The aim of this study was to validate the actual nursing diagnosis of imbalanced nutrition: less than body requirements in older patients. It is a retrospective and comparative study. To validate the nursing diagnosis, we used the Fehring's models: the Diagnostic Content Validity Model and the Patient-Focused Clinical Diagnostic Validity Model. They were used to find out the significance of the defining characteristics of the nursing diagnosis of imbalanced nutrition: less than body requirements. After data collection, we calculated a weighted score (WS) for each defining characteristic. There were two samples in the study. The first sample (n 1) consisted of 101 nurses-experts according to the modified Fehring's criteria. The second sample (n 2) consisted of 50 hospitalized older patients who had fewer than 17 points (a score indicative of malnutrition) in the first and second parts of the standardised nutrition assessment tool-the MNA (Mini Nutritional Assessment). Out of 22 items, the nurses rated one item as major: food intake less than recommended daily allowance (0.87). In the sample of patients, they rated six items out of 17 as major. They are: insufficient interest in food (0.83), food aversion (0.82), alteration in taste sensation (0.78), decreased body weight (0.77), weight loss with adequate food intake (0.77), and food intake less than recommended daily allowance (0.76). As a result of this study, we suggest considering the inclusion of measurement tools that focus on early detection of malnutrition in all hospitalised older people with lower food intake.
Chronic pain is one of the priority problems in palliative care. The study objective was the validation of the nursing diagnosis of Chronic Pain (00133) in patients in palliative care. It is a retrospective study. To evaluate the defining characteristics of the nursing diagnosis, we used the patient-focused clinical diagnostic validity model of Fehring, which uses information obtained directly from patients. We designed a questionnaire-type measurement tool containing 15 defining characteristics of the nursing diagnosis of Chronic Pain (00133). The sample included n = 83 patients in palliative care who were treated for pain for at least six months. The defining characteristics were rated by the patients on the Likert-type scale (from 1-not at all characteristic of me, to 5-very characteristic of me). After data collection, we calculated weighted scores (WS) for each of the defining characteristics. We used correlation analysis to analyze the relationships between the risk factors. None of the 15 defining characteristics were considered major by the patients. Seven defining characteristics were considered minor: pain (0.68), changes in sleep pattern (0.55), altered ability to continue previous activities (0.54), fatigue (0.52), atrophy of the involved muscle group (0.51), fear of re-injury (0.51), and restlessness (0.50). Eight defining characteristics were discarded by the patients. A statistically significant relationship was found between eight pairs of the minor defining characteristics, p < 0.01. The study results suggest the essential defining characteristics that may help nurses in identifying and defining an accurate nursing diagnosis in clinical practice. S Ú h R N Chronická bolesť patrí k prioritným problémom v paliatívnej starostlivosti. Cieľom výskumu bola validácia ošetrovateľskej diagnózy Chronická bolesť (00133) u pacientov v paliatívnej starostlivosti. Práca má charakter retrospektívnej štúdie. Na posúdenie definujúcich charakteristík ošetrovateľskej diagnózy sme použili Fehringov model klinickej diagnostickej validity zameraný na pacienta, ktorý využíva informácie od pacientov. Vytvorili sme hodnotiaci nástroj dotazníkového typu, ktorý obsahoval
sociálnych vied a zdravotníctva, katedra ošetrovateľstva 2 Fakultná nemocnica v Nitre SummaryThe consideration of the functional condition is a part of taking care of elderly people and it is a principle of the nursing consideration. The level of self-sufficiency is evaluated by nurses working in inpatient medical and social institutions and nurses involved in primary care within the scope of the nursing anamnesis. From the practical standpoint, the knowledge is most important how the patient is able to manage activities of his/her daily life. Many functional tests are used for testing, which serve for objective evaluation of the degree of dependence in an elderly patient, for estimating the load and quantitative needs of the nursing personnel, or help in decisions on the indication of services of the home and social care or situation into permanent institutional care.The target of the work was to determine the ability of the self-care in hospitalized seniors and to determine the deficiency in activities of the daily life through the mediation of functional tests, to compare results of the consideration of the degree of dependence by several functional tests, and to consider the agreement and thus the reliability of the diagnostic conclusion by a nurse. The next target is to affect the ability of taking care of themselves through planned interventions and to determine the efficacy of the applied nursing activities in a selected group from NIC classification systems (Nursing Interventions Classifications) by comparing the ability to take care of oneself at the beginning and at the end of the hospitalization. For the implementation of the research, we used quasiexperiment as the main method. The supplementary method was observation, contents analysis of the nursing documentation and comparison.The measurement scales for objectivizing the deficiency in the self-care were manifested as practical tools for the nursing diagnostics as well as for the measurement of the degree of a progress of the senior functional capacity and for the nursing care efficacy consideration.Key words: taking care of oneself -daily life activities -Barthel ADL index (Activity Daily Living) -NANDA -NIC -NOC SúhrnPosudzovanie funkčného stavu je súčasťou starostlivosti o starých ľudí a je podstatou ošetrovateľského posudzovania. Úroveň sebestačnosti hodnotia sestry v lôžkových zdravotníckych a sociálnych zariadeniach aj sestry v primárnej starostlivosti v rámci ošetrovateľskej anamnézy. Z praktického hľadiska je najdôležitejšie poznať, ako pacient dokáže zvládnuť aktivity denného života. Na testovanie sa používa mnoho funkčných testov, ktoré slúžia na objektívne hodnotenie stupňa závislosti u staršieho pacienta, na odhadnutie záťaže a kvantitatívnej potreby ošetrujúceho personálu, alebo pomáhajú pri rozhodovaní o indikácii služieb domácej a sociálnej starostlivosti alebo o umiestnení do trvalej ústavnej starostlivosti.Cieľmi práce bolo zistiť schopnosť sebaopatery u hospitalizovaných seniorov a určiť deficity pri aktivitách denného života prost...
