The Role of Nursing Diagnoses in Enhancing Prognostic Accuracy in Home-Based Cancer Care: Insights From a Retrospective Cohort Study.
Luca Bertocchi, Andreina Saba, Angelo Dante and 6 others
PMID 40384519WHAT IT FOUND
In home-based cancer care, nurses' documented diagnoses of poor nutrition and death anxiety, plus a high palliative prognostic score and terminal illness, were associated with death.
They may help flag patients needing earlier comfort-focused palliative care.
Key findings
01At the first home visit, a Palliative Prognostic Index score of 5 or higher, terminal illness phase, and palliative status were associated with 6-month mortality; imbalanced nutrition and death anxiety remained associated when nursing diagnoses were added.
02Four or more nursing diagnoses at the first visit were associated with higher mortality in the nursing-diagnoses model, but not after medical and prognostic variables were added.
03Nurses documented an average of 3.6 nursing diagnoses per patient, and the most frequent patient diagnoses were chronic pain, constipation, and ineffective breathing pattern.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used convenience sampling from a single Italian region, so results may not apply elsewhere. No sample size calculation was done, and the study was exploratory. Records were reviewed after care happened, and missing or inconsistent documentation could affect the associations. Nursing diagnoses may reflect overall illness severity rather than independently predict death; the number of diagnoses no longer showed a clear association after adjustment. The study did not test whether documenting or acting on nursing diagnoses changes mortality, comfort, or quality of life. Eight patients were excluded because their care moved residence, so final outcome data were not available for them.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that documenting nursing diagnoses causes death or that any single diagnosis can be used alone to predict mortality. The study is observational, and after medical and prognostic variables were included, only imbalanced nutrition and death anxiety remained associated with death.