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With rapid advancements in sciences and the expanding scope of nursing practice, faculty are challenged to connect the experiences of learners with abstract concepts of science and to cultivate clinical reasoning skills. Rationale for the adoption of the illness-wellness continuum model includes the following: (a) the relationships among illness, health, and the nursing process are relevant in many health situations, and (b) levels of wellness are steeped in holistic principles of self-care, which are consistent with educational and clinical goals. The modified version of the illness-wellness continuum model can serve as the groundwork that prepares nursing students in a constantly changing workplace. [ABSTRACT FROM AUTHOR]

Purpose Data sources Data synthesis Conclusions Implications for nursing practice To analyze the diagnostic concept of “ineffective coping” (00069) proposed by NANDA‐I, using Walker and Avant's framework.The theoretical framework of Walker and Avant was used for the concept analysis. A search was performed in the Virtual Health Library portal using the keywords “ineffective coping” and “enfrentamento ineficaz.”According to the literature, ineffective coping is defined as an adoption of inadequate psychosocial and behavioral strategies in response to a set of contextual stressors that negatively affect well‐being and lifestyle.The concept created for ineffective coping has the potential to address the psychosocial elements associated with life experiences in the face of coping mechanisms.This analysis may contribute to the improvement of nursing care for patients experiencing difficult situations in their lives, as well as the challenges of nursing interventions that promote positive adaptation. [ABSTRACT FROM AUTHOR]

Purpose Methods Findings Conclusions Implications for nursing practice To discuss the midwifery scope of practice within the NANDA‐I taxonomy.Review of the NANDA‐I taxonomy followed by critical analysis of the nursing diagnoses (NDs) within the scope of midwifery practice. Search terms were defined. Two authors independently analyzed all diagnoses, and another author validated the results.Of the 267 NDs in the NANDA‐I taxonomy, 39 (14.6%) perceived a relationship with midwifery's scope of practice, and among these, 15 (5.6%) guaranteed greater specificity and accuracy for clinical reasoning.The suitability of NDs for the broad spectrum of the midwifery scope of practice may need to be completed. Women's responses to life events and health conditions are simultaneously complex and specific, and many NDs in the NANDA‐I terminology may be far from fully identified and developed to represent these responses.Improvements in NANDA‐I diagnosis would contribute to advanced terminology and increased specificity and accuracy of the diagnostic process. This is important in achieving appropriate outcomes and safe and effective interventions for which the nurses and nurse‐midwives are accountable. Many NDs would not necessarily be used in any other context since they are specific to midwifery; however, it would help to develop a NANDA‐I taxonomy that is more inclusive and comprehensive internationally. [ABSTRACT FROM AUTHOR]

Introduction. Increased life expectancy leads to consequent long-term care needs, where informal caregivers may experience overload and strain associated with caregiving, influencing the well-being and health of individuals and eventually leading to an effort to fulfill their role. Within this context, a condition called caregiver role strain has been identified. Objective. To investigate the clinical indicators of the nursing diagnosis caregiver role strain as described in the literature. Materials and Methods. This study is a systematic review of diagnostic accuracy conducted in October 2023, following the recommendations of the Joanna Briggs Institute. The review protocol was registered and approved in the Prospective International Register of Systematic Reviews under registration number CRD42022377411. The QUADAS-2 tool was used to assess the risk of bias and quality of the studies. The databases included SciVerse Scopus (Elsevier), MEDLINE/PubMed (via National Library of Medicine), Latin American and Caribbean Health Sciences Literature (LILACS), CINAHL with Full Text (EBSCO), and PsycINFO (APA), with 48 articles included for quantitative synthesis. Results. Fourteen defining characteristics were identified from the literature, with a predominance of the following indicators: depressive symptoms (45.8%), anxiety (41.6%), physical decline (31.2%), fatigue (22.9%), disturbed sleep pattern (20.8%), emotional disturbance, and irritability (16.6%). The findings suggest that, within the defined circumstances and limitations of the study, examining defining characteristics for the diagnosis caregiver role strain holds potential for advancing scientific knowledge regarding human responses to the challenges experienced by caregivers. Evidence for Practice. The study aligns with clinically relevant indicators crucial for refining and updating the diagnosis, thereby enhancing its level of evidence and clinical accuracy. Simultaneously, it supports addressing the gap in caregiver support and standardized nursing care plans. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions Implications for nursing practice To assess clinical–causal validity evidence of the nursing diagnosis, risk for unstable blood glucose level (00179), in individuals with type 2 diabetes mellitus.A case–control study was conducted in 5 primary healthcare units, involving 107 subjects with type 2 diabetes mellitus, 60 in the case group and 47 in the control group. Causality was determined by the association between sociodemographic and clinical factors, risk factors related to the nursing diagnosis, and the occurrence of unstable blood glucose level. An association was considered when the risk factor had a p‐value of <0.05 and odds ratio >1.Risk factors, such as stress, inadequate physical activity, and low adherence to therapeutic regimen, were prevalent in the sample. Time since diagnosis between 1–5 and 6–10 years, multiracial ethnicity, and the risk factor of low adherence to therapeutic regimen increased the likelihood of the outcome. Completion of high school education was identified as a protective factor.The clinical validation of the nursing diagnosis, risk for unstable blood glucose level, has been successfully established, revealing a clear association between sociodemographic and clinical factors and the risk factors inherent to the nursing diagnosis.The results contribute to advancing scientific knowledge related to nursing education, research, and practice and provide support for the evolution of nursing care processes for individuals with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Purpose Methods Findings Conclusions Implications for nursing practice This study aims to conduct a thorough analysis of the concept of insufficient health literacy (IHL) in older adults and to refine a nursing diagnosis proposal while considering the specific characteristics of this demographic.A comprehensive concept analysis was undertaken using Walker & Avant's method as a framework.A systematic search across seventeen databases yielded 29 relevant studies for inclusion. Through analysis, we identified 15 antecedents, 3 attributes, and 7 consequents associated with IHL in older adults.The concept analysis brought clarity to the understanding of IHL within older adults, facilitating the refinement of a diagnosis proposal. This process was instrumental in establishing a diagnostic structure that accounts for the unique needs and challenges faced by older adults.The structured diagnosis derived from the concept analysis provides a solid theoretical foundation for nurses specializing in Gerontology. By tailoring care interventions to address the specific requirements of older adults, this framework enhances the quality of nursing practice and contributes to improved patient outcomes in geriatric care settings. [ABSTRACT FROM AUTHOR]

Purpose Methods Findings Conclusions Implications for nursing practice Nurses’ clinical reasoning skills regarding impaired swallowing can help prevent patient complications and maintain quality of life. Clinical reasoning skills need content‐validated defining characteristics (DCs). We aimed to validate the content of these DCs for nursing diagnosis “impaired swallowing.”Content validation of the DCs was performed by 275 dysphagia nursing experts in Japan, using 3 rounds of the Delphi technique and Fehring's Diagnostic Content Validation (DCV) model. Three rounds of questionnaires on 84 DCs were completed via printed mail.The valid response rates for each round were as follows: round 1, 90.2%; round 2, 77.8%; and round 3, 71.3%. Of the 84 DCs, 77 that met the consensus criteria were categorized as major (n = 18), minor (n = 45), and excluded (n = 14). There were four minor DCs other than the oral, pharyngeal, and esophageal phases. DCs listed from outside NANDA‐I included 12 major, 16 minor, and 3 excluded characteristics. Of the NANDA‐I DCs, 5 were no consensus and 11 were excluded. The total DCV score for the 63 major and minor DCs was 0.8.Our results recommend the addition of 28 DCs and the exclusion of 11 for the NANDA‐I nursing diagnosis “impaired swallowing” (00103). Major DCs were prominent indicators of impaired swallowing and signs of aspiration or pharyngeal residuals. Minor DCs included not only the three phases but also other signs necessary for a comprehensive understanding of impaired swallowing.This validation study strengthens the clinical usefulness of the DCs for impaired swallowing, which can improve nurses’ clinical reasoning skills. Major and minor DCs can increase the awareness of impaired swallowing and enable accurate intervention, thereby preventing patient complications and maintaining quality of life. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to evaluate the hospitalization diagnoses and nursing diagnoses of the refugee and local population hospitalized in internal medicine clinics, which are especially important in the early diagnosis, treatment, and rehabilitation of chronic diseases, and to emphasize their importance in nursing care. Methods: The study was carried out in a descriptive retrospective design. The files of 3563 patients admitted to the internal medicine clinic of a training and research hospital in Türkiye in 2022 were evaluated. SPSS 26.0 program was used for data analysis. Results: In the study, 95.3% of hospitalizations were native and 4.7% were refugee patients. It was determined that refugee patients admitted to the internal medicine service had a lower mean age compared to the native population (p < 0.05), but there was no difference in the duration of hospitalization (p > 0.05). When the medical diagnoses of hospitalization were examined, it was determined that the highest number of hospitalizations in the native and refugee populations were for bacterial infections in both genders. In nursing diagnoses, it was determined that both populations and genders were diagnosed with infection risk by the medical diagnoses of the patients. Conclusion: As a result of the study, it was observed that the duration of hospitalization, reasons for hospitalization, and nursing diagnoses of local and refugee patients were similar. In addition, it was determined that the patients' medical hospitalization diagnoses and nursing diagnoses were compatible. [ABSTRACT FROM AUTHOR]

