Judith Hibbard, DrPH Jessica Greene Jean Stockard Martin Tusler University of Oregon
Validating a Proposed Nursing Diagnosis of Longing Using Expert Nurses Michelle Markwardt, SN ...
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Validating a Proposed Nursing Diagnosis of Longing Using Expert Nurses Michelle Markwardt, SN Danielle Hibbard, SN Shelley-Rae Pehler, PhD, RN Department of Nursing University of Wisconsin-Eau Claire Background This study is phase 2 of a three-step process to create a nursing diagnosis for the human response of longing in patients. Phase 1 was a concept analysis of the literature which provided defining characteristics and related factors, the framework for nursing diagnoses. Phase 2 incorporates the identifiers found in phase 1 to create a survey for nursing experts. What is a nursing diagnosis? Nursing diagnoses are tools to communicate patient needs to other nurses and health care providers. Patients are assessed and assigned diagnoses which help a nurse plan care that is personalized to the patient’s needs, which may be physical, emotional, relational, spiritual, or other. Research Questions 1. To what extent are the defining characteristics of longing present in patients? 2. Is the definition of longing developed during Phase One accurate? 3. In what situations is longing seen in patients? Methods Fehring’s (1986) Diagnostic Content Validity Model. Expert nurses rate the defining characteristics on a five point Likert scale. Weighted ratio formula is used to identify major and minor defining characteristics. Minor characteristics have a weight of 0.5 – 0.79. Major characteristics have a weight of 0.8 – 1.0. Qualtrics is used as the survey tool. Of the respondents only those meeting expert criteria are used. Sample This group represented 22% of the overall sample. According to a study conducted by the American Nurses Association (2011) as of 2008, 13.2% of nurses have a masters degree or above in nursing. Therefore our sample is representative of this population. Defining Characteristics Characteristics Not Validated Longing Definition Longing is the intense desire for something, some state, or some relationship without which one’s life feels incomplete. 35 (88%) agreed with the definition. Discussion of Findings The participants could identify that Longing is a human response they have seen in patients. Major characteristics (>0.80) not identified. Most participants worked in Medical/Surgical acute care setting. Any life-threatening or life-changing diagnoses are more likely to be found in other settings (e.g. oncology, rehabilitation). As in pain research, nurses may be under- diagnosing longing in patients. Still need patient’s perspective. Limitations Low return rate. Inability to send reminder emails. Population of patients cared for may not experience longing making it difficult for nurses to recognize longing. Future Research Survey patients for their experiences of longing. Develop and test assessment strategies to identify longing in patients. Develop and test intervention strategies to treat longing in patients. Acknowledgements We thank the Office of Research and Sponsored programs for supporting this research, and Learning & Technology Services for printing this poster. Photo Credits: Catholic Lane. (n.d.). [Holding hands]. [photograph]. Retrieved from http://catholiclane.com/failing-to-protect-our-own-in-americas-nursing-homes/ holding-hands-with-elderly-patient/ Thomond, C. (Nov. 8, 2011). [Nurse ambulating elderly patient]. [photograph]. Retrieved from http://www.theguardian.com/society/2011/nov/09/nhs-care-quality-under-fire References: Registered nurses in the u.s.: Nursing by the numbers. (2011, May 1). American Nurses Association. Retrieved March 22, 2014, from http://nursingworld.org/FunctionalMenuCategories/MediaResources/MediaBackgrounders Characteristics Rating Frustration with the Situation 0.77 Worry 0.76 Frustration with the Disease 0.76 Feeling Vulnerable 0.73 Frightened 0.73 Need to be Understood 0.72 Uncertainty 0.72 Daydreams About how Life was Before Diagnosis 0.72 Yearning for Happiness in Difficulties 0.72 Loss 0.71 Feeling Powerless 0.71 Interruption of Life 0.71 Wish Diagnosis or Disease was a Dream 0.71 Grief 0.70 Yearning for Something They Could No Longer Do 0.70 Periods of Intense Emotional Experiences 0.70 Need to Maintain Routines 0.70 89% Characteristics Rating Darkness in Their Understanding of Life 0.49 Without Hope 0.49 Lack of Caring about Anything Anymore 0.48 Conscious Effort to Convey to Others That Their Lives are No Different 0.45 Seeking Something New 0.41 Feeling Unified 0.40 Excitement 0.38
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Transcript of Validating a Proposed Nursing Diagnosis of Longing Using Expert Nurses Michelle Markwardt, SN ...
