bluuebunny/crossref_metadata_2025_split huggingface dataset:
NLINKS: Online, Peer‐Reviewed Bibliographic References on Sleep
Authors: Lavin Mary Ann , Krieger Mary M. , McNary Patricia A. , Meyer Geralyn A. , Carlson Judith H. , Perry Anne G. , James Dottie 
Published: August 2004

PURPOSETo develop a methodology for establishing an online (http://www.nlinks.org), peer‐reviewed, annotated bibliography. Disturbed sleep patterns and sleep deprivation were the arbitrarily selected foci.METHODSTasks included developing an annotated bibliographic form and collecting reviews, first from investigators and next from an online solicitation, and improving the annotated form as needed with the implementation of each of the following steps: (a) selecting MEDLINE and CINAHL search strategies for the years 1966–1982 and 1982–2001, respectively, (b) classifying an article's evidence base and its contribution to language development; (c) evaluating construct and content validity of the evidence base and the contribution to language development classifications, (d) determining interrater reliability in evaluating reviews, (e) publishing the results online, and (f) preparing for the deductive phase of the research and future research efforts.FINDINGSThere was high interrater reliability within the contribution to language development scale but not within the evidence‐based scale. This finding led to a discussion on the evidence base of nursing. Comparisons between evidence base of medicine and nursing were made. A three‐tiered matrix was developed to allow for the cross‐categorization of level of nursing evidence with diagnoses, defining characteristics, related factors, interventions or treatments, and outcomes. Access to literature within any one cell of the matrix required knowledge of filters used by MEDLINE and CINAHL and adapting these filters to capture subject headings consistent with language development subjects and terms.CONCLUSIONSFuture searches are planned and the implications for nursing informatics, education, practice, and research have been articulated. The move toward evidence‐based nursing is international in nature.
Evaluation of Impaired Physical Mobility in Patients With AIDS
Authors: Barbosa Dulce Aparecida , Myria Ribeiro  , Diniz Aparecido , Oliveira Susy Motta , Bettencourt Ana Rita 
Published: August 2004

PURPOSETo identify the defining characteristics and related factors of impaired physical mobility in patients with AIDS, according to NANDA criteria.METHODSThorough physical exams of all patients with AIDS who were admitted during a single month were conducted. Related factors and defining characteristics for impaired physical mobility were documented.FINDINGSStudy participants were 14 patients with AIDS (11 males, 3 females); median age was 34 (range: 23–44 years), and median time of hospital admission was 19 days (range: 7–40). Impaired physical mobility was diagnosed in 8 (57%) patients. The defining characteristics according to NANDA criteria were postural instability during routine activity (n= 6, 75%), and limited ability to perform fine motor activities (n= 4, 50%). The most evident related factors were sensoriperceptual impairment (n= 5, 62%); pain (n= 6, 75%); and decreased muscle strength, control, and/or mass (n= 3, 37%).CONCLUSIONSNANDA criteria provided essential support for impaired physical mobility.
Accuracy of Nursing Diagnosis: Interrater Agreement
Authors: Lopes Monteiro da Cruz Diná de Almeida , Rita de Cássia Grassia Peres  
Published: August 2004

PURPOSETo estimate the interrater agreement of the Lunney Scoring Method, a 7‐point scale (from −1 to +5) to measure accuracy of nursing diagnoses.METHODSThis descriptive‐exploratory study with two raters applied the scale to 388 nursing diagnoses identified by 89 nurses and nursing students. Proportion of agreements and frequencies of score differences between raters were calculated. Cohen's Kappa was computed excluding 3 ratings of −1 assigned by only one of the raters.FINDINGSRaters agreed on 235 (61%) of the nursing diagnoses. The frequencies of score differences between raters were 1 point on 101 (21%) nursing diagnoses, 2 points on 11 (3%), and 3 points on 41 (11%). Kappa's coefficient was 0.51 (p<0.001).DISCUSSIONThere was acceptable agreement between raters using the Lunney Scoring Method. The proportion of score differences between raters can be interpreted as the magnitude of the disagreements, and revealed that differences of 3 points occurred in only 41 (11%) of the ratings.CONCLUSIONSAccuracy of nursing diagnosis is a matter of concern for practice, research, and teaching in nursing. The development, use, and refinement of instruments on nursing diagnosis accuracy would increase credibility for nursing diagnosis research. The application of such instruments in teaching and practice could facilitate sharing experiences between novices and expert diagnosticians. This study was carried out with a Portuguese (Brazil)‐speaking sample. Transcultural research on nursing diagnosis accuracy should be conducted to identify relevant cultural differences on diagnostic concepts. Such results could improve the international dialogue on nursing diagnostic concepts.
Risk Factors for Peripheral Neurovascular Dysfunction in Patients With Diabetes Mellitus and Arteriosclerosis Obliterans: A Pilot Study
Authors: Egawa Takako , Imai Yukika , Kurihara Hiroko , Hanafusa Moshiaki , Uehara Junko , Ogino Satoshi 
Published: August 2004

