International Journal of Nursing Knowledge

To describe a new method of validating nursing outcomes and indicators that incorporates nurses’ and patients’ perspectives.

The Nurse–Patient Outcome Content Validation Method was developed in light of the experience of conducting the content validation of the nursing outcome Knowledge: Heart Failure Management (1835). It was developed based on Fehring's content validation model used for the validation of NANDA International nursing diagnoses. It expands the concept of who is an expert in the validation of nursing outcomes.

The Nurse–Patient Outcome Content Validation Method is a new method in which the concept of experts is expanded to gather patients’ as well as healthcare professionals’ perspectives on the importance of indicators to measure an outcome. Based on the importance ratios, the indicators are grouped into three categories: critical, supplemental, or unnecessary. To validate the outcome, importance ratios of critical and supplemental indicators are summed and divided by the total number of the indicators to calculate the outcome content validity (OCV) score of the nursing outcome.

The Nurse–Patient Outcome Content Validation Method is a new method of content validation of nursing outcome and indicators that incorporates the patient perspective.

The Nurse–Patient Outcome Content Validation Method provides a mechanism to include nurses’ and patients’ perspectives to content validity research of nursing outcomes. It supports patient empowerment since the patient is viewed as an expert regarding the experience of living and managing his/her clinical condition.

To evaluate the incidence and the prediction of unstable blood glucose level among critically ill patients hospitalized in an intensive care unit.

A cohort study was conducted with 62 adult patients hospitalized at an intensive care unit of a hospital located in Minas Gerais, Brazil, between March and July of 2017. Patient's demographic information, along with scores for Simplified Acute Physiology Score III, primary medical diagnosis, discharge status, diagnosis of diabetes and/or sepsis, length of stay, glycemic variability, type of nutrition, types of medications and treatments, and oxygen therapy were collected daily. A daily venous blood sample was collected to measure blood glucose levels during the patient's hospitalization period. Bivariate analysis was used to explore the association among the potential diagnostic indicators and the outcome of unstable blood glucose levels. Multivariate Cox regression was used to identify the potential predictors for the outcome.

Of the total of 62 participants, 45.1% (n=28) had unstable blood glucose level. Among the 28 patients with unstable blood glucose levels, half of them (n=14, 50%) had hypoglycemia and the other half had hyperglycemia (n=14, 50%). Decreased number of days hospitalized and the use of intensive glucose control with regular insulin were associated with decreased odds of developing hyperglycemia. The presence of mechanical ventilation was associated with a higher risk for the development of hypoglycemia.

This study provides knowledge and evidence of diagnostic indicators for unstable blood glucose levels that are not currently included in the NANDA-International terminology for the nursing diagnosis Risk for unstable blood glucose level (00179).

This study identified important diagnostic indicators that nurses can observe during the assessment to identify patients that are at risk for developing unstable blood glucose level and provide the appropriate care.

Avaliar a incidência e predição de glicemia instável em pacientes adultos internados em uma Unidade de Terapia Intensiva.

Estudo de coorte concorrente, realizada entre março e julho de 2017, com amostra de 62 pacientes. As variáveis independentes coletadas da admissão do paciente a unidade foram sexo, raça, idade, Simplified Acute Physiology Score III, diagnóstico de internação, tipo de saída, diabetes, sepse, tempo de permanência, variabilidade glicêmica, tipo de nutrição, medicamentos e terapêutica, e oxigenoterapia (cateter nasal e ventilação mecânica). Os dados foram analisados por estatística descritiva e análise de sobrevida com teste de Log-rank e regressão multivariada de Cox.

Dos 62 pacientes, 45,1% (n=28) desenvolveram a glicemia instável. Dos 28 pacientes com glicemia instável, metade (n=14, 50%) apresentou hipoglicemia, e a outra metade apresentou hiperglicemia (n=14, 50%). Menor tempo de permanência e controle estrito da glicemia foram fatores de proteção para desenvolvimento de hiperglicemia. Ventilação mecânica foi associada ao desenvolvimento de hipoglicemia.

Este estudo fornece conhecimento e evidência sobre indicadores diagnósticos para o desenvolvimento de glicemia instável, que atualmente não estão incluídos na terminologia da NANDA-Internacional para o diagnóstico de enfermagem Risco de glicemia instável.

Este trabalho contribui para o aperfeiçoamento da Taxonomia da NANDA-Internacional e, por conseguinte, da linguagem padronizada de enfermagem.