Aim Design Methods Data sources Results Conclusion Objetivo Diseño Métodos Fuentes de datos Resultados Conclusión This research quantitatively explored the prevalence of NANDA‐I nursing diagnoses related to the care of patients experiencing heart failure.A systematic review and meta‐analysis were conducted with the systematic review protocol registered in PROSPERO (registration number: CRD42022382565).Systematic searches were performed between March and April 2022, including peer review for selection, quality assessment, data extraction, and analysis of all included studies. A subsequent meta‐analysis was performed, focusing on the proportion of nursing diagnoses in patients with heart failure. The logistic random effects model with maximum likelihood estimation assessed the combined proportion, and heterogeneity between studies was evaluated using the I2 statistic. The goodness‐of‐fit of the meta‐analysis results was assessed using the leave‐one‐out method and by evaluating publication bias through contour‐enhanced funnel plots.PubMed, SCOPUS, CINAHL, WOS, and Embase were used.Of the 11 studies that met the eligibility criteria, 44 nursing diagnoses were identified as most frequently occurring in patients experiencing heart failure, and only 16 diagnoses appeared in more than one publication. The combined mean proportion was 35.73% (95% CI = [26.67%; 48.56%]), indicating the presence of heterogeneity based on the I2 value. However, no publication bias was observed.The results of the meta‐analysis suggest priority diagnoses in individuals with heart failure, such as deficient knowledge (00126). Additionally, secondary diagnoses, such as activity intolerance (00092), excess fluid volume (00026), and ineffective breathing pattern (00032), were identified as responses to decreased cardiac output (00029). Less prevalent nursing diagnoses were associated with deterioration of health status and the need for hospitalization.Investigar cuantitativamente la prevalencia de diagnósticos de enfermería NANDA‐I asociados con la atención de pacientes con insuficiencia cardíaca.Revisión sistemática y metanálisis. El protocolo de revisión sistemática quedó registrado en PROSPERO) número de registro: CRD42022382565).Se realizaron búsquedas sistemáticas entre marzo y abril de 2022, llevándose a cabo una revisión por pares sobre la selección, evaluación de calidad, extracción de datos y análisis de todos los estudios incluidos. Se realizó un metanálisis posterior centrado en la proporción de diagnósticos de enfermería en pacientes con insuficiencia cardíaca. El modelo logístico de efectos aleatorios con estimación de máxima verosimilitud evaluó la proporción combinada y la heterogeneidad entre los estudios se evaluó mediante el estadístico I2. La bondad de ajuste de los resultados del metanálisis se evaluó mediante el método Leave‐one‐out y la evaluación del sesgo de publicación mediante gráficos de embudo (funnel plot), denominado Contour‐Enhanced Funnel Plot.PubMed, SCOPUS, CINAHL, WOS, Embase.En los 11 estudios que cumplieron con los criterios de elegibilidad, se identificaron 44 diagnósticos de enfermería aunque sólo 16 diagnósticos aparecieron en más de una publicación. La proporción media combinada fue del 35,73% (IC del 95%) = [26,67%; 48,56%]), y el valor de I2 indica la presencia de heterogeneidad, aunque no hay sesgo de publicación.Los resultados de este metaanálisis indican que habría diagnósticos prioritarios en personas con insuficiencia cardíaca, como Conocimientos deficientes (00126). Además, se han identificado otros diagnósticos de enfermería como diagnósticos secundarios: Intolerancia a la actividad (00092), Exceso de volumen de líquidos (00026) y Patrón respiratorio ineficaz (00032), que sería la respuesta a Disminución del gasto cardíaco (00029). Además de diagnósticos de enfermeríaa menos prevalentes relacionados con el deterioro del estado de salud y la necesidad de hospitalización. [ABSTRACT FROM AUTHOR]

Aggression and violence influence nurse-client relationships and the quality of care provided, and just as important, they also influence the nurses' physical and emotional well-being. The Neuman systems model is utilized to define and understand factors that contribute to aggressive and violent behavior and for the purposes of providing a systematic approach to the prevention and management of stressors leading to aggression and violence. [ABSTRACT FROM AUTHOR]

Introduction: Nursing care left undone occurs when nurses omit activities because of resource shortfalls. Higher levels of nursing care left undone are associated with worse nurse staffing and organizational factors. Plentiful evidence from acute, long‐term and community care supports such associations; however, mental healthcare settings are under‐studied. Aim: The aim of the study was to describe nursing care left undone's frequency in mental health inpatient settings and explore its association with nurse staffing levels. Method: As part of the multi‐centre cross‐sectional MatchRN Psychiatry study, data were collected by questionnaire from 114 units in 13 Swiss psychiatric hospitals. Nursing care left undone was analysed describing frequencies descriptively and used linear mixed models to assess its association with staffing. Results: Data from 994 nurses were analysed. The most commonly omitted activities were evaluating nursing processes (30.5%), formulating nursing diagnoses (27.4%) and defining care objectives (22.7%). Nursing care left undone was higher in units with low staffing levels. Discussion: As in somatic care settings, in psychiatric hospitals, 'indirect' care activities are most commonly omitted. Implications for Practice: This study highlights factors affecting the frequency of nursing care left undone, including staffing levels and perceived leadership. The findings emphasize the importance of nurse managers taking action to improve work environment factors. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to identify NANDA‐I nursing diagnoses that midwives working in obstetrics and gynecologic service use while managing the electronic nursing care process. Methods: This retrospective study was conducted in a descriptive way to evaluate electronic care plan records of 3025 patients staying in obstetrics and gynecologic service between April 1, 2020. and April 1, 2021. Diagnoses in the records of the electronic care process were digitalized by two faculty members. Then, NANDA‐I nursing diagnoses used by midwives were identified. NANDA‐I nursing diagnoses used by midwives were identified. Findings: It was determined that diagnoses in care plans documented from the system within the 1‐year period fell into eight domains and 10 classes, and 5819 diagnoses were given in total. The most frequent diagnoses given in obstetrics and gynecologic service were "acute pain" and "risk for bleeding." Conclusion: Findings of this study revealed that nursing care records in obstetrics and gynecologic service did not have a large number of diagnoses and interventions. Implications for nursing practice: Care plans directly reflect the contribution of the care to the patient. Consequently, midwives being aware of and recording nursing diagnoses while giving care will ensure a standardized language and visibility in care. More coverage of midwifery‐related diagnoses in the midwifery curriculum will make NANDA‐I nursing diagnoses more visible in midwifery as well. [ABSTRACT FROM AUTHOR]

