Background and objectives

The nursing assessment in the psychiatric department differ from those used in other departments considerably. We developed a psychiatric knowledge-based clinical decision support system (Psy-KBCDSS), which may aid nurses in solving patients’ problems in the psychiatric department. In addition, we compared the sensitivity and specificity for the nursing diagnoses between the psychiatric nursing process system (Psy-NPS) and Psy-KBCDSS to determine that the Psy-KBCDSS can assist nurses in performing the nursing assessment and diagnosis.

Methods

Visual Studio 2019 was adopted as the primary software development tool, and C# as the main development language. The concept of the nursing process was applied to develop the Psy-KBCDSS user interface. We developed a clinical diagnostic validity inference engine to calculate the frequencies of the nursing assessment items and nursing diagnoses in clinical tasks in the Psy-NPS for generating a knowledge-based database of the Psy-KBCDSS. The sensitivity and specificity for nursing diagnoses formulated by senior and junior nurses were used to determining the effectiveness of adopting Psy-NPS and Psy-KBCDSS.

Results

This study include 22 nursing diagnoses commonly encountered in psychiatric wards. The top eight most common diagnoses in the Psy-NPS and Psy-KBCDSS were altered thought processes, ineffective coping, sensory and perceptual alterations, insomnia, risk for other-directed violence, anxiety, impaired social interaction, and risk for suicide. Compared with the Psy-NPS, the Psy-KBCDSS had significantly higher sensitivity for sensory and perceptual alterations, ineffective coping, and insomnia and significantly higher specificity for ineffective coping.

Conclusions

Considering its high sensitivity and specificity for various nursing diagnoses, the Psy-KBCDSS, as an empirical patient-oriented nursing clinical decision-making support system, can assist nurses in clinical nursing tasks including nursing process–based patient assessment and nursing diagnosis.

中文翻译：

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基于知识的精神科护理过程临床决策支持系统的设计与评价

背景和目标

精神科的护理评估与其他科室的护理评估有很大不同。我们开发了基于精神科知识的临床决策支持系统（Psy-KBCDSS），可以帮助护士解决精神科患者的问题。此外，我们比较了精神科护理过程系统（Psy-NPS）和Psy-KBCDSS对护理诊断的敏感性和特异性，以确定Psy-KBCDSS可以帮助护士进行护理评估和诊断。

方法

Visual Studio 2019 被用作主要的软件开发工具，C# 是主要的开发语言。护理过程的概念被应用于开发 Psy-KBCDSS 用户界面。我们开发了一个临床诊断有效性推理引擎来计算 Psy-NPS 中临床任务中护理评估项目和护理诊断的频率，以生成基于知识的 Psy-KBCDSS 数据库。高级和初级护士制定的护理诊断的敏感性和特异性用于确定采用 Psy-NPS 和 Psy-KBCDSS 的有效性。

结果

该研究包括精神病病房中常见的 22 项护理诊断。Psy-NPS 和 Psy-KBCDSS 中最常见的前八项诊断是思维过程改变、应对无效、感觉和知觉改变、失眠、其他指向暴力的风险、焦虑、社交互动受损和自杀风险。与 Psy-NPS 相比，Psy-KBCDSS 对感觉和知觉改变、无效应对和失眠的敏感性显着更高，对无效应对的特异性显着更高。

结论

考虑到其对各种护理诊断的高度敏感性和特异性，Psy-KBCDSS作为一个以患者为导向的经验性护理临床决策支持系统，可以协助护士完成基于护理过程的患者评估和护理诊断等临床护理任务。