bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of Increased Intracranial Pressure and High Risk for Increased Intracranial Pressure
Authors: Wall Barbra M. , Philips Jane Perry , Howard Janet C.
Published: February 2008

The authors designed this validation study to determine the defining characteristics of increased intracranial pressure and the risk factors for high risk for increased intracranial pressure. Using Fehring's Diagnostic Content Validity Model, a purposive sample of 219 nurses validated 17 major and 16 minor defining characteristics of increased intracranial pressure and nine major and six minor risk factors for high risk for increased intracranial pressure. Ratings were similar among nurses with diverse educational preparation but varied among nurses in different specialty areas, suggesting that practice setting is important in nursing diagnosis validation studies.
Achieving Linguistic Clarity: A Model to Aid Translations
Authors: Coler Marga Simon
Published: February 2008

An international validation study of selected NANDA nursing diagnoses prompted the development of a linguistic model for standardizing and operationalizing the defining characteristics. The translation of NANDA‐approved defining characteristics into Portuguese illuminated problems related to the way that sentences, phrases, and words are used. Defining characteristics were reduced into the simplest linguistic components—words. In Portuguese translation, all of the major NANDA‐defining characteristics were classified into two alphabetized lists as single‐word phenomena/states or qualifiers. Linguistic standardization permitted similar expressions of the defining characteristics in Portuguese and English.
Altered Family Processes Related to an Ill Family Member: A Validation Study
Authors: Brewer Nell Walker , Warren A. Michele
Published: February 2008

The purpose of this retrospective descriptive survey was to validate the defining characteristics for altered family processes related to an ill family nursing diagnosis. Using Ferhing's (1987) Diagnostic Cantent Validation Model, data were collected from 58 registered nurses. Clinical nurses submitted 14 defining characteristics not identified by NANDA nor found in the literature. Many of these characteristics expressed the same concepts in different terms from those used by NANDA. The results of this study give credibility to NANDA's conceptually stated defining characteristics and suggest further clinical research.
Measurement and Clinical Decision Making: Focus on Instrument Development
Authors: Davis Gail C.
Published: February 2008

Valid and reliable instruments are essential to responsible and accurate diagnosis, planning, and evaluation by professional nurses working independently or collaboratively with other healthcare professionals. The author provides an overview of the instrument development process and emphasizes the importance of measurement as an intrinsic part of the clinical decisionmaking process. Discussion focuses attention on the differences between an index and a scale, both of which are needed as part of assessment protocols. Some differences in strategies required for estimating validity and reliability for scales and indexes are highlighted.
Conceptualizations of Decision Making in Nursing: Analytic Models and “Knowing the Patient”
Authors: Radwin Laurel E.
Published: February 2008

Most studies of clinical decision making in nursing have been guided by analytic theories, such as information‐processing and decision‐analysis theories. Recently, some investigators have used naturalistic methods and have identified “knowing the patient” as relevant to clinical judgment. The author discusses two lines of inquiry and offers possible explanations for differences between the two conceptualizations of clinical decision making. Insights for future research are proposed.
Components of Written Nursing Diagnostic Statements
Authors: Dobrzyn Janet
Published: February 2008

The author examined whether nurses in an acute care setting use nursing diagnoses and correctly construct nursing diagnostic statements. Using a retrospective chart audit of a 237–bed acute care hospital, the author examined 150 diagnostic statements written by registered nurses. The Ziegler Criteria for Evaluating the Quality of the Nursing Process (ZCEQNP) was used to measure the components of the nursing diagnostic statements. The ZCEQNP is composed of 12 specific criteria that judge a diagnosis in general, and the response and etiology components individually. The findings revealed that only 4 of 150 diagnostic statements met all 12 criteria. The etiology component of the diagnostic statements was the least accurate: Only 16 out of 150 diagnostic statements met all of the etiology criteria. The findings indicate that nurses do not accurately compose nursing diagnostic statements. Implications and strategies for improvement are suggested.
Integrating Nursing Diagnosis for Population Groups Within Community Health Nursing Practice
Authors: Neufeld Anne , Harrison Margaret
Published: February 2008

Conflicting views exist about the utility of nursing diagnosis in community health nursing, particularly in relation to its use with population groups. Until recently, this application of nursing diagnosis received limited consideration by the North American Nursing Diagnosis Association. As a result, discussion is needed regarding the ways in which use of nursing diagnosis with population groups in community settings may be different from the use of nursing diagnosis with individuals. In this article several distinctive characteristics of the use of nursing diagnosis for health promotion with various population groups are addressed. Thoughtful consideration of these distinctive characteristics can provide a foundation for effective use of nursing diagnosis with population groups in community settings.
Diagnoses of the Human Response Pattern, Communicating: A Proposal for Revision
Authors: de Carvalho Emilia Campos , Coler Marga Simon
Published: February 2008

