Content Validation of the Operational Definitions of the Nursing Diagnoses of Activity Intolerance,Excess Fluid Volume,and Decreased Cardiac Output in Patients With Heart Failure

Abstract

Objectives

To consensually validate the operational definitions of the nursing diagnoses activity intolerance, excessive fluid volume, and decreased cardiac output in patients with decompensated heart failure.

Method

Consensual validation was performed in two stages: analogy by similarity of defining characteristics, and development of operational definitions and validation with experts.

Results

A total of 38 defining characteristics were found. Operational definitions were developed and content-validated. One hundred percent of agreement was achieved among the seven experts after five rounds. “Ascites” was added in the nursing diagnosis excessive fluid volume.

Conclusion

The consensual validation improves interpretation of human response, grounding the selection of nursing interventions and contributing to improved nursing outcomes.

Implications for Practice

Support the assessment of patients with decompensated heart failure.

Objetivos

Realizar a validação consensual das definições operacionais dos diagnósticos de enfermagem Intolerância à atividade, Volume de líquidos excessivo e Débito cardíaco diminuído em pacientes com insuficiência cardíaca descompensada.

Método

Validação consensual em duas etapas: Analogia de semelhança das características definidoras e desenvolvimento de definições operacionais e validação com expertst.

Resultados

Foram encontradas 38 características definidoras para os diagnósticos de enfermagem. Suas definições operacionais foram desenvolvidas e seu conteúdo validado. Os resultados mostram que houve 100% de concordância entre os sete experts após cinco rodada. As definições operacionais foram classificadas com base no nível de concordânica. “Ascite” foi acrescentada ao diagnóstico Volume de líquidos excessivo.

Conclusão

A validação consensual melhora a interpretação das respostas humanas, embasando a seleção de intervenções de enfermagem e contribuindo para melhorar os resultados.

Implicações Para A Prática

Apoio à avaliação dos pacientes com insuficiência cardíaca descompensada.

Keywords

Heart failure nursing diagnosis validation study

Get full access to this article

View all access options for this article.

References

Aliti

G. B.

Linhares

J. C. C.

Linch

G. F. C.

Ruschel

K. B.

Rabelo

E. R.

(2011). [Signs and symptoms in patients with decompensated heart failure: Priorities nursing diagnoses]. Revista Gaúcha de Enfermagem, 32(3), 590–595. (Portuguese).

Andrade

D. R.

Jr. Galvão

F. H. F.

Santos

S. A.

(2009). [Ascites: Evidence-based state of the art]. Revista da Associação Medica Brasileira, 55(4), 489–496. (Portuguese).

Barth

Q. C. M.

Aliti

Rabelo

E. R.

(2010). Decreased cardiac output: Clinical validation in patients with decompensated heart failure. International Journal of Nursing Terminologies and Classifications, 21(4), 156–165.

Bocchi

E. A.

Marcondes-Braga

F. G.

Ayub-Ferreira

S. M.

Rohde

L. E.

Oliveira

W. A.

Almeida

D. R.

, … Montera

M. W.

(2009). [III Brazilian guideline on chronic heart failure]. Arquivos Brasileiros de Cardiologia, 93(1, Suppl. 1), 1–71. (Portuguese).

Bocchi

E. A.

Marcondes-Braga

F. G.

Bacal

Ferraz

A. S.

Albuquerque

Rodrigues

(2012). [Guideline update on chronic heart failure]. Arquivos Brasileiros de Cardiologia, 98(1, Suppl. 1), 1–33. (Portuguese).

Boery

R. N. S. O.

Guimarães

H. C. Q. C. P.

Barros

A. L. B. L.

(2005). [Operational definitions of the defining characteristics of the nursing diagnosis fluid volume excess]. Acta Paulista de Enfermagem, 18(2), 197–202. (Portuguese).

Bonow

R. O.

Mann

D. L.

Zipes

D. P.

Libby

(Eds.). (2007). Braunwald's heart disease: A textbook of cardiovascular medicine (8th ed.). Philadelphia: Saunders.

Brasil Ministério da Saúde . (2009). [Indicators and basic data – IDB] . Retrieved from http://tabnet.datasus.gov.br (Portuguese).

Fusco

C. C.

Shiotsu

C. H.

(2011). [Activity intolerance in cardiomyopathy patients: Defining characteristics]. Arquivos Brasileiros de Cardiologia, 21(1), 7–10. (Portuguese).

10.

Galdeano

L. E.

Rossi

L. A.

(2006). [Validation of a diagnostic content: Expert selection criteria]. Ciência, Cuidado e Saúde, 5(1), 60–66. (Portuguese).

11.

Herdman

T. H.

(Ed.). (2012). NANDA International nursing diagnoses: Definitions and classification, 2012–2014. Oxford: Wiley-Blackwell.

12.

