Evaluation of the NANDA International, Inc. diagnostic classification in Spain: Development and validation of the EVALUAN-I tool.

PURPOSE: To develop and validate a tool to evaluate the NANDA International, Inc. diagnostic classification. METHODS: The tool, EVALUAN-I, was validated in a non-probabilistic sample (N = 460) on Spanish Registered Nurses (September-December 2019) in two phases. First, design and construct the instrument in three steps: (1) literature review to define the construct focusing on the orientation toward nursing concepts and theoretical foundations, the level of scientific evidence, the structural configuration, the applicability, the nurses' clinical reasoning skills, and the attitudes toward nursing diagnosis, (2) substantiation of the questionnaire items and design according to the criteria for a diagnostic classification, (3) expert test to establish the face validity and content validity. The second phase revolved around (4) conducting a pilot test and measuring the temporal stability (test-retest) and Cohen's kappa coefficient; assessing psychometric properties by measuring (5) reliability (internal consistency using Cronbach alpha and interfactor correlation) and (6) construct validity (exploratory and confirmatory factor analysis). The manuscript follows the STROBE checklist. The study was approved by the Research Ethics Committee with registration number 2019-190-1. FINDINGS: EVALUAN-I displayed moderate test-retest stability, adequate construct validity, and excellent reliability. The confirmatory factor analysis provided evidence about the configuration of EVALUAN-I in relation to nine analytical dimensions: clinical competence, nurses' reasoning skills, attitudes towards nursing diagnosis, discipline's central concepts, classification's contents, physiopathological attributes, level of scientific evidence, diagnostic precision, and conceptual correspondence between terminologies. CONCLUSIONS: EVALUAN-I is a valid and reliable instrument, which can be used to improve the epistemological, normative, and intuitive configuration of NANDA International, Inc. in a structured, systematic manner. IMPLICATIONS FOR NURSING PRACTICE: Comprehensive evaluation of NANDA International, Inc. in different clinical settings around the world using a validated instrument, like EVALUAN-I, would allow strengths and weaknesses to be identified and contribute to the classification's development and practical application.

OBJETIVO: Diseñar y validar un instrumento de medida para evaluar la taxonomía diagnóstica NANDA International, Inc. MÉTODOS: La herramienta, EVALUAN-I, ha sido validada con una muestra no probabilística (N = 460) de enfermeras españolas (septiembre-diciembre 2019) en dos fases. Primera, diseño y construcción del instrumento en tres etapas: (1) definición del constructo a través de una revisión bibliográfica centrada en la orientación hacia los conceptos y fundamentos teóricos de la enfermería, el nivel de evidencia científica, la configuración estructural, la aplicabilidad, las habilidades de razonamiento clínico de las enfermeras y las actitudes hacia los diagnósticos enfermeros, (2) fundamentación normativa de los criterios que debe reunir una clasificación diagnóstica y (3) prueba de expertos para establecer la validez aparente y validez de contenido. La segunda fase se centra en (4) el desarrollo de un pilotaje y medición de la estabilidad temporal a través del test-retest y cálculo del coeficiente Kappa de Cohen; evaluación de las propiedades psicométricas a través de la (5) fiabilidad (consistencia interna mediante Alfa de Cronbach y correlación interfactorial) y (6) validez de constructo (análisis factorial exploratorio y confirmatorio). El manuscrito se ajusta a los criterios STROBE. El estudio fue aprobado por el Comité de Ética de la Investigación con el número de registro 2019-190-1. [Correction added on 20 April 2022, after first online publication: In point (4) of the 'Methods' section, "Kappa de ohen" has been corrected to "Kappa de Cohen" in this version.] RESULTADOS: EVALUAN-I mostró moderada estabilidad test-retest, adecuada validez de constructo y excelente fiabilidad. El análisis factorial confirmatorio mostró evidencias acerca de la configuración de EVALUAN-I en 9 dimensiones de análisis: competencia clínica, aptitudes para el razonamiento diagnóstico, actitudes ante el diagnóstico enfermero, conceptos centrales de la disciplina, contenidos de la clasificación, atributos fisiopatológicos, nivel de evidencia científica, precisión diagnóstica y comparativa conceptual entre terminologías. CONCLUSIONES: EVALUAN-I constituye un instrumento válido y fiable para mejorar la configuración epistemológica, normativa e intuitiva de NANDA International, Inc. de una manera estructurada y sistematizada. IMPLICACIONES PARA LA PRÁCTICA CLÍNICA: La valoración global de la taxonomía NANDA International, Inc. en los distintos contextos clínicos a nivel internacional a través de una herramienta validada como EVALUAN-I permitiría identificar las fortalezas y debilidades necesarias para contribuir a su desarrollo y aplicación práctica.

