manager and 4 designated control counties that had traditional case management service. Nurse care managers were trained in the care of people with dementia and their caregivers, the use of role transition theory, and the Progressively Lowered Stress Threshold model of care to provide and coordinate services for enrollees. All referred people with cognitive impairment and their families in the 8 study counties were eligible for inclusion. Three selected NOC outcomes were tested in clinical settings. Interrater reliability for the outcomes was good (87%,95%). The construct validity of Caregiver Stressors Outcome was .74 when correlated with the Caregiver Stress Index. FINDINGS Of the 142 subjects with cognitive impairment enrolled within the first year of the grant, 113 had a caregiver. The outcomes were used to evaluate differences in caregiver outcomes at baseline and at 6-month intervals. The majority of caregivers at follow-up was female and had been providing care for ,5 years. For each of the outcomes the majority of caregivers had improved scores, with only 2,4 caregivers getting scores indicating worsening conditions or remaining the same. CONCLUSIONS Preliminary analysis shows a trend of improved outcomes with the use of a nurse care manager. The NOC caregiver outcomes showed good variability among caregivers at baseline, with caregiver responses distributed throughout the scales. The NOC outcomes also provide guidance for interventions of the nurse care managers. Further evaluation of the outcomes is needed, including examining the relationships of placement, health status, and service use of each outcome. The caregiver outcomes offer an effective and efficient means to evaluate services delivered to caregivers of people with dementia. [source] Nursing Diagnosis in Medical-Surgical PatientsINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Márcia Paschoalina Volpato PURPOSE. To identify nursing diagnoses identified in patients in a medical-surgical unit. METHODS. Data were collected through interviews and physical examination of 60 patients on a female ward in order to formulate NANDA diagnoses. The data collection tool was based on Gordon's 11 Functional Health Patterns. Four researchers with medical-surgical nursing expertise reached the nursing diagnosis through consensus. FINDINGS. A total of 338 diagnoses were identified from 49 different categories. Nineteen categories were identified in more than 10% of the sample: risk for infection (58%), pain (50%), constipation (42%), activity intolerance (35%), sleep pattern disturbance (28%), altered physical mobility (27%), impaired skin integrity (27%), fatigue (25%), sexual pattern dysfunction (23%), anxiety (23%), risk for ineffective manipulation of therapeutic regimen (20%), risk for trauma (20%), risk for impaired skin integrity (18%), ineffective coping (18%), altered nutrition: more than body requirements (12%), impaired communication (12%), urinary incontinence (10%), fluid volume excess (10%), and altered nutrition: less than body requirements (10%). The most frequent diagnoses related to Health Functional Patterns were identified in health control and perception, with 28% of the 338 formulated diagnoses, activity-exercise and nutritional-metabolic with 20% each. CONCLUSIONS. There was great diversity in the quality of the reported needs in the studied sample, which demands extensive knowledge and a wide range of abilities to identify needs as well as implement care in the affected patients. Studies such as this one will enhance delineation of the nursing knowledge base in order to justify allocation of human resources in specific areas. [source] Relevance of Cues for Assessing Hallucinated Voice ExperiencesINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2003Margaret England PhD PURPOSE. To assess psychiatric nurses' views of the importance of itemized content represented on an Inventory of Voice Experiences (IVE) for ongoing assessment of atypical auditory sense perception in people who hear voices. METHODS. Over 6 months, 317 experienced psychiatric nurses rated 58 assessment cues for hallucinated voice experiences. Cronbach's alpha, Cohen's kappa, and Bartko's intraclass correlation coefficients were used to measure concordance of the nurses' judgments against two hypothetical standards derived for purposes of the study. FINDINGS. There was moderate support for both the internal consistency of the nurses' judgments concerning the importance of itemized content represented on the WE and overall equivalence of the content. There was modest-to-moderate concordance of the