Nursing Diagnosis Researchfor Students

Chapter Five

Nursing Diagnosis Research for Students

ContributorMargaret Lunney

For Decades, All New Nursing Diagnoses have been Based On Research = Evidence-Based Nursing

• Number and Types of Studies Vary for Individual Diagnoses

• Additional Studies are Needed for All Nursing Diagnoses:• Meaning and Use with Variety of Populations• Use with Interventions and Outcomes

• YOU can Help!

• Conduct Your Own Nursing Diagnosis Research - Examples Follow

The Importance of Research Support for Nursing Diagnosis

Answers Research Questions Such as:

• What Meanings of the Concept are Described in the Literature?

• How is This Concept Distinguished from Other Related Concepts?

• What have Been the Uses for This Concept?

• Instructions on How to Conduct a Concept Analysis(Walker and Avant 2005)

Concept Analysis

Answer Research Questions Such as:• What is the Meaning of the Concept with a Specific Population?

• What are the Defining Characteristics?

• What are the Related Factors?

• What are the Appropriate Uses for the Diagnosis(es)?

• Subjects:• Nurses Who Work with People Experiencing the Diagnosis• People Who Experience the Diagnosis – Considered as the Best

Type of Data

Content Validation Studies

In Clinical Studies, Answer Research Questions Such as:• How Does a Specific Diagnosis Differ from Other Related Diagnoses?

• Does This Diagnosis Occur Under Certain Conditions?

• What is the Frequency of Occurrence Under Certain Conditions?

• How Consistently is the Diagnosis Used by Nurses?

• What Factors Influence Occurrence of the Diagnosis?

• To What Extent Do People with Risk Factors Experience the Diagnosis?

• What are the Outcomes When Interventions are Provided for This Diagnosis?

Construct and Criterion-Related Validity

Answers Research Questions Such as:• To What Extent Do Experienced Nurses Agree Regarding the

Relevant Diagnoses for a Specific Population?

• Which Nursing Diagnoses Should be Included in Standards of Care for a Specific Population?

• Which Nursing Diagnoses Should be Available in the Front (Primary or Main) Screens of EHRs for a Specific Population?

• Which Diagnoses Should Routinely be Used in a Specific Health Care Setting?

Consensus Validation

In Clinical Studies, Answer Research Questions Such as:• Which Defining Characteristics can Reliably Predict a Diagnosis?

• Which Defining Characteristics are Most Sensitive to Occurrence of a Diagnosis?

• Which Defining Characteristics are Major (Most Commonly Prevalent) Defining Characteristics?

• Which Defining Characteristics are Not Sensitive Enough to Predict a Diagnosis (Some Diagnoses have Too Many Defining Characteristics)?

Sensitivity, Specificity and Predictive Values

Answers Research Questions Such as:• How Accurate are Nurses with Specific Education, Experience,

Types of Competencies, and So Forth?

• What Factors Impact on Accuracy in Specific Settings?

• What Factors in Three Categories Should be Modified or Mitigated to Positively Affect Accuracy?• The Situational Context• Types of Clinical Cases• Nurse Diagnosticians

Accuracy of Nurses’ Diagnoses

Answer Research Questions Such as:

• What are the Frequencies of Using Specific Diagnoses?

• Under What Circumstances are Diagnoses Being Used?

• Which Nursing Interventions are Being Used with Diagnoses?

• What are the Effects on Patient Outcomes When Diagnoses and Interventions are Applied?

Implementation Studies

Sources for Research Design• Books, Journals and Librarians• Teachers and Researchers

Read Research Articles

Use Published Research as Models (e.g. Chapter in NANDA-I Book).

Develop Research Teams:• Colleagues• Administrators• Doctorally Prepared Nurses

Getting Started as a Researcher

Getting Started as a Researcher• Reflect on Practice• Effort

1. Knowledge Development for Nursing2. Contribution to Quality-Based Nursing Care

(Lunney 2008)

Rewards!

ReferencesLunney M. (2008) The need for international nursing diagnosis research and a theoretical framework.

International Journal of Nursing Terminologies and Classifications 19(1), 28-34.Walker L, Avant K. (2005) Strategies for Theory Construction in Nursing, 4th edn. Norwalk, CT:

Appleton and Lange.