International Journal of Nursing Knowledge

To develop a nursing diagnosis proposal derived from the concept of “disuse syndrome” based on an integrative review.

The conceptual derivation technique, proposed by Walker and Avant, was used in the following phases: an integrative review of the literature was carried out, applying the parameters of Whitermore and Knalf, where 43 articles were selected that covered the existence of the concept in the nursing discipline and other health sciences, the concepts were subsequently analyzed, and the new concept was redefined following the middle-range theory of causality and validation of nursing diagnoses proposed by Oliveira-Lopes et al.

The proposal of the new nursing diagnosis was developed, including the following elements: diagnostic label adult disuse syndrome, the corresponding definition, 25 defining characteristics, eight related factors, eight risk populations, and 14 associated problems.

The concept of the proposed new diagnosis describes adult disuse syndrome as a phenomenon that transcends the physiological component and should be viewed from a multidimensional view, expressing a clinical judgment related to a series of nursing diagnoses that appear together.

The results of this study will help nursing professionals to identify the phenomenon of adult disuse syndrome in any setting and in turn guide optimal care interventions that decrease the consequences of adult disuse syndrome.

This study aims to examine the nursing diagnosis skills of students who took the case-based online nursing processes course during the COVID-19 pandemic.

The study followed a descriptive and cross-sectional design. The participants were first-year students (n = 148) enrolled in the nursing principles course in the spring semester of the 2020–2021 academic year in the nursing department of a university. The course on nursing processes was delivered online due to the COVID-19 pandemic. At the end of the course, students who volunteered to participate in the study developed nursing diagnoses for the cases assigned to them. The data were collected from the students using two forms and were evaluated using a form developed by the researchers. The data were analyzed with numeric and percentage calculations.

Although 56.8% of the students stated that they had difficulty making nursing diagnoses, 56.8% of them thought online education was not useful. The most commonly made diagnoses by the students who participated in the study included hyperthermia (66.2%), ineffective breathing pattern (54.7%), risk of falling (39.9%), fatigue (34.5%), and anxiety (33.8%). It was also found that students were able to identify objective data more easily as diagnosis criteria, whereas they were not able to identify abstract concepts.

It was seen that the students who participated in the study had low levels of nursing diagnoses. Based on the findings, it is recommended that different teaching methods be employed in the online nursing processes course, and these methods be evaluated in terms of their effects on students’ learning outcomes.

The online nursing process course should be made more efficient. First-year nursing students are not yet ready to identify nursing diagnoses in terms of knowledge and skills.

To identify nursing interventions for the management of adult patients undergoing cardiotoxic oncologic therapy.

This scoping review was performed in accordance with the JBI guidelines. The literature search took place between July and August 2022. Studies examining interventions for the management of adult cancer patients undergoing cardiotoxic therapy were included. The characteristics and results of the studies were synthesized and analyzed in a narrative way.

In the nine included studies, it was verified that the interventions were implemented to guide the actions of the health team in general rather than specifically nursing staff. Nine nursing interventions related to the Classification of Nursing Interventions were included.

The nursing interventions identified focused on rigorous cardiovascular surveillance, risk assessment, and actions to identify and mitigate cardiotoxicity.

It is believed that the implementation of the identified nursing interventions will lead to evidence-based nursing practice and will contribute to the development of care products and processes that assess the cardiological risks and cardiotoxicity.

Identificar as intervenções de enfermagem no manejo de pacientes adultos submetidos à terapia oncológica cardiotóxica.

Revisão de escopo seguindo a JBI. A busca da literatura ocorreu entre julho e agosto de 2022. Foram incluídos estudos que abordam intervenções para o manejo de pacientes adultos oncológicos submetidos à terapia cardiotóxica. As características e resultados foram sintetizados e analisados de forma narrativa.

Nos nove estudos incluídos, verificou-se que as intervenções foram direcionadas às ações da equipe de saúde, em geral, e não àquelas específicas da enfermagem. A partir da literatura, foram identificadas nove intervenções de enfermagem relacionadas à Classificação das Intervenções de Enfermagem.

As intervenções de enfermagem identificadas direcionaram-se para vigilância cardiovascular rigorosa, avaliação de risco e ações para identificar e mitigar a cardiotoxicidade.

Acredita-se que a implementação das intervenções identificadas proporcionará uma prática de enfermagem baseada em evidências e contribuirá para o desenvolvimento de produtos e processos assistenciais que avaliem os riscos cardiológicos e a cardiotoxicidade.

To describe the current application status of NANDA-I nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) in cardiac rehabilitation nursing and identify useful NANDA-I, NIC, and NOC (NNN) linkages for clinical nursing practitioners.

This scoping review was performed in accordance with the Joanna Briggs Institut guidelines. We systematically searched eight databases, and the literature search took place between June and July 2023. The characteristics and results of the studies were synthesized and analyzed in a narrative way.