Purpose: The coronavirus disease 2019 (COVID‐19) generates long‐term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post‐COVID‐19 conditions. Methods: This was a case–control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID‐19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS. Findings: This study included 120 individuals. Prolonged days of isolation (p = 0.005), fear (p < 0.001), stress overload (p < 0.001), and impaired rehabilitation (p = 0.003) were significantly associated with CPS. Conclusions: A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS. Implications for nursing practice: The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post‐COVID‐19 conditions, in addition to promoting the use of the NANDA‐International taxonomy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the accuracy of defining characteristics and causal relationships of the etiological factors of the nursing diagnosis deficient knowledge in individuals with heart failure. Data sources: An analytical, cross‐sectional study on the diagnostic accuracy of the defining characteristics and causal relationships of the etiological factors of the nursing diagnosis. The sample consisted of 140 patients with chronic HF and in outpatient follow‐up. The latent class analysis method was used to test the accuracy of measurements and estimate the prevalence of the diagnosis. The calculation of subsequent probabilities and the odds ratio (were also parameters employed. The study was approved by the Research Ethics Committee of the Federal University of Pernambuco. Data synthesis: The diagnosis had an estimated prevalence of 38.57% in the sample. The inaccurate statements about the disease and/or therapy, self‐care deficient performance, and inadequate behavior were the clinical indicators that best predicted the presence of the diagnosis and demonstrated the same sensitivity value (1.0000), specificity (1.0000), and 95% confidence interval (0.9999–1.0000) for all. The populations at risk was elderly (OR = 2.12, confidence interval 95% = 1.05–4.27), and illiterate individuals (OR = 2.07, confidence interval 95% = 1.03–4.16) had an approximately twofold great chance of developing havening deficient knowledge. Conclusion: The evaluation of the accuracy of clinical indicators, corresponding to the defining characteristics in the study, contributed to screening and diagnostic establishment capacity in clinical practice, and to the translation of theoretical and practical knowledge. Implications for nursing practice: Accurate clinical indicators of the nursing diagnosis deficient knowledge facilitate the clinical reasoning of nurses and favor the professional's role in the development of health education strategies focused on the acquisition of knowledge about the disease by patients, family members, and caregivers. [ABSTRACT FROM AUTHOR]

Purpose: This research was planned to follow the healing process of the oral mucosa in patients in intensive care with an "Impaired Oral Mucous Membrane Integrity" nursing diagnosis based on the "NOC (1100) Oral Health Assessment" outcome criteria. Method: This study, which was planned in a methodological and descriptive type of research, was carried out with 50 patients who were hospitalized in the intensive care clinic of a state hospital between June and December 2022, with a nursing diagnosis of "Impaired Oral Mucous Membrane Integrity." Data were collected using a Patient Information Form and the "NOC (1100) Oral Health Evaluation Scale" for the nursing outcomes classification. In the analysis of the data descriptive statistical methods, Pearson correlation test, Friedman test as well as Cohen's kappa test were used to evaluate the agreement between two independent observers. Findings: In the study, content validity index value of the NOC scale was calculated to be 0.90. The examination of the participants' mean scores on the NOC (1100) Oral Health Assessment Scale showed that there were statistically significant differences in terms of the repeated evaluations, except for the NOC indicators of "Oral mucosal integrity," "Gum integrity," and "Tooth integrity" (p < 0.01). No statistically significant correlation was found between the mean NOC scale scores of the patients according to the variables of age, body mass index, mechanical ventilation time, and length of stay in the intensive care unit (p > 0.05). Conclusions: The findings showed that the Turkish version of NOC (1100) Oral Health Assessment Scale was a valid tool for monitoring the healing process of the oral mucosa in patients in intensive care. Implications of nursing practice: With the use of NOC (1100) Oral Health Assessment Scale, a common language will be formed in the evaluation for monitoring the healing process of the oral mucosa in nursing care. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to develop and validate a case study to aid in the diagnostic reasoning of nursing students and nurses. Methods: It is a validation study using a case study based on Lunney's method including (1) content validation of the case study by nurse experts through the Delphi technique, (2) identification of nursing diagnoses (NDs) in the case, (3) evaluation of diagnostic accuracy, and (4) establishment of a priority diagnosis by nurse experts. Findings: The case study was developed from the findings of a narrative literature review on the cues of the NDs with a prevalence > 50% in patients with peripheral arterial occlusive disease. Two rounds of expert evaluation were required to validate the case study. The experts identified 18 NDs with different degrees of accuracy. The highly accurate diagnoses most frequently identified by the experts were: Ineffective peripheral tissue perfusion (100%), impaired walking (83%), impaired comfort (50%), and chronic pain (50%). The diagnosis considered a priority by all experts was ineffective peripheral tissue perfusion. Conclusions: The case study was developed and had its content validated. High‐accuracy diagnoses were identified, and a priority was determined. Implications for Nursing Practice: The validated case study may be used by students and nurses to facilitate the development of diagnostic reasoning and critical thinking in practice, teaching or research. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe the use of the nursing diagnosis Risk for Falls in Primary Care System of the Community of Madrid. Methods: A retrospective review of the clinical histories was carried out in 262 health centers from January 2005 to December 2015. The study population are the patients who have recorded in their electronic health record the nursing diagnosis Risk for Falls. Findings: Frequency of use of the Risk for Falls ND in the Community of Madrid was 53,340 diagnoses, increasing from 650 nursing diagnosis in 2005 to 14,695 in 2015. NOC Nursing Outcomes total identified were 109,145, which represents an average of 2.05 NOC Nursing Outcomes per diagnosis. NOC Nursing Outcomes frequently appeared as follows: Fall Prevention Behavior (35.9%), Safe Home Environment (11.3%), and Risk Control (10.5%). NIC Nursing Interventions total identified were 104,293, representing an average of 1.96 NIC nursing interventions per diagnosis. NIC Nursing Interventions frequently appeared as follows: Fall Prevention (45.9%), Environmental Management: Safety (27%), and Risk Identification (5.8%). Conclusions: Nursing diagnosis of Risk for Falls and the care process related to this diagnosis is starting to be used by the primary care nurses of the Community of Madrid. Implication for nursing practice: Risk factors related to the nursing diagnosis of risk for falls identified in our study can be addressed with activities that nurses must implement to prevent falls. Nursing methodology in general and specifically the diagnosis of risk for falls must be included in guides and protocols for the prevention of falls, and its use should be promoted by primary care nurses. [ABSTRACT FROM AUTHOR]

Background and aims. The introduction of accreditation criteria for hospitals has generated increased interest in applying the nursing process to clinical practice and developing nursing care plans. Nursing diagnosis plays a pivotal role in the formulation of these care plans. The objective of the study is to investigate the correlation between nursing diagnosis education and nurses' intentions, attitudes toward the use of nursing diagnosis and the behavior in using it in practice; to explore the differences between nurses' intentions, attitudes and behavior, considering nurses' socio-demographic and professional data. Methods. A cross-sectional design was used. A web-based survey was applied to gather data. A sample of 664 hospital nurses was recruited from five Romanian hospitals. Results. Education on nursing diagnosis showed significant results in relation to nurses' intentions (F(2,126.35) = 23.99, p < 0.001), attitudes (χ2 (2, N = 664) = 44.62, p < 0.001) and behavior (F(2,167.69) = 29.53, p < 0.001) in using it in clinical practice. Nurses with education highly focused on nursing diagnosis have significantly stronger intention to use it, more positive attitudes and higher behavior in using it in clinical practice compared to nurses whose education simply had included a nursing diagnosis course, or nurses without any education on the topic. Significant differences were identified in intention (t (83.86) = -4.49, p < 0.001) and attitudes (U = 12697.50, z = - 3.99, p < 0.001, r = -0.0006) of management nurses compared to clinical nurses. Conclusion. Nursing education on nursing diagnosis significantly impacts nurses' intentions, attitudes, and behavior in their daily practice. Romanian nurses display slightly positive intention and attitudes toward nursing diagnosis but need more training for effective/practical clinical application. [ABSTRACT FROM AUTHOR]

The previous article discussed the pathophysiology involved in disorders of the nervous system. Having considered some of the most prevalent disorders, this second part uses a case study to explore effective patient assessment and emphasise the importance of facilitating patient self-management for improved outcomes. By addressing these key aspects, nursing professionals can enhance the quality of care and the support provided to individuals experiencing neurological disorders. [ABSTRACT FROM AUTHOR]