The authors present an analysis of the concept of communication, and propose a revision of NANDA's taxonomic human response pattern communicating, and its nursing diagnosis, impaired verbal communication. The authors recommend that the definitions of the human response pattern and its diagnosis be modified to incorporate facets other than verbal emissions. The addition of new defining characteristics and related factors also should be considered. New defining characteristics could include modifications of criteria of the American Speech and Hearing Association, highlighting disturbances in speech, language, hearing, and vision in addition to some of the present NANDA defining characteristics. Proposed related factors are classified as alterations in human patterns (developmental, physiological, psychological, social, cultural and environmental).
An Analysis of the Nursing Diagnosis Ineffective Management of Therapeutic Regimen Compared to Noncompliance and Orem's Self‐Care Deficit Theory of Nursing
Authors: Bakker Roel H. , Kastermans Marijke C. , Dassen Theo W. N.
Published: February 2008

The authors compare the nursing diagnosis ineffective management of therapeutic regimen with that of noncompliance and with Orem's concept of self‐care deficit. The article describes how the diagnosis of ineffective management of therapeutic regimen is more comprehensive than noncompliance. A question of patient autonomy is raised considering how the patient manages his or her therapeutic regimen. The major conclusion is that the nursing diagnosis of ineffective management of therapeutic regimen is based on continuous interaction between patient and nurse. The authors recommend that noncompliance be eliminated as a nursing diagnosis.
Fatigue: A Summary of the Definitions, Dimensions, and Indicators
Authors: Tiesinga Lucas J. , Dassen Theo W. N. , Halfens Ruud J. G.
Published: February 2008

Fatigue is a universal complaint that may or may not be related to medical diagnoses or therapeutic treatment. Fatigue is a complex, multicausal, multidimensional, nonspecific, and subjective phenomenon for which no one definition is widely accepted. The absence of theories concerning the nursing diagnosis of fatigue limits insight into the phenomenon and hinders the development of valid and reliable instruments for the measurement of fatigue. Therefores, the authors have undertaken a concept analysis of fatigue, to a) document how it is defined in the literature; b) which dimensions of the concept of fatigue are distinguished; and c) which indicators of both the content and forms of fatigue represent the concept in practice. This concept analysis has resulted in a theoretical frame of reference that can indicate directions not only for further research into the nursing diagnosis of fatigue, but also for the development of measuring instruments.
Diagnostic Language Consistency Among Multicultural English‐Speaking Nurses
Authors: Wieck K. Lynn
Published: February 2008

Cultural differences among nurses may influence the choice of terminology applicable to use of a nursing diagnostic statement. This study explored whether defining characteristics are consistently applied by culturally varied nurses in an English language setting. Two diagnoses, pain, and high risk for altered skin integrity, were studied within six cultures: African, Asian, Filipino, East Indian, African‐American, and Anglo‐American nurses. Overall, there was consistency between the cultural groups. Analysis of variance for the pain scale demonstrated differences among cultures on two characteristics of pain, restlessness and grimace. The only difference on the high risk for altered skin integrity scale was found on the distructor, supple skin.
A Phenomenological Description of the Experience of Spiritual Distress
Authors: Smucker Carol
Published: February 2008

The purpose of this study was to describe the phenomenon of spiritual distress in order to clarify the nursing diagnosis of spiritual distress and to evaluate its defining characteristics. Phenomenological interview procedures were used. Ten participants were asked to describe a time in their life when they had been concerned about the meaning of life, death, and/or their beliefs (the major defining char‐acteristic of this nursing diagnosis). The data were analyzed using a hermeneutical approach. The thematic structure of this experience indicated a biphasic process through which participants moved from distress to change and growth. Implications for nursing are discussed and suggestions made for further research on spiritual distress.
Considerations in Diagnosing in the Spiritual Domain
Authors: Engebretson Joan
Published: February 2008

As nurses move into the spiritual domain, it is important to recognize beliefs and values implicit in Western Judeo‐Christian culture. Cross‐cultural comparisons are used to illuminate three Western spiritual assumptions: monotheism, transcendence, and dualism. Awareness of these assumptions can help nurses accommodate spiritual‐cultural pluralism. Relevant to Western cultural bias, three types of errors lead to misdiagnosing spiritual distress or spiritual growth by confusing ideas of religion, psychology, and medicine with spirituality. These errors are discussed relevant to nursing practice. More work needs to be done to differentiate and understand spiritual issues related to health.
A Multivariate Approach for Validation of Anxiety and Fear
Authors: Whitley Georgia Griffith , Tousman Stuart A.
Published: February 2008

The purpose of this study was to reduce the defining characteristics for the nursing diagnoses anxiety and fear into sets of smaller, more manageable and meaningful variables for clinical use and further investigation. A sample of 233 nurse experts rated defining characteristics of anxiety and fear on three study instruments; a sample of 69 hospitalized clients rated defining characteristics of anxiety on one study instrument. Results of principle components analyses identified patterns within defining characteristics and provided consolidation of characteristics into meaningful and usable sets.
An Exploration of the Nursing Diagnosis Terminal Syndrome
Authors: Adams Phyllis Jean , Nichols Brenda S.
Published: February 2008

