Identification And Revision Of Core Nursing Outcomes Of Patient With Depressive Disorder And Its Primary Application

Objective:To identify and revise the core nursing outcomes of patients with depressive disorders from NOC(3rd edition), and investigate the validity,reliability,Score level and influencing factors of the core nursing outcomes of patients with depressive disorders on assessing among Chinese patients with depression disorder. In order to provide nurses a series of standardized tools to assess common nursing problems of patients with depressive disorders and effectiveness of nursing measures, then provide direction for the goal of nursing and nursing interventions. Methods:(1)Identification of core nursing outcomes of patients with depressive disorders: First, nursing diagnosis of depressive disorders were screened through literature reviews. Second, based expert arranges method, 43 clinical nurses working in the psychiatric unit were asked to evaluate the performance of nursing diagnosis. Third, through literature reviews, nursing outcomes which are related to the 5 most common nursing diagnosis were screened. At last, Selected 44 clinical nurses working in the psychiatric unit, they were asked to evaluate the importance of nursing outcomes. The core nursing outcomes of patients with depressive disorders were identified by the statistical result.(2)Revision of 8 core nursing outcomes of patients with depressive disorders: Selected 39 experts, through twice experts consultation,the express way of 8 core nursing outcomes’ name,metric,indexs was revised. then, through pre survey, 20 hospitalized patients with depressive disorders were selected, Listened to their advice, found and adjusted the indexs which were unreadable.(3) Primary application of 3 core nursing outcomes of patients with depressive disorders: use the nursing outcome "Depression Self-Control", "Mood Equilibrium", "sleep" as investigative tools, have a research on 100 hospitalized patients who were diagnosed as depressive disorder by ICD-10. Results:(1)Identification of core nursing outcomes of patients with depressive disorders: According to the nursing outcomes which is related to the 5 most frequent diagnosis, and the mean value of importance﹥4.50, 8 nursing outcomes were identified as the core nursing outcomes of patients with depressive disorders : “Mood Equilibrium”,“Depression Level”,“Depression Self-Control”,“Suicide Self-Restraint”,“Self-Mutilation Restraint”,“Aggression Self-Control”,“Sleep,“Cognition”.(2)Revision of 8 core nursing outcomes of patients with depressive disorders:(1).The positive coefficients of two rounds of expert consultation were 100.00% and 94.87%. the author itative coefficient of two rounds of expert consultation was 0.71,0.84. The expression of 2 nursing outcomes’ name and 7 nursing outcomes’ metric were adjusted, 51 indicators were deleted,merged,added or revised.(2) Pre survey found eight nursing outcomes is more suitable for earegiver—rating, and nursing outcomes“Suicide Self-Restraint”,“Self-Mutilation Restraint” and “Aggression Self-Control” are not suitable for the patients with depressive disorders who have no suicidal idea,thoughts of self harm or aggressive behavior, and it is not suiable for using the 8 the core nursing outcomes at same time.(3) Primary application of 3 core nursing outcomes of patients with depressive disorders:(1) The nursing outcome "Depression Self-Control", "Mood Equilibrium" and "sleep" s internal consistency were 0.765,0.793,0.910, The content validity was good, and have the reaction and feasibility.(2) In this 3 core nursing outcomes, the score of 6 indicators have no significant differences before and after hospitalization, the score of other indicators and the total score outcomes were improved by hospitalization, have the statistically significant difference.(3) The investigation results showed: In outcome "Depression Self-Control", educational background and marital status can affect total score, and there is a correlation between the age and the total score. In outcome "Mood Equilibrium", type of depressive disorder can affect total score.(4) There is a correlation between total score of outcome "Depression Self-Control", " Mood Equilibrium" and score of HDMA, HAMA. Conclusion:8 core nursing outcomes of patients with depressive disorders can reflect the most common nursing problem, and they the most important. They are a set of outcomes that captures the essence of nursing practice in patients with depressive disorders by identifying the outcomes selected most frequenly. The screening technique for nursing outcomes provide reference to the method for identifing nursing outcomes for other diseases.It is necessary to revise 8 core nursing outcomes of patients with depressive disorders before clinical application, The 8 core nursing outcomes of patients with depressive disorders allow nurses to measure and evalua te their interventions to solve the specific health problems more sensitively.The nursing outcome "Depression Self-Control", "Mood Equilibrium" and "sleep" are credible and reliable, have the reactivity and feasibility. Through the nursing intervention, the ability of depressive self control,mood stability level and sleep quality of patients with depressive disorders were improved. nurses should put more attention on patients with lower level of education, Unmarried or older age to improve their ability of depressive self control. nurses should put more attention on patients with major depressive disorder to improve their mood stability level. From those, can provide direction for the goal of nursing and nursing interventions.