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Nursing diagnoses disturbed body image (00118) and situational low self-esteem (00120) in patients with head and neck cancer: Differential clinical validation using Q methodology. 护理诊断头颈癌患者身体形象紊乱(00118)和情境性低自尊(00120):使用Q方法学的鉴别临床验证
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-06-01 DOI: 10.1111/2047-3095.12426
Susana S A Miguel, Tiago Dias Domingues, Sílvia Caldeira

Purpose: When submitted to mutilating surgery, patients with head and neck cancer may present profound physical and psychosocial changes, temporary or definitive, with an individual impact and family. The most frequent human responses to this health condition are subjective, particularly concerning body image and self-esteem. Differential validation emerges to provide nurses with clinical indicators for clinical reasoning and planning of effective interventions, considering the specific defining characteristics of each diagnosis. This study aimed at conducting a differential clinical validation of the nursing diagnoses of disturbed body image and low situational self-esteem in patients with head and neck cancer using Q methodology.

Method: We performed an observational cross-sectional study using Q methodology. Thirty-eight participants were included. Data were analyzed using Q methodology procedures. The research and ethics committee approved the study.

Findings: Factor analysis was performed, and eight defining characteristics were identified for the diagnosis of disturbed body image and one for situational low self-esteem: avoiding looking at one's body, avoiding touching one's body, the behavior of monitoring one's body, depersonalization of body part by use of impersonal pronouns, focus on past appearance, focus on past function, negative feeling about body, and refusal at acknowledging change and helplessness.

Conclusions: The use of the Q methodology in this process of differential validation allowed the study of two diagnoses of a subjective nature, disclosing the most specific defining characteristics of each and contributing to increasing the knowledge of these human responses.

Implications for nursing practice: This study contributes to a better understanding of the predominant defining characteristics of the diagnoses under study. In terms of the NANDA-I taxonomy, it helps to raise the levels of evidence for diagnoses. Using a qualitative and quantitative methodology allows for maintaining a more holistic research approach and greater rigor and acceptance of the results.

目的:头颈癌患者在接受残割手术时,可能会出现深刻的生理和心理变化,可能是暂时的,也可能是决定性的,对个人和家庭都有影响。人类对这种健康状况最常见的反应是主观的,特别是在身体形象和自尊方面。考虑到每种诊断的具体定义特征,差异验证的出现为护士提供临床推理和有效干预计划的临床指标。本研究旨在运用Q方法学对头颈癌患者身体形象紊乱和情境自尊低下的护理诊断进行差异性临床验证。方法:采用Q方法学进行观察性横断面研究。38名参与者被纳入研究。数据分析采用Q方法程序。研究和伦理委员会批准了这项研究。结果:通过因子分析,确定了身体形象障碍诊断和情境性低自尊诊断的8个特征:避免看自己的身体、避免触摸自己的身体、监控自己的身体、使用非人格化代词的身体部位去人格化、关注过去的外表、关注过去的功能、对身体的消极感觉、拒绝承认变化和无助。结论:在微分验证过程中使用Q方法可以研究两种主观性质的诊断,揭示每种诊断的最具体定义特征,并有助于增加对这些人类反应的了解。对护理实践的启示:本研究有助于更好地理解所研究的诊断的主要定义特征。就NANDA-I分类而言,它有助于提高诊断证据的水平。使用定性和定量方法可以保持更全面的研究方法,并提高结果的严谨性和接受度。
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引用次数: 0
Evaluation of clinical oral care outcomes according to nursing outcomes classification 根据护理成果分类评估临床口腔护理成果
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-05-30 DOI: 10.1111/2047-3095.12427
Funda Büyükyılmaz PhD, BSN, Yeliz Çulha PhD, BSN, Sakine Coşkun MSc, Didem Cengiz RN

Purpose

This research was planned to follow the healing process of the oral mucosa in patients in intensive care with an “Impaired Oral Mucous Membrane Integrity” nursing diagnosis based on the “NOC (1100) Oral Health Assessment” outcome criteria.