Climate change, an urgent public health problem, will increase the morbidity and mortality of older adults. The 2020 report of The Lancet Countdown highlighted that older adults are susceptible to the effects of extreme weather events, including heatwaves. Through the lens of the socio-ecological model, we identified influences on persons at risk for heat-related illnesses. We applied the Heat-related Intolerance Screening Tool (HIST) to a case that demonstrates the impact of physical, social, environmental, and societal factors on older people. The hypothetical case provides a context for ambulatory care nurses to explore innovative ways to screen for heat intolerance to mitigate the risk of heat-related illnesses, such as heat stroke. Our innovation supports the broad utility of the simple HIST by ambulatory care nurses to identify and prevent heat-related illnesses, thereby reducing emergency room visits and hospital admissions. [ABSTRACT FROM AUTHOR]

This study was aimed at investigating the effect of standardized patient simulation training on getting nursing students to gain care providing skill for the individual diagnosed with dementia. The study is a randomized controlled trial. Training was provided to the experimental group (n = 36) through patient simulation method, while the control group (n = 35) was trained through standard curriculum. As a result of simulation training, it was determined that the experimental group students' communication skills, ability to evaluate cognitive capacity, and ability to identify nursing diagnoses and interventions suitable for the individual diagnosed with dementia were higher compared to those of the control group students (p <.05). It was concluded that simulation training was effective in getting nursing students to gain care providing skill for the individual diagnosed with dementia [ABSTRACT FROM AUTHOR]

HIV disproportionately affects the South compared to other regions of the US. Some people living with HIV (PLWH) may acquire HIV-associated neurocognitive disorders (HAND), of which HIV-associated dementia (HAD) is the most severe form. This study aimed to examine the disparities in mortality among individuals with HAD. Data were obtained from the South Carolina Alzheimer's Disease and Related Dementias Registry from 2010 to 2016 (HAD: n = 505; N = 164,982). Logistic regression and Cox proportional hazards models were used to determine mortality related to HIV-associated dementia and potential sociodemographic differences. Adjusted models controlled for age, gender, race, rurality, and place of diagnosis. Individuals diagnosed in a nursing facility were three times more likely to die with HAD compared to those diagnosed in the community (OR: 3.25; 95% CI: 2.08–5.08). Black populations were more likely to die with HAD compared to White populations (OR: 1.52; 95% CI: 0.953-2.42). Disparities in mortality among patients with HAD were found in place of diagnosis and by race. Future research should determine if mortality among individuals with HAD were as a result of HAD or non-HIV related decline. [ABSTRACT FROM AUTHOR]

Purpose Method Findings Conclusions Implications for nursing practice To analyze evidence of content validity of the nursing diagnosis (ND) Risk for Unstable Blood Pressure in incarcerated women. A methodological study assessing the content validity of an ND, was performed in Brazil, between June and September 2022, with 49 nurses as experts. The label, definition, and relevance of the 19 risk factors of the ND Risk for Unstable Blood Pressure were appraised. Based on the predictive diversity model, the content validity index (CVI) and respective 95% confidence intervals were calculated for each risk factor. A CVI ≥ 0.8 was considered adequate evidence of content validity.The label and the definition of the diagnosis was reformulated. The relevance of 19 etiological factors showed a CVI ≥ 0.8. According to the recommendation of the panel of experts, one of the etiological factors was split in two and two label of etiological factors were changed.A new label (Risk for Imbalanced Blood Pressure), new definition, and 20 etiological factors (11 risk factors, five associated conditions, and four at‐risk populations) of the ND Risk for Unstable Blood Pressure in incarcerated women were considered valid.NANDA‐I accepted the proposal for this nursing diagnosis; hence this study contributed to updating the classification based on scientific evidence. This evidence will favor diagnostic reasoning and recognition of the diagnosis during clinical assessment, and support studies assessing the clinical validity of these elements in incarcerated women. [ABSTRACT FROM AUTHOR]

Background: This study aimed to understand the experiences of nurses working in the integrated nursing care service, a relatively recent addition to the Korean hospital infrastructure, to suggest ways in which to address their grievances and needs and improve their job satisfaction, thereby reducing turnover. Methods: This study adopted a qualitative approach to explore subjects' vivid experiences. Data were collected through in-depth interviews with 17 nurses with over one year of experience working in integrated nursing care wards. The main question asked was "Can you describe your experiences in the integrated nursing care ward?" All interviews were recorded, transcribed, and analyzed using Colaizzi's method for phenomenological research. Results: Six theme clusters were derived from the analysis: "distorted perceptions of the integrated nursing care ward," "challenges owing to distorted perceptions of the integrated nursing care ward," "loneliness and fighting alone," "being ridiculed," "practicing textbook holistic care," and "the satisfaction felt only in the integrated nursing care ward." For the overarching theme, we identified "Satisfaction in providing holistic care despite the challenges." Conclusions: While working in the integrated nursing care ward, nurses practiced holistic nursing care, which in turn built their self-esteem. However, they experienced greater levels of stress as a result of misinformation. Therefore, dissemination of accurate information is necessary to correct public misunderstandings of the integrated nursing care wards. Further, adequate compensation and support systems are needed to relieve the stress nurses felt because of such misunderstandings. Additionally, nurses should be motivated to continue to provide quality care for the patients and take pride in their work. Future research should explore the physical and mental concerns of nurses working in integrated care wards. [ABSTRACT FROM AUTHOR]

Aim Design Methods Findings Conclusions Implications for Nursing Practice Impact Reporting Method Patient or Public Contribution To analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.A methodological study with a quantitative approach was performed.The analysis was performed between January and May 2021 by 34 nurses with clinical/theoretical/research experience with diabetes or nursing diagnoses. These nurses evaluated the relevance, clarity and precision of 12 diagnosis‐specific etiological factors, 22 clinical indicators and their conceptual and operational definitions.All 12 etiological factors analysed were considered relevant to diagnostic identification. However, five showed inconsistencies regarding the clarity or precision of the operational definitions, requiring adjustments. Regarding the 22 clinical indicators evaluated, all of them presented a Content Validity Index (CVI) that was statistically significant. However, in the indicators, the colour does not return to lowered limb after 1 min of leg elevation, and cold foot had Content Validity Index (CVI) <0.9 regarding relevance and accuracy of operational definitions.Twelve etiological factors and 22 clinical indicators were validated. Thus, this study revealed new and relevant aspects characterising peripheral perfusion in patients with diabetic foot that have not yet been clinically validated.This study contributes to support the professional practice of nurses through the early identification of etiological factors and clinical indicators in persons with diabetic foot. As a proposal, we suggest the inclusion of new defining characteristics and related factors for the nursing diagnosis ineffective peripheral tissue perfusion in the NANDA‐I taxonomy.The research highlights new and relevant aspects such as etiological factors and clinical indicators to characterise peripheral perfusion in patients with diabetic foot. Based on these findings, clinical validation is recommended to confirm the relevance of the proposed elements in the population studied for greater reliability and improved diagnostic assessment for the professional practice of nurses.EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To describe the health literacy (HL) levels of hospitalised patients and their relationship with nursing diagnoses (NDs), nursing interventions and nursing measures for clinical risks. Design: Retrospective study. Methods: The study was conducted from December 2020 to December 2021 in an Italian university hospital. From 146 wards, 1067 electronic nursing records were randomly selected. The Single‐Item Literacy Screener was used to measure HL. Measures for clinical risks were systematically assessed by nurses using Conley Index score, the Blaylock Risk Assessment Screening Score, Braden score, and the Barthel Index. A univariable linear regression model was used to assess the associations of HL with NDs. Results: Patients with low HL reported a higher number of NDs, interventions and higher clinical risks. HL can be considered a predictor of complexity of care. Conclusions: The inclusion of standardised terms in nursing records can describe the complexity of care and facilitate the predictive ability on hospital outcomes. Implications for the profession and/or patient care: HL evaluation during the first 24 h. From hospital admission could help to intercept patients at risk of higher complexity of care. These results can guide the development of interventions to minimise needs after discharge. Patient or Public Contribution: No patient or public contribution was required to design or undertake this research. Patients contributed only to the data collection. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is Known on the Subject?: Artificial intelligence (AI) is freely available, responds to very basic text input (such as a question) and can now create a wide range of outputs, communicating in many languages or art forms. AI platforms like OpenAI's ChatGPT can now create passages of text that could be used to create plans of care for people with mental health needs. As such, AI output can be difficult to distinguish from human‐output, and there is a risk that its use could go unnoticed. What this Paper Adds to Existing Knowledge?: Whilst it is known that AI can produce text or pass pre‐registration health‐profession exams, it is not known if AI can produce meaningful results for care delivery.We asked ChatGPT basic questions about a fictitious person who presents with self‐harm and then evaluated the quality of the output. We found that the output could look reasonable to laypersons but there were significant errors and ethical issues. There are potential harms to people in care if AI is used without an expert correcting or removing these errors. What are the Implications for Practice?: We suggest that there is a risk that AI use could cause harm if it was used in direct care delivery. There is a lack of policy and research to safeguard people receiving care ‐ and this needs to be in place before AI should be used in this way. Key aspects of the role of a mental health nurse are relational and AI use may diminish mental health nurses' ability to provide safe care in its current form.Many aspects of mental health recovery are linked to relationships and social engagement, however AI is not able to provide this and may push the people who are in most need of help further away from services that assist recovery. Background: Artificial intelligence (AI) is being increasingly used and discussed in care contexts. ChatGPT has gained significant attention in popular and scientific literature although how ChatGPT can be used in care‐delivery is not yet known. Aims: To use artificial intelligence (ChatGPT) to create a mental health nursing care plan and evaluate the quality of the output against the authors' clinical experience and existing guidance. Materials & Methods: Basic text commands were input into ChatGPT about a fictitious person called 'Emily' who presents with self‐injurious behaviour. The output from ChatGPT was then evaluated against the authors' clinical experience and current (national) care guidance. Results: ChatGPT was able to provide a care plan that incorporated some principles of dialectical behaviour therapy, but the output had significant errors and limitations and thus there is a reasonable likelihood of harm if used in this way. Discussion: AI use is increasing in direct‐care contexts through the use of chatbots or other means. However, AI can inhibit clinician to care‐recipient engagement, 'recycle' existing stigma, and introduce error, which may thus diminish the ability for care to uphold personhood and therefore lead to significant avoidable harms. Conclusion: Use of AI in this context should be avoided until a point where policy and guidance can safeguard the wellbeing of care recipients and the sophistication of AI output has increased. Given ChatGPT's ability to provide superficially reasonable outputs there is a risk that errors may go unnoticed and thus increase the likelihood of patient harms. Further research evaluating AI output is needed to consider how AI may be used safely in care delivery. [ABSTRACT FROM AUTHOR]

