Intervention for ineffective airway clearance in asthmatic children: A controlled and randomized clinical trial

This study aimed to analyse the effectiveness of an intervention for the nursing diagnosis of ineffective airway clearance in asthmatic children. A blinded, randomized and controlled clinical trial was developed in a paediatric hospital located on northeast of Brazil with 42 asthmatic children aged ≤ 36 months. The children were randomly divided into two groups (intervention and control) by means of a simple drawing. The applied intervention included actions related to change of positioning and stimulation of cough. The main findings of this study show that before the intervention, no significant difference was observed in the health status of the children. After the intervention, the indicators of choking (16.83 vs. 26.17, P = 0.007) and adventitious breath sounds (16.4 vs. 26.6, P = 0.005) were higher, on average, in the intervention group. It was observed an improvement in obstructive symptoms in children who received the intervention proposed.     

Multinational validation of anxiety, hopelessness, and ineffective airway clearance

The effective use of nursing diagnosis internationally depends in part on incorporating language and cultural difference into the common language of nursing. International validation studies can provide a basis for this effort. This study tested three diagnoses--anxiety, hopelessness, and ineffective airway clearance--through multinational validation. The Diagnostic Content Validity (DCV) model was used to collect data from critical care nurses in six countries. Defining characteristics rated as critical (greater than .80) by the total sample were dyspnea for ineffective airway clearance and panic and nervousness for anxiety. No critical defining characteristics for hopelessness were identified. DCV ratios for all defining characteristics are compared by country.     

Ineffective airway clearance in adult patients after thoracic and upper abdominal surgery

AimThe aim of this study is to analyze the accuracy of the defining characteristics of ineffective airway clearance (IAC) in patients after thoracic and upper abdominal surgery.BackgroundAlthough numerous studies have described the most prevalent respiratory NANDA-I diagnoses, only few investigates the precision of nursing assessments.MethodsA cross-sectional study was conducted with 192 patients in a surgical clinic. Accuracy measures were obtained by the latent class analysis method.ResultsIAC was present in 46.73% of the sample. The defining characteristics with better predictive capacity were changes in respiratory rate and changes in respiratory rhythm. However, other defining characteristics also had high specificity, such as restlessness, cyanosis, excessive sputum, wide-eyed, orthopnea, adventitious breathing sounds, ineffective cough, and difficulty vocalizing.ConclusionResults can contribute to the improvement of nursing assessments by providing information about the key clinical indicators of IAC.     

Childhood smoking: the research, clinical and theoretical imperative for nursing action

BACKGROUND: Tobacco smoking is a major international health issue which nurses are ideally positioned to address. Childhood represents a critical period for intervention to prevent/reduce smoking. During childhood, the majority of smokers first experiment with smoking, are initiated into the smoking subculture and become addicted to tobacco. Children are highly susceptible to smoking as a result of developmental factors, which promote or facilitate high-risk behaviours, limited coping skills, limited defences and inadequate legal protection against youth-focused marketing of tobacco. AIM: This paper is intended to sensitize nurses to the magnitude of childhood smoking as an international health problem and to familiarize them with current intervention approaches and care issues pertinent to child and adolescent populations. METHOD: An extensive literature review was conducted to determine the impact of childhood smoking at the personal and community level, characteristics of child smokers, the processes associated with smoking cessation, intervention approaches and intervention models for use by nurses across the spectrum of clinical settings. FINDINGS: Evidence exists that behaviourally based interventions by nurses for smoking prevention/cessation are effective with children. Key components of effective behaviourally based antismoking approaches for smokers include addressing self-efficacy to quit, providing social support, resisting temptation to smoke and discussing issues related to relapse and relapse prevention. For all children, the reinforcement of non-smoking behaviour is essential. Intervention models, which can be incorporated into routine clinical care of individual children or with groups, emphasize the importance of parental involvement, routine screening for tobacco use and provision of a clear message that smoking and tobacco use is unhealthy.     

International nursing research in social support: theoretical and methodological issues

Social support has been widely studied within cultures as a variable that is protective of health and mental health, either directly or as a buffer against life stress. When research is conducted across cultures, several conceptual and methodological issues emerge. The purpose of this paper is to discuss the conceptual basis for assuming that social support is a universal phenomenon, to suggest areas in which manifestations of social support may be culture-specific, and to present methodological issues that need to be addressed in conducting valid international research on social support.     

Professional identity and nursing: contemporary theoretical developments and future research challenges

JOHNSON M., COWIN L.S., WILSON I. & YOUNG H. (2012) Professional identity and nursing: contemporary theoretical developments and future research challenges. International Nursing Review Aim: We propose that the conceptual orientation of professional identity is a logical consequence of self‐concept development by focusing on career and its meaning and presents a measurable set of concepts that can be manipulated to improve retention of student and registered nurses within health service. Background: Although professional identity is a term that is commonly written of in nursing literature, its theoretical origins remain unclear, and available empirical evidence of its presence or ability to change is omitted from nursing research. Sources of evidence: We present a professional identity pathway and explore the factors that influence professional identity throughout a career in nursing. Discussion: Nurses' professional identities develop throughout their lifetimes, from before entering nursing education, throughout their years of study and clinical experience, and continue to evolve during their careers. Education is, however, a key period as it is during this time students gain the knowledge and skills that separate nurses as professional healthcare workers from lay people. Conclusion: Finally, a call for longitudinal studies of students to graduates, using conceptually derived and psychometrically proven instruments capable of detecting the subtle changes in the construct over time, is recommended. Further empirical research into the theoretical concepts that underline professional identity, and the factors that influence changes in this important construct in nursing, is required. Ultimately, the practical relevance of such research will lie in the potential it provides for enhanced nursing career support and improved workforce policies.     

Cues for nursing diagnosis of ineffective self-management of fluid and dietary restrictions in dialysis therapy in Japan

PURPOSE. We aimed to identify the cues of expert nurses and validate the cue information on the defining characteristics for a nursing diagnosis of ineffective self‐management of fluid and dietary restrictions in dialysis therapy in Japan. METHODS. We used qualitative interviews and two‐round Delphi studies. FINDINGS. The expert nurses regarded four signs of unmaintained fluid and dietary restrictions as major defining characteristics and nine other cues as minor defining characteristics. CONCLUSIONS. Expert nurses in dialysis therapy regard symptoms of health behavior as major cues for nursing diagnosis of ineffective self‐management of fluid and dietary restrictions in dialysis therapy. IMPLICATIONS FOR NURSING PRACTICE. Verification of the clinical validity and development of a specific, clinically useful database on nursing diagnoses are required.     

The national survey of families and households: A rich data base for nursing research

A summary of the information contained in the National Survey of Families and Households (NSFH), a public-domain data base, is provided. The representativeness of the sample with respect to sex and age and the reliability of a subset of the variables that address depression are evaluated. Suggestions for the use of this data base, with emphasis on variables of direct relevance to family health nursing research, are made. ©1995 John Wiley & Sons, Inc.