nurses' original and subsequent judgments but a lack of concordance of the nurses' judgments with equally weighted judgments of the principal investigator even though the judgments of the investigator were based on extant literature and published reports of voice hearers. CONCLUSIONS. Results may reflect the effects of repeated testing, but it also is possible that some nurses did not have enough knowledge or professional experience to quantify judgments about the importance of hallucinated voice descriptions tied to the items on the WE. The findings are being used to refine the IVE. PRACTICE IMPLICATIONS. Findings provide nurses with opportunities for discerning specific characteristics, antecedents, and consequences of voice hearing along with their implications for health and well-being. Discernment of this information will facilitate identification of more specific and meaningful options for helping voice hearers manage their voices. Search terms: Auditory hallucinations, schizophrenia [source] Experienced and Less-Experienced Nurses Diagnostic Reasoning: Implications for Fostering Students' Critical ThinkingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2003Catherine G. Ferrario DNSc PURPOSE. To compare the use of mental representations (heuristics) in diagnostic reasoning of expert (,5 years' experience) and novice (<5 years' experience) emergency nurses. METHODS. Clinical simulations were completed by a nationwide randomly selected sample of 173 experienced and 46 less-experienced emergency nurses (N =229). FINDINGS. Experienced nurses used the heuristic, Judging by Causal Systems (diagnostic inferences deduced from systems of causal factors) significantly more did than less-experienced nurses. PRACTICE IMPLICATIONS. Standardized nursing diagnoses may cut short the time needed to develop representational thinking and spare cognitive reserves for reasoning needed for complex patients. Faculty need to promote students' cognitive development through strategies that promote active, reflective, and integrative learning. Search terms: Clinical experience, diagnostic reasoning [source] Applicability of the International Classification of Nursing Practice (ICNP®) in the Areas of Nutrition and Skin CareINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2003Margareta Ehnfors PhD PURPOSE. To evaluate completeness, granularity, multiple axial content, and clinical utility of the beta version of the ICNP® in the context of standardized nursing care planning in a clinical setting. METHODS. An 35-bed acute care ward for infectious diseases at a Swedish university hospital was selected for clinical testing. A convenience sample of 56 patient records with data on nutrition and skin care was analyzed and mapped to the ICNP. FINDINGS. Using the ICNP terminology, 59%-62% of the record content describing nursing phenomena and 30%-44% of the nursing interventions in the areas of nutrition and skin care could be expressed satisfactorily. For about a quarter of the content describing nursing phenomena and interventions, no corresponding ICNP term was found. CONCLUSIONS. The ICNP needs to be further developed to allow representation of the entire range of nursing care. Terms need to be developed to express patient participation and preferences, normal conditions, qualitative dimensions and characteristics, nonhuman focus, and duration. PRACTICE IMPLICATIONS. The practical usefulness of the ICNP needs further testing before conclusions about its clinical benefits can be determined. Search terms: ICNP®, nursing classification, standardized terminology, VIPS [source] Use of Nursing Diagnoses and Interventions in Public Health Nursing PracticeINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2002Jennifer C. Rivera MSN PURPOSE. To determine the frequency of use of NANDA diagnoses and the Nursing Interventions Classification in care plans written by public health nurses (PHNs) in Orange County, CA. METHODS.Retrospective chart review. FINDINGS. The frequency pattern of nursing diagnoses and nursing interventions used in care plans is consistent with the scope of practice of the PHN, whose emphasis is on health promotion and disease prevention. CONCLUSIONS. The most commonly used diagnoses and interventions provide evidence of a core set of interventions useful for PHN practice. IMPLICATIONS FOR PRACTICE.Linking diagnoses and interventions allow PHNs to build a body of knowledge based on patient care and improve clinical decision-making process. Search terms:Interventions, nursing diagnosis, public health nursing Utilisation des diagnostics infirmiers et interventions en santé publique BUT.Déterminer la fréquence des diagnostics infirmiers (ANADI) et des interventions (NIC) dans les plans de soins rédigés par les infirmières de santé publique dans le Comté d'Orange, CA. METHODE.