The application of NANDA-I nursing diagnosis, NIC and NOC in cardiac rehabilitation nursing can be divided into three topics: the content, value and effect of NANDA-I nursing diagnosis, NIC and NOC.

The application of NANDA-I, NIC, and NOC in the field of cardiac rehabilitation nursing shows positive effects on the whole, which can provide more standardized theoretical guidance, improve nursing outcomes in clinical settings, and enhance nursing quality.

This experience report will guide nurses to use NANDA-I, NIC, and NOC for better cardiac rehabilitation care.

To determine the trajectories of spiritual distress and religious involvement among cancer patients during chemotherapy.

A prospective longitudinal study was conducted over 15 months with quarterly data collection, in a total of with five cut points. Data collection was applied a questionnaire that embraced sociodemographic characteristics, clinical profile, Spiritual Distress Scale, and Belief into Action Scale. Regarding, data analysis was performed univariate, bivariate, and multivariate statistics, and the study was approved by the Ethics Committee.

From the 322 cancer patients at the beginning, the attrition rate was 17.5% in the last time point. Most of participants were women (56.6%), with an average age of 60.3 years, and had a religious affiliation (93.7%). Statistically significant values were found of spiritual distress and religious involvement across the five cuts. At the end of 3 months after starting chemotherapy, the highest value of spiritual distress and the lowest value of religious involvement were reached.

Cancer patients who are submitted to chemotherapy, after 3 months of treatment experience the peak of spiritual distress and the lowest value of religious involvement. This critical period for nurses’ is required a massive approach regarding spiritual and religious needs.

Therefore, knowing the trajectories of spiritual distress and religious involvement during a certain period allows for the anticipating of planning of nursing therapeutic interventions in order to promote spiritual health and spiritual well-being outcomes in cancer patients.

To identify the most relevant clinical characteristics of the nursing diagnosis frail elderly syndrome (FES) in hospitalized patients aged 65 or older and analyze their impact on 9-month mortality and hospital readmission.

A prospective and prognostic accuracy study was conducted in patients aged 65 or older, who were admitted to hospital more than 24 h. A consecutive convenience sampling process was used. Assessment included defining characteristics (DCs) of FES, clinical fraility scale (CFS), frail scale (FS), and 9-month mortality and hospital readmission. Statistical tests were used to verify associations between variables. Binary logistic regression analysis and area under the curve were used, to identify significant predictors for the outcomes and evaluate the prognostic accuracy of the DCs.

This study involved 150 patients. CFS scored 65 patients (43.3%, confidence interval 95% 35.2% a 51.6) as frail and proved a prognostic value of mortality at 9 month from pre-frail state (p = 0.020). The mean number of DCs for FES nursing diagnosis was 6.35 (SD = 3.14). Validated tools for measuring frailty were associated with all DCs, excepting nutritional imbalance: below body needs. The hospital readmission during the following 9 months was only statistically related to memory impairment (p = 0.07).

Clinical frailty scale showed good results as a predictor of mortality. The study suggests exploring including it, in clinical manifestations of elderly frail syndrome. This study found that only memory impairment defining characteristic was predictive of hospital readmission. Further research should identify other relevant and prognostic clinical manifestations.

These findings highlight the importance of being vigilant on cognitive decline during hospital admissions. The most prevalent and determinant DCs identified in this study indicate that clinical should focus on preserving functional and mental abilities as well as mobility.

To assess the quality of the nursing process in Romania by evaluating nursing documentations with the quality of diagnoses, interventions and outcomes (Q-DIO) measurement instrument.

A quantitative cross-sectional research design was employed using probabilistic sampling to select nursing documentations from a Romanian university hospital. The data were analyzed using the Q-DIO measurement instrument.

Low quality levels of nursing process documentation were found. The Q-DIO subscale “Nursing diagnoses as process” (assessment) revealed a mean = 1.36 (SD 0.52) of maximum 2. Nurses collected lots of data but did not use these to state nursing diagnoses. “Nursing diagnoses as product” showed inaccurate diagnoses; mean = 1.24 (SD 0.48) of maximum 4. Nursing interventions were planned and documented, but their impact on the etiology of nursing diagnoses was low; mean = 0.76 (SD 0.18). The quality of nursing outcomes mean was 0.57 (SD 0.29).

Nurses failed making connections between nursing assessment, diagnoses, interventions, and outcomes, and standardized nursing languages (SNLs) were not used. Statistically significant differences were found among all Q-DIO sub-concepts except for “Nursing diagnoses as process.”

The documentation was structured but did not support the nursing process and its documentation, and SNLs were not implemented. There was an underutilization of data to state nursing diagnoses, and nursing interventions were mostly ineffective, leading to low nursing outcomes.

This study provides new insights on the nursing process and its documentation in Romania and a baseline for future research. Policymakers, administrators, and educators should consider educating nurses to use standardized nursing languages and apply the Advanced Nursing Process.