International Journal of Nursing Knowledge最新文献

Purpose: To clinically validate the NANDA International (NANDA-I), nursing diagnoses (ND) of "Ineffective breastfeeding (00104)" and "Readiness for enhanced breastfeeding (00106)" in postpartum women and their infants, and to determine the sensitivity, specificity, and predictive value of their elements.

Methods: Cross-sectional study was conducted from June 2023 to April 2024. Recruitment happened at a public teaching hospital, approaching dyads from the neonatology outpatient clinic and the rooming-in. The researcher applied the tool, assessed the dyad and medical records. Statistical analysis was based on accuracy measures and inferential statistics. The study was approved by the Ethics Committee.

Findings: The sample comprised 205 Brazilian dyads: 57 (27.80%) presented "Ineffective breastfeeding (00104)," whereas 203 (99.02%) presented the "Readiness for enhanced breastfeeding (00106)." "Unsustained sucking on the breast" was the most sensitive defining characteristic (DC) for the "Ineffective breastfeeding (00104)." All the DCs of "Readiness for enhanced breastfeeding (00106)" showed relevant sensitivity.

Conclusions: Findings validated the presence of NANDA-I ND "Ineffective breastfeeding (00104)" and "Readiness for enhanced breastfeeding (00106)" in a sample of dyads, demonstrating accuracy in such population.

Implications for nursing practice: This is an essential step to raise the level of evidence of the studied ND from NANDA-I terminology. Furthermore, this study has potential to contribute to improving nurse's clinical reasoning on breastfeeding, as well as to highlight that women can present simultaneously the two diagnoses, so naming them is useful to identify mothers more likely to breastfeed and those who will need more differentiated interventions.

Purpose: To evaluate the accuracy of clinical indicators and etiological factors associated with the nursing diagnosis of ineffective overweight self-management among university students.

Method: A diagnostic accuracy study with a cross-sectional design was conducted with 108 university students. A latent class analysis model with random effects was used to establish sensitivity and specificity measures of clinical indicators, estimate the prevalence of the diagnosis, and calculate posterior probabilities for the diagnosis. Odds ratios for etiological factors were calculated using univariate logistic regression. The study was approved by the Research Ethics Committee of the responsible institution.

Results: The nursing diagnosis of ineffective overweight self-management had an estimated prevalence of 38.1% in the sample. Sensitive clinical indicators included excessive calorie consumption (0.9514) and dissatisfaction with body image (0.8834). Specific indicators included negative self-perception of health (0.9999), inadequate eating behavior (0.9990), and impaired emotional health (0.8273). A personal history of overweight (OR = 2.78; p-value = 0.018) increased the likelihood of developing ineffective overweight self-management by approximately two and a half times.

Conclusion: Ineffective overweight self-management is prevalent among university students and is characterized by two sensitive clinical indicators, three specific indicators, and a population at risk that increases the likelihood of this diagnosis.

Implications for nursing practice: Accurate clinical indicators and the identification of etiological factors for the diagnosis of ineffective overweight self-management support nurses' clinical reasoning in practice. Moreover, verifying accurate components for diagnosing ineffective overweight self-management contributes to the development of interventions aimed at promoting the health of university students.

Purpose: This study aimed to validate the content of the nursing diagnosis (ND) "Risk for elopement attempt" and increase its level of evidence (LOE) in the NANDA International (NANDA-I) Classification.

Method: A content validity study was conducted based on expert opinions. The sample consisted of 33 experts with academic training in nursing and practical and theoretical experience concerning the nursing process. Data collection was performed using a Google Forms® questionnaire, which was electronically sent to the experts. Data analysis involved descriptive statistics, and the diagnostic content validity was based on the Fehring model. This study was approved by the Research Ethics Committee of the institution.

Findings: The title and definition of the ND under investigation were validated, along with 15 risk factors. Among these, "Substance misuse" was classified as major (0.96), whereas the others were validated as minor. Of the 13 risk populations, 6 were validated and classified as major, such as "Individuals with history of elopement" (0.90); 6 were validated and classified as minor, including "Individuals with a history of nonadherence to treatment regimen" (0.79); and "Economically disadvantaged individuals" were discarded (0.46). Of the three associated conditions, one was validated as major, namely, "Mental disorders" (0.86), whereas the other two were classified as minor.