Method

This study, which was planned in a methodological and descriptive type of research, was carried out with 50 patients who were hospitalized in the intensive care clinic of a state hospital between June and December 2022, with a nursing diagnosis of “Impaired Oral Mucous Membrane Integrity.” Data were collected using a Patient Information Form and the “NOC (1100) Oral Health Evaluation Scale” for the nursing outcomes classification. In the analysis of the data descriptive statistical methods, Pearson correlation test, Friedman test as well as Cohen's kappa test were used to evaluate the agreement between two independent observers.

Findings

In the study, content validity index value of the NOC scale was calculated to be 0.90. The examination of the participants’ mean scores on the NOC (1100) Oral Health Assessment Scale showed that there were statistically significant differences in terms of the repeated evaluations, except for the NOC indicators of “Oral mucosal integrity,” “Gum integrity,” and “Tooth integrity” (p < 0.01). No statistically significant correlation was found between the mean NOC scale scores of the patients according to the variables of age, body mass index, mechanical ventilation time, and length of stay in the intensive care unit (p > 0.05).

Conclusions

The findings showed that the Turkish version of NOC (1100) Oral Health Assessment Scale was a valid tool for monitoring the healing process of the oral mucosa in patients in intensive care.

Implications of nursing practice

With the use of NOC (1100) Oral Health Assessment Scale, a common language will be formed in the evaluation for monitoring the healing process of the oral mucosa in nursing care.

目的 本研究计划根据 "NOC(1100)口腔健康评估 "结果标准,跟踪重症监护室护理诊断为 "口腔黏膜完整性受损 "的患者的口腔黏膜愈合过程。 方法 本研究计划采用方法学和描述性研究类型,对象是 2022 年 6 月至 12 月期间在一家国立医院重症监护门诊住院的 50 名患者,其护理诊断为 "口腔黏膜完整性受损"。数据收集采用患者信息表和 "NOC(1100)口腔健康评估量表 "进行护理结果分类。在分析数据时,使用了描述性统计方法、皮尔逊相关检验、弗里德曼检验和科恩卡帕检验来评估两名独立观察者之间的一致性。 研究结果 经计算,NOC 量表的内容效度指数值为 0.90。对参与者在 NOC(1100)口腔健康评估量表上的平均得分进行的研究表明,除 "口腔黏膜完整性"、"牙龈完整性 "和 "牙齿完整性 "这三个 NOC 指标外,其他指标的重复评价差异均有统计学意义(P <0.01)。根据年龄、体重指数、机械通气时间和在重症监护室的住院时间等变量,患者的平均 NOC 量表得分之间没有统计学意义上的相关性(p >0.05)。 结论 研究结果表明,土耳其版 NOC(1100)口腔健康评估量表是监测重症监护患者口腔黏膜愈合过程的有效工具。 对护理实践的启示 使用 NOC(1100)口腔健康评估量表后,在护理中监测口腔黏膜愈合过程的评估将形成一种共同语言。
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引用次数: 0
Etiological factors of chronic pain syndrome in young adults with post-coronavirus disease 2019 condition 科罗纳病毒病后青壮年慢性疼痛综合征的病因 2019 年状况
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-05-26 DOI: 10.1111/2047-3095.12428
Daniel Freitas Oliveira Damasceno RN, Tahissa Frota Cavalcante PhD, MSc, RN, Larissa Katlyn Alves Andrade Nursing Student, Francisco Breno Barbosa de Oliveira RN, Marcos Venicios de Oliveira Lopes PhD, MSc, RN, Rafaella Pessoa Moreira PhD, MSc, RN, Huana Carolina Candido Morais PhD, MSc, RN

Purpose

The coronavirus disease 2019 (COVID-19) generates long-term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post-COVID-19 conditions.

Methods

This was a case–control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID-19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS.

Findings

This study included 120 individuals. Prolonged days of isolation (p = 0.005), fear (p < 0.001), stress overload (p < 0.001), and impaired rehabilitation (p = 0.003) were significantly associated with CPS.

Conclusions

A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS.

Implications for nursing practice

The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post-COVID-19 conditions, in addition to promoting the use of the NANDA-International taxonomy.