To discuss priorities and possibilities for promoting international collaboration and new research evidence on NANDA International, Inc. (NANDA-I).

Theoretical reflection article based on the literature and the authors’ opinions on the subject matter, carried out by six research nurses.

International research collaboration for NANDA-I allows the improvement of research production in an actual clinical setting, especially with multicenter and validation studies, conducted by researchers from different countries. This provides for improved understanding of patients’ experiences and may help to produce robust scientific evidence.

The generation of new evidence may lead to an increase in NANDA-I visibility and in nurses’ understanding of its meaning for clinical practice and for the formulation of diagnostic hypotheses.

To construct a middle-range theory, based on the Roy adaptation model, for nurses can diagnose an ineffective infant feeding pattern.

Scientific findings were used through a literature review and the concepts of the Roy model.

The theory indicated new elements for the diagnosis: 12 etiological factors and 13 clinical indicators. Most of those are not contained in the NANDA taxonomy.

The middle-range theory for these diagnoses highlights the need for a review of the components present in the taxonomy.

This approach guides research on nursing diagnoses to revise the content of the theory and to expand its concepts and elements for the diagnosis of an ineffective infant feeding pattern.

To analyze the Nursing Diagnosis risk for falls indicators in aged with hypertension and to verify the association of this diagnosis with sociodemographic variables and antihypertensive agents used by the aged.

Analytical study, cross-sectional with quantitative approach. It was carried out in three health units in the city of Redenção, Ceará, Brazil, in the Brazilian Northeast. A total of 153 elderly subjects participated in the study. Statistical analysis was performed using Fisher's exact test, Pearson's chi-square test and multinomial logistic regression of variables that presented association with the Nursing Diagnosis.

Use of throw rugs, difficulties with gait, acute illness (p = .004), age greater than or equal to 65 years and impaired vision were associated with the Nursing Diagnosis risk for falls (00155). The work situation (retired) was the only sociodemographic variable that had a significant association with the risk for falls. Antihypertensive agents were not associated with the diagnosis.

Age greater than or equal to 65 years, use of throw rugs, difficulties with gait, acute illness, and impaired vision can be useful to infer the risk for falls and to confirm their presence in the aged with hypertension.

This study provides data that can help nurses in the process of inferring the diagnosis risk for falls in the aged with hypertension, which streamlines the planning and implementation of preventive interventions.

analisar os elementos estruturais do Diagnóstico de Enfermagem Risco de quedas em idosos com hipertensão arterial e verificar a associação desse diagnóstico com variáveis sociodemográficas e agentes anti-hipertensivos utilizados pelos idosos.

estudo analítico, transversal com abordagem quantitativa. Foi realizado em três unidades de saúde do município de Redenção, no Nordeste brasileiro. Um total de 153 idosos participaram deste estudo. A análise estatística foi pelo teste exato de Fisher, qui-quadrado de Pearson e a regressão logística multinominal de variáveis que apresentaram associação com o Diagnóstico de Enfermagem.

uso de tapetes soltos, dificuldades na marcha, doença aguda (p = 0,004), idade maior ou igual a 65 anos e visão prejudicada foram associados ao Diagnóstico de Enfermagem Risco de quedas (00155). A situação de trabalho (aposentado) foi a única variável sociodemográfica que teve associação significante com o Risco de quedas. Os agentes anti-hipertensivos não foram associados ao diagnóstico.

a idade maior ou igual a 65 anos, uso de tapetes soltos, dificuldades na marcha, doença aguda e visão prejudicada podem ser úteis para inferir o Diagnóstico de Enfermagem Risco de quedas e para confirmar sua presença em idosos com hipertensão arterial.

este estudo fornece dados que podem ajudar o enfermeiro no processo de inferência do diagnóstico Risco de quedas em idosos com hipertensão arterial, o que agiliza o planejamento e a implementação de intervenções preventivas.

To analyze the concept of healthy aging and propose the development of a nursing diagnosis

Concept analysis using the method proposed by Walker and Avant

Four bibliographic databases were searched, and 36 articles were included in the analysis. Seven antecedents, seven attributes, and three consequences for “healthy aging” were identified.

The concept analysis supported the development of the new nursing diagnosis “readiness for enhanced healthy aging,” which can assist nurses in implementing actions aimed at promoting the health of older adults.

The establishment of a nursing diagnosis may provide nurses the opportunity to implement interventions that promote the maintenance of functional and cognitive capacity, psychological and spiritual well-being, and social engagement, aiming at healthy aging with high quality of life.