Prevalence and clustering of NANDA-I nursing diagnoses in the pre-hospital emergency care setting: A retrospective records review study.

AIM: To determine the prevalence and clustering of NANDA-International nursing diagnoses in patients assisted by pre-hospital emergency teams. DESIGN: Retrospective descriptive study of electronic record review. METHODS: Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two-step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020. RESULTS: Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six-cluster solution (n = 26.788) was found. Five clusters had a single high-prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co-occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051). CONCLUSION: Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre-hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre-hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre-hospital clinical setting. IMPACT: What problem did the study address? There are different models of pre-hospital emergency care services. The use of standardized nursing languages in the pre-hospital setting is not homogeneous. Studies on NANDA-I nursing diagnoses in the pre-hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA-I nursing diagnoses in the pre-hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance. Patients attended by pre-hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre-hospital setting, increasing the evidence of individualized and standardized care plans for pre-hospital care. REPORTING METHOD: STROBE checklist has been used as a reporting method. NO PATIENT OR PUBLIC CONTRIBUTION: Only patients' records were reviewed without further involvement.

Worldwide prevalence of inadequate work ability among hospital nursing personnel: A systematic review and meta-analysis.

PURPOSE: To estimate the worldwide pooled prevalence of inadequate work ability among hospital nursing personnel using the Work Ability Index (WAI). DESIGN: Systematic review and meta-analysis. METHODS: A systematic search was conducted on Medline/PubMed, Scopus, Web of Science, Scielo, PsychInfo, CINAHL, Nursing and Allied Health, LILACS, and Google Scholar from inception to July 2021 to identify observational studies on work ability among hospital nursing personnel using the WAI. Two researchers independently completed the study selection, quality assessments, and data extraction on the prevalence of inadequate work ability that was pooled using the random effects model. Finally, subgroup analyses were performed to explore sources of heterogeneity. FINDINGS: A total of 42 studies were included, consisting of 24,728 subjects worldwide from 14 countries. Of these, 35 studies were included in the meta-analytical analyses. The worldwide pooled prevalence of inadequate work ability among hospital nursing personnel was 24.7% (95% CI = 20.2%-29.4%). High levels of heterogeneity were detected in all studies. Prevalence was higher in studies where samples were composed of nurses and nursing assistive personnel (26.8%; 95% CI = 22.4%-31.5%) than in those of nurses alone (22.2%; 95% CI = 13.1%-32.9%) and in studies where the sample was over 40 (28.1%; 95% CI = 19.5%-37.5%) than in those with a sample under that age (22.4%; 95% CI = 15.8%-29.7%). CONCLUSIONS: Almost one in four members of hospital nursing staff in the world has inadequate work ability and therefore are at risk of several negative outcomes during their working life. These prevalence data correspond to the pre-pandemic period, so new studies should also be especially useful in quantifying the impact of the COVID-19 pandemic on work ability in the hospital nursing workforce. CLINICAL RELEVANCE: The above findings justify the launch of initiatives that include annual assessment for the early identification of inadequate work ability, offering the possibility of anticipated corrective measures. Nursing workforce older than 40 years and those belonging to the professional category of nursing assistive personnel should be priority target groups for screening and intervention to improve work ability.

NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care.

AIM: To determine the prevalence of NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care setting. DESIGN: Retrospective descriptive study of electronic record review. METHODS: Eight thousand three hundred three episodes recorded during the year 2019 were recovered from the electronic health records of a public emergency care agency. The prevalence of NANDA International nursing diagnosis, Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions was determined. A cross-tabulation analysis was performed to determine the linkages. Data were accessed in November 2020. RESULTS: NANDA International nursing diagnoses Anxiety (00146) and Fear (00148) represented more than 90% of the diagnoses recorded in the domain. Anxiety level (1211) and emotional support (5270) were the most recorded Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions, with almost 20% and 5% of total records, respectively. The linkage between nursing diagnosis Anxiety (00146), outcome Anxiety level (1211) and intervention Anxiety reduction (5820) was the most recorded with slightly more than 3% of the total. CONCLUSION: Eight different NANDA International nursing diagnoses in the coping/stress tolerance domain were recorded. Nursing Outcomes Classification outcomes were selected aimed mainly at psychological well-being and Nursing Interventions Classification interventions to support coping. In general, linkages were aimed to provide emotional support, physical well-being, information, education and safety. IMPACT: This study showed that pre-hospital emergency care nurses diagnose and treat human responses in the coping/stress tolerance domain. Expert consensus-based linkages may be complemented by the results of this study, increasing the levels of evidence of both individualized and standardized care plans for critical patients assisted by pre-hospital emergency care nurses.

Nurses' characteristics and practice environments: Comparison between clusters with different attitude and utilisation profiles regarding nursing diagnosis.

