“Impaired Resilience (00210)” in patients under fertility treatment: Clinical validation study

Abstract

Purpose

The aim of this study was a clinical validation of the NANDA-I nursing diagnosis “Impaired Resilience (00210)” in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics.

Methods

A cross-sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility-related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee.

Findings

The “Impaired Resilience (00210)” had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are “decreased interest in vocational activities,” “depression,” “impaired health status,” “ineffective coping strategies,” “low self-esteem,” “renewed elevation of distress,” and “social isolation.” No item showed differential item functioning. “Renewed elevation of distress” and “low self-esteem” were the most sensitive defining characteristics and had the highest negative predictive value. “Shame” was the most specific one.

Conclusions

The nursing diagnosis “Impaired Resilience (00210)” was validated, and results may improve its accuracy in people going through fertility treatment.

Implications for nursing practice

This paper contributes by raising knowledge regarding NANDA-I nursing diagnosis and enhancing the quality of nurses’ critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field.

Objetivo

Este estudo teve como objetivo a validação clínica do diagnóstico de enfermagem “Resiliência comprometida (00210)” em pessoas a realizar tratamento de fertilidade; e determinar a sensibilidade, especificidade e valor preditivo das características definidoras.

Métodos

Foi conduzido um estudo transversal entre Setembro de 2019 e Junho de 2020. 104 participantes foram recrutados através de sítios afetos ao tema da fertilidade, respondendo um questionário online após o seu consentimento informado. O modelo Rasch foi empregue na análise estatística. O estudo foi aprovado pela Comissão de Ética.

Resultados

A “Resiliência comprometida (00210)” teve uma prevalência de 15.4% na amostra, e 7 características definidoras foram confirmadas: “Interesse diminuído pelas atividades profissionais”; “Depressão”; “Estado de saúde comprometido”; “Estratégias de coping ineficazes”; “Isolamento social”. Nenhum item apresentou funcionamento diferencial. O “Aumento renovado da angústia” e a “Baixa autoestima” foram as características mais sensíveis e com valores preditivos negativos mais altos. A “Vergonha” foi a característica mais específica.

Conclusões

O diagnóstico de Enfermagem NANDA-I de “Resiliência comprometida (00210)” foi validado e os resultados possibilitaram melhorar a sua acurácia em pessoas a realizar tratamento de fertilidade.

Implicações para a prática

Este artigo contribuiu para elevar o corpo do conhecimento da terminologia NANDA-I dos diagnósticos de enfermagem e contribuir para elevar a qualidade do julgamento crítico e poder de decisão clínica dos enfermeiros. Uma intervenção mais eficaz e preventiva permitirá apoiar as pessoas na sua habilidade para lidar com a adversidade durante o tratamento de fertilidade, sendo promotora de uma abordagem de Enfermagem baseada na resiliência em contexto reprodutivo.

Keywords

infertility nursing resilience validation studies

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