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Rodríguez-Suárez CA, González-de la Torre H, Hernández-De Luis MN, Fernández-Gutiérrez DÁ, Martínez-Alberto CE, Brito-Brito PR. Effectiveness of a Standardized Nursing Process Using NANDA International, Nursing Interventions Classification and Nursing Outcome Classification Terminologies: A Systematic Review. Healthcare (Basel) 2023; 11:2449. [PMID: 37685482 PMCID: PMC10487812 DOI: 10.3390/healthcare11172449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/31/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
The decision-making in clinical nursing, regarding diagnoses, interventions and outcomes, can be assessed using standardized language systems such as NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification; these taxonomies are the most commonly used by nurses in informatized clinical records. The purpose of this review is to synthesize the evidence on the effectiveness of the nursing process with standardized terminology using the NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification in care practice to assess the association between the presence of the related/risk factors and the clinical decision-making about nursing diagnosis, assessing the effectiveness of nursing interventions and health outcomes, and increasing people's satisfaction. A systematic review was carried out in Medline and PreMedline (OvidSP), Embase (Embase-Elsevier), The Cochrane Library (Wiley), CINAHL (EbscoHOST), SCI-EXPANDED, SSCI and Scielo (WOS), LILACS (Health Virtual Library) and SCOPUS (SCOPUS-Elsevier) and included randomized clinical trials as well as quasi-experimental, cohort and case-control studies. Selection and critical appraisal were conducted by two independent reviewers. The certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation Methodology. A total of 17 studies were included with variability in the level and certainty of evidence. According to the outcomes, 6 studies assessed diagnostic decision-making and 11 assessed improvements in individual health outcomes. No studies assessed improvements in intervention effectiveness or population satisfaction. There is a need to increase studies with rigorous methodologies that address clinical decision-making about nursing diagnoses using NANDA International and individuals' health outcomes using the Nursing Interventions Classification and the Nursing Outcome Classification as well as implementing studies that assess the use of these terminologies for improvements in the effectiveness of nurses' interventions and population satisfaction with the nursing process.
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Affiliation(s)
- Claudio-Alberto Rodríguez-Suárez
- Research Support Unit, Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain
- Nursing Department, Faculty of Healthcare Science, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | - Héctor González-de la Torre
- Research Support Unit, Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain
- Nursing Department, Faculty of Healthcare Science, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | | | - Domingo-Ángel Fernández-Gutiérrez
- Primary Care Management of Tenerife, Canary Health Service, 38004 Santa Cruz de Tenerife, Spain; (D.-Á.F.-G.); (P.-R.B.-B.)
- Faculty of Healthcare Science, Universidad de La Laguna (ULL), 38200 Santa Cruz de Tenerife, Spain
| | | | - Pedro-Ruymán Brito-Brito
- Primary Care Management of Tenerife, Canary Health Service, 38004 Santa Cruz de Tenerife, Spain; (D.-Á.F.-G.); (P.-R.B.-B.)
- Faculty of Healthcare Science, Universidad de La Laguna (ULL), 38200 Santa Cruz de Tenerife, Spain
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Brito-Brito PR, Galdona-Luis I, Rodríguez-Álvaro M, García-Hernández AM. Psychosocial Care Needs, Personality Styles, and Coping Strategies of Mourners in a Rural Municipality in Spain: An Observational Study. Healthcare (Basel) 2023; 11:1244. [PMID: 37174786 PMCID: PMC10177754 DOI: 10.3390/healthcare11091244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/14/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Grieving is a natural, self-limiting process of adaptation to a new reality following a significant loss, either real or perceived, with a wide range of manifestations that have an impact on the health of the grieving individual. This study aims to analyse the relationships between interpersonal styles, coping strategies, and psychosocial care needs in a sample of mourners in a rural municipality. Initial hypothesis: there are associations between types of grief and psychosocial needs, as well as between types of grief and interpersonal styles or coping strategies. An observational, descriptive, analytical, cross-sectional study was carried out with a sample of 123 people. Female participants represented 64.2% of all participants. The mean age was 42.7 (±13.2) years, and 86.2% of participants reported continuing to suffer from the loss, with a 10.5% prevalence of maladaptive grieving. Regarding the associations identified between coping strategies and the interpersonal characteristics of the mourners, we found that those with the best coping scores described themselves as self-confident, boastful, jovial, forceful, gentle-hearted, self-assured, outgoing, and/or neighbourly. By contrast, mourners who obtained poorer coping scores self-identified as shy, unsparkling, timid, unsociable, unbold, and/or bashful. This provides a clinical profile linked to maladaptive grieving in which emotional, self-perception, and social problems are prevalent.
