评估国际 NANDA 诊断分类在西班牙的应用：EVALUAN-I 工具的制定和验证。
Evaluation of the NANDA International, Inc. diagnostic classification in Spain: Development and validation of the EVALUAN-I tool.
机构信息
RN Maternal and Child Insular University Hospital Complex (Canary Islands Health Service), Associate Professor Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Canary Islands, Las Palmas, Spain.
RN Doctoral Primary Care Facility, Primary Healthcare Management, Gran Canaria (Canary Islands Health Service), Canary Islands, Las Palmas, Spain.
出版信息
Int J Nurs Knowl. 2023 Jan;34(1):21-34. doi: 10.1111/2047-3095.12366. Epub 2022 Apr 14.
PURPOSE
To develop and validate a tool to evaluate the NANDA International, Inc. diagnostic classification.
METHODS
The tool, EVALUAN-I, was validated in a non-probabilistic sample (N = 460) on Spanish Registered Nurses (September-December 2019) in two phases. First, design and construct the instrument in three steps: (1) literature review to define the construct focusing on the orientation toward nursing concepts and theoretical foundations, the level of scientific evidence, the structural configuration, the applicability, the nurses' clinical reasoning skills, and the attitudes toward nursing diagnosis, (2) substantiation of the questionnaire items and design according to the criteria for a diagnostic classification, (3) expert test to establish the face validity and content validity. The second phase revolved around (4) conducting a pilot test and measuring the temporal stability (test-retest) and Cohen's kappa coefficient; assessing psychometric properties by measuring (5) reliability (internal consistency using Cronbach alpha and interfactor correlation) and (6) construct validity (exploratory and confirmatory factor analysis). The manuscript follows the STROBE checklist. The study was approved by the Research Ethics Committee with registration number 2019-190-1.
FINDINGS
EVALUAN-I displayed moderate test-retest stability, adequate construct validity, and excellent reliability. The confirmatory factor analysis provided evidence about the configuration of EVALUAN-I in relation to nine analytical dimensions: clinical competence, nurses' reasoning skills, attitudes towards nursing diagnosis, discipline's central concepts, classification's contents, physiopathological attributes, level of scientific evidence, diagnostic precision, and conceptual correspondence between terminologies.
CONCLUSIONS
EVALUAN-I is a valid and reliable instrument, which can be used to improve the epistemological, normative, and intuitive configuration of NANDA International, Inc. in a structured, systematic manner.
IMPLICATIONS FOR NURSING PRACTICE
Comprehensive evaluation of NANDA International, Inc. in different clinical settings around the world using a validated instrument, like EVALUAN-I, would allow strengths and weaknesses to be identified and contribute to the classification's development and practical application.
目的
开发和验证一种评估国际护理诊断协会（NANDA International, Inc.）诊断分类的工具。
方法
该工具名为 EVALUAN-I，在非概率样本（N=460）中进行了验证，该样本为西班牙注册护士（2019 年 9 月至 12 月），分两个阶段进行。第一阶段，通过三个步骤设计和构建该工具：（1）文献回顾，以确定护理概念和理论基础、科学证据水平、结构配置、适用性、护士临床推理技能以及对护理诊断的态度等方面的构建重点；（2）根据诊断分类的标准对问卷项目和设计进行论证；（3）专家测试，以确定表面效度和内容效度。第二阶段包括：（4）进行试点测试和测量时间稳定性（测试-重测）和 Cohen's kappa 系数；通过测量（5）可靠性（内部一致性使用 Cronbach alpha 和因子间相关性）和（6）构念效度（探索性和验证性因子分析）来评估心理测量特性。本手稿遵循 STROBE 清单。该研究获得了研究伦理委员会的批准，注册号为 2019-190-1。
结果
EVALUAN-I 显示出中等的测试-重测稳定性、足够的构念效度和极好的可靠性。验证性因子分析提供了 EVALUAN-I 与九个分析维度之间配置的证据：临床能力、护士推理技能、对护理诊断的态度、学科核心概念、分类内容、生理病理属性、科学证据水平、诊断精度以及术语之间的概念对应。
结论
EVALUAN-I 是一种有效且可靠的工具，可用于以结构化、系统的方式提高国际护理诊断协会（NANDA International, Inc.）在认识论、规范性和直觉方面的配置。
对护理实践的意义
在全球不同的临床环境中使用经过验证的工具（如 EVALUAN-I）对国际护理诊断协会（NANDA International, Inc.）进行全面评估，可以确定其优势和劣势，并有助于分类的发展和实际应用。
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