Validating a Proposed Nursing Diagnosis of Longing Using Expert Nurses
Michelle Markwardt, SN Danielle Hibbard, SN Shelley-Rae Pehler, PhD, RNDepartment of Nursing University of Wisconsin-Eau Claire
Background This study is phase 2 of a three-step process to create a
nursing diagnosis for the human response of longing in patients.
Phase 1 was a concept analysis of the literature which provided defining characteristics and related factors, the framework for nursing diagnoses.
Phase 2 incorporates the identifiers found in phase 1 to create a survey for nursing experts.
What is a nursing diagnosis? Nursing diagnoses are tools to communicate patient needs
to other nurses and health care providers. Patients are assessed and assigned diagnoses which help a
nurse plan care that is personalized to the patient’s needs, which may be physical, emotional, relational, spiritual, or other.
Research Questions1. To what extent are the defining characteristics of longing
present in patients?
2. Is the definition of longing developed during Phase One accurate?
3. In what situations is longing seen in patients?
Methods Fehring’s (1986) Diagnostic Content Validity Model. Expert nurses rate the defining characteristics on a five point
Likert scale. Weighted ratio formula is used to identify major and minor
defining characteristics. Minor characteristics have a weight of 0.5 – 0.79. Major characteristics have a weight of 0.8 – 1.0.
Qualtrics is used as the survey tool. Of the respondents only those meeting expert criteria are
used.
Sample
This group represented 22% of the overall sample. According to a study conducted by the American Nurses Association (2011) as of 2008, 13.2% of nurses have a masters degree or above in nursing. Therefore our sample is representative of this population.
Defining Characteristics
Characteristics Not Validated
Longing Definition Longing is the intense desire for something, some state, or
some relationship without which one’s life feels incomplete. 35 (88%) agreed with the definition.
Discussion of Findings The participants could identify that Longing is a human
response they have seen in patients. Major characteristics (>0.80) not identified.
Most participants worked in Medical/Surgical acute care setting.
Any life-threatening or life-changing diagnoses are more likely to be found in other settings (e.g. oncology, rehabilitation).
As in pain research, nurses may be under-diagnosing longing in patients.
Still need patient’s perspective.
Limitations Low return rate. Inability to send reminder emails. Population of patients cared for may not experience longing
making it difficult for nurses to recognize longing.
Future Research Survey patients for their experiences of longing. Develop and test assessment strategies to identify longing
in patients. Develop and test intervention strategies to treat longing in
patients.
Acknowledgements We thank the Office of Research and Sponsored programs for supporting this research, and Learning & Technology Services for printing this poster.Photo Credits:Catholic Lane. (n.d.). [Holding hands]. [photograph]. Retrieved from http://catholiclane.com/failing-to-protect-our-own-in-americas-nursing-homes/holding-hands-with-elderly-patient/ Thomond, C. (Nov. 8, 2011). [Nurse ambulating elderly patient].[photograph]. Retrieved from http://www.theguardian.com/society/2011/nov/09/nhs-care-quality-under-fireReferences:Registered nurses in the u.s.: Nursing by the numbers. (2011, May 1). American Nurses Association. Retrieved March 22, 2014, from http://nursingworld.org/FunctionalMenuCategories/MediaResources/MediaBackgrounders/NursingbytheNumbers
Characteristics Rating Frustration with the Situation 0.77Worry 0.76Frustration with the Disease 0.76Feeling Vulnerable 0.73Frightened 0.73Need to be Understood 0.72Uncertainty 0.72Daydreams About how Life was Before Diagnosis 0.72Yearning for Happiness in Difficulties 0.72Loss 0.71Feeling Powerless 0.71Interruption of Life 0.71Wish Diagnosis or Disease was a Dream 0.71Grief 0.70Yearning for Something They Could No Longer Do 0.70Periods of Intense Emotional Experiences 0.70Need to Maintain Routines 0.70
89%
Characteristics Rating
Darkness in Their Understanding of Life 0.49
Without Hope 0.49
Lack of Caring about Anything Anymore 0.48
Conscious Effort to Convey to Others That Their Lives are No Different 0.45
Seeking Something New 0.41
Feeling Unified 0.40
Excitement 0.38
