An initial examination of the psychometric properties of the Diagnostic Instrument for Social and Communication Disorders (DISCO-11) in a clinical sample of children with a diagnosis of Autism spectrum disorder.

INTRODUCTION: The diagnostic interview for social and communication disorders (DISCO - 11; Wing 2006), is a semi-structured, interview-based instrument used in the diagnosis of children with autism spectrum disorder (ASD). This paper explores the psychometric properties of the DISCO-11 used in a specialist Paediatric clinical setting. Two key research questions were examined; (1) Does the factor structure of the DISCO-11 reflect the diagnostic and statistical manual 5th edition (DSM-5, American Psychiatric Association [APA], 2013) dyad of impairment in ASD? (2) Is there evidence of diagnostic stability over time using the DISCO? METHODS: Review assessments of 65 children with ASD were carried out using standardised measures including the DISCO-11 and the autism diagnostic observation schedule. RESULTS: The results revealed two factors resembling the DSM-5 algorithms, as used in DISCO-11, which were named as social-communication, and restricted and repetitive behaviours. The reliability, for the overall DISCO score was good (Cronbach's alpha = 0.78). The social communication and social interaction subscale showed good reliability (Cronbach's Alpha = 0.77) as did the restricted and repetitive patterns of behaviour, interests or activities subscale (Cronbach's Alpha = 0.74). Acceptable internal reliability was found for the overall DISCO score and the subscales of social communication and social interaction and the restricted and repetitive patterns of behaviour, interests or activities. Test-retest showed good stability of diagnosis over time. DISCUSSION: This study supports that the DISCO-11 shows potential as a valid and reliable instrument that can be used both for clinical and research purposes.

Temporality and existential mood in Heideggerian phenomenology.

BACKGROUND: The philosophical perspective of a research methodology should explicitly underpin the decisions the researcher makes throughout the research. It is therefore important to understand the philosophical background and origins of Heideggerian phenomenology when using it as a research methodology. AIM: To discuss in detail the main philosophical ideas underpinning Heideggerian phenomenology. DISCUSSION: Anxiety and boredom are two significant existential moods in Heideggerian phenomenology. Time is the basis of these moods and is an 'originary temporality'. Originary temporality consists of a unified structure that includes the past, present and future. The experience of being human ('dasein') and its care/worry structure are significant features of originary temporality and consequently existential mood. Existential anxiety discloses the threefold characteristics of temporality to the individual, while existential boredom disrupts its unified structure. Both moods highlight the limits of existence to the individual and may culminate in additional distressing moods. CONCLUSION: It is essential for nurse researchers using Heideggerian phenomenology to understand the philosophical ideas underlining it. IMPLICATIONS FOR PRACTICE: The depiction of originary temporality and existential mood illustrated in this article could help nurse researchers embarking on a Heideggerian phenomenological study. The article could also inform researchers new to Heideggerian phenomenological research of the methodology's philosophical background.

Factors Influencing the Introduction of a Process of Advance Care Planning in Outpatient Hemodialysis Facilities.

Individuals with kidney failure on outpatient hemodialysis therapy may experience many biopsycho social complications and existential concerns. Consequently, there is a need to implement a process of advance care planning to effectively meet the extensive needs of these individuals. However, this article suggests there are various barriers in some outpatient hemodialysis facilities that may hinder the introduction of advance care planning. This article provides a critical discussion of some of these elements, including increased time pressure, nurse-patient communication, and the nurse-patient relationship. The article also makes recommendations that would facilitate the implementation of a process of advance care planning in outpatient hemodialysis facilities.

Experiences of Patients on Outpatient Hemodialysis Therapy Who Are Anticipating a Transplant.

The person with kidney failure may experience many lifestyle disruptions that initiate distressing responses. This article reports on the results of a phenomenological study that explored the experiences of patients with kidney failure who were receiving outpatient hemodialysis therapy and who were either on the transplant list or in the process of being assessed to get on the transplant list. The participants described the existential distress they endured as a result of living with this disease and treatment; however, the participants' descriptions of distress were different than the psychological perspective of emotional distress depicted in the existing research. The information provided in this article can enhance nurses' ability to recognize and respond more appropriately to the distressing moods experienced by patients with kidney failure on outpatient hemodialysis.

Waiting for a kidney transplant: patients' experiences of haemodialysis therapy.

AIM: This paper is a report of an exploration of the experiences of patients with end-stage kidney disease who were having haemodialysis. BACKGROUND: The losses and lifestyle disruptions caused by end-stage kidney disease are a fundamental source of suffering for people. The hope of a transplant is an important factor in people's ability to cope with end-stage kidney disease and dialysis. METHOD: A Heideggerian phenomenological methodology was used. A purposive sample was selected of 16 patients with end-stage kidney disease having hospital-based haemodialysis therapy in the Republic of Ireland. Qualitative interviews were conducted in 2006-2007. Data were analysed using qualitative interpretive analysis. FINDINGS: The overarching pattern identified was 'Waiting for a kidney transplant'. This pattern consisted of three themes: living in hope, uncertainty and being on hold. Participants described their experiences of living in hope while they waited for a kidney transplant. However, as the waiting time continued indefinitely, participants became uncertain, and this meant that they were unable to contemplate opportunities in the future. Moreover, the restrictions of haemodialysis therapy prevented them from performing many of the activities they had taken for granted in the past. Consequently, they described their experiences of being on hold while they waited for a kidney transplant. CONCLUSION: Nurses should engage in open and honest discussions with patients in relation to kidney transplantation so that they are able to recognize and address their concerns about kidney transplantation.

Communicating with nurses: patients' views on effective support while on haemodialysis.

BACKGROUND: Haemodialysis therapy is one form of treatment for end-stage renal disease (ESRD). Patients have to adhere to a strict regimen of dialysis, dietary and fluid restrictions, and medications. AIM: This study explores the experiences of 16 people with ESRD undergoing hospital-based haemodialysis therapy. METHOD: A small-scale study using a phenomenological method was carried out. A total of 16 patients were interviewed and qualitative interpretive analysis was used. RESULTS: The theme 'communicating with nurses: reality versus myth' was created from the analysis of the interview data. Participants indicated that nurses rarely communicated with them during dialysis. The only time nurses seemed to approach participants was to manage the physical and technical aspects of care. CONCLUSION: This study will hopefully increase nurses' awareness of the importance of effective communication in providing supportive care to patients with renal disease.