Purpose Methods Findings Conclusion Implications for nursing practice To identify the prevalence of the nursing diagnosis of compromised end‐of‐life syndrome in patients in end‐of‐life care.This is a clinical validation based on a cross‐sectional epidemiological clinical study conducted at the National Cancer Institute in Rio de Janeiro, Brazil. The defining characteristics of a syndrome diagnosis were identified, defined as a “subset of nursing diagnoses,” using sensitivity and specificity measures through the application of latent class statistical methods.The statistical results revealed seven nursing diagnoses characterizing the syndrome: imbalanced nutrition: less than body requirements, nausea, anxiety, ineffective breathing pattern, disturbed sleep pattern, ineffective thermoregulation, and fatigue. Compromised end‐of‐life syndrome was present in 76% of the sample.The study demonstrated the presence of compromised end‐of‐life syndrome in most end‐of‐life patients from the sample.Recognizing the presence of the syndrome diagnosis enables nurses to have efficient and effective clinical reasoning for implementing the nursing process in palliative care. CAAE Number: 85415618.0.3001.5274. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications for the profession and/or patient care Impact Reporting method No Patient or Public Contribution To determine the prevalence and clustering of NANDA‐International nursing diagnoses in patients assisted by pre‐hospital emergency teams.Retrospective descriptive study of electronic record review.Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two‐step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020.Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six‐cluster solution (n = 26.788) was found. Five clusters had a single high‐prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co‐occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051).Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre‐hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases.Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre‐hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre‐hospital clinical setting.What problem did the study address? There are different models of pre‐hospital emergency care services. The use of standardized nursing languages in the pre‐hospital setting is not homogeneous. Studies on NANDA‐I nursing diagnoses in the pre‐hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA‐I nursing diagnoses in the pre‐hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance. Patients attended by pre‐hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact?Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre‐hospital setting, increasing the evidence of individualized and standardized care plans for pre‐hospital care.STROBE checklist has been used as a reporting method.Only patients' records were reviewed without further involvement. [ABSTRACT FROM AUTHOR]

Background: Euthanasia has been incorporated into the health services of seven countries. The legalisation of these practices has important repercussions for the competences of nurses, and it raises questions about their role. When a patient with advanced disease expresses a wish to die, what is expected of nurses? What are the needs of these patients, and what kind of care plan do they require? What level of autonomy might nurses have when caring for these patients? The degree of autonomy that nurses might or should have when it comes to addressing such a wish and caring for these patients has yet to be defined. Recognising the wish to die as a nursing diagnosis would be an important step towards ensuring that these patients receive adequate nursing care. This study-protocol aims to define and validate the nursing diagnosis wish to die in patients with advanced disease, establishing its defining characteristics and related factors; to define nursing-specific interventions for this new diagnosis. Methods: A prospective three-phase study will be carried out. Phase-A) Foundational knowledge: an umbrella review of systematic reviews will be conducted; Phase-B) Definition and validation of the diagnostic nomenclature, defining characteristics and related factors by means of an expert panel, a Delphi study and application of Fehring's diagnostic content validation model; Phase-C) Definition of nursing-specific interventions for the new diagnosis. At least 200 academic and clinical nurses with expertise in the field of palliative care or primary health care will be recruited as participants across the three phases. Discussion: The definition of the wish to die as a nursing diagnosis would promote greater recognition and autonomy for nurses in the care of patients who express such a wish, providing an opportunity to alleviate underlying suffering through nursing-specific interventions and drawing attention to the needs of patients with advanced disease. The new diagnosis would be an addition to nursing science and would provide a framework for providing care to people with advanced disease who express such a wish. Nurses would gain professional autonomy about identifying, exploring and responding clinically to such a wish. [ABSTRACT FROM AUTHOR]

Objective: to verify the content validity of the nursing diagnosis proposal Ocular dryness in adult patients admitted to an intensive care unit. Materials and methods: this is a methodological study of content validation of the nursing diagnosis proposal Ocular dryness, operationalized through a focus group. The selection of specialists took into account the clinical and/or academic experience in the area of nursing diagnoses and/or ocular dryness and/or dry eye and/or ocular health, as well as the time of performance with the theme. Thirteen nurses who met the criteria described above were invited, of whom 10 agreed to participate. The validation approach was by consensus. Data were analyzed using descriptive statistics, level of expertise and analysis of diagnostic elements. Results: after the final consensus of the nurse judges in relation to the diagnostic elements, a proposal of the diagnosis Ocular dryness was defined based on the validity of content with a new definition, 14 defining characteristics, 9 related factors, 2 populations at risk and 20 associated conditions. In addition, after judging the coherence of the elements in relation to the diagnostic structure, the judges issued the consensus in relation to the conceptual and operational definitions. Conclusions: the study allowed verifying the validity of the content by judges of the nursing diagnosis proposal Ocular dryness in patients in intensive care units, which favors the diagnostic reasoning of nurses and the planning of effective interventions related to this diagnosis, allowing the management of the patients in order to provide ocular integrity. [ABSTRACT FROM AUTHOR]

