Department of Fundamentals of Nursing, Ege University School of Nursing, İzmir, Turkey.
Nurs Outlook. 2012 Jan-Feb;60(1):21-8. doi: 10.1016/j.outlook.2011.03.007. Epub 2011 Jun 23.
There are limited studies on nursing diagnoses of the elderly living in nursing homes worldwide. This study aimed to define the most frequent nursing diagnoses in the elderly residents of a nursing home elder care and rehabilitation center. Seventy-four elderly individuals were included in the study. Data were collected using the "Elderly Individual's Introduction Form" between April 2007 to August 2007. The content of the form was based on a guide to gerontologic assessment, and Gordon's Functional Health Patterns. The nursing diagnoses (NANDA-I Taxonomy II) were identified by the 2 researchers separately according to the defining characteristics and the risk factors. The consistency between the nursing diagnoses defined by the 2 researchers was evaluated using Cohen's kappa (κ). There was an 84.7% agreement about nursing diagnoses defined by the 2 researchers separately. The weighted kappa consistency analyses showed there was an adequate level of consistency (κ = 0.710), and the findings were significant (p < 0.0001). The most frequent diagnoses were ineffective role performance (86.5%), ineffective health maintenance (81.2%), risk for falls (77%), and impaired physical mobility (73%). The diagnosis of ineffective role performance was more frequent in patients with dementia (x(2) =10.993, df = 1, p = 0.001). There was a very significant relationship between dementia and the diagnosis of impaired verbal communication (x(2) = 32.718, df = 1, p = 0.0001). The relationship between mobility disorder and self-care deficit was also significant (x(2) = 19.411, df = 1, p = 0.0001). To improve quality in patient care, nurses should use nursing diagnoses with a systematic assessment and should help the elderly in health promotion or use of the maximum current potential.
目前全球范围内针对养老院老年人护理诊断的研究非常有限。本研究旨在确定养老院老年护理和康复中心老年人的最常见护理诊断。该研究共纳入 74 名老年人。研究数据于 2007 年 4 月至 8 月间采用“老年人个体介绍表”收集，该表的内容基于老年评估指南和 Gordon 的功能性健康模式。两位研究者根据界定特征和危险因素分别对护理诊断（NANDA-I 分类 II）进行独立识别。研究者间对护理诊断的一致性采用 Cohen's kappa（κ）评估。两位研究者独立定义的护理诊断之间存在 84.7%的一致性。加权 kapp 一致性分析显示，一致性处于中等水平（κ=0.710），且差异具有统计学意义（p<0.0001）。最常见的诊断为无效角色表现（86.5%）、健康维护无效（81.2%）、跌倒风险（77%）和躯体活动障碍（73%）。痴呆患者的无效角色表现诊断更为常见（x²(2)=10.993, df=1, p=0.001）。痴呆与言语沟通受损的诊断之间存在显著关系（x²(2)=32.718, df=1, p=0.0001）。活动障碍与自我照顾缺陷之间的关系也具有统计学意义（x²(2)=19.411, df=1, p=0.0001）。为提高患者护理质量，护士应通过系统评估使用护理诊断，并应帮助老年人促进健康或利用其当前的最大潜能。