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Affiliation(s)
- Pedro-Ruymán Brito-Brito
- Training and Research in Care, Primary Care Management Board of Tenerife, The Canary Islands Health Service, 38004 Santa Cruz de Tenerife, Spain
- Department of Nursing, Faculty of Healthcare Sciences, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain
| | - Irayma Galdona-Luis
- Electronic Health Record Training, Primary Care Management Board of Tenerife, The Canary Islands Health Service, 38004 Santa Cruz de Tenerife, Spain
| | - Martín Rodríguez-Álvaro
- Department of Nursing, Faculty of Healthcare Sciences, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain
- Santa Cruz de La Palma Primary Health Care Centre, Health Area of La Palma, The Canary Islands Health Service, 38200 Santa Cruz de Tenerife, Spain
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Martín-Dorta WJ, García-Hernández AM, Delgado-Hernández J, Sainz-Fregel E, Miranda-Martín RC, Suárez-Pérez A, Jiménez-Álvarez A, Martín-Felipe E, Brito-Brito PR. Psychometric Testing of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia. Int J Environ Res Public Health 2023; 20:3935. [PMID: 36900945 PMCID: PMC10001674 DOI: 10.3390/ijerph20053935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: The CEECCA questionnaire assesses the ability to communicate among individuals with aphasia. It was designed using the NANDA-I and NOC standardised nursing languages (SNLs), reaching high content validity index and representativeness index values. The questionnaire was pilot-tested, demonstrating its feasibility for use by nurses in any healthcare setting. This study aims to identify the psychometric properties of this instrument. (2) Methods: 47 individuals with aphasia were recruited from primary and specialist care facilities. The instrument was tested for construct validity and criterion validity, reliability, internal consistency, and responsiveness. The NANDA-I and NOC SNLs and the Boston test were used for criterion validity testing. (3) Results: five language dimensions explained 78.6% of the total variance. Convergent criterion validity tests showed concordances of up to 94% (Cohen's κ: 0.9; p < 0.001) using the Boston test, concordances of up to 81% using DCs of NANDA-I diagnoses (Cohen's κ: 0.6; p < 0.001), and concordances of up to 96% (Cohen's κ: 0.9; p < 0.001) using NOC indicators. The internal consistency (Cronbach's alpha) was 0.98. Reliability tests revealed test-retest concordances of 76-100% (p < 0.001). (4) Conclusions: the CEECCA is an easy-to-use, valid, and reliable instrument to assess the ability to communicate among individuals with aphasia.
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Affiliation(s)
| | | | | | - Estela Sainz-Fregel
- Primary Care Management of Tenerife, The Canary Islands Health Service, 38400 Puerto de la Cruz, Spain
| | | | - Alejandra Suárez-Pérez
- Rehabilitation Department, University Hospital of the Canary Islands, The Canary Islands Health Service, 38320 San Cristóbal de La Laguna, Spain
| | - Alejandra Jiménez-Álvarez
- Rehabilitation Department, University Hospital of the Canary Islands, The Canary Islands Health Service, 38320 San Cristóbal de La Laguna, Spain
| | - Elena Martín-Felipe
- Neurology Department, Nuestra Señora de la Candelaria University Hospital, The Canary Islands Health Service, 38010 Santa Cruz de Tenerife, Spain
| | - Pedro-Ruymán Brito-Brito
- Training and Research in Care, Primary Care Management Board of Tenerife, The Canary Islands Health Service, Department of Nursing, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
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Brito-Brito PR, Rodríguez-Álvaro M, Fernández-Gutiérrez DÁ, Martínez-Alberto CE, Cabeza-Mora A, García-Hernández AM. Nursing Diagnoses, Planned Outcomes and Associated Interventions with Highly Complex Chronic Patients in Primary Care Settings: An Observational Study. Healthcare (Basel) 2022; 10:healthcare10122512. [PMID: 36554037 PMCID: PMC9778131 DOI: 10.3390/healthcare10122512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/21/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
The information logged by nurses on electronic health records (EHRs) using standardised nursing languages can help us identify the characteristics of highly complex chronic patients (HCCP) by focusing on care in terms of patients' health needs. The aim of this study was to describe the profile of HCCPs using EHRs from primary care (PC) facilities, presenting patients' characteristics, functional status based on health patterns, NANDA-I nursing diagnoses, health goals based on Nursing Outcomes Classification (NOC), and care interventions using Nursing Interventions Classification (NIC). With an observational, descriptive, cross-sectional, epidemiological study design, this study was carried out with a sample of 51,374 individuals. The variables were grouped into sociodemographic variables, clinical variables, resources, functional status (health patterns), nursing diagnoses, outcomes, and interventions. A total of 57.4% of the participants were women, with a mean age of 73.3 (12.2), and 51% were frail or dependent. Prevalent conditions included high blood pressure (87.2%), hyperlipidaemia (80%), osteoarthritis (67.8%), and diabetes (56.1%). The participants were frequent users of healthcare services, with 12.1% admitted to hospital in the past year. Some 49.2% had one to four health patterns assessed, with more information on biological and functional aspects than on psychosocial aspects. The mean number of nursing diagnoses was 7.3 (5.2), NOC outcomes 5.1 (4.1), and NIC interventions 8.1 (6.9). Moderately and highly significant differences were observed between dysfunction in physical activity/exercise health pattern and age group, and between dysfunction in other health patterns and classification as a frail or dependent elderly person. Regarding the presence of certain nursing diagnoses, significant differences were observed by age group, classification of elderly person status, and presence of diseases. A total of 20 NIC interventions showed moderately or relatively strong associations for older age groups, higher levels of dependency, and chronic health conditions.