Conclusions: This study validated the content of the "Risk for elopement attempt" ND, allowing it to be assigned a higher LOE based on the nursing experts. All components were validated except for one of the associated conditions.

Implications for nursing practice: The validated ND will be submitted to NANDA-I, enabling it to achieve a higher LOE in the classification. This update will enhance the quality of this diagnostic classification and, consequently, patient care and nursing education and research.

Purpose: To develop and validate the content of the components of the auriculotherapy nursing intervention.

Methods: This descriptive and methodological study was carried out in three steps: an integrative literature review, with a diagnosis of the state of the art and a basis for the study; development of the nursing intervention based on the Nursing Interventions Classification (NIC) and validation by the Kappa Index (k = ≥0.61) and the content validity index (CVI ≥ 0.80). The experts were recruited using the snowball method, who met the inclusion criteria: being a nurse, having completed an auriculotherapy course, having clinical experience with auriculotherapy, and having used the NICs in clinical practice for at least 1 year. The instrument for validation was sent via Google Forms in April 2022.

Results: The title, definition, and 11 activities of the new nursing intervention with Kappa and CVI indexes accepted for content validity were validated.

Conclusions: The content validation of the nursing intervention was fundamental for the suitability of its components, allowing it to be refined.

Implications for nursing practice: The contribution of the study consists of the possible inclusion of this intervention in the NIC, favoring the use of standardized language in the clinical practice of auriculotherapy.

Purpose: This study describes the design, integration, and semantic interoperability process of a minimum data set using standardized nursing language in the caring module of the TEC-MED care platform.

Methods: The caring module was developed in three phases (2020-2022): platform concept, functional design and construction, and testing and evaluation. Phases involved collaboration among academics, information technology developers, and social/healthcare professionals. Nursing taxonomies (NANDA-I, NOC, NIC) were integrated to support the nursing process. The platform was piloted in six Mediterranean countries.

Findings: The final platform features an assessment module with eight dimensions for data collection on older adults and their caregivers. A clinical decision support system links assessment data with nursing diagnoses, outcomes, and interventions. The platform is available in six languages (English, Spanish, French, Italian, Greek, and Arabic). Usability testing identified the need for improved Arabic language support.

Conclusions: The TEC-MED platform is a pioneering tool using standardized nursing language to improve care for older adults in the Mediterranean. The platform's multilingualism promotes accessibility. Limitations include offline use and mobile app functionality. Pilot testing is underway to evaluate effectiveness and facilitate cross-cultural validation of nursing taxonomies.

Implications for nursing practice: The TEC-MED platform offers standardized nursing care for older adults across the Mediterranean, promoting consistent communication and evidence-based practice. This approach has the potential to improve care quality and accessibility for a vulnerable population.

Purpose: The objectives of this study were to refine and validate the NANDA-I nursing diagnosis risk for perioperative hypothermia (RPH) (00254).

Methods: A quantitative, descriptive study was carried out according to the adapted diagnostic content validation model by Fehring. Data from a previously conducted literature study were triangulated with expert validation data to examine the nursing diagnosis RPH as well as potentially suggested new factors resulted from the literature review. In addition, the Wisdom of Crowds model was also considered. A nonprobability sampling technique, including purposive and snowball sampling methods, was used to recruit a panel of nurse experts. An anonymous and standardized questionnaire was developed in three languages for data collection. For validation, descriptive statistics, weighted ratios, and a one-sample T-test were used.

Results: Ninety-two nurse experts from seven countries and three continents participated in this study. Fifty-eight nurse experts (63%) were female, and 33 (36%) were male, with a mean age of 42.26 years and 19.22 years of working experience. The diagnosis label, definition, 4 out of 5 risk factors (RF), 6 out of 14 at-risk populations (ARPs), and 5 out of 9 associated conditions (ACs) were classified as major. One RF, eight ARP, and four ACs were considered minor. In addition, the experts validated 1 RF, 5 ARP, and 12 ACs from a previous literature study at least minor.

