Correspondence Between NANDA International Nursing Diagnoses and Outcomes as Proposed by the Nursing Outcomes Classification

Resilience in Older People: A Concept Analysis

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

Developmental Strategy and Validation of the Midwifery Interventions Classification (MIC): A Delphi Study Protocol and Results from the Developmental Phase

This study protocol aims to describe the rationale and developmental strategy of the first study in the Italian context which aimed to define a Midwifery Interventions Classification, an evidence-based, standardized taxonomy and classification of midwifery interventions. Midwifery interventions require a specific definition, developed through a consensus-building process by stakeholders to develop the Italian taxonomy of the Midwifery Interventions Classification with the potential for international transferability, implementation, and scaling up. A multi-round Delphi study was designed between June and September 2022, and data collection is planned between February 2023 and February 2024. The developmental phase of the study is based on a literature review to select meaningful midwifery interventions from the international literature, aiming to identify an evidence-based list of midwifery interventions. This phase led to including 16 articles derived from a systematic search performed on PubMed, CINAHL, and Scopus; 164 midwifery interventions were selected from the data extraction performed on the 16 included articles. Healthcare professionals, researchers, and service users will be eligible panelists for the Delphi surveys. The protocol designed a dynamic number of consultation rounds based on the ratings and interim analysis. A nine-point Likert scoring system is designed to evaluate midwifery interventions. Attrition and attrition bias will be evaluated. The results from the study designed in this protocol will inform the development of the Italian taxonomy of the Midwifery Interventions Classification. A shared classification of midwifery interventions will support audit and quality improvement, education, and comparable data collections for research, sustaining public recognition of midwifery interventions to promote optimal maternal and newborn health.

Assessment of tissular integrity in patients with diabetic foot

ABSTRACT Objective: Evaluate the impairment of tissue integrity in patients with diabetic foot and verify its association with time of diagnosis of the disease. Methods: Cross-sectional study conducted with 134 patients in an outpatient clinic located in the Northeast region of Brazil. A semi-structured questionnaire was used for data collection, which was subjected to descriptive analysis and the Mann-Whitney U non-parametric test. Results: Indicators with the lowest average score were: skin temperature, sweating, skin lesions, right and left pedal pulses, right and left tibial pulses. Patients less than ten years old had worse scores on thickness, elasticity, right tibial pulse and tissue integrity. Those with a diagnosis time of more than ten years had a greater impairment of sensation and right pulse. Conclusion: All indicators showed some impairment of tissue integrity, and the time of diagnosis of the disease was associated with six of these.

Validation and applicability of instrument for documenting the nursing process in intensive care

OBJECTIVE

to validate the content of an instrument for documenting the steps of the Nursing Process, using the standardized languages NANDA-I, NOC, and NIC (NNN), aiming at hospitalized patients in an Intensive Care Unit (ICU).

METHOD

A methodological research performed in three steps: design of the existing instrument from the systems NANDA-I, NOC and NIC; content validation by 13 judges, from a four-point Likert-type scale - items were evaluated as to their clarity and pertinence; applicability: judgement of the content regarding clarity, reading ease, and presentation for 40 critical-care nurses. The Content Validity Index (CVI) and the Kappa coefficient (k) was calculated to measure the proportion of relevance and clarity, was well as to verify the level of agreement between the experts in each item.

RESULTS

The instrument was considered clear and pertinent, with CVI above 0.8 in most items and overall Concordance Index (CI) of 0.90, showing a satisfactory level of agreement between judges. Regarding applicability, the instrument was deliberated clear, of easy reading, and with proper presentation by most critical-care nurses, being validated through 11 diagnoses with their respective results and nursing interventions.

CONCLUSION

The instrument showed to be valid and applicable for the group studied. It is expected that this study is able to contribute to the improvement of the Nursing Process in intensive care.

The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process

Objectives

Comprehensive nursing assessment, as the first step in the nursing process, involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process. The aim of this study is to determine the effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing nursing process.

Methods

A randomized controlling design was conducted. Of 84 undergraduate nursing students, 42 students were allocated to the intervention or control group. In clinical education, a patient assessment form based on Gordon's functional health patterns was applied to help students in the intervention group to develop nursing process, while the control group received traditional methods. The data were gathered using a demographic information questionnaire, skills in nursing process development checklist, and attitudes towards nursing process questionnaire.

Results

The average scores for students’ attitude and skills in developing nursing process in the intervention group were greater than those of the control group.

Conclusion

Applying nursing assessment using the patient assessment form based on Gordon's functional health patterns can improve the students' learning in developing nursing process.

Factors influencing clinical decision making used by mental health nurses to provide provisional diagnosis: A scoping review

Medical diagnosis has traditionally been the role of medical officers. However, mental health nurses working in crisis/emergency settings within Australia are expected to provide a provisional diagnosis postassessment of a consumer. There is limited literature and understanding how mental health nurses develop a provisional diagnosis. In this scoping review, we aimed to first identify and describe the clinical decision-making processes used by mental health nurses across a variety of clinical settings. Second, we sought to explore the factors influencing mental health nurse's diagnostic practice in a variety of settings. Literature was searched using CINAHL (EBSCOhost), PubMed, and ProQuest. Peer-reviewed literature published between 2007 and 2017 was used for this scoping review. Two major themes were identified: clinical decision making (CDM) in mental health nursing and diagnostic practice in nursing. A combination of clinician, environmental, and patient factors were found to have influenced CDM. Furthermore, mental health nurses rely heavily on tacit knowledge when making clinical decisions. Little is known about the use of diagnostic practice in mental health nursing in Australia; however, the limited literature revealed an overlap between the factors which influence CDM and diagnostic practice, respectively. Further research is needed into the use of diagnostic practice in mental health nursing to develop frameworks to assist with CDM pertaining to application of provisional diagnosis by mental health nurses working in assessment environments.

The cultural expression of spiritual distress in Israel

BACKGROUND

Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel.

METHODS

We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care.

RESULTS

Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress.

CONCLUSIONS

Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.