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Affiliation(s)
- Pedro-Ruymán Brito-Brito
- Nursing Department, Faculty of Healthcare Sciences, Universidad de La Laguna, 38200 Santa Cruz de Tenerife, Spain
- Canary Islands Research Group on Nursing Taxonomies (CARECAN), 38200 Santa Cruz de Tenerife, Spain
- Primary Care Management Board of Tenerife, The Canary Islands Health Service, 38003 Santa Cruz de Tenerife, Spain
| | - Martín Rodríguez-Álvaro
- Nursing Department, Faculty of Healthcare Sciences, Universidad de La Laguna, 38200 Santa Cruz de Tenerife, Spain
- Canary Islands Research Group on Nursing Taxonomies (CARECAN), 38200 Santa Cruz de Tenerife, Spain
- Health Services Management Board of La Palma, The Canary Islands Health Service, 38713 Breña Alta, Spain
| | - Domingo-Ángel Fernández-Gutiérrez
- Nursing Department, Faculty of Healthcare Sciences, Universidad de La Laguna, 38200 Santa Cruz de Tenerife, Spain
- Canary Islands Research Group on Nursing Taxonomies (CARECAN), 38200 Santa Cruz de Tenerife, Spain
- Primary Care Management Board of Tenerife, The Canary Islands Health Service, 38003 Santa Cruz de Tenerife, Spain
- Correspondence:
| | - Carlos-Enrique Martínez-Alberto
- Canary Islands Research Group on Nursing Taxonomies (CARECAN), 38200 Santa Cruz de Tenerife, Spain
- Nuestra Sra, de la Candelaria Nursing College, 38010 Santa Cruz de Tenerife, Spain
| | - Antonio Cabeza-Mora
- Primary Care Management Board of Gran Canaria, The Canary Islands Health Service, 35006 Las Palmas de Gran Canaria, Spain
| | - Alfonso-Miguel García-Hernández
- Nursing Department, Faculty of Healthcare Sciences, Universidad de La Laguna, 38200 Santa Cruz de Tenerife, Spain
- Canary Islands Research Group on Nursing Taxonomies (CARECAN), 38200 Santa Cruz de Tenerife, Spain
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Rodríguez-Suárez CA, Rodríguez-Álvaro M, García-Hernández AM, Fernández-Gutiérrez DÁ, Martínez-Alberto CE, Brito-Brito PR. Use of the Nursing Interventions Classification and Nurses’ Workloads: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10061141. [PMID: 35742192 PMCID: PMC9222990 DOI: 10.3390/healthcare10061141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The Nursing Interventions Classification allows the systematic organisation of care treatments performed by nurses, and an estimation of the time taken to carry out the intervention is included in its characteristics. The aim of this study is to explore the evidence related to the use of the Nursing Interventions Classification in identifying and measure nurses’ workloads. Methods: A scoping review was conducted through a search of the databases Ovid Medline, PubMed, Web of Science, CINAHL, Scopus, LILACS and Cuiden. The DeCS/MeSH descriptors were: “Standardized Nursing terminology” and “Workload”. The search was limited to articles in Spanish, English and Portuguese. No limits were established regarding year of publication or type of study. Results: Few reports were identified (n = 8) and these had methodological designs that contributed low levels of evidence. Research was focused on identifying specific interventions, types of activities, the prevalence of interventions and the time required to perform them. Conclusions: The evidence found on determination of nurses’ workloads using the Nursing Interventions Classification was inconclusive. It is essential to increase the number of reports, as well as the settings and clinical context in which the Nursing Interventions Classification is used, with greater quality and methodological rigour.