As a result of the limitations of a single nursing diagnosis, NANDA has encouraged the development of “syndromes.” A study was undertaken using an investigator‐developed tool to identify the cluster of defining characteristics, nursing diagnoses and nursing interventions for terminally ill patients, regardless of disease origin. The sample consisted of completed medical records of 15 randomly selected chronic obstructive pulmonary disease patients and 15 randomly selected cancer patients. For all three areas there were commonalities, specifically 10 defining characteristics, seven nursing diagnosis and a 27%–48% agreement on the nursing interventions selected. A clustering of data has been documented to support the establishment of the nursing diagnosis, terminal syndrome.
Effect of Curriculum Change on Student Anxiety and Diagnostic Reasoning
Authors: Briody Margaret E.
Published: February 2008

Curriculum revision was undertaken to address student anxiety and diagnostic reasoning ability. A quasi‐experimental study was conducted with the revised curriculum as the intervention. Subjects were convenience samples of senior baccalaureate students (N = 38) the year before and after the intervention. Spielberger's State/Trait Anxiety Inventory revealed significantly less state anxiety in the intervention group, with no difference in trait anxiety. Gordon's Diagnostic Reasoning Test indicated no significant difference in knowledge of nursing diagnosis language or concepts, but a difference in the inferential ability of the intervention group on one vignette. After the curriculum change, students were less anxious and somewhat improved in their ability to infer nursing diagnoses.
Restoring Power Through Nursing Intervention
Authors: Kubsch Sylvia , Wichowski Harriet Conley
Published: February 2008

PURPOSE. To test the effectiveness of seven therapeutic nursing interventions in alleviating powerlessness in chronically ill clients was tested.

METHODS. Part I of the study tested the Holistic Power Model, developed by the researchers, in a pilot study. Part II compared the effectiveness of seven therapeutic nursing interventions to decisional control in alleviating powerless in experimental (N = 25) and control groups (N = 25).

FINDINGS. An inverse relationship was found between power resource scores and the perception of powerlessness. There was a significant difference in perceived powerlessness between the experimental and control groups following intervention.

CONCLUSIONS. Utilization of specific therapeutic nursing interventions is more effective in alleviating perceived powerlessness than utilizing the interventions of decisional control.
Dungan Model of Dynamic Integration
Authors: Dungan Joyce M.
Published: February 2008

TOPIC. The Dungan Model of Dynamic Integration (DMDI), which views humans as having three synergistic dimensions of body, mind, and spirit.

PURPOSE. To present a new nursing model for practice and education.

SOURCE. This is the author's model and it is composed of concepts and constructs that are well‐documented in nursing literature.

CONCLUSIONS. Dynamic Integration is a broad conceptual model that allows for testing a number of mid‐range theories to add to the science and discipline of nursing.
Noun Phrases for Nursing Diagnoses
Authors: Sparks Sheila M.
Published: February 2008

TOPIC. The use of noun phrases for nursing diagnoses instead of the current mixture of phrases and clauses

PURPOSE. This article reviews the current list of qualifiers; discusses language clarity, precision, grammatical concerns; and defines noun phrases.

SOURCE. Literature review

CONCLUSIONS. The author proposes a list of qualifiers to replace the current list, and recommends a revised list of nursing diagnoses using noun phrases to improve their clinical usefulness, allow for alphabetization, and enhance clarity.
Children's Spiritual Response: Validation of the Nursing Diagnosis Spiritual Distress
Authors: Pehler Shelly‐Rae
Published: February 2008

PURPOSE. The dimension of spirituality is woven into client phenomena, which nurses diagnose and treat, yet previous research identifies that nurses do not know if the nursing diagnosis of spiritual distress describes the spiritual response(s) found in children.

METHODS. A descriptive study using a modification of Fehring's (1987) model for nursing diagnosis validation with board‐certified chaplains as the expert participants (N = 26).

FINDINGS.
Only two of the defining characteristics in the 13–18 year‐old‐group met the criteria for “major,” as defined by Fehring (1987). As the ages of the children increased, the more likely defining characteristics met the criteria for “minor.” Participants offered suggestions for clarifying the definition, described additional defining characteristics found in children, and identified situations in which chaplains are called upon to assess spirituality.

CONCLUSIONS. The results of this research add to the knowledge of spiritual responses in children.
Risk for Suicide and Risk for Violence: A Case for Separating the Current Violence Diagnoses
Authors: Smith Janet E. , Early Jane A. , Green Patricia T. , Lauck Donna L. , Oblaczynski Catherine , Smochek Mary Rose , Wright Gertrude
Published: February 2008

PURPOSE. To identify accurate descriptive terms for risk for violence and risk for suicide and to provide operational definitions for these terms

METHODS. The Delphi technique, with two rounds, was used to differentiate the operational definitions that represent risk for suicide from those that represent risk for violence. The expert panel consisted of 23 healthcare professionals with a minimum of a master's degree. In addition to the expert panel, a control group (N = 11) participated to assess content validity.

