International Journal of Nursing Knowledge最新文献

{"title":"Clinical validation of the nursing diagnosis of inadequate nutritional intake in children with cancer.","authors":"Iane Ximenes Teixeira, Natália Cabrera Matos, Marcos Venícios de Oliveira Lopes, Viviane Martins da Silva, Amanda Laryssa Gomes do Nascimento, Yanka Alcântara Cavalcante, Ana Beatriz Oliveira Marques Dos Santos, Daniele Paula Alves Mouta","doi":"10.1111/2047-3095.70022","DOIUrl":"https://doi.org/10.1111/2047-3095.70022","url":null,"abstract":"<p><strong>Purpose: </strong>To clinically validate the nursing diagnosis \"Inadequate Nutritional Intake\" based on elements identified within a specific situation theory framework in the context of children with cancer.</p><p><strong>Methods: </strong>This is a diagnostic accuracy study following the Standards for Reporting Diagnostic Accuracy Studies (STARD) protocol. Specifically, it refers to the clinical validation phase of the nursing diagnosis Inadequate nutritional intake, using a cross-sectional design. The study was conducted in a tertiary pediatric hospital with a sample of 69 children diagnosed with cancer.</p><p><strong>Findings: </strong>A total of 11 clinical indicators demonstrated diagnostic accuracy above 50%, including: ascites, low weight-for-age ≤2 SD, cachexia, mid-upper arm circumference < 10th percentile, fatigue, pale mucous membranes, dry mucosa, dry skin, weight loss greater than 5% within 1 month, compromised immune response, and delayed wound healing. The primary etiological factors identified in this study were chemotherapy, economic disadvantage, inadequate dietary pattern, insufficient dietary intake, rejection of hospital food, and family food culture. The nursing diagnosis had a prevalence of 7.25% among the participating children.</p><p><strong>Conclusions: </strong>Despite the low prevalence, this study highlights that inadequate nutritional intake is a real and complex health issue in this population, with multiple etiological factors requiring a precise and systematic assessment for early identification by healthcare professionals, particularly nurses. This underscores the importance of research focused on refining nursing diagnoses in specific populations.</p><p><strong>Implications for nursing practice: </strong>Validation studies such as this enhance the accuracy and evidence-based nature of nursing practice, while also supporting collaborative decision-making for addressing nutritional issues in children with cancer, considering the various etiological factors involved.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-led ultrasound accuracy: A critical commentary on \"Diagnostic accuracy of nurse-performed lung ultrasound for pulmonary congestion in acute kidney injury: An exploratory study\".","authors":"Helga Martins, Eric Lopes, Susana Miguel","doi":"10.1111/2047-3095.70023","DOIUrl":"https://doi.org/10.1111/2047-3095.70023","url":null,"abstract":"","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of standardized nursing intervention validation processes.","authors":"Ashfaq Ahmad, Arej Iltaf, Javed Iqbal, Brijesh Sathian, Rafi Ullah","doi":"10.1111/2047-3095.70019","DOIUrl":"https://doi.org/10.1111/2047-3095.70019","url":null,"abstract":"","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of internal structure validity of the nursing outcome \"Mechanical Ventilation Weaning Response: Adult (0412)\" for critically ill COVID-19 patients.","authors":"Aline Batista Maurício, Viviane Martins da Silva, Agueda Maria Ruiz Zimmer Cavalcante, Larissa Giardini Bruni, Sue Ann Moorhead, Elizabeth Swanson, Karen Dunn Lopez, Marcos Venícios de Oliveira Lopes, Alba Lucia Bottura Leite de Barros","doi":"10.1111/2047-3095.70020","DOIUrl":"https://doi.org/10.1111/2047-3095.70020","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the evidence of internal structure validity of the nursing outcome (NO) \"Mechanical Ventilation Weaning Response: Adult (0412)\" of the NOs classification for critically ill COVID-19 patients.</p><p><strong>Methods: </strong>A methodological study focused on internal structural validation, part of a multicenter study, was carried out in the intensive care units of two hospitals in Brazil, from 2020 to 2021. Patients in critical condition due to COVID-19 subjected to mechanical ventilation for more than 24 h and with an invasive device attached to the ventilator in the final phase of the weaning process were evaluated. The researchers used an instrument containing sociodemographic and clinical data and a physical examination of the clinical conditions based on the indicators of the NO. An exploratory factor analysis was performed, using the Kaiser-Meyer-Olkin method, in addition to other additional adjustment indexes. Reliability was assessed using McDonald's omega, Cronbach's alpha, and Gutmann's lambda 6 coefficients.