PURPOSETo develop a nursing diagnostic tool to help prevent foot disease in patients with diabetes mellitus at risk for developing peripheral neurovascular dysfunction.METHODSSubjects were 24 patients with diabetes mellitus. Ankle pressure index, percutaneous oxygen partial pressure (PtcO2), and circulation in the foot were measured using a laser flow meter. Neurologic disorders were evaluated using the Achilles reflex, sensory tests, and taste tests. Basic data (age, gender, fasting blood glucose as an indicator of the duration and severity of disease, hemoglobin, total cholesterol, lipids) were gathered from medical records. Patients were divided into two groups: those who had arteriosclerosis obliterans (10 males, 5 females) and those who did not (5 males, 4 females).FINDINGSThere was a significant decrease in ankle pressure, PtcO2, and sensory perception in the feet of those with arteriosclerosis obliterans. There was also a significant decrease in taste sensation in this group.CONCLUSIONSThese results suggest that patients with diabetes mellitus who have arteriosclerosis obliterans are already at risk for developing neurologic disorders and arteriosclerosis in the lower limbs. Clinical symptoms measured were able to determine risk for peripheral neurovascular dysfunction in patients with diabetes. The screening and assessment of these risk factors is noninvasive, making it possible for nurses to perform them by using their assessment skills.
Cleft Lip and Palate: Differences Between Pre‐ and Postoperative Nursing Diagnoses
Authors: Bertoncello Fontes Cassiana Mendes , Lopes Monteiro da Cruz Diná de Almeida 
Published: August 2004

PURPOSETo compare nursing diagnoses of patients undergoing cleft lip/palate correction between pre‐ and postoperative phases; to describe the related Functional Health Patterns according to frequencies of nursing diagnoses.METHODSResearchers assessed 40 patients hospitalized for cleft lip/palate correction by interview and physical examination before and after the surgical procedure. Four nurses independently made the nursing diagnoses for each patient based on the recorded data. The criterion to accept the diagnoses as valid was the consensus of a minimum of two out of four nurses. The MacNemar test was applied to verify whether the frequencies of the diagnoses changed after the surgery procedure.FINDINGSNurses identified 454 diagnoses (35 categories). Knowledge deficit (p= 0.02), and self‐esteem disturbance (p<0.00) decreased in frequency after the surgical procedure. The frequencies of the following diagnoses significantly increased after surgery (p<0.00): risk for infection, risk for suffocation/aspiration, altered oral mucous membrane, sleep pattern disturbance, pain, fatigue, and impaired tissue integrity. The most altered Functional Health Pattern in the pre‐ and postoperative phases were Self‐Perception/Self‐Concept (28%) and Nutritional‐Metabolic (51%).DISCUSSIONPreoperatively, care needs were related to psychosocial functioning. In the postoperative phase they were primarily related to biologic risks and comfort. Although these findings showed that surgery altered the response profile of the sample, differences in the forms used for the pre‐ and postoperative assessments might have contributed to these results.CONCLUSIONSThe results of this study can be used to determine core competencies needed for nursing care in the area of craniofacial anomalies.
Evaluation of NOC Measures in Home Care Nursing Practice
Authors: Keenan Gail M. , Barkauskas Vi , Lee Jan , Stocker Julia , Treder Marcy , Clingerman Evelyn 
Published: August 2004

