The Adequacy of the Q Methodology for Clinical Validation of Nursing Diagnoses Related to Subjective Foci

Differential validation of nursing diagnoses: An integrative literature review on the use of the method

PURPOSE

This review aimed to analyze the use of differential validation of nursing diagnosis.

METHODS

Integrative literature review with search on international databases. The diagnoses, the type of the diagnosis differential validation, the sample, the method, main results, and the limitations were extracted. Ten studies were included.

FINDINGS

Differential diagnostic validation publication dates from 1994, and Brazil was the predominant country.

CONCLUSIONS

This method seems helpful in improving diagnosis accuracy, particularly those related to subjective, behavioral, or complex human responses.

IMPLICATIONS FOR NURSING PRACTICE

Using this model may facilitate understanding the specificity of nursing diagnosis, which is critical for teaching clinical reasoning and for new opportunities to research.

End-of-life: An urgent update in nursing terminology

Although nursing terminologies and classifications represent nursing knowledge across diverse clinical areas, end-of-life care seems under represented in many aspects of these instruments. NANDA- I is an international nursing diagnostic classification widely used in nursing education and research. This taxonomy is based on seven axes, including the axis of time. In this commentary we bring discussion to the need to update nursing terminology by including the term end-of-life in the time axis of NANDA-I. After describing the epidemiologic aspects of end-of-life care and discussing the relevant nursing role, we discuss patients' and family's human responses towards the end-of-life time and circumstance, which are central to defining nursing diagnoses. End-of-life care is one priority in health care, and nursing diagnoses should represent that situation as well. This paper focuses on a specific and international nursing diagnosis classification, NANDA-I, which lacks an end-of-life component to its time axis for defining labels of nursing diagnoses. Attending to the importance of classifications in clinical reasoning, nursing diagnoses could better represent responses towards this health condition, opening new opportunities for increasing nursing roles in clinical practice, and also for new studies aiming to validate nursing diagnoses, and promoting an evidence-based practice by including end-of-life in the axis time.

International Collaboration and New Research Evidence on Nanda International Terminology

OBJECTIVES

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

METHODS

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

CONCLUSIONS

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.

IMPLICATIONS FOR NURSING KNOWLEDGE

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.

Paths taken by Brazilian Nursing for the development of terminological subsets

OBJECTIVE

to discuss the paths taken by Brazilian Nursing in the development of terminological subsets of the International Classification for Nursing Practice.

METHOD

documentary research, carried out in master's dissertations and doctoral theses, which developed terminological subsets, available at the Bank of Doctoral Theses and Master's Dissertations of the Under-graduation Personnel Improvement Coordination. The variables were analyzed were institution, year; academic level, type of health service, methodological approach, clientele, theoretical reference, validation of terms, cross mapping, modeling of new concepts, validation of statements, method used for elaboration, term collection, finalization and dissemination.

RESULTS

124 doctoral theses and master's dissertations were found, 91 were excluded and 33 were included, 23 (69.70%) of which were master's dissertations, with the highest production in 2014 (n=10; 30.30%), with emphasis on the Northeast (36.36%); the 'Primary Care' scenario, with six studies (18.18%); and the predominant clientele was cancer patients. As for the methodological characteristics, in 96% of the studies, the quantitative approach was used; in 2%, a qualitative approach; and 2% associated the quantitative and qualitative approaches. As for the type of study, 60% were methodological and 24% descriptive-exploratory, with the Horta model being the most used (36%).

CONCLUSION

the paths are successful, yet still permeated by weaknesses in the validations and potentialities to standardize the language.

"Call for the Use of Axial Terms": Toward Completeness of NANDA-I Nursing Diagnoses Labels

PURPOSE

This article explores the current structure of NANDA-I nursing diagnoses (ND) labels.

METHODS

Critical analysis of the ND labels, as categorized in the NANDA-I terminology.

FINDINGS

Most of the 244 ND labels are composed of terms from the focus and judgment axes.

CONCLUSIONS

The specificity of the human responses toward health and life transitions may not be totally represented in the two most common axes, as categorized within taxonomy II.

IMPLICATIONS FOR NURSING PRACTICE

Improvements in NANDA-I diagnosis labels would contribute to an advanced terminology and to increased specificity and accuracy of the diagnostic process that is needed in clinical practice. Completeness of the ND labels would reflect clinical reasoning preciseness and help students and nurses in delivering more personalized, safe, and effective patient-centered care.

OBJETIVO

Este artigo explora os títulos dos diagnósticos de enfermagem da NANDA-I. MÉTODOS: Análise crítica dos títulos dos diagnósticos de enfermagem da NANDA-I.

RESULTADOS

A maioria dos 244 diagnósticos de enfermagem classificados são compostos essencialmente por termos referentes ao foco e ao julgamento. CONCLUSÕES: A especificidade das respostas às transições de saúde e vida pode não estar totalmente representada nos dois eixos mais comuns, como apresentado na taxonomia II. IMPLICAÇÕES PARA A PRÁTICA: Melhorias nos diagnósticos da NANDA-I em relação ao seu aspeto multiaxial contribuiriam no desenvolvimento da sua terminologia e poderiam melhorar a especificidade e acurácia do processo diagnóstico que é necessário à prática clínica. Complementar os títulos dos diagnósticos de enfermagem poderia refletir a acurácia do raciocínio clínico e ajudar os estudantes e enfermeiros em prestarem cuidados centrados no paciente mais personalizados, seguros e eficazes.