da Silva Cláudia Gabrielle, de Araújo Suelayne Santana, da Silva Jadiane Ingrid, Lira Ana Luísa Brandão de Carvalho, Lopes Marcos Venícios de Oliveira, Lopes Camila Takáo, Frazão Cecília Maria Farias de Queiroz
Nurses, Masters in Nursing, Federal University of Pernambuco, Recife, Brazil.
Nurse, Master's Student in Nursing at the Federal University of Pernambuco, Recife, Brazil.
Int J Nurs Knowl. 2023 Apr;34(2):116-125. doi: 10.1111/2047-3095.12386. Epub 2022 Jul 6.
To analyze the content of the nursing diagnosis deficient knowledge in individuals with heart failure.
Methodological study to validate the content of a nursing diagnosis based on the predictive model of diversity, carried out through the organization of the phenomenon of interest and analysis by judges using the collective wisdom model. The NANDA-I Knowledge Deficient diagnosis was evaluated by 48 judges and considered valid when it presented a median content validity index ≥ 0.8 in the confidence intervals.
Note that 66.6% of the judges indicated that the new definition proposed was more adequate than the definition adopted by NANDA-I. After the experts' analysis, the following defining characteristics were considered valid: inaccurate statements about the disease and/or therapy, inadequate performance in the management of intercurrences, increase in hospital readmissions, worsened quality of life, deficit in self-care performance, and follow-up of inadequate instruction; related factors are as follows: inadequate guidance offered by health professionals, nonparticipation of the patient in the planning of their health care, weakened relationship between professional and individual; populations at risk-elderly and low level of education of the individual and/or caregiver and the associated condition, mild cognitive impairment. Anxiety, depression, and impaired social interaction were elements considered not relevant to the content domain.
The validation of the content of the aforementioned diagnosis in patients with heart failure, through the analysis of judges with different degrees of expertise, made it possible to improve the definition and expansion of new diagnostic indicators.
Updated diagnostic elements for the nursing diagnosis deficient knowledge in individuals with heart failure will facilitate accurate clinical judgment and the establishment of a therapeutic plan aimed at etiological factors modifiable by nurses.
分析心力衰竭患者护理诊断“知识缺乏”的内容。
基于多样性预测模型对护理诊断内容进行验证的方法学研究，通过对感兴趣的现象进行组织，并由评判者采用集体智慧模型进行分析。48名评判者对北美护理诊断协会（NANDA - I）的“知识缺乏”诊断进行了评估，当在置信区间内呈现的中位数内容效度指数≥0.8时，则认为该诊断有效。
注意到66.6%的评判者表示，所提出的新定义比NANDA - I采用的定义更合适。经过专家分析，以下定义特征被认为有效：关于疾病和/或治疗的不准确表述、处理并发症时表现不佳、再次入院率增加、生活质量恶化、自我护理能力不足以及随访指导不足；相关因素如下：医护人员提供的指导不足、患者未参与其医疗保健计划、医护人员与患者之间的关系薄弱；高危人群——老年人以及个体和/或照顾者教育水平低及相关情况、轻度认知障碍。焦虑、抑郁和社交互动受损被认为与内容领域无关。
通过对具有不同专业程度的评判者进行分析，对心力衰竭患者上述诊断的内容进行验证，从而有可能改进新诊断指标的定义和扩展。
心力衰竭患者护理诊断“知识缺乏”的更新诊断要素将有助于准确的临床判断，并有助于制定针对护士可改变的病因因素的治疗计划。