Mapeo cruzado de los factores relacionados y de riesgo de NANDA-I con la Clasificación Internacional de Enfermedades / Cross-mapping of Related and Risk Factors of NANDA-I with those of the International Classification of Diseases

Introducción: Enfermería desarrolla su actividad en un contexto multidisciplinar donde se mezclan la esfera autónoma y la de otros profesionales, y es de primordial la competencia diagnóstica. NANDA-International es la clasificación enfermera más utilizada; mientras que la Clasificación Internacional de Enfermedades es la de referencia para los problemas médicos. En ocasiones, los factores relacionados/riesgo de NANDA-International coinciden con diagnósticos médicos. Objetivo: Realizar mapeo cruzado entre NANDA-International y la Clasificación Internacional de Enfermedades. Métodos: Estudio observacional con distribución de frecuencias mediante mapeo cruzado identificando sinónimos o cuasi-sinónimos en ambas clasificaciones. Resultados: Se determinaron n = 1715 factores relacionados/riesgo, n = 1193 clasificados en una ocasión y n = 522 duplicados. Los factores genuinos y específicos fueron n = 1593 (52,16 por ciento); n = 1460 (47,84 por ciento) estaban también en la clasificación médica. Conclusiones: Algunos Dominios y clases NANDA-International muestran factores genuinos y específicos de la disciplina enfermera; otros están, además, en la clasificación médica, cuya resolución no es competencia autónoma enfermera. De esta manera, NANDA-International puede llegar a convertirse en un instrumento extenso y poco útil, con etiologías poco específicas. Se deben mejorar y potenciar contenidos relativos a metaparadigmas enfermeros para hacerse visible con entidad propia en los sistemas de salud(AU)

Introduction: Nursing develops its activity in a multidisciplinary setting where the autonomous sphere and that of other professionals are mixed, while diagnostic competence is paramount. NANDA-International is the most widely used nurse classification, while the International Classification of Diseases is the reference for medical problems. Occasionally, the related factors/risk of NANDA-International coincide with medical diagnoses. Objective: To carry out cross-mapping between NANDA-International and the International Classification of Diseases. Methods: Observational study with frequency distribution by cross-mapping and identifying synonyms or quasi-synonyms in both classifications. Results: We determined 1715 related factors/risk; 1193 were classified on one occasion and 522 were duplicated. The genuine and specific factors were 1593 (52.16 percent); 1460 (47.84 percent) were also in the medical classification. Conclusions: Some NANDA-International domains and classes show genuine and specific factors in the nursing discipline, while others are also in the medical classification, whose resolution is not autonomously a nursing competence. In this way, NANDA-International can become an extensive and unhelpful tool, with little specific etiologies. Content related to nursing metaparadigms must be improved and enhanced to become visible with their own entity in the health systems(AU)

English in the nursing degree: a pending subject.

OBJECTIVE: The new competence profile of nursing professionals, scientific and medical development, the free circulation of health professionals worldwide, and the increasing social and cultural diversity requires that nurses have specific abilities in spoken and written English. The objective of this research is to describe the characteristics of the English language training required for a Bachelors of Nursing in Spain. METHOD: A descriptive cross-sectional observational study has been performed in forty-six Spanish universities that offer the Bachelor in nursing degree. RESULTS: In line with the directives of the European Higher Education Area, all universities contemplate the mandatory credit of a second language emphasizing English, although there is considerable variability in the emphasis: 39.4% do not include any English subject, and of the remaining 60.6% who do include it, 60% considered it an elective subject, 32.5% basic education, and 7.5% mandatory. CONCLUSIONS: The English training has different characteristics in each university, which implies a different commitment from each center for this learning. This fact questions the adequacy of the education in relation to the new competence profile required by the European Higher Education Area, which may adversely affect future professional development.