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Affiliation(s)
- Claudio-Alberto Rodríguez-Suárez
- Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain
- Correspondence: (C.-A.R.-S.); (M.R.-Á.)
| | - Martín Rodríguez-Álvaro
- Santa Cruz de La Palma Primary Health Care Centre, Canary Health Service and Nursing Department, University of La Laguna, 38700 Santa Cruz de La Palma, Spain
- Correspondence: (C.-A.R.-S.); (M.R.-Á.)
| | | | - Domingo-Ángel Fernández-Gutiérrez
- Primary Care Management of Tenerife, Canary Health Service and Nursing Department, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain; (D.-Á.F.-G.); (C.-E.M.-A.)
| | - Carlos-Enrique Martínez-Alberto
- Primary Care Management of Tenerife, Canary Health Service and Nursing Department, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain; (D.-Á.F.-G.); (C.-E.M.-A.)
| | - Pedro-Ruymán Brito-Brito
- Training and Research in Care, Primary Care Management of Tenerife, Canary Health Service, 38200 Santa Cruz de Tenerife, Spain;
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Martín-Dorta WJ, Brito-Brito PR, García-Hernández AM. Development and Content Validation of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia Based on the NANDA-I and NOC. Healthcare (Basel) 2021; 9:1459. [PMID: 34828504 PMCID: PMC8619169 DOI: 10.3390/healthcare9111459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022] Open
Abstract
This study presents the development and content validation of an instrument assessing the ability to communicate among individuals with aphasia. The study consists of three stages: (i) Selection and definition of the component dimensions and areas, construction of items assessing these dimensions, administration instructions, and qualitative criteria for assigning diagnoses; (ii) Face validity and content validity; (iii) Pilot test. The tentative questionnaire was designed using two defining characteristics of the NANDA-I ("Impaired verbal communication" and "Readiness for enhanced communication") and the NOC outcome indicators "Communication", "Communication: Expressive", "Communication: Receptive", and "Information Processing". The areas and items reached initial content validity index (CVI) and representativeness index (RI) values of 0.87 and above. Those that did not reach the expected values were modified after expert review. The resulting questionnaire was pilot-tested for feasibility and administration times. An instrument containing five dimensions, fourteen areas, and 43 items was obtained and administered in 15 (12-31) minutes. A panel of experts evaluated the final questionnaire (CEECCA), awarding its areas and items CVI and RI values of 0.90 and above. In the absence of further psychometric studies, the questionnaire appears to be useful for assessing ability to communicate in individuals with aphasia.
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Affiliation(s)
- Willian-Jesús Martín-Dorta
- Primary Care Management of Tenerife, The Canary Islands Health Service, 38003 Santa Cruz de Tenerife, Spain
| | - Pedro-Ruymán Brito-Brito
- Training and Research in Care, Primary Care Management of Tenerife, The Canary Islands Health Service, 38204 Santa Cruz de Tenerife, Spain;
- Department of Nursing, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain
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Rodríguez-Álvaro M, García-Hernández AM, Brito-Brito PR. Grieving is not a Nursing Diagnosis. Int J Nurs Knowl 2020; 31:260-261. [PMID: 32052916 DOI: 10.1111/2047-3095.12278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Rodríguez-Álvaro
- Universidad de La Laguna, Grupo de Investigación Cuidados al Final de la Vida (CUFINVIDA) and Servicio Canario de Salud, Canarias, España
| | - A M García-Hernández
- Universidad de La Laguna and Grupo de Investigación Cuidados al Final de la Vida (CUFINVIDA), Canarias, España
| | - P R Brito-Brito
- Universidad de La Laguna, Grupo de Investigación Cuidados al Final de la Vida (CUFINVIDA) and Servicio Canario de Salud, Canarias, España
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Rodríguez-Álvaro M, Brito-Brito PR, García-Hernández AM, Aguirre-Jaime A, Fernandez-Gutierrez DA. The Grieving Nursing Diagnoses in the Primary Healthcare Setting. Int J Nurs Knowl 2018; 30:34-42. [PMID: 29360242 DOI: 10.1111/2047-3095.12202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To estimate the prevalence of Grieving, risk for Complicated Grieving, and Complicated Grieving in the primary care setting. METHODS Retrospective epidemiological study, analyzing data from electronic health records (EHR). FINDINGS A total of 84% of the 9,063 records had diagnostic labels without defining characteristics, related factors, or risk factors. A larger frequency of complicated grieving was found in deceased mourners. CONCLUSIONS The grieving epidemiology opens new chances for the research using data from EHR. PRACTICE IMPLICATIONS The adequacy of the records is essential to develop a profile of the patient at risk of complications after the loss. This research is an important step to build an epidemiological basis for nursing diagnosis of grieving in the primary health care setting.
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