International Journal of Nursing Knowledge最新文献

Purpose

The purpose of this study was to identify nursing interventions and activities for patients with multiple traumas who have variations in physical mobility.

Methods

We used integrative literature review following Whittemore and Knafl method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ guidelines and adopting the Oxford Center for Evidence-Based Classification Medicine – Levels of Evidence. The data collection was carried out between October and December 2019 and updated in May 2022, in the following databases: Virtual Health Library, Cochrane Library, Excerpta Medica dataBASE, Medical Literature Analysis and Retrieval System Online, PubMed®, SciVerse Scopus, The Cumulative Index to Nursing and Allied Health Literature, and Web of Science.

Findings

There were 103 articles to be fully read and evaluated. From these, 34 publications were selected. Most nursing interventions and activities identified were placed in the NIC class Activity and Exercise Management in the Physiological: Basic domain, which has interventions to organize or to assist with physical activity, energy conservation, and expenditure; followed by Elimination Management (interventions to establish and maintain regular bowel and urinary elimination patterns and manage complications due to altered patterns); Immobility Management (interventions to manage restricted body movement and the sequelae); Nutrition Support (interventions to modify or maintain nutritional status); Physical Comfort Promotion (interventions to promote comfort using physical techniques); and Self-Care Facilitation (interventions to provide or assist with routine activities of daily living).

Conclusions

The interventions and nursing activities found in this research were not only related to the change in mobility in victims of multiple traumas but also aimed to prevent the consequences of immobility and to take care of already established conditions.

Implications for the nursing practice

This research enables the taxonomy's development and the validation of interventions for selected groups of patients. This allows the contribution to the development of the NIC—an important resource to improve nursing practice in teaching, research, and care.

Purpose

The purpose of this study was to verify the validity of the content of the proposal for the nursing diagnosis of low self-efficacy in health.

Methods

Content validation study using the approach proposed by Lopes, a panel of 47 experts on the phenomenon of interest analyzed the content of the diagnosis using a Likert-type scale to evaluate the relevance of 16 clinical indicators and 18 etiological factors of the nursing diagnosis under investigation. These components were previously identified and defined through a middle-range theory. Based on the predictive diversity model, the experts’ verifications were weighted according to their level of expertise. The pseudomedian and 95% confidence intervals were calculated. A content validity index above 0.9 was considered valid, and the Wilcoxon test was used to validate each pseudomedian with a p-value above 0.05.

Findings

Thirteen clinical indicators were considered relevant, demonstrating the importance of these elements for the clinical identification of low self-efficacy in health. Three clinical indicators were excluded because they were not representative for this diagnosis. The eighteen etiological factors analyzed were considered relevant.

Conclusion

The findings of the present study may help nurses to identify low self-efficacy in health early and direct effective interventions to increase people's confidence in their abilities to promote their health.

Implications for nursing practice

A new diagnostic framework is presented with peer-reviewed content, representing a phenomenon frequently reported by clinicians. This new diagnosis can guide nursing care and produce better health outcomes that depend on patients’ confidence in their ability to take care of their own health.

Purpose

This article describes a theorizing strategy that integrates the components of classifications or terminologies with elements of grand or middle-range theories.

Methods

The source of metatheoretical data to support the strategy was the levels of theories by Dickoff et al. (1968). Terminological data sources were professional classifications and terminologies.

Findings

The authors synthesized data and philosophical, metatheoretical, theoretical, and terminological knowledge from primary sources on the subject to construct arguments and demonstrate suitable links.

Conclusions

The proposal presented in this article of a strategy for building theories integrates theories and classifications or standardized nomenclatures. It applies levels of theorization: scrutiny of phenomena, description, conceptualization, naming, relationship, modeling, and operationalization to achieve higher levels of explanatory, predictive, and prescriptive properties on generated theory.

Implications for Nursing Practice

The implications for practice and research are connected to the theorizing strategy proposed in this article. We assume that using professional language at all levels of theorization can ensure that the concepts generated are closer to clinical practice.

Purpose

The aim was to apply the Advanced Nursing Process and demonstrating procedures of surgical positioning, as well as to show the participating the Nursing Outcomes Classification findings in order to translate the knowledge on specific preventive perioperative positioning into practice, the review of clinical protocols and nursing care plan.

Methods

The methods used include case report about knowledge translation by applying training modalities, review and adaptation of clinical protocols and examination of nursing care plans.

Findings

One hundred and nine healthcare providers attended the training, including nurses and nursing technicians working in the surgical center and the outpatient surgical center of the hospital chosen for this study. The surgical positioning protocols were revised based on the evidence described in the literature and the main surgical guidelines. The review of care registered in the institution's electronic system for the nursing prescription stage of the diagnosis Risk of perioperative positioning injury was based on the review on evidence on risk factors, the main guidelines in the area and the interventions suggested by Nursing Intervention Classification. The electronic system had registered 14 cares for this diagnosis, and after the review, one care was excluded and eight new cares were included, totaling 21 cares.

Conclusion

Nursing teams play a prominent role in positioning patients for surgery, protecting them in a moment of extreme vulnerability, thus making knowledge about the fundamental elements of surgical positioning essential. This emphasizes the importance of training, and of reviewing protocols and records of procedures that promote safety to patients and care teams.