PURPOSETo evaluate the reliability, validity, usefulness, and sensitivity of 89 NOC outcomes in two Visiting Nurse Associations in Michigan.METHODSOf a total 190 NOC outcomes 89 were assigned for testing. Interrater reliability and criterion validity were assessed a total of 50 times per outcome (on 50 different patients) across the study units. The total number of times the reliability and validity were assessed for each of the 89 measures studied ranged from 5–45.Three RN research assistants (RNRAs) oversaw and participated in data collection with the help of 15 clinicians. Convenience sampling was used to identify subjects. A roster of outcomes to be studied was maintained and matched with patient conditions whenever possible until the quota of outcomes assigned had been evaluated. Clinicians and RNRAs independently rated the outcomes and indicators applicable to the patient. NANDA diagnoses, NIC interventions, and medical diagnoses were recorded.FINDINGSA total of 258 patients (mean age 62) enrolled; 60% were women, 23% were from minority groups, and 78% had no college degree. Thirty‐six of the 89 NOC measures were designated “clinically useful.” The 10 outcomes with the highest interrater reliability were Caregiver Home Care Readiness; Caregiver Stressors; Caregiving Endurance Potential; Infection Status; Mobility Level; Safety Status: Physical Injury; Self‐Care: Activities of Daily Living; Self‐Care: Bathing; Self‐Care: Hygiene; and Wound Healing: Secondary Intention. Criterion measurement and repeated ratings provided evidence to support the validity and sensitivity of the NOC outcomes. Evidence also suggested that NOC label level ratings could be a feasible, reliable, and valid method of evaluating nursing outcomes under actual use. For some measures, adjustments in the scales and anchors are needed to enhance reliability. For others, it may be unrealistic to reliably score in one encounter, thus scoring should be deferred until the clinician has adequate knowledge of the patient.CONCLUSIONSContinued study and refinement that are coordinated and integrated systematically strongly recommended. Comprehensive study in an automated system with a controlled format will increase the efficiency of future studies.
Nursing Outcomes for Evaluations of Caregiver Outcomes in a Rural Alzheimer Demonstration Project
Authors: Specht Janet 
Published: August 2004

PURPOSETo evaluate the effectiveness of the interventions of nurse care managers in the care of family members of people with dementia.METHODSData were collected as part of a 3‐year Administration on Aging–funded Alzheimer Demonstration Project to provide expanded in‐home services to rural Iowans affected by Alzheimer disease and related disorders in 8 rural Iowa counties—randomly selected to have a nurse care manager and 4 designated control counties that had traditional case management service. Nurse care managers were trained in the care of people with dementia and their caregivers, the use of role transition theory, and the Progressively Lowered Stress Threshold model of care to provide and coordinate services for enrollees. All referred people with cognitive impairment and their families in the 8 study counties were eligible for inclusion. Three selected NOC outcomes were tested in clinical settings. Interrater reliability for the outcomes was good (87%–95%). The construct validity of Caregiver Stressors Outcome was .74 when correlated with the Caregiver Stress Index.FINDINGSOf the 142 subjects with cognitive impairment enrolled within the first year of the grant, 113 had a caregiver. The outcomes were used to evaluate differences in caregiver outcomes at baseline and at 6‐month intervals. The majority of caregivers at follow‐up was female and had been providing care for ≥5 years. For each of the outcomes the majority of caregivers had improved scores, with only 2–4 caregivers getting scores indicating worsening conditions or remaining the same.CONCLUSIONSPreliminary analysis shows a trend of improved outcomes with the use of a nurse care manager. The NOC caregiver outcomes showed good variability among caregivers at baseline, with caregiver responses distributed throughout the scales. The NOC outcomes also provide guidance for interventions of the nurse care managers. Further evaluation of the outcomes is needed, including examining the relationships of placement, health status, and service use of each outcome. The caregiver outcomes offer an effective and efficient means to evaluate services delivered to caregivers of people with dementia.
Cognitive Coherence: Use of Nursing's Standardized Language
Authors: Graiver Mary M. , Shannon Marcia , Decker Sally 
Published: August 2004

