International Collaboration and New Research Evidence on Nanda International Terminology

An Evaluation of the NANDA International, Inc., Diagnostic Classification Among Spanish Nurses: A Cross-Sectional Study

Background/Objectives: The NANDA International, Inc., (NANDA-I) diagnostic classification is the most widely used standardized nursing language internationally. The EVALUAN-I tool was developed to evaluate the NANDA-I diagnostic classification. The aim was to analyze the use of the NANDA-I diagnostic classification among Spanish nurses and assess its correlation with sociodemographic characteristics. Methods: A cross-sectional study was conducted on a non-probabilistic sample of Spanish nurses working in clinical, management, and academic settings using the EVALUAN-I tool (September 2019-December 2020). The analysis was conducted using R® (version 3.6.3, Lavaan package; R Core Team, 2020), with statistical significance set at p < 0.05. This study was approved by the Research Ethics Committee (2019-190-1). Results: A total of 483 responses were obtained. There was a correlation between the intensity of use of NANDA-I and its application in practice (polychoric correlation = 0.50; p < 0.001). Nurses with a PhD degree considered nursing diagnoses to be less evidence-based (p = 0.037) but more useful (p = 0.035). Academic and research nurses stated that NANDA-I was more useful (p = 0.007), even for exclusive responsibilities (p = 0.034), and that it provided greater significance to diagnoses (p = 0.0012). Conclusions: NANDA-I is the most widely used standardized nursing language in Spain. Nurses' academic qualifications and work environment significantly influence their perceptions and use of NANDA-I. Advanced education fosters a critical yet positive perspective, highlighting a relationship between the intensity of its use, its application in clinical practice, and the nurse's educational background. Tools such as EVALUAN-I promote its integration and evidence-based practice, but challenges remain in improving perceptions, scientific evidence, and visibility in electronic health records to enhance its clinical impact and nursing recognition.

Exploring the conceptual history of validity in nursing diagnoses: A Koselleckian perspective

PURPOSE

This purpose of this article was to use the method of conceptual history to analyze the evolution of the concept of "validity" in nursing diagnoses and to identify key transformations, theoretical influences, and implications for contemporary clinical judgment and decision-making.

METHODS

Five stages derivate from the approach proposed by Reinhart Koselleck, including: identify the concept and its relevance, historical contextualization, contextual use, semantic changes over time, and synthesis and interpretation.

FINDINGS

The concept of "validity" in nursing diagnoses is essential for accurate diagnostics, interdisciplinary communication, and evidence-based decision-making, though its interpretation varies due to differing philosophical perspectives and methodological challenges. Historically, "validity" in nursing evolved from empirical methods to theory-driven approaches incorporating psychometric and clinical frameworks. Validation processes have adapted, integrating scientific rigor, ethical considerations, and practical utility, while also reflecting societal, technological, and cultural shifts. Today, the focus is on balancing methodological diversity and evidence-based practice, with a need for continuous quality improvement, interdisciplinary collaboration, cultural sensitivity, and patient involvement.

CONCLUSIONS

The concept of "validity" in nursing diagnoses has evolved from early empirical methods to its current focus on evidence-based practices, interdisciplinary integration, and cultural sensitivity, emphasizing the need for accurate, technologically informed diagnostics to enhance patient care and guide clinical decision-making.

IMPLICATIONS FOR NURSING PRACTICE

Nursing must integrate diverse perspectives, cultural sensitivity, and technology into its diagnoses, and professionals should be trained in both scientific and ethical aspects to improve patient outcomes.

Nursing diagnoses for people hospitalized with heart failure: an integrative review

OBJECTIVES

to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.

METHODS

an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.

RESULTS

analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.

FINAL CONSIDERATIONS

evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.

Urinary incontinence in women: assessment with the aid of standardized nursing terminologies NANDA-I and NOC

OBJECTIVES

to assess urinary impairment in incontinent women with the aid of standardized nursing terminologies NANDA-I and NOC.

METHODS

a cross-sectional study, carried out with 97 women attending the gynecology outpatient clinic of a university hospital. Data collection took place using a form that contained information about NANDA-I diagnoses related to urinary incontinence and NOC Urinary Continence indicators. Statistical analysis was performed to assess the impairment of NOC indicators in the presence of NANDA-I nursing diagnoses.

RESULTS

diagnosis Mixed Urinary Incontinence was the most prevalent (43.3%), and, in its presence, the most compromised indicators were voids in appropriate receptacle, gets to toilet between urge and passage of urine and empties bladder completely.

