Introduction: Cognitive impairment after abdominal surgeries is the most frequently manifested as postoperative delirium/acute confusion. The assessment of patient´s cognitive status is an important part of care management. Objective: The objective of the study was to show the changes in cognitive functions through the SMMSE (The Standardized Mini-Mental State Examination) in patients after abdominal surgeries that were diagnosed with acute confusion. Methodology and Sample: We used the translated Slovak version of the SMMSE presented by Vajdičková & Kolibáš (2000). The scale was applied in n = 111 purposively selected participants, the 65-85 year-old patients with acute confusion who were assessed minimally 3 times (on the 1st, 4th and 7th days of acute confusion). We used Fischerov F test (ANOVA) and Student´t-test for statistical data processing. Results: The statistically significant differences in cognitive functions were not found between the genders. The differences were found in the groups according to age on the 4th day between the 1st group (65-75 year-olds), the 2nd group (76-80 year-olds) vs. the 3rd group (81-85 year-olds). There were significant differences between individual measurements and diagnoses in the comparison according to the diagnoses (K35, K80, K56, K40, K25, and C18). Conclusion: The expected differences in cognitive functions were found in the groups according to age and diagnoses of abdominal surgeries. Fluctuating cognition is one of the defining characteristics of nursing diagnosis Acute Confusion.
- Keywords
- Standardized Mini-Mental State Examination (SMMSE),
- MeSH
- Acute Disease MeSH
- Abdomen surgery MeSH
- Surgery Department, Hospital MeSH
- Surgical Procedures, Operative adverse effects MeSH
- Delirium * diagnosis MeSH
- Inpatients statistics & numerical data MeSH
- Cognition Disorders diagnosis MeSH
- Humans MeSH
- Nursing Diagnosis * MeSH
- Nursing Research MeSH
- Postoperative Complications * MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Statistics as Topic MeSH
- Age Factors MeSH
- Mental Status Schedule statistics & numerical data MeSH
- Confusion diagnosis MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
Cieľ: Cieľom štúdie bola obsahová validácia ošetrovateľskej diagnózy Chronická zmätenosť a identifikácia definujúcich charakteristík v podmienkach slovenskej praxe. Metodika: Na validáciu sme vybrali Diagnostic Content Validity Model (model DCV) podľa Fehringa. Za expertov sme považovali sestry, ktoré získali minimálne 4 body podľa modifikovaných Fehringových kritérií. Experti posudzovali významnosť definujúcich charakteristík ošetrovateľskej diagnózy v pripravenom validačnom hárku. Obsahoval 9 definujúcich charakteristík ošetrovateľskej diagnózy, 1 neutrálnu charakteristiku a 2 položky z nástroja MMSE (Folsteinov test, Mini-Mental State Examination). Súbor expertov tvorilo 144 slovenských sestier. Výsledky: Za hlavné definujúce charakteristiky (vážené skóre viac ako 0,75) považovali experti zmeny v časopriestorovej orientácii (0,87), klinicky podložená organická porucha mozgu (0,78), dlhotrvajúca kognitívna porucha (0,78), narušená interpretácia podnetov a reakcia na ne (0,76) a progresívna kognitívna porucha (0,76), ktoré sú totožné s charakteristikou syndrómu demencie. Záver: Experti nepovažovali všetky definujúce charakteristiky ošetrovateľskej diagnózy Chronická zmätenosť za rovnako významné. Určitý podiel zohráva zloženie samotného súboru expertov, ktorý naplnil skôr minimálnu hranicu kritérií na experta, nekompatibilita NANDA International Taxonómie II so zoznamom sesterských diagnóz.
Aim: The aim of this study was the content validation of nursing diagnosis Chronic confusion and the identification of the defining characteristics in the conditions of Slovak clinical practice. Methodology: For the validation we used Diagnostic Content Validity Model (model DCV) as per Fehring. We consider the experts were nurses, who achieved minimum of 4 points according to the modified Fehring’s criteria. Experts assessed the importance of defining characteristics of nursing diagnosis using prepared validation worksheet. Validation worksheet contained 9 defining characteristics of nursing diagnosis, 1 neutral characteristic and two items from the tool MMSE (Folstein test, Mini-Mental State Examination). The group of experts consisted of 144 Slovak nurses. Results: Experts consider as the most important defining characteristic (score more than 0,75) the changes in time-spatial orientation (score 0,87), clinical evidence of organic brain impairment (score 0,78), long-standing cognitive impairment (score 0,78), altered interpretations to stimuli and altered response to stimuli (score 0.76), and progressive cognitive impairment (0,76), which are same with the characteristics of the syndrome of dementia. Conclusion: Experts did not consider all the defining characteristics of nursing diagnosis Chronic confusion as equally important. Certain proportion is the actual composition set of experts, who filled the first minimum threshold criteria for expert, an incompatibility NANDA International Taxonomy II with the list of nursing diagnoses.