Étude rétrospective des dossiers. RÉSULTATS.La répartition des diagnostics infirmiers et des interventions utilisés dans les plans de soin est cohérente avec la pratique des infirmières en santé publique, c'est-à-dire qu'elle souligne l'importance de la promotion de la santé et la prévention de la maladie. CONCLUSIONS.Les diagnostics et interventions les plus fréquemment utilisés permettent d'identifier le groupe d'interventions au centre de la pratique des soins en santé publique. IMPLICATIONS POUR LA PRATIQUE.L'articulation des diagnostics et interventions de soins permet de construire un corpus de connaissances en santé publique basée sur le soin des patients et d'améliorer le processus de décision clinique. Mots-clés:Diagnostics infirmiers, interventions, soins infirmiers en santé publique Utilización de los diagnósticos e intervenciones de enfermería en la práctica de enfermería de salud pública PROPÓSITO.Determinar la frecuencia del uso de los diagnósticos de la NANDA y de la clasificación de las intervenciones enfermeras (NIC), en planes del cuidados escritos por enfermeras de salud pública en el Condado de Orange, California. MÉTODOS.Revisión retrospectiva de gráficos. RESULTADOS. El patrón de frecuencia de diagnósticos de enfermería y de intervenciones enfermeras utilizados en los planes del cuidados, es consistente con el ámbito asistencial de las enfermeras de salud pública, cuyo énfasis está en la promoción de salud y la prevención de la enfermedad. CONCLUSIÓN.Los diagnósticos e intervenciones más comúnmente utilizados, proporcionan evidencia de un grupo nuclear de intervenciones útiles a la práctica de enfermería de salud pública. IMPLICACIONES PARA LA PRÁCTICA.Conectar los diagnósticos y las intervenciones permite a las Enfermeras de Salud Pública construir un cuerpo de conocimientos basado en el cuidado de los pacientes y mejorar el proceso de toma de decisiones en la práctica clínica. Términos de búsqueda:Diagnóstico enfermero, enfermería de salud pública, intervenciones Uso de diagnósticos e intervenções de enfermagem na prótica de enfermagem em Saúde Pública OBJETIVO.Determinar a freqüência de uso dos diagnósticos da NANDA e da Classificação de Intervenções de Enfermagem (NIC) em planos de cuidados escritos por enfermeiras da área de Saúde Pública no Condado de Orange, Califórnia. MÉTODO.Revisão retrospectiva de fichas. ACHADOS.O padrão de freqüência de diagnósticos de enfermagem e intervenções de enfermagem utilizados em planos de cuidados é compatível com o escopo da prática das enfermeiras da área de Saúde Pública, cuja ênfase está na promoção da saúde e prevenção de doenças. CONCLUSãO.Os diagnósticos e intervenções mais comumente utilizados evidenciam a existência de um conjunto de intervenções principais, que éútil para a prática destas enfermeiras. IMPLICAÇõES PARA A PRÁTICA. A ligação entre diagnósticos e intervenções permite às enfermeiras da área de saúde pública construírem um corpo de conhecimentos baseado no cuidado do paciente e melhora o processo de tomada de decisão. Palavras para busca:Diagnóstico de enfermagem, enfermagem em saúde publica, intervenções [source] Chronic Pain: Nursing Diagnosis or Syndrome?INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 4 2001Diná Almeida Lopes Monteiro Cruz PhD PROBLEM. To explore the existence of a pattern of nursing diagnoses that represents a chronic pain syndrome. METHODS. The nursing diagnoses of 68 oncologic and 46 nononcologic patients with chronic pain were submitted to univariate and multivariate analyses. Diagnoses ranked above the 75th percentile, without association with pain etiology, and presenting a pattern in cluster analyses and multidimensional scaling was accepted as possible components of chronic pain syndrome. FINDINGS. The possible components of chronic pain syndrome were disturbed sleep pattern,a constipation or risk for constipation, deficient knowledge,a impaired physical mobility, and anxiety/fear. CONCLUSIONS. Although a pattern of diagnoses has been proposed, confirmation will require further studies and the exploration of the clinical usefulness of the concept of chronic pain as a syndrome. PRACTICE IMPLICATIONS. Increased skill in the assessment and understanding of chronic pain can result in improved relief strategies. Douleur chronique: Diagnostic infirmier ou syndrome? PROBLÈME. Explorer l'existence d'un regroupement de diagnostics