International Journal of Nursing Knowledge

In this secondary analysis, 890 patients 40 years of age and older were assessed within 24 hours of transfer from intensive care to medical/surgical units. Nursing diagnoses documented in the hospital record were compared to supporting clinical evidence obtained from subjects, the hospital record, and interviews with subjects and nurse caregivers. The congruence, based on the kappa statistic, between the nursing diagnosis and clinical evidence ranged from 0.1% for altered thought processes to 10% for impaired gas exchange, impaired physical mobility, and potential for injury, while no diagnoses were made for self-care deficits or sensory alterations, visual, when clinical evidence for them was available.

The purpose of this study was to reduce the defining characteristics for the nursing diagnoses anxiety and fear into sets of smaller, more manageable and meaningful variables for clinical use and further investigation. A sample of 233 nurse experts rated defining characteristics of anxiety and fear on three study instruments; a sample of 69 hospitalized clients rated defining characteristics of anxiety on one study instrument. Results of principle components analyses identified patterns within defining characteristics and provided consolidation of characteristics into meaningful and usable sets.