NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care.

The study was done in one public emergency care agency in Andalusia, Spain, so its documented patterns may not match other services or countries. Nursing care was under-recorded in 50.62% of the records made, so the reported prevalence may not reflect all patients. Records with more than one coping/stress diagnosis or with diagnoses in other domains were excluded, which the authors say considerably underestimates prevalence. The electronic record system did not allow outcomes and interventions to be linked to a specific diagnosis in a nested way, so associations were based on the whole record. The EHR offered preselected coping/stress diagnoses chosen by expert consensus, which may have guided nurses toward certain labels and away from others. Diagnosis accuracy was not assessed, so recorded labels may not match the patients' actual problems. Nurse training, experience, attitude, and variation in care-plan ability were not controlled. The study reports what was documented, not patient outcomes or whether interventions helped.

The authors declared no conflicts of interest.

Do not read the recorded linkages as evidence that anxiety reduction, touch, presence, or emotional support improve patient outcomes. This study only describes what nurses documented in one emergency service.