</p><p><strong>Findings: </strong>Among the 20 indicators evaluated, 6 were included in the final structure organized into two factors, the first being composed of spontaneous respiratory rhythm, spontaneous respiratory depth, discomfort, and difficulty breathing on own, and the second of anxiety and fear. This two-dimensional structure explains about 62.9% of the total variance. The final structure showed good internal consistency, suggesting that the indicators were measuring the same construct.</p><p><strong>Conclusions: </strong>The structure proposed for the NO was shown to be reliable and valid for practice and research to evaluate patients with COVID-19 in the final phase of ventilatory weaning.</p><p><strong>Implications for nursing practice: </strong>The findings are expected to provide robust evidence for clinical nursing practice. The proposal to organize this NO into dimensions could facilitate the nurse's clinical reasoning and make the monitoring of indicators more organized and faster for the evaluation of patients in ventilatory weaning.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' personal and environmental factors in approaches to nursing diagnoses: A cluster analysis.","authors":"Mattia Bozzetti, Ilaria Marcomini, Miriam Mariani, Gianmario Pedretti, Alberto Silla, Roberta Pendoni","doi":"10.1111/2047-3095.70021","DOIUrl":"https://doi.org/10.1111/2047-3095.70021","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to identify distinct nurse clusters based on personal and environmental factors influencing their approaches to nursing diagnosis (NDs).</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 444 nurses from two hospitals in Italy. Data were collected using validated tools: the Behavioral Beliefs Scale (BBS), Normative Beliefs Scale (NBS), Control Beliefs Scale (CBS), positions on nursing diagnosis, Intention Scale (INT), Behavior Scale, Practice Environment Scale of the Nursing Work Index, and Nurse Clinical Reasoning Scale. A cluster analysis was performed.</p><p><strong>Results: </strong>The study analyzed 444 nurses, predominantly female (85.36%) with a mean age of 40.11 and 20.92 years of experience in nursing. Factor analysis confirmed the unidimensional structures for the BBS, NBS, and CBS scales, with excellent fit and reliability. Three clusters emerged: \"positive beliefs\" (37.4%), \"neutral beliefs\" (48.6%), and \"negative beliefs\" (14%). Nurses in the positive cluster exhibited stronger clinical reasoning skills and more favorable perceptions of the work environment. Significant differences were noted across clusters regarding practice environment subscales and behavioral beliefs.</p><p><strong>Conclusions: </strong>Both personal and environmental factors significantly impact nurses' engagement with NDs. Tailored strategies to improve clinical reasoning and enhance work environments are essential to fostering positive attitudes and effective use of NDs.</p><p><strong>Implications for nursing practice: </strong>By classifying nurses based on their beliefs regarding nursing diagnoses, administrators and educators can more effectively tailor interventions to improve the application of nursing diagnoses in practical environments.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of nurse‑performed lung ultrasound for pulmonary congestion in acute kidney injury: An exploratory study.","authors":"Bruna Gomes Barbeiro, Patricia Rezende do Prado, Vinicius Batista Santos, Mayra Gonçalves Menegueti, Bryan Boling, Fernanda Raphael Escobar Gimenes","doi":"10.1111/2047-3095.70018","DOIUrl":"https://doi.org/10.1111/2047-3095.70018","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the diagnostic accuracy of nurse-performed lung ultrasound (LUS) for detecting pulmonary congestion in adults with acute kidney injury (AKI) and to relate ultrasound findings to the defining characteristics of the NANDA-I nursing diagnosis excess fluid volume.</p><p><strong>Methods: </strong>In this prospective exploratory diagnostic accuracy study, conducted between October 2022 and September 2023, a critical care nurse performed bedside LUS, following the bedside lung ultrasound in emergency protocol, in a convenience sample of 64 intensive care unit patients with AKI in a general hospital in Brazil. Pulmonary congestion was defined as ≥3 B-lines in ≥2 intercostal spaces per hemithorax. The reference standard was radiological evidence of vascular congestion on chest radiograph or computed tomography interpreted by blinded intensivists. Sensitivity, specificity, positive and negative predictive values were calculated with 95% confidence intervals. Agreement between LUS and radiologic findings was assessed using Gwet's AC1 coefficient. The COVID-19 pandemic limited patient flow; therefore, no formal sample-size calculation was feasible. Results should be considered preliminary.