CONCLUSIONS

urinary impairment was worse in women with elements of stress and urge urinary incontinence.

Decreased cardiac output: an integrative review

OBJECTIVE

to identify, in the scientific literature, the defining characteristics and contributing factors (related factors, associated conditions and populations at risk) for nursing diagnosis decreased cardiac output.

METHOD

an integrative literature review, conducted between September and October 2020, with an update in March 2022, in the MEDLINE via PubMed, LILACS, SciELO, CINAHL and EMBASE databases. Using acronym PEO, studies published in the last 10 years in Portuguese, English and Spanish were included. A descriptive analysis was carried out to present the elements mapped in the literature.

RESULTS

analysis of 31 articles identified different elements, highlighting 4 new related factors: hyperglycemic stress, prone position, left lateral position, sleep deprivation. Individuals with a history of cardiovascular disease and males were identified as possible populations at risk.

FINAL CONSIDERATIONS

the elements for decreased cardiac output, identified in the literature, add evidence that justifies the permanence of this diagnosis in the NANDA-I classification.

Débito cardíaco diminuído: revisão integrativa

RESUMO Objetivo: identificar, na literatura científica, as características definidoras e fatores contribuintes (fatores relacionados, condições associadas e populações em risco) para o diagnóstico de enfermagem débito cardíaco diminuído. Método: revisão integrativa da literatura, conduzida entre setembro e outubro de 2020, com atualização em março de 2022, nas bases de dados MEDLINE via PubMed, LILACS, SciELO, CINAHL e EMBASE. Com uso do acrônimo PEO, foram incluídos estudos publicados nos últimos 10 anos em português, inglês e espanhol. Realizouse análise descritiva para apresentar os elementos mapeados na literatura. Resultados: análise de 31 artigos identificou diferentes elementos, com destaque para 4 novos fatores relacionados: estresse hiperglicêmico, posição prona, posição lateral esquerda, privação do sono. Indivíduos com história de doença cardiovascular e do sexo masculino foram apontados como possíveis populações em risco. Considerações finais: os elementos para débito cardíaco diminuído, identificados na literatura, agregam evidências que justificam a permanência desse diagnóstico na classificação da NANDA-I.

Excessive fluid volume risk middle-range theory

ABSTRACT Objective to construct a middle range theory for developing the excessive fluid volume risk diagnostic proposition in patients undergoing hemodialysis. Method this is a methodological study, developed for the theoretical-causal validity of a nursing diagnosis. The study was carried out in four stages: study selection, identification of the main concepts of the theory, pictogram construction and proposition elaboration. These steps were operationalized through an integrative literature review, with a sample of 82 articles selected from the Web of Science, PubMed, CINAHL, Scopus and Science Direct databases. Results the data extracted from the sample articles enabled identifying five essential terms to define excessive fluid volume risk. Furthermore, 31 etiological factors of excessive fluid volume risk were identified, in addition to a pictogram and 12 propositions. Conclusion and implications for practice the construction of a middle-range theory focused on excessive fluid volume risk in patients undergoing hemodialysis refines terminology and expands the understanding of nursing phenomena. Thus, the data from this research will provide clear and robust knowledge for the conduct of nurses’ actions in clinical practice.

Teoria de médio alcance do risco de volume de líquidos excessivo

RESUMO Objetivo construir uma teoria de médio alcance para o desenvolvimento da proposição diagnóstica risco de volume de líquidos excessivo em pacientes em hemodiálise. Método trata-se de um estudo metodológico, desenvolvido para a validade teórico-causal de um diagnóstico de enfermagem. O estudo foi realizado em quatro etapas: seleção dos estudos, identificação dos conceitos principais da teoria, construção do pictograma e elaboração das proposições. Essas etapas foram operacionalizadas por meio de uma revisão integrativa da literatura, com uma amostra de 82 artigos selecionados nas bases de dados Web of Science, PubMed, CINAHL, Scopus e Science Direct. Resultados os dados extraídos dos artigos da amostra possibilitaram a identificação de cinco termos essenciais para a definição do risco de volume de líquidos excessivo. Além disso, foram identificados 31 fatores etiológicos do risco de volume de líquidos excessivo, além de construídos um pictograma e 12 proposições. Conclusão e implicações para a prática a construção de uma teoria de médio alcance voltada para o risco de volume de líquidos excessivo em pacientes em hemodiálise refina as terminologias e amplia a compreensão dos fenômenos da enfermagem. Assim, os dados desta pesquisa fornecerão conhecimentos claros e robustos para a condução das ações do enfermeiro na prática clínica.