The Nursing Diagnosis of “Death Anxiety”: Content Validation by Experts

Prevalence of preoperative anxiety among hospitalized patients in a developing country: a study of associated factors

BACKGROUND

Preoperative anxiety is a health concern among patients scheduled for surgical interventions. Little is known about the prevalence of preoperative anxiety among patients in different healthcare systems of developing countries. This study was conducted to determine the prevalence of preoperative anxiety among patients undergoing surgery in Palestine. Another objective was to identify the factors associated with preoperative anxiety.

METHODS

This study was conducted in a cross-sectional descriptive design. Patients scheduled for surgical interventions were interviewed using an interviewer-administered questionnaire. The questionnaire collected the demographic, clinical, and surgical variables of the patients. The questionnaire also contained the Amsterdam preoperative anxiety and information scale (APAIS), and a short version of the Spielberger state-trait anxiety inventory (STAIS-5/STAIT-5).

RESULT

A total of 280 patients were included. The mean APAIS total score was 13.6 ± 5.9, the mean APAIS anxiety domain score was 8.3 ± 4.3, and the mean APAIS need for information domain was 1.6 ± 0.50. Of the patients, 76 (27.1%) had high anxiety and 160 (57.1%) expressed a high need for information. The higher APAIS anxiety scores were predicted by being female, having chronic diseases, being scheduled to be operated on within 24 h, and having experienced surgical complications. The mean STAIS-5 score was 10.0 ± 4.2 and the mean STAIT-5 was 10.3 ± 3.8. Of the patients, 140 (50.0%) had high state anxiety and 56 (20.0%) had high trait anxiety. Higher STAIS-5 scores were predicted by being female, younger than 42 years, and scheduled to be operated on within 24 h. Higher STAIT-5 scores were predicted by being female. A positive correlation was identified between APAIS total, APAIS anxiety, APAIS need for information, STAIS-5, and STAIT-5 scores.

CONCLUSION

Preoperative anxiety was prevalent among patients scheduled for surgical operations in Palestinian hospitals. Anesthesiologists and other providers of perioperative care should screen preoperative patients who are female, have chronic diseases, are scheduled to be operated on within 24 h, and having had experienced surgical complications for preoperative anxiety. More studies are still needed to investigate the effects of the implemented measures on the prevalence of preoperative anxiety.

"Readiness for enhanced healthy aging" nursing diagnosis: Content validation by experts

PURPOSE

To validate the content nursing diagnosis "Readiness for enhanced healthy aging."

METHODS

Descriptive, methodological study of diagnostic content validation, using the Fehring model. The sample consisted of 74 nurses experts in gerontology, with knowledge in NANDA-I nursing diagnoses.

FINDINGS

The title, one definition, and the three defining characteristics proposed for the diagnosis were validated, as well as the suggestion of domain and location class in NANDA-I Taxonomy II. The Diagnostic Content Validity Index was 0.81.

CONCLUSIONS

The validation of the diagnostic content by experts was fundamental for adequacy of the elements of the proposed diagnosis, which supported the elaboration of the diagnostic framework for submission to the NANDA-I taxonomy.

IMPLICATION FOR NURSING PRACTICE

The diagnosis "Readiness for enhanced healthy aging" can help nurses understand the phenomenon of "Healthy Aging" and, consequently, will support the planning and implementation of interventions aimed at promoting the health of the elderly population and those in the aging process. In addition, this diagnosis will offer nurses the opportunity to rethink health promotion strategies in their care plan, making a commitment to the population regarding the promotion of healthy aging, as recommended by the Word Health Organization.

Death anxiety, moral courage, and resilience in nursing students who care for COVID-19 patients: a cross-sectional study

Background

Being on the frontline of the battle against COVID-19, nurses and nursing students have been under considerable psychological stress and pressure. The present study is done to explore death anxiety, moral courage, and resilience in nursing students caring for COVID-19 patients in the south of Iran.

Methods

The present study is cross-sectional research conducted between September and December 2021. A total of 420 senior nursing students (nursing interns) who were undergoing their clinical training courses were invited to participate in the study by convenience sampling method from three hospitals affiliated with the University of Medical Sciences of Southern Iran. Data were collected using a demographics survey, Nurses’ Moral Courage Questionnaire, Connor-Davidson Resilience Scale, and Templer’s Death Anxiety Scale. 

Results

The nursing students participating in this study had a death anxiety mean score of 12.78 ± 1.17. The results showed that there was a significant and indirect correlation between death anxiety on the one hand and moral courage (r = -0.91, p < 0.001) and resilience (r = -0.89, p < 0.001) on the other in nursing students caring for patients with COVID-19. Also, it was found that there was a significant and direct correlation between the students’ resilience and moral courage scores (r = 0.91, p < 0.001).

Conclusion

The nursing students caring for COVID-19 patients had experienced high levels of death anxiety in the past few months. Considering the persistence of the COVID-19 crisis in Iran and other countries, there is an urgent need for measures to preserve and improve the physical, mental, and spiritual health of nursing students, enhance their moral courage and resilience and reduce their death anxiety.

Conceptual development and validation of the nursing diagnosis "Disturbed thought process"

PURPOSE

To validate the content of the nursing diagnosis proposal Disturbed thought process.

METHODS

With an exploratory and descriptive design, the content validation for each component of the diagnosis proposal was pursued, based on a previous broad conceptual work, through consulting experts, applying Fehring's Diagnosis Content Validation Model. The modified Delphi technique was used by sending out three rounds of questionnaires electronically to seek consensus among the experts.

FINDINGS

The nursing diagnosis version validated in this study includes the diagnosis label Disturbed thought process, the corresponding definition, 15 defining characteristics, and 13 related factors. The resulting diagnosis total Diagnosis Content Validation score was 0.99, implying its content validation.

CONCLUSIONS

The validated diagnosis proposal describes a human response for which nursing professionals can autonomously assess and prescribe interventions leading to improvement of this health problem and/or alleviate its consequences, preserving the patient's autonomy and helping them to address their situation. It will be included in the next edition of the nursing diagnosis classification NANDA-I 2021-2023.

IMPLICATIONS FOR NURSING PRACTICE

The results of this study will help nursing professionals reduce the potential impact among patients who suffer from an alteration in cognitive functioning in its executive function dimension, as the validated diagnosis proposal will make it possible to identify and report this problem precisely.

Development and Validation of the Operational Definitions of the Defining Characteristics of the Nursing Diagnosis of Insomnia in the Occupational Health Setting

PURPOSE

To develop and validate the operational definition (ODs) for each defining characteristic (DC) contained in the Nursing Diagnosis (ND) "insomnia" (00095) in the occupational health context.

METHODS

Methodological study carried out in two stages, including a consensus of experts to develop the ODs (Stage 1) and an online Delphi panel, performed in two rounds, to validate them (Stage 2).

FINDINGS

The 15 ODs proposed in Stage 1 were narrowed down to six validated ODs in the first round (diagnostic content validity index [DCVI] = 0.80-0.89). In the second round, five ODs were validated (DCVI = 0.80-0.94). Finally, the remaining four ODs were validated by the general consensus of experts.

CONCLUSIONS

The ODs were validated, although there remains some doubt as to whether some of the DCs can be applied to the field of occupational health.

IMPLICATIONS FOR NURSING PRACTICE

The ODs developed and validated could improve the diagnostic accuracy of the ND "insomnia" (00095) in the context of occupational health.