Tessália Vieira de Camargo, 126 - Cidade Universitária, Campinas, Brazil.
Center for Nursing Classification and Clinical Effectiveness, University of Iowa, Iowa City, Iowa.
Int J Nurs Knowl. 2020 Apr;31(2):134-144. doi: 10.1111/2047-3095.12256. Epub 2019 Aug 14.
To clinically validate indicators of the nursing outcomes "Breastfeeding establishment: Infant (1000)" and "Breastfeeding establishment: maternal (1001)", and their conceptual and operational definitions in infants admitted to a neonatal unit and their mothers.
This study utilized several methods in a stepwise approach including an integrative review of the literature, content validation, and clinical validation. The content validity index was performed by eight experts, who evaluated revised content of the studied nursing outcomes. In the clinical validation, 61 mother-infant dyads were evaluated by two pairs of nurses: one pair used an instrument with developed definitions, whereas the other used an instrument without definitions. The evaluations were compared using Fleiss' kappa and weighted kappa.
The agreement between all evaluators was considered excellent for almost all nursing outcome indicators related to the mothers. The pair of evaluators using the definitions had an agreement greater than 0.80 for most indicators. For the pair that did not use the definitions, agreement was poor.
There was an increase in uniformity and accuracy between the assessments when using the conceptual and operational definitions for the nursing outcome indicators related to Breastfeeding establishment.
This study contributed to the development of terms within the Nursing Outcomes Classification, and enriched the body of nursing knowledge.
临床验证护理结局“母乳喂养建立：婴儿（1000）”和“母乳喂养建立：产妇（1001）”及其在新生儿病房婴儿及其母亲中概念和操作定义的指标。
本研究采用逐步方法，综合使用了多种方法，包括文献综合评价、内容验证和临床验证。内容效度指数由 8 名专家进行评估，他们对研究护理结局的修订内容进行了评估。在临床验证中，由两对护士评估 61 对母婴对：一对使用具有定义的仪器，另一对使用没有定义的仪器。使用 Fleiss'kappa 和加权 kappa 比较评估。
与母亲相关的几乎所有护理结局指标的所有评估者之间的一致性均被认为是极好的。使用定义的评估者对大多数指标的一致性大于 0.80。对于未使用定义的评估者，一致性较差。
在使用与母乳喂养建立相关的护理结局指标的概念和操作定义时，评估之间的一致性和准确性有所提高。
本研究为护理结局分类中的术语制定做出了贡献，丰富了护理知识体系。
