Physical activity deficit: a proposed nursing diagnosis.

TOPIC: Physical inactivity is a major public health problem. Many of the leading causes of death and disability are associated with physical inactivity. The literature is filled with documentation about the importance of living physically active lifestyles. Healthcare professionals have started to incorporate health promotion into their practices, but there is still a large amount of work to do. PURPOSE: To discuss the label, definition, defining characteristics, and related factors of the proposed nursing diagnosis "physical activity deficit." This diagnosis has been submitted for consideration to the North American Nursing Diagnosis Association (NANDA). SOURCES: Existing empirical literature, professional journals, government documents, clinical handbook, text books, a conference statement, and a U.S. Surgeon General's report. CONCLUSIONS: Nurses are in an ideal position to lead when it comes to health promotion. Because physical inactivity is a modifiable risk factor for many diseases and disabilities, it is essential that it is included in nursing science. The diagnosis "physical activity deficit" would allow nurses to take a role in teaching the hazards of physical inactivity, explaining the benefits of activity, and encouraging regular exercise programs.

Clinical validation of ineffective breathing pattern, ineffective airway clearance, and impaired gas exchange.

PURPOSE: To describe the clinical validation of symptoms or defining characteristics of three respiratory diagnoses. The contributing factors or etiologies of the diagnoses were identified and the degree of importance of 30 nursing interventions, 15 direct care and 15 teaching, was rated for each diagnosis and each patient. Three nursing diagnoses--ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE)--were among the most frequently used, yet no reported clinical studies validated the defining characteristics of these diagnoses. This study answers the research questions: What are the defining characteristics of IBP, IAC, and IGE? What are the etiologies of IBP, IAC, AND IGE? What are the most important interventions for IBP, IAC, and IGE? DESIGN: Standardized clinical validation using a convenience sample of 76 people hospitalized with medical and surgical diagnoses, in one U.S. city, and identified as having one of the three diagnoses. Data were collected in 1992-1993. METHODS: A literature-based concept analysis generated 37 possible defining characteristics for the three diagnoses which were included in the instrument. The nurse experts conducted a health history and physical examination of each patients and decided (a) whether the 37 defining characteristics were present or absent, (b) the degree of importance of each possible defining characteristic for making one or more of the diagnoses, (c) the etiologies, and (d) which of the 30 nursing interventions were important for each diagnosis and patient. FINDINGS: For each diagnosis, many of the 37 possible defining characteristics were judged as present but few reached the criterion of .50 as important for making one of the diagnoses. Two of the possible defining characteristics reached this criterion for IBP, seven for IAC, and two for IGE. In contrast to the defining characteristics approved by NANDA, the subjective cues of "expresses fatigue" and "expresses anxiety" were judged as important for making one or more of the diagnoses. CONCLUSIONS: Clinical validation methods allow discriminating among defining characteristics. Data that are present are not necessarily characteristic of a diagnosis, and the subjective cues of expresses fatigue or anxiety may be important for making these diagnoses.

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.

Quantitative methods for clinical validation of nursing diagnoses.

CLINICAL VALIDATION STUDIES of nursing diagnoses are necessary to support use of diagnostic concepts and their defining characteristics in clinical settings. Diagnostic concepts approved by the North American Nursing Diagnosis Association, i.e., human responses to health problems and life processes, need to be tested through clinical research. Because validation studies have some unique procedures, we explain methods to be used by CNSs to conduct clinical studies.

Invest in yourself: cultivating personal power.

The seeds of power may need to be cultivated by nurses who seek to be more personally effective. This article explores the reasons for powerlessness and offers strategies to achieve a self-concept of power.

Application of empowerment theory for CNS practice.

Power is necessary for the clinical nurse specialist (CNS) to successfully conduct objectives of practice in bureaucratic hospital settings. To obtain power, the CNS could use strategies of an empowerment theory to fully operationalize roles in hospitals. This article will discuss how the CNS may be empowered utilizing strategies in four empowering categories. In addition, the many benefits of empowering the CNS are reviewed.

Research by committee: a format to organize and conduct studies.

Research by committee is a relatively new format to conduct research projects. Since this format is best suited for projects that are multifaceted, the conduct of clinical validation studies of nursing diagnosis, which requires the input of educators, clinical experts and researchers, is possible. In order to conduct research by committee effectively, several dimensions must be considered such as how to form and coordinate a committee, as well as how to use resources, distribute workload, and motivate members. The author offers attributes of research by committee and a practical guide for optimally utilizing a committee format for the conduct of studies.

Said another way. What is the language of nursing?

Nursing is multidimensional, interactive, interdisciplinary, and complex. Almost anything that can be said about nursing can be said another way. Some things worth being said and heard will not follow the norms of journal presentation. A forum accommodates the emerging voice, the new format, the innovative approach. Nursing Forum, in an effort to honor the "independent voice" in nursing, presents here the voice who elects to enter the dialogue, but who does so "in another way."