BACKGROUNDThe framework of regulation/cognition/perception can be used in a baccalaureate curriculum to explore mental health and medical‐surgical life processes in a population of clients experiencing altered life processes.MAIN CONTENT POINTSAn example from mental health is the phenomenon of mood. Specific NANDA labels include impaired social interaction and ineffective individual coping. NIC labels that apply include “socialization enhancement” and “behavior management: self‐harm.” NOC labels include Social Involvement and Decision Making. In a medical‐surgical setting the phenomenon of nutrition can be used as an example. NANDA labels include altered nutrition: more than body requirements. NIC labels include “nutrition management,”“weight reduction assistance,” and “weight management.” NOC labels include Weight Control, Knowledge: Diet, and Nutrition Status: Food and Fluid Intake.CONCLUSIONSThese examples of the use of standardized language within a nursing curriculum demonstrate the linkages that are possible within specific courses as well as throughout those courses united by a common conceptual framework.
Nursing Rounds Link Nursing Diagnoses to Clinical Practice
Authors: Jaco Mary K. , Gordon Mary D. , Marvin Janet A. 
Published: August 2004

BACKGROUNDA pediatric burn nursing internship program was developed to train new graduate nurses to become competent and confident in their practice. The goals were to teach critical thinking, develop individualized plans of care for patients with burns, and guide the development of sound nursing practice. The strategy was to build the curriculum around nursing diagnoses. Theoretical content of the program included pediatrics, burns, and critical care nursing.MAIN CONTENT POINTSThe format for linking the patient, the problem, and nursing practice was nursing rounds. Each class day began with a nursing round focused on an assigned topic for the day: growth and development, pulmonary, cardiovascular, gastrointestinal, fluid and electrolytes, integumentary, resuscitation of a burn patient, or nutritional/metabolic and psychosocial needs. A student assessed the assigned patient, reviewed existing patient data, identified the appropriate nursing diagnoses, and recommended changes to the existing plan of care. A concept map (a schematic representation of the relationship of defining characteristics, related factors, and nursing interventions) was developed as an adjunct tool to diagram the desired components. The presentations were made to senior nursing staff and preceptors who critiqued the work and provided other feedback.CONCLUSIONSThis educational process was a guided learning activity with multiple benefits, including incorporation of critical thinking into practice by individualizing the plans of care and recognizing relationships between nursing theory and practice. The unexpected benefits were the increased presence of the nurturing role by senior staff, increased familiarity of students with other staff members, and increased awareness of the plan of care by all staff. A future study of this process includes outcome evaluation as it is incorporated into daily practice for senior as well as novice nurses.
Nursing Classification Language to Describe Family Presence During Resuscitation and Invasive Procedures
Authors: Lamont Scott Chisholm 
Published: August 2004

PURPOSETo suggest appropriate classification labels and definitions that accurately reflect family presence.METHODSBased on a comprehensive review of the literature, content analysis of selected case studies was performed. Themes and details were identified. Concept analysis was then performed sequentially for the implied nursing diagnoses, outcomes, and interventions to determine labels and definitions, based on the discovered themes and details.FINDINGSFamily nursing care is oriented toward diagnosis and treatment of family responses to illness within the family unit. It is clear from the current literature that many families wish to be present when a family member undergoes resuscitation; however, no nursing diagnosis exists for this identifiable response to an acute crisis within the family unit. Based on the data gathered, a family nursing diagnosis, “supportive family,” is proposed. Taxonomically this diagnosis best fits in the Role Relationships domain of the NANDA Taxonomy II. Additionally, a new label needs to be created in NIC within the Family domain, under the class of “life span care” labeled family presence facilitation. The goal of family presence facilitation as a family systems nursing intervention is to ease normal grieving, support normal family coping, and empower families. NOC includes several outcomes that may be appropriate for evaluating individual and family responses to family presence facilitation; however, an outcome focused on the specific assessment findings diagnostic of a supportive family, labeled Family Member Support, within the Family Health domain is proposed.CONCLUSIONSFurther research must be done to validate the nursing classification language appropriate for this practice. Additionally, research using these proposed terms must be performed to demonstrate both clinical usefulness and the outcomes actually achieved. A method for tracking outcomes and identifying problems must be developed, and the data captured must be broadly shared.
Utilization of Nursing Diagnoses by Students During a Pediatric Nursing Course in Turkey
Authors: Erdemir Firdevs 
Published: August 2004

