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Importance of Nursing Diagnosis Research

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Title: Importance of Nursing Diagnosis Research


1
Importance of Nursing Diagnosis Research
  • Margaret Lunney, RN, PhD
  • Chairperson, Research Committee
  • NANDA International
  • Keynote address given at the AENTDE conference in
    Valladolid, Spain
  • October 25th 26,th 2007

2
Nursing diagnosis research is critically needed
for ongoing development of the nursing diagnosis
taxonomy for international use.
3
Classifications are needed whenever the
communication of names for phenomena are
important.
4
To develop and maintain a classification, ongoing
research is needed. Research processes are used
to establish evidence.
5
Knowledge of the research process is available in
books, articles, and workshops.
6
The goal is to promote nursing research to
support the nursing diagnosis classification.
7
To adequately support an international
classification, nursing diagnosis research is
needed in every country for 3 reasons.
8
1. The EHR is international and inevitable.
9
2. The usefulness of an international
classification depends on global consensus.
10
3. Changes in clinical practice are continuous,
so studies are needed to identify, describe,
explain, and predict clinical practice patterns.
11
Research is a systematic, disciplined process to
develop, refine, and expand a body of knowledge.
Theoretical Framework for Nursing
Diagnosis Research
Types of Nursing Diagnosis Research
12
In many types of studies, the foundation of the
research process is the theoretical framework.
13
Theoretical Framework linguistic theory
provides useful explanations for the importance
of developing scientific classifications.
14
Words are maps to the territory
15
The meanings of words are known through context.
Context is known through experience.
16
The meanings of words are extensional(physic
al world)andIntensional(ideas about
thephysical world)
17
We cant think without names. The names for
things influence our thinking. Thinking about
things also influences our naming.
18
We experience only a small fraction of phenomena,
e.g., Bessie the cow.
19
Human beings abstract from their experiences and
observations.
8. Wealth 7.
Asset 6. Farm asset 5. Livestock
4. Cow 3. Bessie 2. Perception 1.
Process___________________________ Words are
abstractions of similarities, not differences
(read from bottom up)
20
Nurses abstract from their interactions with
patients and families.
Energy level Is adequate
Wants help from a nurse
Calm demeanor
No signs of distress
Self esteem?
Vital signs Are good
Color is good
21
This is an example of an abstraction ladder
applied to nursing diagnosis.
  • 8.
    Neuman Systems Model 7. Lines of Defense
  • 6. Functional Health Patterns
  • 5. Cognitive-Perceptual Pattern
  • 4. Decision Making
  • 3. Decisional Conflict re feeding
  • 2. Cheryls Breastfeeding
  • 1. Breastfeeding experience____________
  • Words are abstractions of similarities, not
    differences
  • (read from bottom up)

22
Summary A theory of nursing diagnosis is that
we name things to think about them, interpret the
meaning, and, with others, provide actions for
quality care.

23
Use this theoretical framework to explain the
importance of nursing diagnosis research.
24
Many types of nursing diagnosis research are
needed.
25
Qualitative methods that can be used are
participant action research, grounded theory, and
phenomenology.
Nurses from Hackettstown Regional Medical Center w
orking in participant action research study
26
Example Participant Action Research.An
advantage is that you involve the stakeholders,
e.g., patients or nurses.
27
We used action research methods to conduct a
consensus validation study of the common
diagnoses (NANDA), interventions (NIC) and
outcomes (NOC) for 2 local populations.
28
The action research methods for consensus
validation were developed by Dr. Judy Carlson of
Honolulu, Hawaii.
29
In this study, 100 consensus of staff nurses was
achieved on relevant NANDA, NIC and NOC terms for
2 populations.
People with Diabetes
Women in Labor one hour after delivery
30
The results were brought back for use at the
bedside.
The nurses who produced the research product use
the research findings.
31
Quantitative designs for ndx research can be
nonexperimental, quasi-experimental, or
experimental.
32
This is what part of the tool we used for the
respiratory study looked like.
  • Defining Characteristics Present/
    Absent
  • ABG from Baseline, Abnormal ______/________
  • ABG from Normal Values, Abnormal ______/________
  • Values
  • pH ______/________
    pCO2 ______/________
  • HCO3 ______/________
  • pO2 ______/________
  • O2 Sat ______/________
  • Adventitious Breath Sounds
  • Crackles/Rales
  • Fine _______/_______ Course _______/_____
    __
  • Gurgles/Rhonchi _______/_______
  • Wheezes _______/_______
  • Stridor _______/_______

33
Guidelines can be found in books and examples in
journals can be followed. Also, ask for help
from a mentor.
34
Quantitative clinical validation studies are
critically needed because we do not know unless
we systematically investigate.
35
Guidelines for planning a quantitative clinical
study were described by Carlson Lunney (1995).
36
The science of nursing needs a broad base of
research to support its diagnostic language.
37
Nurses worldwide need to work together to design
and conduct studies of new and existing diagnoses.
38
Will you help us to build a future for nursing
science by conducting nursing diagnosis research?
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