Jessup

Abraham

W. T.

Casey

D. E.

Feldman

A. M.

Francis

G. S.

Ganiats

T. G.

, … Yancy

C. W.

(2009). 2009 Focused Update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation. Journal of the American College of Cardiology, 53(15), 1343–1382.

13.

Kato

Stevenson

L. W.

Palardy

Campbell

P. M.

May

C. W.

Lakdawala

N. K.

, … Setoguchi

(2012). The worst symptom as defined by patients during heart failure hospitalization: Implications for response to therapy. Journal of Cardiac Failure, 18(7), 524–533.

14.

Lima

E. S.

Cruz

C. G.

Santos

F. C.

Gomes-Neto

Bittencourt

H. S.

Reis

F. J. F. B.

, … Rodrigues Junior

E. S.

(2011). Effect of ventilatory support on functional capacity in patients with heart failure: A pilot study. Arquivos Brasileiros de Cardiologia, 96(3), 227–232.

15.

Lopes

J. L.

Altino

Silva

R. C. G.

(2010). Content validation of current and new defining characteristics of the nursing diagnosis: Decreased cardiac output. Acta Paulista de Enfermagem, 23(6), 764–768.

16.

Margoto

Colombo

R. C. R.

Gallani

M. C. B. J.

(2009). Clinical and psychosocial features of heart failure patients admitted for clinical decompensation. Revista da Escola de Enfermagem da USP, 43(1), 41–49.

17.

Martins

Q. C. S.

Aliti

G. B. L.

Joelza

Rabelo

E. R.

(2011). Excess fluid volume: Clinical validation in patients with decompensated heart failure. Revista Latino-Americana de Enfermagem, 19(3), 540–547.

18.

Melo

R. P.

Lopes

M. V. O.

Araujo

T. L.

Silva

L. F.

Santos

F. A. A. S.

Moorhead

(2011). Risk for decreased cardiac output: Validation of a proposal for nursing diagnosis. Nursing in Critical Care, 16(6), 287–294.

19.

Montera

M. W.

Almeida

R. A.

Tinoco

E. M.

Rocha

R. M.

Moura

L. Z.

Réa-Neto

, … Fiorelli

A. I.

(2009). [II Brazilian guideline on acute heart failure]. Arquivos Brasileiros de Cardiologia, 93(3, Suppl. 3), 1–65. (Portuguese).

20.

Myers

R. P.

Cerini

Sayegh

Moreau

Degott

Lebrec

Lee

S. S.

(2003). Cardiac hepatopathy: Clinical, hemodynamic, and histologic characteristics and correlations. Hepatology, 37, 393–400.

21.

Oliva

A. P. V.

(2003). Decreased cardiac output: Validation with postoperative heart surgery patients. International Journal of Nursing Terminologies and Classifications, 22(1), 39–44.

22.

Pereira

J. M. V.

Cavalcanti

A. C. D.

Santana

R. F.

Cassiano

K. M.

Queluci

G. C.

Guimarães

T. C. F.

(2011). [Nursing diagnoses for inpatients with cardiovascular diseases]. Escola Anna Nery Revista de Enfermagem, 15(4), 737–745. (Portuguese).

23.

Pokorski

Moraes

M. A.

Chiarelli

Costanzi

A. P.

Rabelo

E. R.

(2009). Nursing process: From literature to practice. What are we actually doing? Revista Latino-Americana de Enfermagem, 17(3), 302–307.

24.

Rodrigues

C. G.

Moraes

M. A.

Sauer

J. M.

Kalil

R. A. K.

Souza

E. N.

(2011). Nursing diagnosis of activity intolerance: Clinical validation in patients with refractory angina. International Journal of Nursing Terminologies and Classifications, 22(3), 117–122.

25.

Salotti

S. R. A.

Guimarães

H. C. Q. C. P.

Virmond

M. C. L.

(2007). [Elaboration and validation of nursing diagnosis: Protection ineffective from ocular surroundings]. Revista Instituto de Ciências da Saúde, 25(2), 121–125. (Portuguese).

26.

Scarparo

A. F.

Laus

A. M.

Azevedo

A. L. C. S.

Freitas

M. R. I.

Gabriel

C. S.

Chaves

L. D. P. C.

(2012). [Reflections on the use of Delphi technique in research in nursing]. Revista Rene, 13(1), 242–251. (Portuguese).

27.

Scherb

C. A.

Head

B. J.

Maas

M. L.

Swanson

E. A.

Moorhead

Reed

, … Kozel

(2011). Most frequent nursing diagnoses, nursing interventions, and nursing-sensitive patient outcomes of hospitalized older adults with heart failure. International Journal of Nursing Terminologies and Classifications, 22(1), 13–22.

28.

Souza

Zeitoun

S. S.

Barros

A. L. B. L.

(2011). Decreased cardiac output: A systematic review of the defining characteristics. Acta Paulista de Enfermagem, 24(1), 114–119.