Illness Representations of Injury: A Comparison of Patients and Their Caregivers

Validation of the Nursing Diagnosis "Labile Emotional Control" in Traumatic Brain Injury

OBJECTIVE

To validate the defining characteristics of the nursing diagnosis "labile emotional control" in traumatic brain injury (TBI) outpatients.

DESIGN

This was a descriptive, cross-sectional, quantitative study.

METHODS

Thirty-one Brazilian nurses who were experts in the area of TBI answered a semistructured questionnaire on the diagnosis "labile emotional control" based on NANDA-International (NANDA-I) Taxonomy II (2015-2017) using a Likert-type scale to rate the 13 defining characteristics. Based on Fehring's model, the weighted average of ≥80 was used to define the main characteristic and the mean of ≥0.50 was considered for total content validation.

RESULTS

Out of the 13 defining characteristics of the nursing diagnosis studied, "leaving a social situation" (0.80) and "expression of emotions inconsistent with the triggering factor" (0.81) were classified as principal characteristics, while the 11 others were classified as secondary characteristics. The diagnosis "labile emotional control" obtained a total score of 0.69, which was considered valid according to NANDA-I Taxonomy II.

CONCLUSIONS

Because this is a new diagnosis with subjective characteristics, there is a need to train nurses to recognize the defining characteristics for the diagnosis.

CLINICAL RELEVANCE

The validation of this diagnosis helps nurses understand and identify the subjective characteristics of the emotional impressions expressed by patients with TBI. These defining characteristics will help improve TBI nurses' clinical practice.

Characteristics and Correlates of Caregivers' Perceptions of Their Family Members' Memory Loss

BACKGROUND

Understanding caregiver's perceptions of their family member's memory loss is a necessary step in planning nursing interventions to detect and address caregiver burden.

OBJECTIVE

The purpose of this study was to characterize caregivers' perceptions of their family members' memory loss and identify potential correlates within Leventhal's common sense model (CSM).

METHODS

This secondary analysis used baseline data from a larger randomized controlled trial. Patients with memory loss and their caregivers (N = 83 dyads) from the community were included. The adapted Brief Illness Perception Questionnaire (BIPQ) assessed caregivers' illness perceptions. Eight additional instruments measured correlates within the CSM. Responses were described; multiple linear regression was used to predict BIPQ dimension scores, and logistic regression was used to predict dichotomized BIPQ scores.

RESULTS

Most caregivers were female, White, and spouses of the patients; they reported a range of perceptions on the nine BIPQ dimensions. Patients' cognitive function consistently emerged as a significant correlate of caregivers' illness perceptions, explaining the most variance in caregivers' perceived consequences, identity, and treatment control (p < .01). Caregivers' reactions to patients' behavioral symptoms and caregivers' trait anxiety were associated with perceived illness coherence (p < .01). Caregivers with higher severity of daily hassles and White caregivers perceived that their family members' memory loss would last longer (p < .001).

DISCUSSION

Caregivers' perceptions of family members' memory loss varied; distinct dimensions of caregivers' illness perception were associated with a range of clinical and psychosocial factors. This exploratory study demonstrates the complexity of applying the CSM to caregivers of persons with memory loss.