FINDINGS. Thirty‐six definitions were agreed upon for suicide, 39 for violence.

CONCLUSIONS. These definitions represent the basic distinctions between the two behavioral manifestations.
Utilization of Nursing Diagnosis in Three Australian Hospitals
Authors: King Virginia M. , Chard Mary E. , Elliot Tess
Published: February 2008

PURPOSE.
To document nursing diagnoses on nursing care plans in an Australian context where NANDA nursing diagnoses were utilized.

METHODS.
An audit of 198 nursing care plans at three selected hospitals by three university lecturers involved in teaching nursing diagnosis.

FINDINGS.
Pain was the nursing diagnosis most often documented; the majority of other diagnoses pertained to physical problems experienced by patients.

CONCLUSIONS.
The results of this research add to the knowledge of nursing diagnosis utilization and have implications for the provision of nursing care and its teaching and research.
Nursing Assessment of Altered Sexuality: A Review of Salient Factors and Objective Measures
Authors: LeMone Priscilla , Jones Donna
Published: February 2008

TOPIC.
Nursing assessment of altered sexuality.

PURPOSE.
To review salient factors affecting assessment and objective measures available for use in assessment.

SOURCE.
Literature specific to nursing assessment of sexuality and to instruments measuring altered sexuality.

CONCLUSIONS.
Many standards of care include the assessment of sexuality, and nurses believe it to be an important aspect of care. However, the assessment of altered sexuality does not often occur in actual practice. The use of an objective measure of sexuality is recommended for both initial and on‐going assessments in acute‐care and community‐based settings.
Nursing Diagnoses in Patients With Leukemia
Authors: Courtens A.M. , Abu‐Saad H. Huijer
Published: February 2008

PURPOSE. To identify and describe nursing diagnoses, their related factors, and defining characteristics, in hospitalized leukemia patients and to categorize these nursing diagnoses within Functional Health Patterns.

METHODS. Content analysis of 15 nursing records and interviews with 7 oncology nurses working on a hematology/oncology ward in a University hospital in Maastricht, the Netherlands.

FINDINGS. In the leukemia population, 47 nursing diagnoses with their associated characteristics were identified and classified within 10 Functional Health Patterns. Most of the nursing diagnoses were related to the Nutritional‐Metabolic, the Cognitive‐Perceptual, Activity‐Exercise, the Role‐Relationship, and the Coping‐Stress‐Tolerance patterns.

CONCLUSIONS. Results describe the nursing care needs of patients with leukemia. Since the study used a small sample, results should be interpreted with caution. Further research is recommended.
Teaching Baccalaureate Nursing Students to Project Outcomes to Nursing Interventions
Authors: Chase Susan K.
Published: February 2008

PURPOSE. To develop an innovative method of teaching baccalaureate nursing students to plan for and recognize outcomes to specific nursing interventions.

METHODS. A case study design that measured the effectiveness of a teaching innovation. Tools for students (N = 8) to use during clinical practice included an Intervention‐Outcome Analysis Tool and a Nursing Clinical Outcomes Tool.

FINDINGS. Quantitative and qualitative evaluation data were presented that showed growth in the ability to set and meet patient outcomes during the semester.

CONCLUSIONS. Thinking in terms of outcomes moved students beyond problem solving in their clinical thinking and assisted them to learn to develop individualized outcome statements for their patients.
Nursing Diagnoses and Interventions for Post‐Acute‐Phase Battered Women
Authors: Carlson‐Catalano Judy
Published: February 2008

PURPOSE. To identify nursing diagnoses and interventions applicable for post‐acute‐phase battered women.

METHODS. Eight battered women were interviewed twice for 2 hours. Gordon's functional health patterns provided the framework for data collection.

FINDINGS. Fifty‐three nursing diagnoses and 52 nursing interventions were indicated in the data; 24 nursing diagnoses and 26 nursing interventions were present in all participants' data.

CONCLUSIONS. With the use of comprehensive interventions, nurses can make a major contribution to society by enabling battered women to move to a more protected lifestyle.
Nursing Diagnosis in the International Classification for Nursing Practice (ICNP)
Authors: Wake Madeline , Coenen Amy
Published: February 2008

TOPIC. International Classification for Nursing Practice (ICNP) Classification of Nursing Phenomena.

PURPOSE. Provide a historical review of nursing diagnosis in the developing ICNP.

SOURCES. Literature, meeting notes, and experience

CONCLUSION. The development of the ICNP has benefited from contributions of many. Continued refinement depends on participation of nurses globally
The Influence of Nursing Diagnosis on Information Processing by Undergraduate Students
Authors: da Cruz Diná de Almeida Lopes Monteiro , Arcuri Edna Apparecida Moura
Published: February 2008

PURPOSE.To examine the influence of a nursing diagnosis course on the information processing by undergraduate students.

METHODS.A quasi‐experimental study conducted with two groups (experimental, n = 15; control, n = 22) of undergraduate nursing students, subjecting only one to a nursing diagnosis course. The students' ability to identify, cluster, and name clusters of relevant data were compared between and within groups.

