Identification and Development of NANDA-I,NOC,and NIC (NNN) Linkages for the Nursing Diagnosis Chronic Pain Syndrome

Abstract

Purpose

To develop NANDA International (NANDA-I), Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC) (NNN) linkages for the Chronic Pain Syndrome (CPS) (00255) nursing diagnosis.

Methods

A six-member expert panel, all active members of the NANDA-I Italian Network Group, was purposively selected based on demonstrated expertise in standardized nursing terminologies and clinical or academic background. The study followed the Iowa NNN linkage development process, supported by a narrative literature review across PubMed/MEDLINE, CINAHL, PsycINFO, and Cochrane Library. Panel members developing a structured linkage table, then convening in iterative consensus meetings to reconcile proposals. Final approval required unanimous consensus, followed by a concluding review by the developers of the NOC and NIC classifications (University of Iowa).

Findings

The NNN linkages for the CPS nursing diagnosis were developed. A total of 57 NOC nursing outcomes were identified to guide care based on the syndrome. The following main NOC to measure the resolution of the diagnosis were identified: Comfort Level (2008); Pain Level (2102); Pain: Disruptive Effects (2101); Self-Care: Activities of Daily Living (ADL) (0300); Self-Care: Instrumental Activities of Daily Living (IADL) (0306), along with outcomes addressing defining characteristics, related factors, and 35 nursing interventions, such as Pain Management: Chronic (1415), Relaxation Therapy (6040), Self-Care Assistance (1800), Emotional Support (5270).

Conclusions

Chronic pain syndrome is a multifaceted condition that significantly affects both individuals and society, and its complexity requires an interdisciplinary approach. Therefore, the identified NNN linkages provide evidence-based guidance for planning and delivering nursing care to effectively manage chronic pain syndrome.

Implication for Nursing Practice

The NNN linkages for the CPS nursing diagnosis serve as a practical, evidence-based resource to improve nursing research, practice and education, as well as support clinical decision-making and documentation. Ultimately, this enhances recognition and visibility of nursing care in the management of patients experiencing chronic pain.

Keywords

chronic pain syndrome chronic pain pain management nursing diagnosis nursing outcomes classification nursing interventions classification

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