English in the nursing degree: a pending subject / Inglês no grau de enfermagem: um assunto pendente / El inglés en el grado de enfermeria: una asignatura pendiente

OBJECTIVE: The new competence profile of nursing professionals, scientific and medical development, the free circulation of health professionals worldwide, and the increasing social and cultural diversity requires that nurses have specific abilities in spoken and written English. The objective of this research is to describe the characteristics of the English language training required for a Bachelors of Nursing in Spain. METHOD: A descriptive cross-sectional observational study has been performed in forty-six Spanish universities that offer the Bachelor in nursing degree. RESULTS: In line with the directives of the European Higher Education Area, all universities contemplate the mandatory credit of a second language emphasizing English, although there is considerable variability in the emphasis: 39.4% do not include any English subject, and of the remaining 60.6% who do include it, 60% considered it an elective subject, 32.5% basic education, and 7.5% mandatory. CONCLUSIONS: The English training has different characteristics in each university, which implies a different commitment from each center for this learning. This fact questions the adequacy of the education in relation to the new competence profile required by the European Higher Education Area, which may adversely affect future professional development. .

OBJETIVO: O perfil de nova competência dos profissionais de enfermagem, o desenvolvimento científico e médico, a livre circulação de profissionais de saúde em todo o mundo, e a crescente diversidade social e cultural requer que os enfermeiros têm habilidades específicas em Inglês falado e escrito. O objetivo desta pesquisa é descrever as características da formação idioma Inglês necessárias para um Bacharelado em Enfermagem, na Espanha. MÉTODO: Um estudo descritivo transversal observacional foi realizado em 46 universidades espanholas que oferecem o grau de Bacharel em enfermagem. RESULTADOS: Em conformidade com as diretivas do Espaço Europeu do Ensino Superior, todas as universidades contemplam o crédito obrigatório de uma segunda língua enfatizando Inglês, embora exista uma grande variabilidade na ênfase: 39,4% não incluem qualquer assunto Inglês, e do restante 60,6 % que o inclua, 60% considerou um assunto eletivo, 32,5% um ensino básico e 7,5% obrigatórios. CONCLUSÕES: O treinamento em Inglês tem características diferentes em cada universidade, o que implica em um compromisso diferente de cada centro para esse aprendizado. Este fato questiona a adequação da educação em relação ao perfil de competências exigidas pelo novo Espaço Europeu do Ensino Superior, o que pode prejudicar o desenvolvimento futuro profissional. .

OBJETIVO: El nuevo perfil competencial de los profesionales de Enfermería, el desarrollo científico-sanitario, la libre circulación de profesionales sanitarios a nivel internacional y la creciente diversidad socio-cultural exige que las enfermeras posean competencias específicas en inglés hablado y escrito. El objetivo del presente estudio es describir las características de la formación en lengua inglesa en el Grado en Enfermería en España. MÉTODO: Se ha realizado un estudio observacional descriptivo y transversal en cuarenta y seis universidades españolas que imparten el Grado en Enfermería. RESULTADO: En línea con las directrices del Espacio Europeo de Educación Superior, todas las universidades contemplan la obligatoriedad de acreditar una segunda lengua, destacando el inglés, aunque existe una notable variabilidad en la importancia otorgada: el 39.4% no incluye ninguna asignatura de inglés, y del 60.6% restante que sí la incluye, el 60% la consideran asignatura optativa, el 32.5% formación básica y el 7.5% obligatoria. CONCLUSIONES: La formación en inglés presenta características diferentes en cada universidad, lo que implica una apuesta diferente de cada centro por su aprendizaje. Este hecho cuestiona la adecuación de la oferta formativa en relación al nuevo perfil competencial exigido por el Espacio Europeo de Educación Superior, pudiendo afectar negativamente al futuro desarrollo profesional. .