FINDINGS.After the course, the experimental group performed better than the control group in the three activities studied.

CONCLUSIONS.The results of this study suggest that the nursing diagnosis content in teaching favors clinical reasoning to determine the patient's nursing care.
Beyond Knowledge Deficit to a Proposal for Information‐Seeking Behaviors
Authors: Conley Virginia M.
Published: February 2008

TOPIC.Nursing assessment of knowledge or informational needs.

PURPOSE.To present a brief evolutionary analysis of knowledge deficit in terms of its significance, application, and use, and to present a proposed diagnosis, “information‐seeking behaviors.”

SOURCES.Literature review of knowledge deficit and “information‐seeking behaviors.”

CONCLUSIONS. Knowledge deficit is a nursing diagnosis that is significant for identifying a patient's need for education or knowledge. Its application has revealed limitations to validity and subsequent use. “Information‐seeking behaviors” is proposed as an alternative diagnosis. Antecedents and defining characteristics are presented and areas for future research proposed.
Powerlessness Regarding Health‐Service Barriers: Construction of an Instrument
Authors: Dunn Joan Dolce
Published: February 2008

PURPOSE.The purpose of the study was to develop a scale to calculate college students' powerlessness regarding health service barriers (PHSB).

METHODS.Scale items were generated to represent two domains of interest: powerlessness and college students' powerlessness regarding health service barriers. The final 20‐item instrument was subjected to multiple measures of validity with college students and panels of nurse experts in the area of nursing diagnosis. Reliability was assessed by two samples (n = 92 and n = 33) of college‐age students. A final administration was conducted with 197 college students.

FINDINGS.The PHSB scale was determined to be an accurate and consistent measure.

CONCLUSIONS.This instrument will provide a reliable and valid measure to conduct research.
The Center for Nursing Classification
Authors: Wakefield Bonnie , Wilkinson Judith M.
Published: February 2008

This is the first of many viewpoints we hope to see in this column. “Viewpoints” provides a forum for discussing theoretical, philosophical, and practical issues associated with nursing diagnosis. Recall the stimulating discussions you had and overheard at the last NANDA conference, and send us your viewpoint. We would also like to see any brief, informal comments you wish to make in response to someone's viewpoint.
Nurse Practitioners' Use of Nursing Diagnoses
Authors: Carison‐Catalano Judy
Published: February 2008

“Where are We Now?” is an occasional feature in Nursing Diagnosis. The column focuses on current issues and trends related to nursing diagnosis development, implementation, and evaluation.
A Validation Study Using the Case‐Control Method of the Nursing Diagnosis High Risk for Aspiration
Authors: Wooldridge Judith , Herman JoAnne , Garrison Carol , Haddock Sue , Massey Jean , Tavakoli Abbas
Published: February 2008

PURPOSE. To develop further the nursing diagnosis risk for aspiration by determining risk factors present in patients who aspirated.

METHODS.
The case‐control design was used to compare cases (n = 131) and controls (n = 206) on past and present exposures thought to be risk factors for aspiration. Data were analyzed using univariate and multiple logistic regression.

FINDINGS.
The following risk factors were statistically significant and comprise the final model: altered level of consciousness, metoclopramide (known to accelerate gastric emptying), vomiting, seizures, and unable to change own position.

CONCLUSIONS.
The risk factors of altered level of consciousness and delayed gastric emptying are currently included in the NANDA taxonomy for the nursing diagnosis risk for aspiration. These risk factors are not included in the taxonomy: vomiting, seizures, and unable to change own position. Results of the study have been submitted to the Diagnosis Review Committee for consideration to further develop this diagnosis.
Application of the Neuman Systems Model to Teaching Health Assessment and Nursing Process
Authors: McHolm Frances A. , Geib Kathleen M.
Published: February 2008

TOPIC.
A nursing theory framework for teaching health assessment.

PURPOSE.
To improve teaching of health assessment and nursing process to beginning‐level baccalaureate nursing students.

SOURCES.
The Assessment and Analysis Guideline Tool, published and unpublished literature, personal observation, and faculty feedback were used in tool development.

CONCLUSIONS.
Faculty concluded that students who could envision the connection of the Neuman Systems Model and NANDA nursing diagnoses through the nursing process would be better able to understand the nursing model and choose appropriate nursing diagnoses for client care.
Processes and Methodologies for Research Validation of Nursing Diagnoses
Authors: Whitley Georgia Griffith
Published: February 2008

TOPIC. Research validation of nursing diagnoses.

PURPOSE. To provide a historical review of processes and methodologies for research validation of nursing diagnoses and suggested directions for future nursing diagnosis research.

SOURCES.
Nursing diagnosis research methodologies and processes from the Invitational Conference on Research Methods for Validating Nursing Diagnoses, Nursing Diagnosis: The Journal of Nursing Language and Classification, and the North American Nursing Diagnosis Association (NANDA) conference proceedings for the first through the 12th conferences.