目的 2019 年冠状病毒病(COVID-19)会产生长期后遗症,但针对慢性疼痛综合征(CPS)患者的研究却很有限。本研究旨在确定COVID-19后遗症患者的CPS病因。 方法 这是一项病例对照回顾性研究。预测变量包括性别、糖尿病、肥胖(易患因素)、不利的社会经济条件、康复受损(致残因素)、反复接触 COVID-19(诱发因素)、家庭隔离、压力过大、对死亡的恐惧、入住重症监护室、俯卧位和使用药物(强化因素)。结果变量为是否存在 CPS。 研究结果 本研究包括 120 名患者。延长隔离天数(p = 0.005)、恐惧(p < 0.001)、压力过大(p < 0.001)和康复受损(p = 0.003)与 CPS 有显著关联。 结论 发现长时间隔离、恐惧、压力过大、康复受损与 CPS 之间存在明显关系。 对护理实践的启示 除了推广使用 NANDA-International 分类标准外,研究结果还可以帮助护士提高对 CPS 病因的认识,支持 COVID-19 后患者的护理计划需求。
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引用次数: 0
A retrospective descriptive study of NANDA-I nursing diagnoses used by midwives working in obstetrics and gynecologic service: An example from south-eastern Turkey 对妇产科助产士使用 NANDA-I 护理诊断的回顾性描述研究:以土耳其东南部为例
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-05-22 DOI: 10.1111/2047-3095.12424
Yeşim Yeşil PhD, Leyla Baran PhD

Purpose

This study aims to identify NANDA-I nursing diagnoses that midwives working in obstetrics and gynecologic service use while managing the electronic nursing care process.

Methods

This retrospective study was conducted in a descriptive way to evaluate electronic care plan records of 3025 patients staying in obstetrics and gynecologic service between April 1, 2020. and April 1, 2021. Diagnoses in the records of the electronic care process were digitalized by two faculty members. Then, NANDA-I nursing diagnoses used by midwives were identified. NANDA-I nursing diagnoses used by midwives were identified.

Findings

It was determined that diagnoses in care plans documented from the system within the 1-year period fell into eight domains and 10 classes, and 5819 diagnoses were given in total. The most frequent diagnoses given in obstetrics and gynecologic service were “acute pain” and “risk for bleeding.”

Conclusion

Findings of this study revealed that nursing care records in obstetrics and gynecologic service did not have a large number of diagnoses and interventions.

Implications for nursing practice

Care plans directly reflect the contribution of the care to the patient. Consequently, midwives being aware of and recording nursing diagnoses while giving care will ensure a standardized language and visibility in care. More coverage of midwifery-related diagnoses in the midwifery curriculum will make NANDA-I nursing diagnoses more visible in midwifery as well.