Implication for nursing practice

The translation of knowledge about the Advanced Nursing Process in the perioperative area contributes to the refinement of classifications and standardization of language in this scenario, subsidizing an evidence-based clinical practice.

Purpose

Due to disability and reduced activities of daily living (ADL), older adult stroke survivors face difficulties deciding whether to receive care at home or move to a facility after discharge. The study aims to evaluate the impact of decision-aid (DA) use on decision-making participation and conflict regarding the selection of post-discharge care locations for older adult stroke survivors and their families.

Data sources

A randomized controlled trial will be conducted among older adult stroke survivors at a medical rehabilitation facility during their recovery period. Randomization units will be blinded and allocated according to the patient's room, and the intervention period will be approximately 2 months, from admission to discharge. The study participants will include (1) people over 65 years of age, (2) stroke survivors, and (3) those facing the need to make decisions regarding the location of post-discharge care. However, those who have difficulty making their own decisions due to severe dementia, aphasia, or altered consciousness will be excluded. In the intervention group, a DA will be provided with its utilization confirmed approximately 1 month after hospitalization. Similarly, the control group will be provided with an informative brochure, with the provision being confirmed approximately 1 month after hospitalization.

Data synthesis

The primary outcome (decision-making conflict) and secondary outcome (decision-making participation) will be evaluated using the decisional conflict scale (DCS) and revised control preference scale (CPS), respectively. Intergroup differences in DCS and CPS will be analyzed using two-way repeated measures analysis of variance and z-test, respectively.

Conclusions

Verification using randomized controlled trials is necessary to determine the effectiveness and versatility of DAs.

Implications for nursing practice

By deepening the knowledge of our priority research areas, the results of the proposed study will strengthen our fundamental knowledge by revealing older adult stroke survivors’ care preferences after discharge.

Purpose

The aim of this study was a clinical validation of the NANDA-I nursing diagnosis “Impaired Resilience (00210)” in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics.

Methods

A cross-sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility-related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee.

Findings

The “Impaired Resilience (00210)” had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are “decreased interest in vocational activities,” “depression,” “impaired health status,” “ineffective coping strategies,” “low self-esteem,” “renewed elevation of distress,” and “social isolation.” No item showed differential item functioning. “Renewed elevation of distress” and “low self-esteem” were the most sensitive defining characteristics and had the highest negative predictive value. “Shame” was the most specific one.

Conclusions

The nursing diagnosis “Impaired Resilience (00210)” was validated, and results may improve its accuracy in people going through fertility treatment.

Implications for nursing practice

This paper contributes by raising knowledge regarding NANDA-I nursing diagnosis and enhancing the quality of nurses’ critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field.

Background

Quality of care is one of the most critical issues in nursing care today. Moreover, all health care employees are responsible for providing support and high-quality, safe care. However, nurses caring for COVID-19 patients face problems such as unfamiliar work environments, exposure to the disease, lack of experience in their new positions, and close public and media attention. This study aimed to investigate missed nursing care and the reasons for missed nursing care during the coronavirus disease 2019 (COVID-19) pandemic in Iran.

Methods

This cross-sectional study included 135 nurses working in COVID-19 units. Data were collected using the MISSCARE Survey. The significance level for the statistical tests was set at p < 0.05.

Results

Most of the participants were women and had a bachelor's degree in nursing. There was a lack of supportive and necessary care more than any other form of care. According to nurses, the most common reasons for missed care were urgent patient situations, inadequate staff, and an unexpected rise in patient volume and/or patient acuity on the unit.

Conclusion

Generally, the results showed that being positioned in a new situation and unfamiliarity with the disease had a significant impact—among nurses—on the amount of care provided. Managers can use this information to solve existing missed-nursing-care problems and contribute to improving the quality of care.

These results can be helpful in controlling missed nursing care and finding a more optimal solution for this problem; thus, we can improve the quality of care delivery and increase the satisfaction of nurses and patients. Additionally, an understanding of the kind of missing nursing care during a pandemic can positively enhance the management of similar situations in the future.

Purpose

The aim of this umbrella review was to determine the most effective nursing interventions for the prevention and management of suicidal behavior. In order to do so, the review identifies interventions from the Nursing Interventions Classifications taxonomy with evidence to this end.

Methods

A systematic search was conducted for systematic reviews included in the PubMed, CINAHL, Cochrane, Scopus, Web of Knowledge, and Joanna Briggs Institute databases between January 1, 2011 and May 1, 2020.

Findings

The review is made up of 21 systematic reviews. In order to carefully analyze the interventions described, these were coded into categories, grouping the interventions into those based on psychological therapy, interventions related to pharmacotherapy, interventions related to the professional relationship between health professional and patient, and interventions aimed at the general public.

Conclusions

Nursing interventions for suicide risk management are prevalent in the scientific literature and are shown to be effective for patients with suicidal ideation or suicide attempts. Prevention and treatment of suicidal behavior require the provision of coping tools, behavioral interventions that directly address suicidal thoughts and behaviors, and support through therapeutic partnerships, among others.

Implications for nursing practice

This paper synthesizes the most current evidence on the most effective Nursing Interventions Classifications interventions for the treatment and prevention of suicidal behavior. It provides nursing practitioners with a comprehensive review of the therapeutic interventions with the best evidence and is useful for the development of clinical guidelines and protocols, as well as for the development of health policies and plans.