Importance of Nursing Diagnosis Research

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Importance of Nursing Diagnosis Research

• Margaret Lunney, RN, PhD
• Chairperson, Research Committee
• NANDA International
• Keynote address given at the AENTDE conference in
  Valladolid, Spain
• October 25th 26,th 2007

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Nursing diagnosis research is critically needed
for ongoing development of the nursing diagnosis
taxonomy for international use.
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Classifications are needed whenever the
communication of names for phenomena are
important.
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To develop and maintain a classification, ongoing
research is needed. Research processes are used
to establish evidence.
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Knowledge of the research process is available in
books, articles, and workshops.
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The goal is to promote nursing research to
support the nursing diagnosis classification.
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To adequately support an international
classification, nursing diagnosis research is
needed in every country for 3 reasons.
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1. The EHR is international and inevitable.
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2. The usefulness of an international
classification depends on global consensus.
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3. Changes in clinical practice are continuous,
so studies are needed to identify, describe,
explain, and predict clinical practice patterns.
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Research is a systematic, disciplined process to
develop, refine, and expand a body of knowledge.
Theoretical Framework for Nursing
Diagnosis Research
Types of Nursing Diagnosis Research
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In many types of studies, the foundation of the
research process is the theoretical framework.
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Theoretical Framework linguistic theory
provides useful explanations for the importance
of developing scientific classifications.
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Words are maps to the territory
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The meanings of words are known through context.
Context is known through experience.
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The meanings of words are extensional(physic
al world)andIntensional(ideas about
thephysical world)
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We cant think without names. The names for
things influence our thinking. Thinking about
things also influences our naming.
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We experience only a small fraction of phenomena,
e.g., Bessie the cow.
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Human beings abstract from their experiences and
observations.
8. Wealth 7.
Asset 6. Farm asset 5. Livestock
4. Cow 3. Bessie 2. Perception 1.
Process___________________________ Words are
abstractions of similarities, not differences
(read from bottom up)
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Nurses abstract from their interactions with
patients and families.
Energy level Is adequate
Wants help from a nurse
Calm demeanor
No signs of distress
Self esteem?
Vital signs Are good
Color is good
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This is an example of an abstraction ladder
applied to nursing diagnosis.

• 8.
  Neuman Systems Model 7. Lines of Defense
• 6. Functional Health Patterns
• 5. Cognitive-Perceptual Pattern
• 4. Decision Making
• 3. Decisional Conflict re feeding
• 2. Cheryls Breastfeeding
• 1. Breastfeeding experience____________
• Words are abstractions of similarities, not
  differences
• (read from bottom up)

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Summary A theory of nursing diagnosis is that
we name things to think about them, interpret the
meaning, and, with others, provide actions for
quality care.

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Use this theoretical framework to explain the
importance of nursing diagnosis research.
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Many types of nursing diagnosis research are
needed.
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Qualitative methods that can be used are
participant action research, grounded theory, and
phenomenology.
Nurses from Hackettstown Regional Medical Center w
orking in participant action research study
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Example Participant Action Research.An
advantage is that you involve the stakeholders,
e.g., patients or nurses.
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We used action research methods to conduct a
consensus validation study of the common
diagnoses (NANDA), interventions (NIC) and
outcomes (NOC) for 2 local populations.
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The action research methods for consensus
validation were developed by Dr. Judy Carlson of
Honolulu, Hawaii.
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In this study, 100 consensus of staff nurses was
achieved on relevant NANDA, NIC and NOC terms for
2 populations.
People with Diabetes
Women in Labor one hour after delivery
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The results were brought back for use at the
bedside.
The nurses who produced the research product use
the research findings.
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Quantitative designs for ndx research can be
nonexperimental, quasi-experimental, or
experimental.
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This is what part of the tool we used for the
respiratory study looked like.

• Defining Characteristics Present/
  Absent
• ABG from Baseline, Abnormal ______/________
• ABG from Normal Values, Abnormal ______/________
  
• Values
• pH ______/________
  pCO2 ______/________
• HCO3 ______/________
• pO2 ______/________
• O2 Sat ______/________
• Adventitious Breath Sounds
• Crackles/Rales
• Fine _______/_______ Course _______/_____
  __
• Gurgles/Rhonchi _______/_______
• Wheezes _______/_______
• Stridor _______/_______

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Guidelines can be found in books and examples in
journals can be followed. Also, ask for help
from a mentor.
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Quantitative clinical validation studies are
critically needed because we do not know unless
we systematically investigate.
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Guidelines for planning a quantitative clinical
study were described by Carlson Lunney (1995).
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The science of nursing needs a broad base of
research to support its diagnostic language.
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Nurses worldwide need to work together to design
and conduct studies of new and existing diagnoses.
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Will you help us to build a future for nursing
science by conducting nursing diagnosis research?