Conclusions: The nursing diagnosis RPH (00254) could be confirmed by specialized experts. No RF, ARP, or AC of the current nursing diagnosis needed to be rejected, and the added diagnostic indicators increased the robustness of the diagnosis.

Implications for nursing practice: A precise concept of the nursing diagnosis RPH improves nurses' clinical reasoning and strengthens an individualized, evidence-based care plan.

Purpose: The purpose of this study was to examine knowledge, attitude, and barriers toward care planning documentation practices with standardized nursing languages (SNLs) of nurses and nursing students at a midwestern healthcare system, comparing student and nurse responses.

Methods: Cross-sectional surveys were given over a 2-month period with nurses and nursing students at different sites in a midwestern healthcare system, using convenience sampling. The Knowledge, Attitude, and Barriers to Using Standardized Nursing Languages and Current Practices Survey was adapted for use and re-tested for validity/reliability (Content Validity Index 0.81-1.00; Cronbach alpha = 0.82-0.99) with 28 Likert scale items measuring knowledge, attitude, and barriers. Descriptive statistics, composite scores, correlations, t-tests, and multiple regression were used to analyze the concepts of the tool.

Findings: 134/400 RNs responded (34%); 109/116 students responded (93.9%). Data analyses indicate adequate to superior levels of knowledge related to SNLs and NANDA International, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), collectively referred to as NNN (NANDA, NIC, & NOC), positive attitudes toward SNLs/NNN and for adopting SNLs/NNN into documentation practices, but moderate to great barriers for implementation in practice. Barriers included lack of financial resources for change, lack of mentors, and lack of mandates to use SNLs. Students scored significantly higher than nurses in attitude only.

Conclusions: Perceptions of nurses and student nurses for current documentation indicate awareness of inadequacy in existing systems and willingness to change existing systems for standardized languages, with perceived barriers to change/implementation of SNLs. Students were more positive about SNLs than nurses.

Implications for nursing practice: Major implications for nursing are to reevaluate electronic documentation systems and determine how to insert and easily apply SNLs in these systems, such that nursing care documentation is standardized, interoperable, effective, time-saving, and attainable.

Objective: To map nursing diagnoses related to cardiovascular function reported in studies involving patients in primary care.

Method: A scoping review follows JBI guidelines. Literature searches were conducted from March to May 2024. Studies included focused on nursing diagnoses for adults and older adult patients with cardiovascular conditions in primary care settings. Results were systematically presented in tables and narratively.

Findings: Among the 12 included studies, the most prevalent diagnosis was "noncompliance" (00079), removed from NANDA-I in 2017. Sixteen other diagnoses were identified, indicating a broader clinical profile of individuals with cardiovascular health issues in primary care. Most studies involved patients with hypertension in Brazil.

Conclusions: Key nursing diagnoses for patients with cardiovascular conditions in primary care were identified. Ineffective health management emerged as a common characteristic among this population.

Implications for nursing practice: Identifying prevalent diagnoses allows nurses to reinforce their commitment to managing cardiovascular conditions, improve care plans, and generate practice indicators for services, thus enhancing the quality of care provided.

Introduction: The postpartum period is considered a phase of many physiological and hormonal changes that affect the individual. Fatigue is something present and can influence the postpartum woman in a negative way. In this way, the nurse has an essential role, and the nursing process can be used to establish an efficient care plan.

Objective: To present the main nursing interventions and activities of the nursing diagnosis (ND) fatigue (00093) in individuals/people in the immediate postpartum period obtained through an integrative literature review and correlate with the proposed ND puerperal fatigue/excessive burden of fatigue in the postpartum period.

Methods: Integrative literature review, carried out in the databases Cochrane, Scopus and Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science (WoS), Virtual Health Library (VHL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL), following rigorous methodological standards.

Results: Six articles were included that identified the main nursing interventions related to the proposed ND puerperal fatigue.

Conclusions: The integrative review highlighted the main nursing interventions and activities, and this study will be the basis for the next stages of the validation process for the ND puerperal fatigue/excessive fatigue in the postpartum period.

Implications for nursing practice: This work can help nurses in clinical practice establish an efficient care plan through the most accurate nursing interventions and thus improve the quality of nursing services.