</p><p><strong>Findings: </strong>Pulmonary congestion was present in 14/64 patients (21.9%). LUS sensitivity was 50% (95% CI 23%-77%) and specificity 94 % (89%-99%). Positive and negative predictive values were 70% and 87%, respectively. Agreement between LUS and radiology was substantial (AC1 = 0.77, 0.63-0.92). No LUS-related adverse events occurred. Presence of ≥3 B-lines-an objective ultrasonographic marker of interstitial fluid-corresponded to the defining characteristic \"pulmonary congestion\" of NANDA-I diagnosis 00026.</p><p><strong>Conclusions: </strong>A single well-trained nurse achieved high specificity using LUS to rule out pulmonary congestion in critically ill patients with AKI. Limited sensitivity and wide confidence intervals highlight the need for larger, multicenter studies with sufficient positive cases. Linking B-lines to the defining characteristic of Excess Fluid Volume supports integration of point-of-care ultrasound into nursing diagnostic reasoning.</p><p><strong>Implications for nursing practice: </strong>Bedside nurse-performed LUS can strengthen clinical decision-making by quickly excluding pulmonary congestion-thereby informing volume-management interventions aligned with the NANDA-I taxonomy.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical indicators of ineffective health maintenance behaviors in women who do not wish to become pregnant: A systematic review.","authors":"Nathaly B M Fróes, Dayane Dos R A R Holanda, Mariana G Pagio, Rebeca R M Nunes, Nirla G Guedes, Viviane M da Silva, Marcos V de O Lopes","doi":"10.1111/2047-3095.70017","DOIUrl":"https://doi.org/10.1111/2047-3095.70017","url":null,"abstract":"<p><strong>Background: </strong>Clinical indicators (CI) of the nursing diagnosis (ND) ineffective health maintenance behaviors (IHMB) (00292) may be present in women who do not wish to become pregnant. Thus, nurses should to be attentive of the individual, cultural, and social characteristics of these women in order to identify behaviors (CI) that may represent a risk for unwanted pregnancy.</p><p><strong>Purpose: </strong>This study aimed to identify CI of IHMB in women of childbearing age who do not wish to become pregnant.</p><p><strong>Design: </strong>Systematic review of diagnostic test accuracy.</p><p><strong>Data sources: </strong>Scopus, PubMed/MEDLINE, Embase, Biblioteca Virtual em Saúde, PsycINFO (Searched on November 12, 2023) and Ovid, Web of Science, CINAHL, Google Scholar, and ProQuest (searched on June 10, 2024).</p><p><strong>Data synthesis: </strong>The final sample resulted in five articles, in which two CI were identified in women who manifested the ND IHMB. \"Ineffective choices in daily life for meeting health goals\" was identified in women when they did not discuss contraceptive methods with their partners. \"Failure to perceive health risk\" was identified when women had low or no perception of pregnancy risk.</p><p><strong>Conclusion: </strong>Two CI of IHMB were identified in women who do not wish to become pregnant: \"ineffective choices in daily life for meeting health goals\" and \"failure to perceive health risk.\"</p><p><strong>Implications for the profession and/or patient care: </strong>These findings will provide nurses a better understanding of behaviors expressed by women who do not wish to become pregnant that prevent them to use contraception, that way nurses can make specific interventions on these issues. Including the indicator failure to perceive health risk to the NANDA International can broaden the spectrum of nurse's assessment for the study population.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content validation of the new nursing intervention \"0565 - ultrasonography: bladder\".","authors":"Vítor Monteiro Moraes, Ana Clara de Brito Cruz, Taline Bavaresco, Amália de Fátima Lucena, Cheryl Marie Wagner, Miriam de Abreu Almeida","doi":"10.1111/2047-3095.70016","DOIUrl":"https://doi.org/10.1111/2047-3095.70016","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the content of the nursing intervention \"0565 - ultrasonography: bladder.\"</p><p><strong>Method: </strong>The content validation study was conducted from September to November 2022, with a sample of 22 specialists who evaluated the components of the nursing intervention \"0565 - ultrasonography: bladder,\" according to the Nursing Interventions Classification, considering the pertinence, relevance, and clarity of the title, definition, and 17 activities of the intervention as well as education level and estimated time to perform. Data collection used an online form followed by a focus group. For analysis, the content validity index with a minimum agreement proportion of 85% was used. Items that did not achieve agreement through the online form were discussed in the focus group.