Aim: To determine the diagnostic accuracy of different methods currently available to identify infection in chronic wounds applicable to adult patients in a community setting. Design: Systematic review of diagnostic test accuracy studies. Review Methods: Two authors independently completed screening, data extraction and quality and bias assessments (QUADAS2). Eligible studies compared a method (index test) for detecting infection (diagnosis of interest) with microscopy and culture of either deep tissue biopsy or wound swab (reference test) in adult patients with wounds of >4 weeks duration (participants). The results were synthesized narratively. Data Sources: We systematically searched CINAHL, Embase and Medline from 2011 to April 2022. Results: Four studies were included, all recruiting from secondary care wound clinics. Two studies assessed the diagnostic accuracy of Moleculight i:X, a bacterial fluorescence imaging device against deep tissue biopsy culture. One study assessed the diagnostic accuracy of the elevation of various enzymes detected in wound fluid against wound swab microscopy of culture. One study assessed the diagnostic accuracy of bacterial protease activity against wound swab microscopy and culture. Sensitivities of these methods ranged from 50 to 75% and specificities from 47 to 100%. Conclusion: Only a small number of studies were included in this systematic review due to our strict inclusion criteria. We have not identified any methods for diagnosing infection in chronic wounds with either a sufficient quality of evidence to recommend their use in community settings at present. Further research is needed to develop and evaluate appropriate diagnostics for this purpose. Impact: This study highlights the paucity of research into wound diagnostics in a community setting and should prompt further research in this area. Accurate diagnostic tests have the potential to improve community‐based wound care by optimizing antibiotic use and potentially improving healing time. Reporting Method: PRISMA‐DTA checklist. Patient or Public Contribution: The PPI group for the NIHR Community Healthcare MIC were supportive of this topic of work. [ABSTRACT FROM AUTHOR]

Introduction: The lack of discussions on nursing care for pregnant women with sickle cell disease in Brazil and the urgent need for intervention and improvements in the nursing care provided to these women sparked this study. In addition, validity is an essential attribute for instruments used in research and/or clinical practice. Objective: To develop and validate an instrument covering the care of pregnant women with sickle cell disease. Materials and methods: This is a methodological, content validation study conducted with specialist judges. The instrument was structured with 19 nursing diagnoses that addressed the biological, psychological, and social dimensions, as well as 126 nursing interventions. The Delphi technique was used with the participation of 18 judges. The results were analyzed using the content validity index and a level of agreement above 0.80. Results: Of the 145 items analyzed, 22 (15.17 %) scored a content validity index < 0.80, and the adjustments suggested by the judges were implemented. The instrument's general content validity index was calculated at 0.87. The instrument reached acceptable content validity parameters, according to the criteria used. Conclusions: The instrument's potential stands out, and it can be improved through its use as a resource for guiding nursing practices directed to pregnant women with sickle cell disease, both in primary health care and in hospital networks. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to identify the key functional care problems, NANDA‐I nursing diagnoses, and intervention plans related to function‐focused care (FFC) using a web‐based case management system for patients who present different cognitive status. Methods: This study employed a retrospective descriptive research design. Data were obtained from system records on patients after the research team trained the case management system at a nursing home in Dangjin in South Chungcheong Province, South Korea. A total of 119 inpatient records were analyzed. Results: The key physical, cognitive, and social functional problems, nursing diagnoses in six domains (health promotion, elimination and exchange, activity/rest, perception/cognition, coping/stress tolerance, and safety/protection), and intervention plans were identified. Conclusion: The identified FFC case management information of interdisciplinary caregivers will provide evidence for the implementation of effective interventions according to a patient's functional status. Additional studies related to the establishment of a large clinical database of advanced case management systems focusing on interdisciplinary caregivers' functional management are needed to support the prioritization of functional care. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the prevalence of Readiness for enhanced health literacy in patients with type 2 diabetes mellitus through the diagnostic accuracy of the defining characteristics. Methods: A diagnostic accuracy study on the diagnosis of Readiness for enhanced health literacy in patients with type 2 diabetes mellitus was conducted using the latent class analysis model. The sample comprised 180 individuals attending a referral outpatient clinic in Maranhão, Brazil. The data analysis was conducted in the R Core Team software. Findings: The prevalence of the nursing diagnosis was 55.23%. The main defining characteristics were expresses desire to enhance health communication with healthcare providers and expresses desire to enhance the understanding of health information to make healthcare choices. All defining characteristics showed significant specificity values. Conclusions: Accurate diagnoses contribute to individualized care plans for patients. Implications for nursing practice: The diagnosis Readiness for enhanced health literacy should be considered in implementing care plans, including interventions to reduce complications in the health status of patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot. Method: A diagnostic accuracy study with a cross‐sectional design was carried out with patients with type 2 diabetes mellitus on outpatient diabetic foot treatment. We evaluated 134 patients with diabetic foot to determine the accuracy of the defining characteristics of ineffective peripheral tissue perfusion. A latent class model with random effects was used to establish the sensitivity and specificity of the defining characteristics assessed. Results: Ineffective peripheral tissue perfusion was present in 83.79% of the patients. The defining characteristics color does not return to lowered limb after 1‐minute leg elevation and edema had high sensitivity (0.8370 and 0.7213) and specificity (0.9991 and 0.9995). Conclusion: The defining characteristics color does not return to lowered limb after 1‐minute leg elevation and edema are good clinical indicators that can be used for screening and confirming ineffective peripheral tissue perfusion in patients with diabetic foot. [ABSTRACT FROM AUTHOR]

Purpose Methods Findings Conclusions Implications for nursing practice The aim of the study was to validate the defining characteristics (DCs) of the nursing diagnosis impaired mood regulation using related criteria in an African context.This descriptive study was conducted in two tertiary mental healthcare institutions in Nigeria. Richard Fehring's clinical diagnostic validity model was employed to collect data from 87 individuals experiencing mood problems. Their scores were validated with other criteria, and the influence of socio‐demographic and clinical variables on participants’ identification of the DCs was determined using analysis of covariance (ANCOVA). The significance level was 0.05.Five of the 27 DCs validated were rated major, 5 considered not characteristics, and the rest were minor characteristics of the diagnosis. A two‐way subject ANCOVA was significant for diagnosis alone, F (2, 87) = 7.41, p = 0.006 (after eliminating the effect of age and gender of the participants), and when combined with duration of illness, F (38, 87) = 2.38, p = 0.036. A positive but weak correlation was found between the DC scale and mood disorder questionnaire, rs (85) = 0.353, n = 87, p = 001 with R2 = 0.102, but a positive and strong correlation with patient health questionnaire, rs (85) = 0.733, n = 87, p = 000 with R2 = 0.565.The DCs listed in NANDA‐I nursing diagnoses manual were valid for the nursing diagnosis. However, there are additional characteristics that would further enhance the applicability of the diagnosis.The result of this study will contribute immensely to the identification of individuals experiencing problems with mood regulation that would otherwise have been missed, thus facilitating early intervention and good outcome. Furthermore, additional characteristics validated in this study offered opportunity for further research on the diagnosis. [ABSTRACT FROM AUTHOR]

Purpose Methods Findings Conclusions Implications for clinical practice To develop an intervention enhancing hospitalized older adults’ nutrition.For the first time, a mixed‐methods design with data triangulation was applied according to the six‐step model of Corry et al. to elaborate on a complex nursing intervention in the form of a logic model. Patients who were aged ≥80 years and hospitalized for at least 5 days were included. Sample size for quantitative practice analysis was 135 older adults, whereas 22 older inpatients participated in interviews and observations for needs analysis and generated data for key principles.The intervention “Eat Enough” encompasses nursing team culture and comprises six actionable targets to deliver needs‐based support and reach required protein and energy intake for hospitalized older adults by sensitizing nurses and the interprofessional team. Facilitating nutritional intake would be supported by an advanced practice nurse who considers the medical and nursing care plan and therapy.The intervention “Eat Enough” demonstrates that nurses play a key role in interprofessional teams to enhance older adults’ nutrition in hospital. The pipeline model displays how the actionable targets can be achieved, and how awareness raising can influence the context—leading to raised calories and protein requirement coverages and shorter length of stay.By identifying risk factors of malnutrition and strengthening nurses’ responsibilities, the intervention “Eat Enough” could significantly enhance nutrition among hospitalized older adults. However, the logic model should be tested and implemented in future research. [ABSTRACT FROM AUTHOR]