目的 本研究旨在确定妇产科助产士在管理电子护理流程时使用的 NANDA-I 护理诊断。 方法 本回顾性研究以描述性方式对 2020 年 4 月 1 日至 2021 年 4 月 1 日期间妇产科 3025 名住院患者的电子护理计划记录进行评估。电子护理流程记录中的诊断由两名教师进行数字化处理。然后,确定助产士使用的 NANDA-I 护理诊断。确定助产士使用的 NANDA-I 护理诊断。 结果 经确定,1 年内系统记录的护理计划中的诊断分为 8 个领域和 10 个类别,共给出 5819 项诊断。妇产科最常见的诊断是 "急性疼痛 "和 "出血风险"。 结论 本研究结果显示,妇产科护理记录中没有大量的诊断和干预措施。 对护理实践的启示 护理计划直接反映了护理对患者的贡献。因此,助产士在提供护理服务时了解并记录护理诊断将确保护理语言的标准化和护理的可视性。在助产课程中增加与助产相关的诊断内容,将使 NANDA-I 护理诊断在助产过程中更加明显。
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引用次数: 0
Letter in response to a published article by Constantina Petrou, Leila Jameel, Noushig Nahabedian, and Fergis Kane on the April 6, 2023. 这封信是对Constantina Petrou、Leila Jameel、Noushig Nahabedian和Fergis Kane在2023年4月6日发表的一篇文章的回应。
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-05-22 DOI: 10.1111/2047-3095.12429
Ceylon Dell
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引用次数: 0
Letter to the editor: Addressing suicidal behavior prevention and treatment with Taoyuan Psychiatric Center's Employee Assistance Program. 致编者信:探讨桃园精神科中心员工协助计划之自杀行为预防与治疗。
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-05-13 DOI: 10.1111/2047-3095.12425
Lien-Chung Wei
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引用次数: 0
Editorial: Don't hide the disciplinary focus, steward it 社论:不要隐藏纪律重点,管理它
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-04-04 DOI: 10.1111/2047-3095.12422
Jane Flanagan PhD, RN, AHN-BC, ANP-BC, FNI, FNAP, FAAN
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引用次数: 0
Analysis of Readiness for enhanced health literacy in patients with type 2 diabetes mellitus 分析 2 型糖尿病患者加强健康知识普及的准备情况。
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-03-31 DOI: 10.1111/2047-3095.12416
Jocelha Maria Costa de Almeida Mater's Student, RN, Eliana Brugin Serra MSc, RN, Livia Maia Pascoal PhD, MSc, RN, Marcelino Santos Neto PhD, MSc, Pharm, Rafaella Pessoa Moreira PhD, MSc, RN, Isaura Letícia Tavares Palmeira Rolim PhD, MSc, RN

Purpose

To estimate the prevalence of Readiness for enhanced health literacy in patients with type 2 diabetes mellitus through the diagnostic accuracy of the defining characteristics.

Methods

A diagnostic accuracy study on the diagnosis of Readiness for enhanced health literacy in patients with type 2 diabetes mellitus was conducted using the latent class analysis model. The sample comprised 180 individuals attending a referral outpatient clinic in Maranhão, Brazil. The data analysis was conducted in the R Core Team software.

Findings

The prevalence of the nursing diagnosis was 55.23%. The main defining characteristics were expresses desire to enhance health communication with healthcare providers and expresses desire to enhance the understanding of health information to make healthcare choices. All defining characteristics showed significant specificity values.

Conclusions

Accurate diagnoses contribute to individualized care plans for patients.

Implications for nursing practice

The diagnosis Readiness for enhanced health literacy should be considered in implementing care plans, including interventions to reduce complications in the health status of patients with type 2 diabetes mellitus.

目的:通过对2型糖尿病患者健康素养提升准备度的定义特征的诊断准确性,估算2型糖尿病患者健康素养提升准备度的患病率:采用潜类分析模型,对 2 型糖尿病患者健康素养提升准备度的诊断准确性进行了研究。样本包括在巴西马拉尼昂州一家转诊门诊就诊的 180 名患者。数据分析在 R Core Team 软件中进行:护理诊断的患病率为 55.23%。主要的定义特征是希望加强与医疗服务提供者的健康交流,以及希望加强对健康信息的理解以做出医疗选择。所有定义特征都显示出明显的特异性:准确的诊断有助于为患者制定个性化护理计划:护理实践的启示:在实施护理计划(包括减少 2 型糖尿病患者健康状况并发症的干预措施)时,应考虑加强健康知识读写能力的诊断。
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引用次数: 0
Psychosocial interventions aimed at family members caring for patients with cancer in the palliative period: A systematic review 针对在姑息期照顾癌症患者的家庭成员的社会心理干预:系统回顾
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-03-31 DOI: 10.1111/2047-3095.12423
Manolya Yıldız RN, Candan Terzioğlu PhD, Fatma Ayhan PhD

Aim

The purpose of this systematic review is to examine evidence-based psychosocial intervention research aimed at family members caring for patients with cancer in the palliative period.

Method

In this systematic review, randomized controlled psychosocial intervention studies for the family member caring for patients with cancer published between January 1, 2016 and July 30, 2021 were reviewed. PubMed (including MEDLINE), Cochrane, APA PsycNet, ProQuest, Science Direct, TR Index, and Wiley Online Library databases were scanned. Eight publications were identified following a database review for English language articles published from 2016 to 2021. Sample, methods, content, and outcomes of included interventions are summarized.