Filozofa v Nitre, Fakulta sociálnych vied a zdravotníctva, Katedra ošetrovateľstva, Nitra **Oddelenie radiačnej a klinickej onkológie, Fakultná nemocnica Nitra Abstrakt Práca je zameraná na riešenie ošetrovateľskej diagnózy "Konflikt v rozhodovaní" (špecifikovať) 000 83. Zameriava sa na rozhodovanie v starostlivosti o zdravie, ktorému čelia často pacienti s onkologickým ochorením. V práci sme sa
Aim: The aim of the study was content validation of the nursing diagnosis of at Risk of Impaired Skin Integrity by a sample of Slovak nurse-experts. It focuses on identifying the major risk factors in pressure ulcer development. Design: Retrospective study. Methods: The Diagnostic Content Validity Model designed by Fehring was used for validation of the nursing diagnosis; we used it to establish the significance of the risk factors of the nursing diagnosis of at Risk of Impaired Skin Integrity in relation to pressure ulcer development. Correlation analysis was used for evaluation of the relationships between the risk factors. The sample consisted of 126 nurse-experts in accordance with modified Fehring criteria. Results: Out of 23 items, the nurses rated nine as significant (the most frequently present) risk factors (the weighted scores are shown in brackets): physical immobilisation (0.92), skeletal prominence (0.9), imbalanced nutritional state (0.86), moisture (0.86), mechanical factors (e.g., shearing forces, pressure, restraint) (0.84), a Norton Scale score of 14 ≥ points (0.81), hyperthermia (0.81), excretions (0.77), and extremes of age (0.76). Statistically significant correlations, which are positive and range between 0.2 and 0.4, were found between some risk factors. The strongest correlations were found between moisture and mechanical factors (r = 0.4008) and moisture and physical immobilization (r = 0.3072). Conclusion: Using the DCV model, the experts identified nine significant risk factors which can be predictors of pressure ulcer development.
Interakcia s chorými v paliatívnej starostlivosti si vyžaduje kvalitne vzdelané sestry. Cieľ: Hodnotenie vybraných tém kurzu "Multimediálna podpora vzdelávania členov interdisciplinárneho tímu so zameraním na paliatívnu starostlivosť", ktorý vznikol v rámci projektu KEGA 022UKF-4/2015. Porovnanie výsledkov ôsmych autotestov na základe bodového hodnotenia a časových údajov medzi študentmi so stredoškolským zdravotníckym vzdelaním (zdravotníci) a bez stredoškolského zdravotníckeho vzdelania (nezdravotníci). Metódy: Výskumný súbor predstavovalo 115 študentov 1. a 2. ročníka študijného odboru "ošetrovateľstvo", v akademickom roku 2016/2017. Z toho bolo 83 študentov zdravotníkov a 32 nezdravotníkov. Z celkovej vzorky bolo 111 žien a 4 muži. Autotesty boli zamerané na témy: Zmeny mobility, Únava, Symptómy gastrointestinálneho systému, Symptómy respiračného systému, Príbuzní a dobrovoľníci, Duchovný rozmer a Profesijná etika v paliatívnej starostlivosti. Výsledky a diskusia: Štatisticky významný rozdiel (p < 0,05) pri bodovom hodnotení sme zistili v témach: Zmeny mobility (p = ,034) a Symptómy gastrointestinálneho systému (p = ,001), kde vyšší počet bodov získali nezdravotníci. Pri hodnotení v súvislosti s dĺžkou času pri vypĺňaní štatisticky významný rozdiel bol zistený v téme Únava (p = ,033), kde zdravotníci dosiahli vyššiu hodnotu oproti nezdravotníkom. Záver: Výsledky výskumu poukazujú na menšie rozdiely pri vzdelávaní zdravotníkov a nezdravotníkov. Zdôrazňujeme však potrebu skvalitňovania prípravy v oblasti paliatívnej starostlivosti, s perspektívou celoživotného vzdelávania.
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