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PURPOSE. To clarify the use of two nursing diagnoses, activity intolerance and impaired physical mobility, with elderly patients.
METHOD. Ninety-two elders from a long-term care facility in Wonju, Korea. A checklist developed by the researchers was used for data collection.
FINDINGS. Defining characteristics from this study related to psychological components of activity intolerance are significant in differentiating between the two diagnoses. Using a decision-making tree based on data from this study, each nursing diagnosis can be correctly identified.
CONCLUSIONS. The results of this study are significant in broadening the defining characteristics to be used in differentiating between two nursing diagnoses.
PRACTICE IMPLICATIONS. Clarification of nursing diagnoses serves to direct students and nurses to choosing appropriate interventions.
As nursing faculty prepare students to meet clients' demands for quality nursing care, they use the nursing process to help students integrate their knowledge and skills. Accurate nursing diagnoses are essential to the implementation of appropriate interventions, but interpreting patient data and making a nursing diagnosis can be challenging because human responses are holistic, complex, and unique, and signs and symptoms can overlap, causing incorrect inferences (Lunney, 2003).
For elders presenting with more complex health problems, a correct nursing diagnosis reflecting their specific needs is important so that interventions are made from the perspective of caring, not just curing. Autonomy and perception of well-being for elderly people frequently depends on their level of physical activity (Chang, 1995), but many elders experience a decrease in physical activity or activity tolerance within the normal aging process or as a result of degenerative disease processes. Mobility impairments and health problems may increase considerably in elders unless a high level of physical activity is maintained to prevent age-related musculoskeletal decline (Voorrips, Lemmink, Van Heuvelen, BuIt, & Van Staveren, 1993). However, one study in Korea found that more than one third (37%) of Korean elders reported difficulty with activities of daily living (ADL) (Ryu, 2001). For this reason, the nursing diagnoses activity intolerance and impaired physical mobility represent important health problems and are often used with elders in Korea (Hur, Lim, & Kim, 1998). In our research team's experience with student nurses who were caring for elders in the community, we found that the students frequently complained of confusion between the two diagnoses...