PURPOSETo determine the utilization of nursing diagnoses by nursing students and their ability to formulate the NANDA nursing diagnoses under the functional health patterns to evaluate whether there is a link between documented nursing diagnoses and patients' assessment data.METHODSData were obtained from the standardized nursing assessment forms and care plans documented by 57 nursing students in a pediatric nursing course. A total of 569 care plans were documented for patients (children and their families).FINDINGSFor 569 children in 3 different pediatric clinics, 70 different nursing diagnoses were documented. Some of the nursing diagnoses were used in various frequencies for a total of 3,433 documented diagnoses in Nutrition‐Metabolic (n= 1,274), Activity‐Exercise (n= 594), Cognition‐Perception (n= 572), Role Relationships (n= 330), and Health Perception‐Health Management (n= 327) Health Patterns. The most frequently occurring NANDA diagnoses were knowledge deficit (n= 275), altered nutrition: less than body requirement (n= 265), risk for altered body temperature (n= 263), anxiety (n= 236), and altered comfort (n= 227).CONCLUSIONSThe majority of the students had adequate knowledge and ability to formulate nursing diagnoses according to NANDA, but documented diagnoses were not always supported by patients' assessment information. This might be a result of the inadequate diagnostic reasoning and teaching methods used, and being introduced to the diagnostic process for the first time in this course. Ultimately, consistent expectations and using the classification systems will lead to competency in diagnostic reasoning.
Implementation of Standardized Nursing Language at a University
Authors: Powelson Stephanie , Leiby Kristen 
Published: August 2004

PURPOSETo evaluate the implementation of the standardized nursing languages (SNL) of NANDA, NIC, and NOC at a midwestern baccalaureate nursing program over four years.METHODSNursing faculty developed 6 items to rate responses using a Likert‐type scale (1 = low to 5 = high.) Two open‐ended questions were included. Faculty and student evaluations shared 4 common items, while 2 items were slightly different. Respondents' evaluations (juniors, seniors, and faculty) over 4 years were compared. Each year approximately 10 faculty and 60 students responded to the survey.FINDINGSRespondents rated the use of SNLs as follows: helpful as a resource (mean ≥4.0), pertinent to the course (mean ≥3.8), pertinent to clinical (mean ≥4.0), and compatible with Watson's Caring Theory (mean ≥4.0). Over 4 years, faculty members' ratings have increased while students' ratings have slightly decreased. Comments revealed the need for additional orientation and more in‐depth discussion about relating SNLs to individualized patient care.CONCLUSIONSContinued research at this university, at other schools of nursing, and in practice settings is needed to evaluate student and faculty satisfaction after introducing standardized nursing languages in planning and documenting patient care.
Itinerant Group: An Innovative Proposal for the Study of Nursing Diagnosis
Authors: Almeida Miriam de Abreu , Araújo Valéria Giordani 
Published: August 2004

BACKGROUNDA nursing diagnosis study group was created in 1994 as a university extension activity organized by professors of the Nursing School of Universidade Federal do Rio Grande do Sul, in the south of Brazil. Nurses and professors met weekly to exchange information and promote discussion about nursing care, with emphasis on nursing diagnosis. In 1996 the group linked to the Brazilian Nursing Association Section in order to expand this work to the professional community.MAIN CONTENT POINTSThis group committed itself to organize meetings open to all the nursing professionals interested in exchanging experiences about nursing care and nursing diagnosis, through the presentation of case studies and papers. In order to facilitate participation and integration of professionals from different health institutions and nursing schools, an itinerant group was formed. From 1999 to 2000 meetings were held in seven different hospitals in the city. The number of participants varied from 19 to 40 people and included students, nurse helpers, and technicians from 6 universities and 15 healthcare institutions.CONCLUSIONSThis experience has been successful in spreading the use of and discussing nursing diagnosis. After a period without meetings, the group will restart in 2002.