Results

Only eight of the 4652 articles examined met the inclusion criteria. Psychosocial interventions such as mindfulness exercises, stress management, acceptance and commitment therapy, cognitive behavioral intervention, and meaning-centered psychotherapy for cancer caregivers were applied for relatives caring for patients with cancer in the palliative period.

Conclusion

Psychosocial interventions applied to family members caring for patients with cancer during the palliative period lead to improvements in depressive symptoms, stress levels, the caregiver burden, quality of life, self-efficacy, coping skills, and awareness levels.

目的 本系统综述旨在考察针对姑息期癌症患者护理家庭成员的循证社会心理干预研究。 方法 本系统综述回顾了 2016 年 1 月 1 日至 2021 年 7 月 30 日期间发表的针对癌症患者家属的随机对照心理干预研究。对 PubMed(包括 MEDLINE)、Cochrane、APA PsycNet、ProQuest、Science Direct、TR Index 和 Wiley Online Library 数据库进行了扫描。在对 2016 年至 2021 年发表的英文文章进行数据库审查后,确定了 8 篇出版物。对纳入的干预措施的样本、方法、内容和结果进行了总结。 结果 在4652篇文章中,只有8篇符合纳入标准。针对癌症护理人员的社会心理干预措施,如正念练习、压力管理、接受与承诺疗法、认知行为干预和以意义为中心的心理疗法,均适用于在姑息期护理癌症患者的亲属。 结论 对姑息期癌症患者家属进行心理干预,可改善抑郁症状、压力水平、照顾者负担、生活质量、自我效能、应对技能和认知水平。
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引用次数: 0
Capturing key function-focused care problems, nursing diagnoses, and interventions for nursing home patients using a web-based case management system 使用基于网络的病例管理系统,为疗养院病人捕捉以功能为重点的关键护理问题、护理诊断和干预措施。
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2023-03-08 DOI: 10.1111/2047-3095.12420
Su Jung Lee PhD, RN, Min Sun Park PhD, RN, Sung Ok Chang PhD, RN

Purpose

The aim of this study is to identify the key functional care problems, NANDA-I nursing diagnoses, and intervention plans related to function-focused care (FFC) using a web-based case management system for patients who present different cognitive status.

Methods

This study employed a retrospective descriptive research design. Data were obtained from system records on patients after the research team trained the case management system at a nursing home in Dangjin in South Chungcheong Province, South Korea. A total of 119 inpatient records were analyzed.

Results

The key physical, cognitive, and social functional problems, nursing diagnoses in six domains (health promotion, elimination and exchange, activity/rest, perception/cognition, coping/stress tolerance, and safety/protection), and intervention plans were identified.

Conclusion

The identified FFC case management information of interdisciplinary caregivers will provide evidence for the implementation of effective interventions according to a patient's functional status. Additional studies related to the establishment of a large clinical database of advanced case management systems focusing on interdisciplinary caregivers’ functional management are needed to support the prioritization of functional care.

目的:本研究旨在利用基于网络的病例管理系统,为出现不同认知状况的患者确定关键功能护理问题、NANDA-I护理诊断以及与功能为中心的护理(FFC)相关的干预计划:本研究采用回顾性描述研究设计。研究小组在韩国忠清南道唐津的一家疗养院对病例管理系统进行培训后,从患者的系统记录中获取数据。共分析了 119 份住院病历:结果:确定了主要的身体、认知和社会功能问题、六个领域(健康促进、消除和交流、活动/休息、感知/认知、应对/压力耐受、安全/保护)的护理诊断以及干预计划:结论:已确定的跨学科护理人员的 FFC 病例管理信息将为根据患者的功能状态实施有效干预提供证据。还需要开展更多研究,以建立一个以跨学科护理人员功能管理为重点的先进病例管理系统大型临床数据库,从而为确定功能护理的优先次序提供支持。
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引用次数: 0
期刊
International Journal of Nursing Knowledge
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