International Journal of Nursing Knowledge最新文献

Purpose: Despite highly effective asthma treatments, the prevalence of asthma is increasing in children and adolescents. Despite easy access to asthma control, sufficient control and management are not achieved. Asthma management is crucial to prevent the development of asthma symptoms and attacks, reduce repeated hospitalizations, and prevent a decrease in the quality of life for both the child and caregivers. This case study aims to increase the utilization of theories, models, and classification systems by evaluating a child diagnosed with asthma for 6 years and their caregivers based on Pender's health promotion model (PHPM). Furthermore, the study aims to establish a connection with NANDA, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), thereby formulating a nursing care plan.

Methods: This case study evaluated a child diagnosed with asthma for 6 years and their caregivers based on PHPM. A nursing care plan was developed by establishing connections with NANDA, NIC, and NOC and based on Pender's health promotion.

Findings: By establishing connections with NANDA, NIC, and NOC, a nursing care plan of a total of six included nursing diagnoses has been created as five based on the PHPM.

Conclusion: The care plan implemented improved S.B.K.'s clinical condition. Furthermore, the mother's social support increased, and her confidence in managing asthma improved. As a result of implementing the model, the mother reached the potential to develop healthy behaviors for S.B.K. and make future-oriented plans.

Implications for nursing practice: It is recommended that NANDA-I, NIC, and NOC, along with PHPM, be used in clinical nursing care and scientific research to enhance the presentation of quality care and the individual's future health potential.

Objective: To assess clinical-causal validity evidence of the nursing diagnosis, risk for unstable blood glucose level (00179), in individuals with type 2 diabetes mellitus.

Methods: A case-control study was conducted in 5 primary healthcare units, involving 107 subjects with type 2 diabetes mellitus, 60 in the case group and 47 in the control group. Causality was determined by the association between sociodemographic and clinical factors, risk factors related to the nursing diagnosis, and the occurrence of unstable blood glucose level. An association was considered when the risk factor had a p-value of <0.05 and odds ratio >1.

Results: Risk factors, such as stress, inadequate physical activity, and low adherence to therapeutic regimen, were prevalent in the sample. Time since diagnosis between 1-5 and 6-10 years, multiracial ethnicity, and the risk factor of low adherence to therapeutic regimen increased the likelihood of the outcome. Completion of high school education was identified as a protective factor.

Conclusions: The clinical validation of the nursing diagnosis, risk for unstable blood glucose level, has been successfully established, revealing a clear association between sociodemographic and clinical factors and the risk factors inherent to the nursing diagnosis.

Implications for nursing practice: The results contribute to advancing scientific knowledge related to nursing education, research, and practice and provide support for the evolution of nursing care processes for individuals with type 2 diabetes mellitus.

Purpose: This study aims to conduct a thorough analysis of the concept of insufficient health literacy (IHL) in older adults and to refine a nursing diagnosis proposal while considering the specific characteristics of this demographic.

Methods: A comprehensive concept analysis was undertaken using Walker & Avant's method as a framework.

Findings: A systematic search across seventeen databases yielded 29 relevant studies for inclusion. Through analysis, we identified 15 antecedents, 3 attributes, and 7 consequents associated with IHL in older adults.

Conclusions: The concept analysis brought clarity to the understanding of IHL within older adults, facilitating the refinement of a diagnosis proposal. This process was instrumental in establishing a diagnostic structure that accounts for the unique needs and challenges faced by older adults.

Implications for nursing practice: The structured diagnosis derived from the concept analysis provides a solid theoretical foundation for nurses specializing in Gerontology. By tailoring care interventions to address the specific requirements of older adults, this framework enhances the quality of nursing practice and contributes to improved patient outcomes in geriatric care settings.

Purpose: Nurses' clinical reasoning skills regarding impaired swallowing can help prevent patient complications and maintain quality of life. Clinical reasoning skills need content-validated defining characteristics (DCs). We aimed to validate the content of these DCs for nursing diagnosis "impaired swallowing."

Methods: Content validation of the DCs was performed by 275 dysphagia nursing experts in Japan, using 3 rounds of the Delphi technique and Fehring's Diagnostic Content Validation (DCV) model. Three rounds of questionnaires on 84 DCs were completed via printed mail.

Findings: The valid response rates for each round were as follows: round 1, 90.2%; round 2, 77.8%; and round 3, 71.3%. Of the 84 DCs, 77 that met the consensus criteria were categorized as major (n = 18), minor (n = 45), and excluded (n = 14). There were four minor DCs other than the oral, pharyngeal, and esophageal phases. DCs listed from outside NANDA-I included 12 major, 16 minor, and 3 excluded characteristics. Of the NANDA-I DCs, 5 were no consensus and 11 were excluded. The total DCV score for the 63 major and minor DCs was 0.8.

