Clinical validation of the NANDA-I diagnosis of impaired memory in elderly patients.

PURPOSE: The aim of this study was to perform a clinical validation of the defining characteristics of impaired memory (IM) in elderly patients at a long-term care institution. METHODS: A sample of 123 elderly patients was evaluated with a questionnaire designed to identify IM according to the NANDA-I taxonomy. Accuracy measures were calculated for the total sample and for males and females separately. RESULTS: Sensitivity and specificity values indicated that: (1) inability to learn new skills is useful in screening IM, and (2) forgets to perform a behavior at a scheduled time, forgetfulness, inability to learn new information, inability to recall events, and inability to recall factual information are confirmatory indicators. CONCLUSION: Specific factors can affect the manifestation of IM by elderly patients. The results may be useful in improving diagnostic accuracy and efficiency of the IM nursing diagnosis.

Simultaneous concept analysis of nursing diagnoses related to respiratory function.

AIM: To perform a simultaneous concept analysis of the concepts associated to nursing diagnoses ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange. BACKGROUND: Concepts about respiratory manifestations need to be well defined, especially in the current pandemic scenario. For that, the simultaneous concept analysis can help in the clarity and differentiation of similar concepts. METHODS: A concept analysis using the Walker and Avant approach and an integrative review. Data were collected by a group of nurses through a literature review. The group identified 10 articles that met the inclusion criteria and complemented the understanding of the concepts analysed through the sequential description of respiratory physiology in technical books. RESULTS: The final list included 28, 22, and 21 clinical indicators for ineffective breathing pattern, impaired gas exchange, and ineffective airway clearance, respectively. The former, the final proposal incorporated 13 indicators that were pointed out by the group and 15 defining characteristics of NANDA-International. For Impaired gas exchange, the indicator "decreased oxygen saturation" was included; among the defining characteristics of NANDA-International, "abnormal arterial blood gases" was excluded, and "abnormal breathing pattern" was subdivided into "alterations in respiratory depth," "bradypnea," "tachypnea," and "change in respiratory rhythm." The latter, only the "wide-eyed" was removed from the final list of clinical indicators, which subsequently consisted of nine indicators suggested by the group and 12 defining characteristics. CONCLUSION: This concept analysis may aid in the process of differentiation for ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange, and aid in safer diagnostic inference. This concept analysis can support the understanding of respiratory nursing diagnoses, helping nurses to identify and differentiate them more safely.