The goal of this study was to carry out a diagnostic content validation regarding the nursing diagnosis Ineffective Breathing Pattern -00032, which was approved by the Taxonomy Committee of NANDA International for the years 2012-2014. A validation study, methodologically based on Fehring's Diagnostic Content Validation, was performed with 52 nurses and medical experts from four hospitals in Moravia and Bohemia who work in nursing care in adult intensive care units or on anaesthesia and resuscitation wards. Main findings:1. The validity of the nursing diagnosis Ineffective Breathing Pattern -00032 has a DCV weighted ratio of 0.63. 2. The DCV weighted ratio of 0.84 of the defining characteristic "dyspnoea" ranks it among the major defining characteristics of the validated diagnosis. 3. The DCV values of 12 defining characteristics between 0.74 and 0.52 ranked as minor defining characteristics of the validated diagnosis. 4. The DCV values of three defining characteristics between 0.40 and 0.32 were considered irrelevant defining characteristics. 5. A strong positive correlation was found between minor defining characteristics "decreased expiratory pressure" and "decreased inspiratory pressure" (r = 0.831), between minor related factors "neuromuscular dysfunction" and "musculoskeletal impairment" (r = 0.710) and between minor related factors "neurological immaturity" and "neuromuscular dysfunction" (r = 0.732). Conclusions:The experts only considered one major diagnostic characteristic significant -dyspnoea, and none of the related factors of Ineffective Breathing Pattern -00032. Despite the limitation of this study, the overall validity of the tested nursing diagnosis is acceptable according to Fehring, without the need to remove the diagnosis from the list presented by the Taxonomy Committee of NANDA International.
Metodika:Aplikován byl design přirozeného experimentu u dvou skupin studentů s použitím pretestu a posttestu. Výzkumné nástroje byly nově pro tuto studii připraveny na podkladě publikovaných článků Herman a Bartlett. Jednalo se o pracovní protokoly pro studenty a nástroj k hodnocení erudice klinické rozvahy. Proběhla obsahová validizace protokolů a u hodnotícího nástroje byla ověřena reliabilita. Sběr dat proběhl u souboru šedesáti tří studentů formou záznamů do pracovních protokolů. Data, extrahovaná z protokolů, byla zpracována na hladině signifi kance 0,05 pomocí Studentova párového t-testu a Wilcoxonova párového testu. Výsledky: Medián celkového skóre erudice klinické rozvahy byl, při maximálním dosažitelném počtu 29 bodů, u studentů prezenční formy v pretestu 18,9 a v posttestu 19,5 bodů. U kombinované formy byl před a po cvičení 18,0 a 17,0 bodů. Závěry: U prezenční formy studia byla erudice klinické rozvahy s pojmy Aliance 3N po procvičování zlepšena, ale rozdíl nebyl statisticky signifi kantní. U kombinované formy studia prokázal Wilcoxonův párový test signifi kantní zhoršení. Využití NANDA diagnóz bylo u obou skupin subjektů explicitní, zásadní nedostatky byly shledány ve volbě optimálních NOC a NIC. ABSTRACT Main aim:To determine the eff ect of practicing nursing process by OPT model of clinical reasoning on the expertise of students of General Nursing study in the use of concepts Alliance 3N. Methods:Applied design was a natural experiment on two groups of students using pretest and posttest. Research instruments for this study were new and prepared on the basis Herman and Bartlett's published articles. Th ese were working protocols for students and a tool to assess erudition of clinical reasoning. Content validation was carried out and evaluation tool was tested on reliability. Th e data were collected in a group of sixty-three students in the form of records to work protocols. Th e data extracted from the protocols were processed at 0.05 level of signifi cance using Student's paired t -test and Wilcoxon paired test. Results: Th e median of total score sheet clinical erudition was at full-time students in the pretest (before practicing) 18.9 points aft er exercise 19.5 (posttest). Th e median of total score before and aft er exercise was 18.0 and 17.0 points at part-time study students. Conclusions: For full-time students' erudition in clinical reasoning with 3N Alliance terms aft er exercises has improved, but the diff erence was not statistically signifi cant. For part-time study students Wilcoxon paired test showed a signifi cant deterioration in student achievement. Use of NANDA diagnoses in both groups of subjects was explicit, major fl aws were found in the choice of optimal NOC and NIC.
The aim of this contribution is to present pilot research of accuracy of clinical balance in teaching students the particular steps of nursing process. The pilot study includes set of 15 full-time students of the Bachelor study branch General Nurse. For each step of the nursing process were prepared sets of records whose content and structure were motivated by principles OPT model of clinical balance of the authors Pesut and Herman. The protocols were used to record defining characteristics, relating or risk factors NANDA International, which were concluded by students from the patient's description (case interpretation). Further to recorded diagnostic conclusion students recorded chosen NOC areas for evaluating the patient and chosen NIC of nursing intervention. As a supporting instrument they obtained files of NOC areas for evaluating the patient and NIC interventions in Czech language. In total, there were prepared four sets of files following different patient description. Set of protocols following the description of the same patient was included at the beginning and at the end of practice. This set was marked as testing one. In testing protocols the accuracy of records was monitored. In order to put the rate of accuracy was used the evaluating instrument OPT model which was modified by the authors of the research. The reliability of this instrument was assessed by Coeficient Cronbach alfa. To judge test-retest reliability was used Spearman correlation coefficient. Obtained data were analysed by Student pair t-test and Wilcoxon pair test level of significance 0.05. It is interesting that in contrast to foreign studies conducted by the authors Kautz, Barlett or Bland the significant difference between the students´ results before and after exercise block was proved only in one evaluating area.
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