CONCLUSIONS.
Future nursing diagnosis research should include concept analysis, expert validation, clinical validation, instrument development, larger studies, powerful statistical analyses, replication and comparison of studies, and concerted efforts to support group research activities that target priority areas of research.
Development of Bilingual Tools to Assess Functional Health Patterns
Authors: Krozy Ronna E. , McCarthy Nancy C.
Published: February 2008

TOPIC.
The theory and process of developing bilingual assessment tools based on Gordon's 11 functional health patterns.

PURPOSE.
To facilitate assessing the individual, family, and community in a student clinical practicum in a Spanish‐speaking country.

SOURCES.
Multiple family and community health promotion theories; translation theories, Gordon's Manual of Nursing Diagnosis (1982); translation/back‐translation involving Ecuadorian faculty and students; student community assessments; faculty and staff workshops in Ecuador.

CONCLUSIONS.
Bilingual, culturally sensitive health assessment tools facilitate history taking, establish nursing diagnoses and interventions, and promote mutual learning. These outcomes demonstrate potential application to other systems in the international nursing community.
Nursing Diagnosis or Patient Problem?
Authors: Beyea Suzanne , Wilkinson Judith
Published: February 2008

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial view's are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column editor: judithwilkinsatt.net; 913.631.1089.

In this Viewpoint, Dr. Suzanne Beyea relates how her thinking about nursing diagnosis may be changing in response to emerging realities in health care.
Integrating Nursing Diagnoses, Interventions, and Outcomes in Public Health Nursing Practice
Authors: Parris Kathleen M. , Place Patricia J. , Orellana Eugenia , Calder Jo‐Ann , Jackson Karen , Karolys Andrea , Meza Molly , Middough Cheryl , Nguyen Vinh , Shim Nancy W. , Smith Donna
Published: February 2008

TOPIC.
Applying standardized nursing language in public health nursing practice.

PURPOSE.
To develop a charting format to document public health nursing practice based on standardized nursing language.

SOURCES.
Literature review of documentation systems for public health nursing practice.

CONCLUSIONS.
A task force of public health nurses developed a charting format based on Taxonomy I of Nursing Diagnosis (NANDA), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC).
Patient Problems, Needs, and Nursing Diagnoses in Swedish Nursing Home Records
Authors: Ehrenberg Anna , Ehnfors Margareta
Published: February 2008

PURPOSE.
To describe the main problems, needs, risks, and nursing diagnoses and to examine the descriptions of some common and serious patient problems in nursing home records.

METHODS.
A retrospective audit of a stratified, random sample (N = 120) of patient records from eight nursing homes in six Swedish municipalities.

FINDINGS.
Results showed major deficiencies in nursing documentation in the patient records. Only one record contained a comprehensive description of one patient problem that corresponded to the requirements of Swedish laws and regulations. No record was found that contained a systematic and comprehensive assessment of any of the selected problems based on established criteria or the use of an assessment instrument.

CONCLUSIONS.
Nursing documentation in patient records does not reflect the use of systematic assessment and research‐based instruments for determining patient care needs. Nurses need skills in assessment in the care of the elderly to be able to set priorities in care and deliver adequate care.
Nursing Diagnosis at Work: From Metaphors to Nursing Diagnoses
Authors: Bond Emily O. , Urick Jean , Judge M. Kay M.
Published: February 2008

Nursing Diagnosis at Work shows that nursing diagnosis is alive, well, and at work in clinical settings. As they strive to enable nurses and nursing students to use data sets to make inferential decisions, the nursing faculty at Southeastern Louisiana University found an innovative source as a data set. Two faculty members describe one of the strategies they use to make nursing diagnosis work for their students. If you have identified another well‐known data set, please share it and the way you have used it. MKMJ.
Notes on NDEC: NDEC Guidelines for Development and Evaluation of Diagnoses Column
Authors: Craft‐Rosenberg Martha , Delaney Connie , Denehy Janice , Herdman T. Heather
Published: February 2008

This column describes the work of the Nursing Diagnosis Extension and Classification (NDEC) research team, which works in a collaborative agreement with NANDA to refine and extend the nursing diagnosis classification. Information in this column is for feedback and dialog only, and does not indicate NANDA acceptance of the content. NDEC contributions and recommendations will be processed by NANDA through its DRC Committee.

Postscript. A joint meeting of members from NANDA and NDEC occurred in Boston after this column was submitted. Present were: Dr. Dorothy Jones (President, NANDA), Drs. Marjory Gordon and T. Heather Herdman (Co‐chairs, DRC Committee), and Dr. Martha Craft‐Rosenberg (Co‐principal investigator, NDEC). The purpose of the meeting was to clarify and strengthen the collaborative relationship between NANDA and NDEC.

