Auditory Sensory/Perceptual Alteration: Suggested Revision of Defining Characteristics

This correlational study of acutely ill geriatric patients examined (1) if psychosocial dysfunctioning is associated with hearing impairment, as popularly believed; (2) the utility of using psychosocial changes as cues for making the nursing diagnosis sensory/perceptual alterations: auditory; and (3) an alternative model of defining characteristics for predicting auditory perception using variables that have been reported in the literature as being associated with hearing loss but, to date, are not part of the approved diagnostic category. A random sample (n = 226) was drawn from daily admission lists of English-speaking patients 65 years of age or older, admitted to nonintensive care units of a medical center hospital. The major defining characteristics for sensory/perceptual alterations were operationalized as seven variables: depression, cognitive function, social contact with children, social contact with other relatives, social contact with friends, subject-reported hearing ability, and subject-reported overall health status. Auditory sensory perception was operationalized as number of tones heard on audiometric examination. Findings indicate that assessing psychosocial functions does not provide nurses with helpful cues for making the auditory alteration diagnosis. Rather results suggest that nurses can make a more accurate diagnosis merely by knowing the patient's age, self-rating of hearing, and checking ear canals for impacted cerumen.     

Selected Nonpharmacological Therapies for Chronic Pain: The Therapeutic Use of the Placebo Effect

Chronic pain is a common problem requiring a multidisciplinary approach. Nursing can offer diverse therapies complementary to the medical-surgical approach. Guidelines for practice and challenges for research are outlined for selected nonpharmacological chronic pain therapies. This article discusses the placebo effect, which is common to all therapies. Placebos can therapeutically empower patients to stimulate their psychophysiologic self-regulation abilities. Effects, theories, ethics, and therapeutic methods of stimulating the placebo effect are explored.     

Nursing Diagnoses and Interventions for Post-Acute-Phase Battered Women

PURPOSE. To identify nursing diagnoses and interventions applicable for post-acute-phase battered women.
METHODS. Eight battered women were interviewed twice for 2 hours. Gordon's functional health patterns provided the framework for data collection.
FINDINGS. Fifty-three nursing diagnoses and 52 nursing interventions were indicated in the data; 24 nursing diagnoses and 26 nursing interventions were present in all participants' data.
CONCLUSIONS. With the use of comprehensive interventions, nurses can make a major contribution to society by enabling battered women to move to a more protected lifestyle.     

Improved Management of Depression Through Nursing Model Application and Critical Thinking

Nurse practitioners need to integrate nursing and medical models as they practice. This paper explores the application of the Neuman systems model and critical thinking to synthesize, analyze, and evaluate the complex and multidimensional aspects of depression from nursing and medical perspectives. An integrative approach using this model and critical thinking facilitates appropriate management. Multiple nursing diagnoses for depression are derived by Neuman systems model variables. Primary, secondary, and tertiary interventions appropriate to both this model and critical thinking are recommended.     

Nurse Practitioners' Use of Nursing Diagnoses

"Where are We Now?" is an occasional feature in Nursing Diagnosis. The column focuses on current issues and trends related to nursing diagnosis development, implementation, and evaluation.