ABSTRACT
BACKGROUND: Critically ill patients have received little attention in the caring literature and yet are a population for whom caring behaviors are particularly important. OBJECTIVES: To describe patients' perceptions of caring exhibited by professional nurses in a critical care unit and to describe the meaning to the patients of these demonstrations of caring. METHODS: We used a phenomenologic approach for this descriptive study, which was conducted on 13 patients hospitalized in a critical care unit for at least 48 hours within 48 hours of their transfer from the unit. We asked them to respond to two open-ended questions and recorded all interviews on audio tapes that were transcribed verbatim. RESULTS: Caring in a critical care unit is attentive, vigilant behavior on the part of the nurse. This vigilance embodies nurturance and incorporates highly skilled, technical practices, as well as basic nursing care and beyond. Caring is a healing process of which lifesaving actions by the nurse are a part. Identifying the characteristics of the individuals involved in this healing process was one way of describing caring. Personal attributes of nurses, family members, and patients themselves are important in the descriptions of the caring process. These attributes are incorporated into the concept of mutuality. CONCLUSIONS: Caring is descriptive of a mutual process in which intentions are joined to form a shared experience. In this mutual process, healing is an outcome that might otherwise be elusive.
Subject(s)
Critical Care/standards , Critical Illness/nursing , Nurse-Patient Relations , Adult , Aged , Aged, 80 and over , Attitude of Health Personnel , Female , Humans , Intensive Care Units , Male , Middle Aged , Patient Satisfaction , Specialties, Nursing/standardsABSTRACT
A working definition of nursing diagnosis was adopted by the North American Nursing Diagnosis Association (NANDA) Biennial Business Meeting in March 1990. Because of the working nature of the definition, members and nonmembers of the Association were invited to judge the merits and faults of the definition and to recommend areas needing further debate, analysis, or modification. The purpose of this article is to apply principles and rules of definition to an analysis of the working definition of nursing diagnosis as adopted by the NANDA General Assembly. In presenting this analysis, concerns and questions regarding the conceptual, logical, and grammatical clarity of essential elements (e.g., clinical judgment; individual, family, or community responses; actual or potential health problems; and actual or potential life processes) in the definition are posed; and, where appropriate, suggestions for clarification are offered. Further debate, research, and clinical testing is requested in an attempt to improve NANDA's very important contribution to the development of nursing practice theory.
Subject(s)
Nursing Diagnosis/classification , Societies, Nursing/organization & administration , Terminology as Topic , Humans , Nursing Diagnosis/standards , Organizational PolicyABSTRACT
Individuals with moderate to severe heart failure may benefit from cardiac fitness training. However, before recommending cardiac rehabilitation to this patient population, nurses must understand exercise physiology and the effects of exercise in the individual with chronic left ventricular dysfunction (LVD). Normal cellular response to exercise, normal cardiovascular responses associated with exercise, cardiovascular adaptation to exercise training or conditioning, cardiovascular responses to exercise in patients with LVD, and cardiac rehabilitation of the patient with chronic congestive heart failure are addressed in this article. Responses to isotonic exercise, rather than isometric, are emphasized.
Subject(s)
Exercise/physiology , Heart Failure/physiopathology , Heart Failure/rehabilitation , Heart Failure/therapy , Heart Rate , Humans , Oxygen Consumption , Stroke VolumeABSTRACT
The quality of life of 51 elderly subjects enrolled in cardiac rehabilitation is described to devise strategies for improving QOL as an outcome of a therapeutic regimen. Based on Chrisman and Fowler's Systems-in-Change Model, physical function, social function, and emotional function were assessed via the McMaster Health Index Questionnaire and the Cantril Self-Anchoring Scale during participation in cardiac rehabilitation. The greatest benefit of cardiac rehabilitation to subjects was in physical function, but benefits were also noted in social and emotional function.