NDEC's guidelines for development and evaluation of diagnoses vary somewhat from NANDA criteria for staging nursing diagnoses. For example, NDEC guidelines state that a nursing diagnosis label is a noun phrase, whereas NANDA's definition of a diagnosis label is “a concise term or phrase that represents a pattern of related cues” (NANDA, 1999, pp. 149–150). The people at the recent meeting determined that guideline development would occur jointly, along with a periodic review of those guidelines. The next issue of tills column will be devoted to highlighting the ongoing collaborative relationship between NANDA and NDEC. It is our hope that this format will stimulate dialogue among the readership.
The Second NANDA/NIC/NOC Conference: Impressions from a Group of First‐Timers
Authors: Meyer Melanie , Burton Janet , Campbell Margie , Connell Suzanne , Faulconer Jennifer , Piirto Susan , Stover Donna
Published: February 2008

In this issue, a group of nurses who practice at Columbus Regional Hospital, in Columbus, IN shares their impressions of the NNN conference on “Documenting Nursing Effectiveness by Using Nursing Informatics,” held in New Orleans in April 1999. We welcome brief, informal responses to published viewpoints.
From Risk for Trauma to Unintentional Injury Risk: Falls—A Concept Analysis
Authors: Schoenfelder Deborah Perry , Crowell Carolyn M.
Published: February 2008

TOPIC.
Concept analysis of the nursing diagnosis risk for trauma.

PURPOSE.
To examine the nursing diagnosis risk for trauma and to specify the risk factors for falling.

SOURCES.
Research and informational articles on falling, and NANDA Nursing Diagnoses: Definitions and Classification, 1999–2000.

CONCLUSIONS.
Replace the current nursing diagnosis risk for trauma with the more specific nursing diagnosis unintentional injury risk: falls. The other risks included in risk for trauma (e.g., burns) also will need to be developed.
Clinical Validation of Characteristics of the Alcoholic Family
Authors: Bartek Jean Krajicek , Lindeman Marlene , Hawks Jane Hokanson
Published: February 2008

PURPOSES.
To validate, from a client and family perspective, the defining characteristics for the nursing diagnosis altered family processes: alcoholism; and to identify demographic, family, and selected treatment information from clients and family members.

METHODS.
Subjects (N = 150) completed Fehring's (1987) Clinical Diagnostic Validation (CVD) Index for 110 defining characteristics of the nursing diagnosis altered family processes: alcoholism.

FINDINGS.
Alcoholic families display behaviors of alcohol abuse, loss of control of drinking, denial, nicotine addiction, impaired communication, inappropriate expression of anger, and enabling behaviors. Family feelings indicate the presence of unhappiness, hurt, frustration, guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness.

CONCLUSIONS.
These clinically validated characteristics will complete the assessment phase of this research and direct the path to future studies to determine appropriate goals/outcomes and interventions related to alcoholic families.
A Critical Time for Nursing Diagnosis Research
Authors: Whitley Georgia Griffith
Published: February 2008

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column editor: judithwilkinsatt.net;913.631.1089.
Viewpoint
Authors: Carlson‐Catalano Judy , Wilkinson Judith
Published: February 2008

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column Editor: judithwilkins@att.net; 913.631.1089
International Nursing Language News
Authors: Oud Nico , Boisvert Cecile , Apalategui Mercedes Ugalde , Egawa Takako
Published: February 2008

With this issue we inaugurate the first column on international nursing language news. The focus of the four newly appointed associate editors is to keep you informed on nursing diagnosis activities beyond NANDA.
Response to S. Beyea's “Nursing Diagnosis or Patient Problem?”
Authors: Maas Meridean
Published: February 2008

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column editor: judithwilkins@att.net; 913.631.1089.
Where to Start? Introducing Standardized Nursing Languages in Educational Settings
Authors: Powelson Stephanie Ann , McGahan Sharon Ann , Wilkinson Judith M. , Powelson Stephanie Ann , McGahan Sharon Ann
Published: February 2008

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column editor: judithwilkins@att.net; 913.631.1089.
Notes on NDEC
Authors: Herdman T. Heather , Gordon Marjory , Craft‐Rosenberg Martha
Published: February 2008

This column describes the work of the Nursing Diagnosis Extension and Classification (NDEC) research team, which works in a collaborative agreement with NANDA to refine and extend the diagnosis classification.
A Multivariate Validation of the Defining Characteristics of Fatigue
Authors: Fu Mei , LeMone Priscilla , McDaniel Roxanne W. , Bausler Cheryl
Published: February 2008

PURPOSE. To validate the nursing diagnosis fatigue by providing evidence to identify, confirm, and consolidate the defining characteristics.

METHODS. The Revised Piper Fatigue Scale and the Schwartz Measurement of Fatigue scales were used to collect data from four groups of healthy women (N = 182). Data were analyzed by maximum‐likelihood factor analysis with varimax rotation, and major and minor defining characteristics were identified and clustered.

FINDINGS. The identified defining characteristics tended to group into the dimensions identified in prior fatigue studies. Although the majority of the NANDA defining characteristics were validated, differences were found.

CONCLUSIONS. atigue is a multidimensional construct. Replication of the study with a variety of samples from different geographic locations and a variety of patient populations will further cross‐validate the defining characteristics of fatigue.