The traits of Alzheimer's disease (AD) include amyloid plaques made of Aβ1-40 and Aβ1-42, and neurofibrillary tangles by the hyperphosphorylation of tau protein. AD is a complex disorder that is heterogenous in genetical, neuropathological, and clinical contexts. Current available therapeutics are unable to cure AD. Systems medicine is a strategy by viewing the body as a whole system, taking into account each individual's unique health profile, provide treatment and associated nursing care clinically for the patient, aiming for precision. Since the onset of AD can lead towards cognitive impairment, it is vital to intervene and diagnose early and prevent further progressive loss of neurons. Moreover, as the individual's brain functions are impaired due to neurodegeneration in AD, it is essential to reconstruct the neurons or brain cells to enable normal brain functions. Although there are different subtypes of AD due to varied pathological lesions, in the majority cases of AD, neurodegeneration and severe brain atrophy develop at the chronic stage. Novel approaches including RNA based gene therapy, stem cell based technology, bioprinting technology, synthetic biology for brain tissue reconstruction are researched in recent decades in the hope to decrease neuroinflammation and restore normal brain function in individuals of AD. Systems medicine include the prevention of disease, diagnosis and treatment by viewing the individual's body as a whole system, along with systems medicine based nursing as a strategy against AD that should be researched further. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematosus (SLE) patients are prone to frequent emergency department (ED) visits. This study explores the epidemiology and outcomes of ED visits by patients with SLE utilizing the Nationwide Emergency Department Sample (NEDS). Methods: Using NEDS (2019), SLE ED visits identified using ICD-10 codes (M32. xx) were compared with non-SLE ED visits in terms of demographic and clinical features and primary diagnoses associated with the ED visits. Factors associated with inpatient admission were analyzed using logistic regression. Variations in ED visits by age and race were assessed. Results: We identified 414,139 (0.35%) ED visits for adults ≥ 18 years with SLE. ED visits with SLE comprised more women, Black patients, ages 31–50 years, Medicare as the primary payer, and had higher comorbidity burden. A greater proportion of Black and Hispanic SLE patients who visited the ED were in the youngest age category of 18–30 years (around 20%) compared to White patients (less than 10%). Non-White patients had higher Medicaid utilization (27%–32% vs 19% in White patients). Comorbidity patterns varied based on race, with more White patients having higher rates of hyperlipidemia and ischemic heart disease (IHD) and more Black patients having chronic kidney disease (CKD), hypertension, and heart failure. Categorizing by race, SLE/connective tissue disease (CTD) and infection were the most prevalent primary ED diagnosis in non-White and White patients, respectively. Age ≥ 65 years, male sex, and comorbidities were linked to a higher risk of admission. Black race (OR 0.86, p =.01) and lowest income quartile (OR 0.78, p =.003) had lower odds of inpatient admission. Conclusion: Infection and SLE/CTD were among the top diagnoses associated with ED visits and inpatient admission. Despite comprising a significant proportion of SLE ED visits, Black patients had lower odds of admission. While the higher prevalence of older age groups, hyperlipidemia, and IHD among White patients may partly explain the disparate results, and further study is needed to understand the role of other factors including reliance on the ED for routine care compared among Black patients, differences in insurance coverage, and potential socioeconomic biases among healthcare providers. [ABSTRACT FROM AUTHOR]

Emerging technological advances hold potential to assist the long-term care (LTC) workforce in caring for an aging population in the home and LTC settings. Technology may alter workforce needs and mitigate rising workforce demand. This study identified and assessed emerging technologies that may assist, replace, and/or support recruitment and retention of the LTC workforce and identified barriers and facilitators to their implementation. We identified a variety of technologies with applications for LTC, created a taxonomy of technology types and functions across LTC settings, and conducted semi-structured interviews with a sample of company leaders to assess perceived impact of their products and services on the LTC workforce. Thematic analysis of those interviews found that technology is not currently positioned to replace the LTC workforce but may facilitate work and support worker recruitment and retention. More rigorous evaluation of technologies in LTC and financing mechanisms are needed to support widespread adoption. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to generate empirical evidence, drawing from clinical records, with the goal of elevating the level of evidence supporting the nursing diagnosis (ND) of 'chronic pain'. Background: Chronic pain is a prevalent condition that affects all age groups. Patients often feel disbelieved about their pain perception, leading to adverse psychological effects, difficulty accessing healthcare and poor rehabilitation outcomes. Design: Retrospective descriptive study. Standards for Reporting Diagnostic Accuracy Studies guidelines were followed in this study. Methods: Data were extracted from Electronic Health Records (EHR) of patients admitted to the University Hospital of Perugia, Italy, between March 2016 and December 2022. The study sample comprised individuals without a specific medical diagnosis or high‐risk population. Out of 1,048,565 EHR, 43,341 clinical‐nursing diaries with the keyword 'pain' were identified, from which 283 clinical‐nursing notes were selected based on a keyword‐based retrieval technique and diagnostic definition for further analysis. Results: Our study findings support the diagnostic descriptors of the 'chronic pain' ND in clinical‐nursing diaries. We observed the presence of 9 out of 11 defining characteristics, 7 out of 10 related factors, 4 out of 8 at‐risk populations and 11 out of 17 associated conditions. Conclusions: The study validated diagnostic criteria for chronic pain and proposed 'haematological pathology' as a new associated condition. The findings were presented to the Diagnosis Development Committee of NANDA‐International for further review. However, limitations of the study prompted the need for further analysis using natural language processing and artificial neural network techniques. As a result, a new research direction using artificial intelligence (AI) tools was initiated. Relevance to Clinical Practice: The study validates diagnostic descriptors for chronic pain and proposes future directions in semantic analysis and AI tools, aiming to enhance clinical practice and decision‐making in nursing care. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The purpose of the study was to determine which NANDA nursing diagnosis are made and which related NIC nursing interventions are carried out most frequently by clinical nursing experts. Methods: The Likert Scale and Fehring's Diagnostic Content Validity Model (DCV model) were used for the research. Sample: The total number of all participants of the validation research, i.e. academic nurses/experts, and clinical nurses/experts (nc=848) from 2 countries - SR and CR, consisted of 4 subsamples. A total of 69 items - activities of two interventions for NIC nursing diagnosis: Risk for Infection 00004 were evaluated. Results: We found out that the total set of experts rated all activities/practices of Intervention I and II as significant. Conclusion: The results of the international study provide valid findings for the development of nursing care and curriculum for future professionals. [ABSTRACT FROM AUTHOR]

Purpose Data sources Data synthesis—findings Conclusions Implications for clinical practice To describe a middle range theory (MRT) with conceptual and explicative capacity of cause and effect situations of Ineffective social support network in nursing.Descriptive study developed through the Lopes, Silva, and Herdman theoretical‐causal validity method, using five steps for theory construction: definition of the approach for constructing the MRT, definition of the main concepts, development of the pictorial diagram, construction of propositions, and establishment of causal relationships and evidence for practice. The foundation of these steps and the development of a predictive nursing theory occurred through Sanicola's Social Network Theory combined with studies from an integrative literature review using the six steps proposed by Whittemore and Knafl.The theory presents etiological factors and clinical indicators for Ineffective social support network, connecting situations related to the person, the members and the configuration of this network, and external situations. The pictogram, symbolically created, represents the hierarchical classification of proximal, intermediate, and distal etiological factors, and their relationship with clinical indicators.The MRT, predictive for the nursing phenomenon Ineffective social support network, provides understanding of the person from an interpersonal perspective, which interferes with and is affected by a network of virtues and vicissitudes, and has negative influences on health outcomes. Due to its practical vocation, this theory represents an advance in the science and praxis of nursing.The findings of this study will contribute to the understanding of the nursing phenomenon Ineffective social support network and consequently support the identification of the nursing diagnosis Ineffective social support network, proposed for inclusion in the NANDA‐I classification. [ABSTRACT FROM AUTHOR]

Purpose Methods Findings Conclusions Implications for nursing practice This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA‐I) classification.This is a case–control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included—344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee.The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at‐risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25–8.56) and ineffective medication self‐management (OR: 3.2; 95% CI:1.77–6.26); at‐risk populations with history (OR: 2.16; 95% CI: 1.29–3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03–7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69–39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85–18.37), atherosclerosis (OR:2.07; 95% CI: 1.32–3.27), critical illness (OR: 2.28; 95% CI: 1.42–3.70), and immobility (OR: 2.09; 95% CI: 1.10–4.12).The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA‐I.The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition. [ABSTRACT FROM AUTHOR]

