Response by authors to Dr. Kelly:
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by Cynthia W. Kelly (April 26, 2007)

We appreciate the thoughtful insights provided by Dr. Kelly in response to our published manuscript that reviewed all of the research studies that were published in five psychiatric mental health nursing journals from 2000-2002. In that manuscript (Zauszniewski & Suresky, 2003), we identified the importance of not only conducting intervention studies in order to build evidence for nursing practice, but also the importance of publishing the findings in nursing journals that are mostly likely read by practicing nurses.

In her letter to the editor, Dr. Kelly recommended the use of the North American Nursing Diagnosis Association’s (NANDA) nursing diagnostic categories (NDC), nursing intervention categories (NIC), and nursing outcomes categories (NOC), as a framework for researchers to develop and test interventions and an approach for providing evidence for future nursing care.

We would agree that the NANDA framework may present an approach that is worthy of consideration for organizing our knowledge and building evidence for nursing practice (Johnson & Maas, 1998). Its many categories (diagnostic, intervention, and outcomes) would suggest there are many available opportunities for designing and implementing nursing intervention research. However, with the many opportunities comes the challenge to build sufficient knowledge in specific areas of practice. The NANDA framework was developed on the basis of expert opinion and is not supported by studies in all aspects of the classification system. We believe this approach would necessitate an extensive program of study on the part of the nursing discipline in order to be used effectively in an interdisciplinary approach to patient care.

In our soon to be published manuscript (Zauszniewski, Suresky, Bekhet, & Kidd, 2007), we focused on intervention studies that were published between 2000 and 2005 in the same psychiatric nursing journals. We found there was much variety in the types of interventions tested and, in few cases, there was only one study about a specific intervention. Our challenge was to organize the published intervention studies within a framework that could provide some guidance for our practice.

As Dr. Kelly pointed out, we believed that using a framework modeled from an interdisciplinary perspective was essential. However, rather than the NANDA framework, we chose to categorize the published intervention studies according to the biopsychosocial model (Boyd, 2002), noting that some interventions addressed more than one aspect of that tripartite model. We believe that the biopsychosocial model provided the best framework for organizing the published intervention studies and a beginning point for examining available evidence for nursing practice within three domains of knowledge: biological, psychological, and social.

M. Jane Suresky, ND, APRN-BC
Jaclene A. Zauszniewski, PhD, RN-BC, FAAN
Abir K. Bekhet, PhD(c), RN
Case Western Reserve University
Cleveland, Ohio 44106-4904

References

Boyd, M. A. (2002). Psychiatric Nursing: Contemporary practice. 2nd. Ed. Philadelphia: Lippincott.

Johnson, M., & Maas, M. (1998). The nursing outcome classification. Journal of Nursing Care Quality, 12, 9-20.

Zauszniewski, J. A., & Suresky, J. (2003). Evidence for psychiatric nursing practice: An analysis of three years of published research. Online Journal of Issues in Nursing, 9(1). Retrieved December 9, 2006, from http://www.nursingworld.org/ojin/hirsh/topic4/tpc4_1.htm

Zauszniewski, J. A., & Suresky, J., Bekhet, A., & Kidd, L. (2007, in press). Moving from Tradition to Evidence: A Review of Intervention Studies Published in Five Psychiatric Nursing Journals in the New Millennium. Online Journal of Issues in Nursing.

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