PRACTICE IMPLICATIONS. Fatigue is a commonly experienced phenomenon in both health and illness. As the knowledge base about fatigue builds, so will the accuracy of nursing assessments and the effectiveness of nursing interventions.
Who Are the Experts? A Commentary on Nursing Diagnosis Validation Studies
Authors: Levin Rona , Wilkinson Judith
Published: February 2008

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column editor: judithwilkins@att.net; 913.631.1089.
Spirituality and Religiousness: Differentiating the Diagnoses Through a Review of the Nursing Literature
Authors: Burkhart Lisa , Solari‐Twadell Ann
Published: February 2008

PURPOSE. To differentiate the definitions of spirituality and religiousness as used in nursing literature.

DATA SOURCES. Journal articles, books, book chapters.

DATA SYNTHESIS. The nursing literature has been inconsistent in defining spirituality and religiousness. The spirituality literature defines spirituality as the broader concept, with religiousness as a subconcept, while the religiousness literature defines religiousness as the broader concept, with spirituality as a subconcept.

CONCLUSIONS. Spirituality and religiousness are two separate nursing diagnoses with some common elements to both.

PRACTICE IMPLICATIONS. The growth of parish nursing as an ANA‐recognized specialty practice has heightened the awareness of caring for the human spirit. Clarity is needed in the terms used to define this specialty.
Report From the Spirituality and Religiousness Diagnosis Working Group
Authors: Burkhart Lisa
Published: February 2008

This column features the work of the Spirituality and Religiousness Diagnosis Working Group, chaired by Lisa Burkhart, PhD(c), MPH, RN. The thinking of this group provides assistance to those of us who struggle in the differentiation of the spiritual and religious concepts
Joining Mind Mapping and Care Planning to Enhance Student Critical Thinking and Achieve Holistic Nursing Care
Authors: Mueller Alma , Johnston Mary , Bligh Diane , Wilkinson Judith
Published: February 2008

Viewpointprovides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit or if you want to discuss it beforehand, contact the column editor: judithwilkins@att.net;913.631.1089.

Search terms:
Care plans, critical thinking, mind maps
Essential Differences Between Evidence‐Based Nursing and Evidence‐Based Medicine
Authors: Lavin Mary Ann , Meyer Geralyn , Krieger Mary , McNary Patricia , Carlson Judith , Perry Anne , James Dorothy , Civitan Tome
Published: February 2008

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints.

This Viewpoint is an expanded version of the introduction to “Online, Peer‐Reviewed Bibliographic References on Sleep,” a presentation at the NNN conference “Developing, Linking, and Integrating Nursing Language and Informatics: Working Together for Quality Care,” April 10–13, Chicago.
Applicability of the International Classification of Nursing Practice (ICNP®) in the Areas of Nutrition and Skin Care
Authors: Ehnfors Margareta , Florin Jan , Ehrenberg Anna
Published: February 2008

PURPOSE.To evaluate completeness, granularity, multiple axial content, and clinical utility of the beta version of the ICNP® in the context of standardized nursing care planning in a clinical setting.

METHODS.An 35‐bed acute care ward for infectious diseases at a Swedish university hospital was selected for clinical testing. A convenience sample of 56 patient records with data on nutrition and skin care was analyzed and mapped to the ICNP.

FINDINGS.Using the ICNP terminology, 59%‐62% of the record content describing nursing phenomena and 30%‐44% of the nursing interventions in the areas of nutrition and skin care could be expressed satisfactorily. For about a quarter of the content describing nursing phenomena and interventions, no corresponding ICNP term was found.

CONCLUSIONS.The ICNP needs to be further developed to allow representation of the entire range of nursing care. Terms need to be developed to express patient participation and preferences, normal conditions, qualitative dimensions and characteristics, nonhuman focus, and duration.

PRACTICE IMPLICATIONS.The practical usefulness of the ICNP needs further testing before conclusions about its clinical benefits can be determined.

Search terms:ICNP®, nursing classification, standardized terminology, VIPS
Experienced and Less‐Experienced Nurses Diagnostic Reasoning: Implications for Fostering Students' Critical Thinking
Authors: Ferrario Catherine G.
Published: February 2008

PURPOSE. To compare the use of mental representations (heuristics) in diagnostic reasoning of expert (≥5 years' experience) and novice (<5 years' experience) emergency nurses.

METHODS. Clinical simulations were completed by a nationwide randomly selected sample of 173 experienced and 46 less‐experienced emergency nurses (N =229).

FINDINGS. Experienced nurses used the heuristic, Judging by Causal Systems (diagnostic inferences deduced from systems of causal factors) significantly more did than less‐experienced nurses.

PRACTICE IMPLICATIONS. Standardized nursing diagnoses may cut short the time needed to develop representational thinking and spare cognitive reserves for reasoning needed for complex patients. Faculty need to promote students' cognitive development through strategies that promote active, reflective, and integrative learning.

Search terms: Clinical experience, diagnostic reasoning