Zielstorff R D, Tronni C, Basque J, Griffin L R, Welebob E M
Massachusetts General Hospital, Boston, USA.
Image J Nurs Sch. 1998;30(4):369-73. doi: 10.1111/j.1547-5069.1998.tb01335.x.
To map the problem or diagnosis terms from three nomenclatures, term to term, to determine commonalities and differences; and to determine whether it is possible to develop a single vocabulary that contains the best features of all. When different nomenclatures are used in different settings, continuity of care is hampered by the need to re-state problems and interventions.
The sample for this descriptive analysis was 396 terms from three nursing diagnosis and problem nomenclatures recognized by the American Nurses Association: the North American Nursing Diagnosis Association (NANDA) Approved List, the Home Health Care Classification (HHCC), and the Omaha System.
Terms from each of the three nomenclatures were mapped to terms in each of the others. Consensus methods were used to resolve differences in mapping decisions. Terms were characterized as "Same," "Similar," "Broader," "Narrower," and "No Match." Validation of consistency and accuracy was done by reverse mapping, use of syllogisms, use of taxonomic groupings, and expert review.
Of 396 terms, 21 concepts accounting for 63 terms were found to be the same or similar in all three nomenclatures; 91 terms were unique to the nomenclature in which they were found ("No Match"). The remaining 242 terms had a narrower or broader relationship to at least one term in another nomenclature. In all three nomenclatures, inconsistencies existed in level of abstractness of the diagnosis or problem terms, and in definition and placement of terms within their own taxonomic structure.
Because of differences in structure and incompatible taxonomic arrangements, a master list of "preferred terms" taken from the three nomenclatures is not feasible. However, the mappings are useful for determining commonalities and the unique contributions of each nomenclature, which can facilitate the development of a uniform language for nursing diagnoses. The mapping can also form the basis for automatic translation of computer-stored nursing diagnoses from one setting to another when different nomenclatures are used.
逐词映射来自三种术语表的问题或诊断术语，以确定其共性与差异；并确定是否有可能开发一个包含所有术语最佳特征的单一词汇表。当在不同环境中使用不同术语表时，由于需要重新表述问题和干预措施，会妨碍护理的连续性。
本次描述性分析的样本是来自美国护士协会认可的三种护理诊断和问题术语表的396个术语：北美护理诊断协会（NANDA）认可列表、家庭健康护理分类（HHCC）和奥马哈系统。
将三种术语表中的每个术语映射到其他术语表中的术语。采用共识方法解决映射决策中的差异。术语被归类为“相同”“相似”“更宽泛”“更狭窄”和“不匹配”。通过反向映射、三段论的使用、分类分组的使用和专家评审来验证一致性和准确性。
在396个术语中，发现有21个概念（共63个术语）在所有三种术语表中相同或相似；91个术语是其所在术语表独有的（“不匹配”）。其余242个术语与另一种术语表中的至少一个术语存在更狭窄或更宽泛的关系。在所有三种术语表中，诊断或问题术语的抽象程度、术语在其自身分类结构中的定义和位置都存在不一致之处。
由于结构差异和不兼容的分类安排，从这三种术语表中提取“首选术语”的主列表是不可行的。然而，这些映射对于确定每种术语表的共性和独特贡献很有用，这有助于开发统一的护理诊断语言。当使用不同术语表时，该映射还可为将计算机存储的护理诊断从一种环境自动翻译到另一种环境奠定基础。