infirmiers représentant le syndrome de douleur chronique (SDC). MÉTHODES. Les diagnostics infirmiers présents chez 68 patients cancéreux et 46 patients non-cancéreux, souffrant de douleur chronique furent soumis à des analyses unidimensionnelles et multidimensionnelles. Les diagnostics qui furent retenus comme composantes possibles du SDC se situaient au dessus du 75e percentile, n'étaient pas associés à l'étiologie et représentaient un ensemble dans les analyses de regroupement et l'échelle multidimensionnelle. RÉSULTATS. Les composantes possibles du SDC furent perturbation des habitudes de sommeil, constipation ou risque de constipation, manque de connaissances, altération de la mobilité et anxiété/peur. CONCLUSIONS. Même si un schéma de diagnostics infirmiers a été proposé, il faudrait encore entreprendre plusieurs recherches et explorer l'utilité clinique du concept syndrome de douleur chronique, avant de confirmer la pertinence de ce syndrome. IMPLICATIONS PRATIQUES. L'amélioration de l'évaluation et de la compréhension de la douleur chronique peut conduire à de meilleures stratégies pour soulager la douleur. PROBLEMA. Explorar a existência de um padrão de diagnósticos de enfermagem que represente uma síndrome de dor crônica. MÉTODOS. Diagnóstics de enfermagem de 68 pacientes com dor crônica oncológica e 46 pacientes com dor crônica não oncológica foram submetidos a análises univariadas e multivariadas. Os diagnóstics posicionados acima do Percentil 75, sem associação com a etiologia da dor e que apresentaram um padrão na Análise de Cluster e no Escalonamento Multidimensional foram aceitos como possíveis componentes da síndrome de dor crónica. RESULTADOS. Os possíveis componentes da síndrome de dor crônica foram: distúrbio do padrão de sono, cnstipação ou risco para constipação, déficit de conhecimento, mobilidade física prejudicada e ansiedade/medo. CONCLUSÕES. Apesar de um padrão de diagnósticos ter sido proposto, a sua confirmação requer outros estudos e a exploração da utilidade clínica de se conceituar a dor crônica como uma síndrome. IMPLIAÇÕES PRÁTICAS. Melhorar a compreensão e as habilidades na avaliação da dor crônica pode resultar em melhores estratégias de alívio. Dolor crónico: Diagnóstico enfermero o síndrome? PROBLEMA. Explorar la existencia de un patrón diagnóstico de enfermería que represente el síndrome de dolor crónico (SDC). MÉTODOS. Los diagnósticos enfermeros de 68 pacientes oncológicos y 46 no-oncológicos con dolor crónico, se sometieron a análisis variable y multivariable. Se aceptaron como posibles componentes del SDC, los diagnósticos que estaban sobre el percentil 75, sin asociación con etiología de dolor y que presentaban un patrón agrupado al hacer el análisis y en la escala multidimensional. RESULTADOS. Los posibles componentes de SDC fueron alteración del patrón del sueño, estreñimiento o riesgo de estreñimiento, déficit de conocimientos, trastorno de la movilidad física y ansiedad/temor. CONCLUSIONES. Aunque un patrón de diagnósticos ha sido propuesto, la confirmación requerirá que se llevan más allá los estudios y la exploración de la utilidad clínica del concepto del dolor crónico, como un síndrome. IMPLICACIONES PARA LA PRÁCTICA. Mejorar la habilidad en la valoración y comprensión del dolor crónico pueden producir mejoras en las estrategias de alivio. [source] Environmental Nursing Diagnoses for Aggregates and CommunityINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2001Pauline M. Green PhD PURPOSE. To describe the application of group-appropriate methods to derive actual nursing diagnoses for a community. METHODS. A triangulation method using multiple sources of data, including an environmental survey, fish consumption survey, government reports, publications, and community assessments FINDINGS. Three priority community environmental nursing diagnoses for aggregates within the community: Knowledge deficit among community residents related to lack of awareness of contaminants in the Anacostia River; "risk for adverse human health effects" among pregnant and nursing women and preschoolers related to consumption of chemically contaminated fish; and knowledge deficit among community residents related to lack of awareness of health effects of consuming chemically contaminated fish. CONCLUSIONS. The diagnoses serve as the basis for community education and other interventions. The methods are practical and useful for this type of research. PRACTICE IMPLICATIONS. The nursing profession is experiencing a growing awareness of the close relationship between environmental health and the health of individuals