Making nursing diagnoses on video recorded case studies
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NANDA International 2012 Conference Abstract
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Session 1.2
Education & Implementation Track

Authors
Tomoko Hasegawa
Yoshiko Uehara
Momoe Sasaki
Kanae Yoshida
Rika Tonami
Yukari Shimizu

Question
To evaluate nursing diagnoses, related factors, and defining characteristics for video recorded case studies. What degree of variation would occur within nursing diagnoses stated by Japanese nurses for video recorded case studies?

Results / Findings
Eighty nurses responded to the questionnaire (80% response rate). Average age was 40.1±7.7 years, and average length of using nursing diagnoses was 6.0±4.8 years. About 74% of the subjects used NANDA-I diagnosis labels. Most frequently stated ND was Acute pain (n=65, 81.2%) related to “bone metastasis” for #1 ND and Anxiety (n=45, 56.2%) related to “terminal stage cancer” for #2 ND for CS1. For CS2, #1 NDs were Impaired physical mobility (n=17, 21.3%) related to “transcervical fracture,” Insomnia (n=11, 13.8%) related to “bed ridden,” Acute pain (n=9, 11.2%) related to “fracture,” Anxiety (n=7, 8.7%) related to “fracture,” and Impaired comfort (n=7, 8.7%) related to “fracture,” and #2 NDs were Risk for impaired skin integrity (n=19, 23.7%) related to “bed ridden,” Constipation (n=16, 20.0%) related to “bed ridden,” and Insomnia (n=10, 12.5%) related to “fracture.”

Discussion / Conclusion
The nurses stated various nursing diagnoses for the video recorded case studies.These results could be caused by differences of the subjects’ clinical judgment skills, and knowledge levels on NDs.

Method
A convenience sample was taken of registered nurses who were providing direct patient care in inpatient settings. A total of 100 nurses agreed to participate in this study. The research methods were approved by the Ethical Review Committee of the University of Fukui, Department of Medical Sciences. The study was conducted from November 2011 to February 2011. The subjects were asked to watch 2 video recorded case studies (each about 15 minutes in length), and then state 2 nursing diagnoses (NDs) with related factors (RFs) and defining characteristics (DCs) for each case study. The subjects were also asked to complete and return a questionnaire to researchers. The questionnaire addressed demographic data, experience using nursing diagnosis, degree and frequency of nursing diagnosis study, and attitude toward nursing diagnosis. Case Studies:  The case studies were chosen from “Assessment Case Studies for Nurses” (Yoshitake & Fujimura, 1996) which are published for nursing assessment education. Case study 1 (CS1) concerned a 45 year-old male patient with terminal stage lung carcinoma who suffered from pain, for control of which he had been hospitalized (Takahashi, 1996). He had not been informed about the stage of his cancer. Case study 2 (CS2) concerned a 72 year-old female patient with a transcervical fracture. She was receiving external traction for the fracture (Arakawa, 1996).

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