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- Nursing diagnosis of ‘‘spiritual distress’’ in women with breast cancer prevalence and major defining characteristicsPublication . Caldeira, Sílvia; Timmins, Fiona; Carvalho, Emília de; Vieira, MargaridaBackground: Spirituality and spiritual needs of cancer patients are frequently mentioned in the nursing literature, but the most significant defining characteristics of spiritual distress in the context of clinical reasoning and nursing diagnosis are rarely explored. Understanding of these is important for effective spiritual intervention. Objective: The aim of this study was to identify the prevalence and the defining characteristics of the nursing diagnosis ‘‘spiritual distress,’’ as classified according to NANDA International, among women with breast cancer. Methods: This was a quantitative and cross-sectional study, comprising the third phase of a larger study investigating the clinical validation of spiritual distress in cancer patients undergoing chemotherapy. Fehring’s clinical diagnostic validation model was used to identify the prevalence and the major defining characteristics of the diagnosis. A convenience sample was used, and data were collected by structured interview. Results: A total of 70 women participated; most were married (62.9%) and had a mean age of 54 years, and 55.7% reported having at least 1 person depending on them. The average length of time since the cancer diagnosis was 30.9 months. Twenty-seven participants were experiencing spiritual distress (38.6%). Eleven defining characteristics were classified as major. Conclusions: The prevalence of spiritual distress and the major defining characteristics give clinical evidence about the nurse’s role in providing spiritual care. The results are useful for the improved use of the NANDA International diagnoses within this domain. Implications for Practice: The findings highlight the importance of assessing the defining characteristics of the diagnosis as an objective strategy to improve clinical reasoning related to spirituality and to facilitate more effective interventions.
- Spiritual distress: proposing a new definition and defining characteristicsPublication . Caldeira, Sílvia; Carvalho, Emília Campos; Vieira, MargaridaObjective To identify the definition and defining characteristics (DCs) of spiritual distress (00066). Method Integrative literature review. Results Thirty-seven articles and 35 DCs were identified. Spiritual distress as a response to health problems in the context of nursing care is different from an impaired ability to experience and integrate meaning in life. Conclusions The diagnosis misses some DCs that emerged from the literature review and lacks comprehensiveness. The domain and the class are reductionist toward its meaning. The taxonomy lacks a spiritual domain to include this and other diagnoses currently dispersed in other domains. Implications for Practice Further content and clinical validation is needed, as well as an assessment, to determine the diagnosis' class and domain.
- Clinical validation of the nursing diagnosis spiritual distress in cancer patients undergoing chemotherapyPublication . Caldeira, Sílvia; Timmins, Fiona; Carvalho, Emília Campos de; Vieira, MargaridaObjective: Validate the nursing diagnosis spiritual distress in cancer patients. Methods: Cross-sectional approach using Richard Fehring's Clinical Diagnostic Validity Model. Findings: The prevalence of diagnosis was 40.8% in a sample of 170 patients. A total of 16 defining characteristics were validated. Expresses suffering had the highest sensitivity value and lack of meaning in life had the highest specificity value. Conclusions: The diagnosis was validated. Cancer patients in spiritual distress are in a state of suffering related to lack of meaning in life. Implications for Practice: Sensitive diagnosis tools and language are required for nurses to make accurate judgments in situations of spiritual distress. Validation in different contexts would increase the clinical evidence of this diagnosis.
- The adequacy of the Q methodology for clinical validation of nursing diagnoses related to subjective FociPublication . Miguel, Susana; Caldeira, Sílvia; Vieira, MargaridaOBJECTIVE: This article describes the adequacy of the Q methodology as a new option for the validation of nursing diagnoses related to subjective foci. METHODS: Discussion paper about the characteristics of the Q methodology. FINDINGS: This method has been used in nursing research particularly related to subjective concepts and includes both a quantitative and qualitative dimension. CONCLUSIONS: The Q methodology seems to be an adequate and innovative method for the clinical validation of nursing diagnoses. IMPLICATIONS FOR PRACTICE: The validation of nursing diagnoses related to subjective foci using the Q methodology could improve the level of evidence and provide nurses with clinical indicators for clinical reasoning and for the planning of effective interventions.