and communities. There is a need for diagnostic labels to describe the responses of aggregates and communities to environmental hazards and conditions. [source] A Multivariate Validation of the Defining Characteristics of FatigueINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2001Mei Fu MSN PURPOSE. To validate the nursing diagnosis fatigue by providing evidence to identify, confirm, and consolidate the defining characteristics. METHODS. The Revised Piper Fatigue Scale and the Schwartz Measurement of Fatigue scales were used to collect data from four groups of healthy women (N = 182). Data were analyzed by maximum-likelihood factor analysis with varimax rotation, and major and minor defining characteristics were identified and clustered. FINDINGS. The identified defining characteristics tended to group into the dimensions identified in prior fatigue studies. Although the majority of the NANDA defining characteristics were validated, differences were found. CONCLUSIONS. atigue is a multidimensional construct. Replication of the study with a variety of samples from different geographic locations and a variety of patient populations will further cross-validate the defining characteristics of fatigue. PRACTICE IMPLICATIONS. Fatigue is a commonly experienced phenomenon in both health and illness. As the knowledge base about fatigue builds, so will the accuracy of nursing assessments and the effectiveness of nursing interventions. [source] Healing Patterns Revealed in Middle School Boys' Experiences of Being Bullied Using Roger's Science of Unitary Human Beings (SUHB)JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 3 2010Danny G. Willis DNS, PMHCNS-BC PROBLEM:, Although two of the primary risk factors for being bullied include "male" and "middle school" status, a gap in knowledge exists of middle school boys' personal accounts and meanings of being bullied and their healing. METHODS:, Giorgi's descriptive phenomenological approach using open-ended semi-structured individual interviews was used to collect and analyze evidence related to middle school boys' lived experiences of being bullied and healing. Roger's Science of Unitary Human Beings (SUHB) guided interpretation of the healing patterns. FINDINGS:, Three patterns of healing were identified in boys' experiences: meaning-making, self-transcendence, and nonviolently claiming personal power. CONCLUSIONS:, Evidence of healing patterns exists in middle school boys' experiences of being bullied, offering a foundation for further research and practice focused on healing. When working with middle school boys who have been bullied, nurses need to ask about their experiences and promote their healing. [source] The Role of Electronic Communication Technology in Adolescent Dating ViolenceJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 3 2010Claire Burke Draucker RN PROBLEM:, Adolescent dating violence and electronic aggression are significant public health problems. The purpose of this study was to (a) identify ways in which technology is used in dating violence and (b) present examples of dating violence in which electronic aggression played a salient role. METHODS:, The data set included the transcribed narratives of 56 young adults who had described their adolescent dating violence experiences for an on going study. FINDINGS:, Eight ways in which technology is used in dating violence were identified using qualitative descriptive methods. CONCLUSIONS:, The findings indicate that electronic communication technology influences dating violence by redefining boundaries between dating partners. [source] Correlation of the Experience of Peer Relational Aggression Victimization and Depression among African American Adolescent Females,JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 4 2009Melissa M. Gomes PhD PROBLEM:, This study aimed to examine if the experience of peer relational aggression victimization (PRAV) can be linked to feelings of depression in the African American adolescent female population. METHODS:, The sample included 241 college-age African American adolescent females assessed for PRAV and depression. Statistical analysis was carried out to determine the relationship between the variables. FINDINGS:, PRAV in this study population does exist as a detrimental phenomenon, whereby PRAV significantly correlates with depression, r (214) = 0.29, p < .01. CONCLUSION:, Nurses can assist the adolescent clients experiencing relational aggression by becoming knowledgeable on the presentation and manifestations of this experience. [source] | ||||||||||||||||||||||||||||||||||||||||||||||