</p><p><strong>Results: </strong>Of the 21 items evaluated, 13 were validated in the first stage of the study. The remaining eight were evaluated in the focus group, modified, and consensually approved.</p><p><strong>Conclusion: </strong>The nursing intervention \"0565 - ultrasonography: bladder\" had its content completely validated.</p><p><strong>Implications for nursing practice: </strong>The validation of this intervention allows its application in clinical practice with standardized nursing languages that give visibility to the profession, highlighting the use of technology in the patient care process and promoting evidence-based practice.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformative caring theory: A theoretical synthesis.","authors":"Kerry A Richardson, Mary K McCurry, Susan Hunter Revell","doi":"10.1111/2047-3095.70014","DOIUrl":"https://doi.org/10.1111/2047-3095.70014","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an integrated nursing educational theory using Walker and Avant's theoretical synthesis methodology.</p><p><strong>Data sources: </strong>Watson's Theory of Human Caring, Mezirow's Transformative Learning Theory, and nursing literature related to undergraduate nursing students' perceptions of caring.</p><p><strong>Data synthesis: </strong>Key concepts from these theories were synthesized in the formation of the transformative caring theory.</p><p><strong>Conclusions: </strong>The transformative caring theory provides a framework for nurse educators to foster nursing students' development of caring behaviors and caring competencies through emancipatory and transformative education.</p><p><strong>Implications for nursing practice: </strong>To assist undergraduate students to gain an understanding of the importance of developing new caring meaning perspectives and caring attributes in their becoming contemporary, caring, compassionate professional nurses. Harnessed with this knowledge, students can become empowered as patient advocates through humanistic, emancipatory, and relational caring praxis to potentiate health, reduce human suffering, and address issues of social injustices and health inequities.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the nursing diagnosis of [ineffective breathing pattern (00032)] in patients hospitalized with COVID-19: A cross-sectional study.","authors":"Caio Rodrigo Menezes Dos Santos, Thiago de Jesus Santos, Andreia Centenaro Vaez, Damião da Conceição Araújo","doi":"10.1111/2047-3095.70007","DOIUrl":"https://doi.org/10.1111/2047-3095.70007","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the prevalence, accuracy of clinical indicators and related factors of the nursing diagnosis of ineffective breathing pattern (00032) in patients hospitalized due to COVID-19.</p><p><strong>Methods: </strong>This is a cross-sectional study conducted in a public hospital, involving 250 adult hospitalizations between 2020 and 2021. Data were collected retrospectively from electronic medical records. Latent class analysis and multivariate logistic regression were performed to analyze the nursing diagnosis of ineffective breathing pattern.</p><p><strong>Findings: </strong>The prevalence of the ineffective breathing pattern diagnosis was 62%. The main clinical indicators identified included tachypnea, use of accessory muscles for breathing, abdominal paradoxical breathing pattern, and hypoxemia. Latent class analysis indicated that the three-class model was the most suitable, with Class 3 showing the highest prevalence. Indicators such as tachypnea and use of accessory muscles demonstrated high sensitivity, while hypoxemia exhibited high specificity. The presence of fatigue, pain, body position that inhibits lung expansion, and obesity significantly increased the likelihood of the ineffective breathing pattern diagnosis.</p><p><strong>Conclusions: </strong>The diagnosis of ineffective breathing pattern is prevalent in patients hospitalized with COVID-19, with precise clinical indicators. Fatigue, pain, inadequate body position, and obesity were associated factors.</p><p><strong>Implications for nursing practice: </strong>The clinical validation of the ineffective breathing pattern diagnosis in the population of individuals infected with SARS-CoV-2 is essential for improving the level of evidence. Additionally, it contributes to the nurse's diagnostic inference in clinical practice and decision making for appropriate treatment.</p>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}