Conclusions: Our results recommend the addition of 28 DCs and the exclusion of 11 for the NANDA-I nursing diagnosis "impaired swallowing" (00103). Major DCs were prominent indicators of impaired swallowing and signs of aspiration or pharyngeal residuals. Minor DCs included not only the three phases but also other signs necessary for a comprehensive understanding of impaired swallowing.

Implications for nursing practice: This validation study strengthens the clinical usefulness of the DCs for impaired swallowing, which can improve nurses' clinical reasoning skills. Major and minor DCs can increase the awareness of impaired swallowing and enable accurate intervention, thereby preventing patient complications and maintaining quality of life.

Purpose: Physical restraint (PR) is applied for patients' safety and to prevent the removal of inserted devices. No matter how well applied, PR causes undesired effects and discomfort to patients. Because PR-Guidelines are not yet implemented in Turkey, an observational study was performed to get baseline data on the type and number of PR-activities and on patients' complications in intensive care unit (ICU) patients.

Methods: An observational pilot study was conducted in anesthesia and reanimation adult ICUs in a midsized general hospital in Turkey. Included were 31 patients and two data collection tools: a basic form (patient demographics, medical information, and complications) and a PR observation guide on nurses' PR-activities. Descriptive statistics (frequencies, percentages, and mean and standard deviation) were used for data evaluation.

Findings: Most patients (61.3%) were male, and 74.2% were aged 60-79 years. Almost a third was unconscious (Glasgow Coma Scale <9) and at risk for falling. Of the total 33 activities of the Nursing Interventions Classification (NIC), 13 were never applied in 33% of patients. The most applied activity was "provide sufficient staff to assist with the safe application of physical restraining devices or manual restraints" (96.8%). Least applied were "explain inpatient and significant others the behaviors necessary for the termination of the intervention," "Provide the dependent patient with a means of summoning help" (6.5%), and "Teach family the risks and benefits of restraint reduction" (3.2%). Overall, 58.1% of patients had PR complications.

Conclusions: For the first time, PR NIC activities were evaluated in a Turkish ICU. Findings show low performance of NIC activities and a high complication rate.

Implications for nursing practice: The findings provide the basis to implement a PR-Guideline in Turkish ICUs to enhance patients' safety and comfort.

چکیده

هدف: شفاف سازی مفهوم خودغفلتی در سالمندان

متدولوژی: تجزیه و تحلیل مفهوم با استفاده از مدل هیبرید که به ترتیب شامل سه مرحله نظری، کار میدانی و تحلیل نهایی است، انجام شد. پس از بررسی گسترده ادبیات به منظور توصیف ویژگی ها و تعریف مفهوم، مرحله کار میدانی به منظور تبیین تجربی مفهوم خودغفلتی در سالمندان انجام شد. در مرحله سوم ویژگی های خودغفلتی در سالمندان از فاز اول و دوم استخراج شد.

نتیجه: خودغفلتی در سالمندان به صورت “رفتارهای پرخطر عینی و ذهنی که به صورت عمدی و غیر عمدی، توسط فرد سالمند در حوزه های سلامت جسمی، معنوی، اختلال در روابط اجتماعی، غفلت از محیط زندگی و عدم رعایت بهداشت فردی بروز می کند که به واسطه ی عواملی چون برخی ویژگی های فردی، عملکرد جسمانی ضعیف، ابتلا به اختلالات روانشناختی شایع دوران سالمندی، مشکلات و چالش های مالی، استرس های آسیب رسان، روابط اجتماعی ناموفق، عدم دسترسی به منابع حمایتی، ناکافی بودن منابع آموزشی در دسترس سالمند و باورهای نامتعارف فرهنگی ایجاد می شود و منجر به اختلال در سلامت جسمی، روانشناختی، افزایش خطر سوء رفتار و کیفیت زندگی پایین فرد سالمند و همچنین افزایش بار مراقبتی- درمانی و اختلال در امنیت روانی جامعه می شود” تعریف می شود.

نتیجه گیری: با توجه به اینکه مفهوم خودغفلتی در سالمندان یک پدیده ی نسبتا ناشناخته و جدید در کشورمان است، نتایج این مطالعه می تواند با واضح سازی این مفهوم، راه را برای انجام فعالیت های گسترده تر تحقیقاتی و ساخت ابزارهای پژوهشی در جهت مداخلات بهتر هموار سازد و همچنین نقش مهمی در ارتقاء کیفیت مراقبت های پرستاری داشته باشد.

پیامدها برای کار پرستاری: خودغفلتی در سالمندان به عنوان مفهومی که منجر به بسیاری از اختلالات در ابعاد سلامت سالمندان مقیم در جامعه می‌شود، نیاز به توجه جدی دارد. پرستاران نمی توانند با یک پدیده ناشناخته بدون کاوش و شناسایی معنای دقیق آن مقابله کنند. بنابراین برای ایجاد بینشی عمیق در پرستاران و شناسایی به موقع و انجام مداخلات مناسب در این افراد، شفاف سازی ابعاد مختلف این مفهوم ضرورت دارد.