International Journal of Nursing Knowledge

The authors analyzed nursing diagnoses recorded in care plans for a 328–bed midwestern county-owned and operated nursing home over a ZO-year period from 1984 to Z993, Data were analyzed using a test for increasing or decreasing the linear trend in the proportion of residents with a particular nursing diagnosis over the ZO-year period. Based on nursing diagnoses trends, the current population of nursing home residents has greater dependency, nutritional, and physiological needs and greater cognitive impairment than ten years ago. Analyses of nursing diagnoses can provide measurable data to assist executive and clinical nursing staff in nursing homes.

The authors conducted a retrospective study to validate gender-specific defining characteristics for the proposed nursing diagnosis altered sexuality. An investigator-designed tool was used to collect data from 100 randomly selected members of NAND A. The Fehring method of diagnostic content validity was used to identify major and minor defining characteristics for men and women. The defining characteristics identified and validated encompass all dimensions of human sexuality, and are more concise and descriptive of this human response than those currently in use. Findings of this study will be used to develop a tool for assessment of altered sexuality in a variety of populations and settings.

The authors sought to validate the defining characteristics of acute pain and chronic pain and to compare the differences between them. Expert nurses (N = 125) rated the importance of 55 clinical indicators for each diagnosis (acute pain and chronic pain). Differential diagnostic validity (DDV) scores were calculated for each clinical indicator for both diagnoses. Only acute pain had a DDV score greater than.80, indicating that the characteristic “communication of pain descriptors” was a critical indicator for acute pain. A majority of defining characteristics differentiated between acute pain and chronic pain, thereby supporting the identification of acute pain and chronic pain as separate nursing diagnoses.

This paper reports a project that identified and validated a nursing diagnosis for the problem of ineffective infant feeding behaviors—feeding dysfunction. Three validation phases were used for development of the diagnosis. During the first phase the literature review provided information about the problem, the etiologies, and the defining characteristics. Phase two of the validation process utilized nurse specialists who were surveyed for their expert judgment of the etiologies and defining characteristics. The third validation phase used case studies of several infants together with assessment of the infants' feeding abilities to validate further the etiologies and defining characteristics. Support for the diagnosis infant feeding dysfunction was evident.

“Where Are We Now” is a regular feature of Nursing Diagnosis. The column focuses on current issues and trends related to nursing diagnosis development, implementation, and evaluation. The writing in this issue focuses on the critical nature of concept analysis as it relates to clinical validation of nursing diagnosis. Dr. Georgia Whitley addresses the importance of concept analysis as a foundation for validation research on a specific diagnosis, particularly as it can be used in identifying defining characteristics und developing their operational definitions.