Background: Audit and feedback (A&F) is among the most widely used implementation strategies, providing healthcare professionals with summaries of their practice performance to prompt behaviour change and optimize care. Wide variability in effectiveness of A&F has spurred efforts to explore why some A&F interventions are more effective than others. Unpacking the variability of the content of A&F interventions in terms of their component behaviours change techniques (BCTs) may help advance our understanding of how A&F works best. This study aimed to systematically specify BCTs in A&F interventions targeting healthcare professional practice change. Methods: We conducted a directed content analysis of intervention descriptions in 287 randomized trials included in an ongoing Cochrane systematic review update of A&F interventions (searched up to June 2020). Three trained researchers identified and categorized BCTs in all trial arms (treatment & control/comparator) using the 93-item BCT Taxonomy version 1. The original BCT definitions and examples in the taxonomy were adapted to include A&F-specific decision rules and examples. Two additional BCTs ('Education (unspecified)' and 'Feedback (unspecified)') were added, such that 95 BCTs were considered for coding. Results: In total, 47/95 BCTs (49%) were identified across 360 treatment arms at least once (median = 5.0, IQR = 2.3, range = 129 per arm). The most common BCTs were 'Feedback on behaviour' (present 89% of the time; e.g. feedback on drug prescribing), 'Instruction on how to perform the behaviour' (71%; e.g. issuing a clinical guideline), 'Social comparison' (52%; e.g. feedback on performance of peers), 'Credible source' (41%; e.g. endorsements from respected professional body), and 'Education (unspecified)' (31%; e.g. giving a lecture to staff). A total of 130/287 (45%) control/comparator arms contained at least one BCT (median = 2.0, IQR = 3.0, range = 0–15 per arm), of which the most common were identical to those identified in treatment arms. Conclusions: A&F interventions to improve healthcare professional practice include a moderate range of BCTs, focusing predominantly on providing behavioural feedback, sharing guidelines, peer comparison data, education, and leveraging credible sources. We encourage the use of our A&F-specific list of BCTs to improve knowledge of what is being delivered in A&F interventions. Our study provides a basis for exploring which BCTs are associated with intervention effectiveness. Trial registrations: N/A. [ABSTRACT FROM AUTHOR]

Objective: We aimed to explore the construct of "high need" and identify common need domains among high-need patients, their care professionals, and healthcare organizations; and to describe the interventions that health care systems use to address these needs, including exploring the potential unintended consequences of interventions. Methods: We conducted a modified Delphi panel informed by an environmental scan. Expert stakeholders included patients, interdisciplinary healthcare practitioners (physicians, social workers, peer navigators), implementation scientists, and policy makers. The environmental scan used a rapid literature review and semi-structured interviews with key informants who provide healthcare for high-need patients. We convened a day-long virtual panel meeting, preceded and followed by online surveys to establish consensus. Results: The environmental scan identified 46 systematic reviews on high-need patients, 19 empirical studies documenting needs, 14 intervention taxonomies, and 9 studies providing construct validity for the concept "high need." Panelists explored the construct and terminology and established that individual patients' needs are unique, but areas of commonality exist across all high-need patients. Panelists agreed on 11 domains describing patient (e.g., social circumstances), 5 care professional (e.g., communication), and 8 organizational (e.g., staffing arrangements) needs. Panelists developed a taxonomy of interventions with 15 categories (e.g., care navigation, care coordination, identification and monitoring) directed at patients, care professionals, or the organization. The project identified potentially unintended consequences of interventions for high-need patients, including high costs incurred for patients, increased time and effort for care professionals, and identification of needs without resources to respond appropriately. Conclusions: Care for high-need patients requires a thoughtful approach; differentiating need domains provides multiple entry points for interventions directed at patients, care professionals, and organizations. Implementation efforts should consider outlined intended and unintended downstream effects on patients, care professionals, and organizations. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) has released a publication outlining key considerations for regulating artificial intelligence (AI) in healthcare. The WHO recognizes the potential benefits of AI in improving clinical trials, diagnoses, and treatment, but also highlights the risks associated with its use. These risks include privacy and security concerns, unethical data collection, cybersecurity risks, and the amplification of biases and misinformation. The WHO has identified six areas for regulation, including transparency, risk management, data validation, data quality, privacy, and collaboration. The goal is to protect healthcare professionals and patients while harnessing the full potential of AI in healthcare. [Extracted from the article]

Purpose Methods Findings Conclusions Implications for nursing practice Insomnia is an important sleep disorder in older persons. Conceptual analysis studies on this nursing diagnosis have been developed, but the diagnostic accuracy has not been verified. This study aimed to verify the diagnostic accuracy of the nursing diagnosis of Insomnia (00095) in older adults in a community center in Brazil.A validation study for diagnostic accuracy of the defining characteristics of the nursing diagnosis Insomnia. Data were collected through telephone interviews with 90 participants. Latent class analysis was used to verify the sensitivity and specificity of the defining characteristics. Poisson regression was used to assess the prevalence of the association of factors related to the nursing diagnosis of insomnia.A 47.42% prevalence of insomnia in the sample was identified. Defining characteristics such as expresses dissatisfaction with sleep and nonrestorative sleep–wake cycle showed the best accuracy values for insomnia, with a specificity of 0.92 (0.78–1.00) and 0.89 (0.74–1.00), respectively. Related factors such as stressors and frequent naps during the day were more likely to develop insomnia in individuals.This study indicates diagnostic accuracy of nursing diagnosis of insomnia in community‐dwelling older people from a community center. The findings highlighted the importance of the defining characteristics of nursing diagnosis insomnia and its main related factors contributing to accurate diagnostic identification.This study can contribute to providing objective clinical indicators of insomnia in the older population to guide nurses in early diagnostic confirmation for the selection of health interventions. In addition, it can be a consistent contribution to theoretical and conceptual reviews of this diagnosis. [ABSTRACT FROM AUTHOR]

Aims: To explore the impact of 12 American Nurses Association recognized standardized nursing terminologies (SNTs) on patient and organizational outcomes. Background: Previous studies reported an effect of SNTs on outcomes, but no previous frameworks nor meta‐analyses were found. Design: Systematic review and meta‐analyses. Review Methods: PubMed, Scopus, CINAHL, and OpenGrey databases were last consulted in July 2021. All abstracts and full texts were screened independently by two researchers. The review included primary quantitative studies that reported an association between recognized SNTs and outcomes. Two reviewers independently assessed the risk of bias and certainty of evidence for each meta‐analyzed outcome using the "Grading of Recommendations, Assessment, Development and Evaluation" (GRADE) approach. Results: Fifty‐three reports were included. NANDA‐NIC‐NOC and Omaha System were the most frequently reported SNTs used in the studies. Risk of bias in randomized controlled trials and not‐randomized controlled trials ranged from high to unclear, this risk was low in cross‐sectional studies. The number of nursing diagnoses NANDA‐I moderately correlated with the intensive care unit length of stay (r = 0.38; 95% CI = 0.31–0.44). Using the Omaha System nurse‐led transitional care program showed a large increase in both knowledge (d = 1.21; 95% CI = 0.97–1.44) and self‐efficacy (d = 1.23; 95% CI = 0.97–1.48), while a reduction on the readmission rate (OR = 0.46; 95% CI = 0.09–0.83). Nursing diagnoses were found to be useful predictors for organizational (length of stay) and patients' outcomes (mortality, quality of life). The GRADE indicated that the certainty of evidence was rated from very low to low. Conclusions: Studies using SNTs demonstrated significant improvement and prediction power in several patients' and organizational outcomes. Further high‐quality research is required to increase the certainty of evidence of these relationships. Clinical relevance: SNTs should be considered by healthcare policymakers to improve nursing care and as essential reporting data about patient's nursing complexity to guide reimbursement criteria. [ABSTRACT FROM AUTHOR]