AIM: To identify clusters of nurses in relation to the utilisation and attitude towards nursing diagnosis and to compare their profiles considering demographics, professional characteristics and nursing practice environments. BACKGROUND: Nursing diagnosis has benefits for both patients and nurses, and the attitude of nurses towards nursing diagnosis has been proposed as a determinant of its use. Therefore, an adequate understanding of nurses' attitude and utilisation profiles regarding nursing diagnosis is essential for the nursing managers who want to adopt nursing diagnosis as a practice framework. METHODS: A cross-sectional survey design was used. A sample of 239 nurses working in the Catalan primary health care system were categorised into clusters with similar attitude and utilisation profiles, which were compared with each other a posteriori. RESULTS: Nursing managers were grouped into more positive attitude clusters than clinical nurses. Nurses working in supportive nursing practice environments were classified into more positive attitude and higher utilisation clusters. CONCLUSION: The field of work and nursing practice environments were found as differential factors in profiles of nurses with different attitudes towards and/or utilisation of nursing diagnosis. IMPLICATIONS FOR NURSING MANAGEMENT: The promotion of supportive nursing practice environments could enhance the implementation and maintenance of nursing diagnosis as a practice framework in primary health care.

Nurses' beliefs about nursing diagnosis: A study with cluster analysis.

AIMS: To identify clusters of nurses in relation to their beliefs about nursing diagnosis among two populations (Italian and Spanish); to investigate differences among clusters of nurses in each population considering the nurses' socio-demographic data, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and actual behaviours in making nursing diagnosis. BACKGROUND: Nurses' beliefs concerning nursing diagnosis can influence its use in practice but this is still unclear. DESIGN: A cross-sectional design. METHODS: A convenience sample of nurses in Italy and Spain was enrolled. Data were collected between 2014-2015 using tools, that is, a socio-demographic questionnaire and behavioural, normative and control beliefs, attitudes, intentions and behaviours scales. RESULTS: The sample included 499 nurses (272 Italians & 227 Spanish). Of these, 66.5% of the Italian and 90.7% of the Spanish sample were female. The mean age was 36.5 and 45.2 years old in the Italian and Spanish sample respectively. Six clusters of nurses were identified in Spain and four in Italy. Three clusters were similar among the two populations. Similar significant associations between age, years of work, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and behaviours in making nursing diagnosis and cluster membership in each population were identified. CONCLUSION: Belief profiles identified unique subsets of nurses that have distinct characteristics. Categorizing nurses by belief patterns may help administrators and educators to tailor interventions aimed at improving nursing diagnosis use in practice.

Blogged nursing: analysis of the phenomenon and contextualization in the Spanish setting.

Blogging within the health profession has grown in the recent past. This article aims to perform an analysis of the theoretical aspects of blogging, the use by professional nurses and students, benefits for patients, and, finally, an approach to the activities of Spanish nursing blogs. Blogs have great advantages as social communication tools. Immediacy in content update, closeness to information consumers, and compatibility with other Web 2.0 tools are points to be highlighted. Nurses use blogs for education and communication with other health professionals, students, and patients. For patients, therapeutic effects have been demonstrated in using blogging to share their health problems and express their experiential viewpoints. There are about 80 blogs written by Spanish nurses; most of them originated in the period between 2010 and 2012. These blogs are targeted to professionals (59%), patients (20%), or mixed (13%). There is a great heterogeneity in content: informative style (20%), opinion (28%), narrative (9%), experiential (2%), or humorous (2%). Nursing language is present in 15%, research and evidence-based practice in 13%, and protocols, guidelines, and procedures in 11% of them. We propose the need to plan institutional strategies for effective use of Web 2.0 resources as well as the need to unify criteria to provide quality content.

Work Ability Index: Psychometric Testing in Aeronautical Industry Workers.

Background: The Work Ability Index (WAI) is an instrument that measures work ability. The wide dispersion of the WAI internationally has led to its adaptation for use in different countries. This study aimed to evaluate the psychometric properties of the Spanish version of the WAI. Methods: A methodological design was used over an opportunistic sample of 233 workers in the aeronautical industry in Spain. Reliability was evaluated through internal consistency. Factorial validity, known groups, and convergent validity were tested. Results: The Cronbach's alpha and item-total correlation indicated an adequate internal consistency. The confirmatory factor analysis, performed to evaluate the factorial validity, found adequate fit indices for a two-factor solution with a high correlation between the factors. Factor 1, "Subjectively estimated work ability and resources", was composed of 3 subscales and factor 2, "Ill-health-related", of 2 subscales. Subscales 4 and 6 had loading in both factors. Workers under 45 years of age obtained higher significant scores than older ones. Convergent validity was also evidenced since WAI was highly correlated with self-assessment of health status. Conclusions: The Spanish version of the WAI has shown evidence of reliability and validity in this study, supporting its use in individual and collective health surveillance by occupational health professionals. The factorial solution that was found has previously been reported in another international context. However, further research is needed to resolve the discrepancies detected in the role of some subscales between other national and international studies.

The Spanish version of the Position on Nursing Diagnosis scale: cross-cultural adaptation and psychometric assessment.

AIM: To report the adaptation into Spanish and psychometric testing of the Position on Nursing Diagnosis scale. BACKGROUND: The Position on Nursing Diagnosis is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. DESIGN: Methodological design. METHOD: The scale was cross-culturally adapted through a process including translation, comparison with versions in other languages, back-translation, review, and pre-testing. An opportunistic sample of 621 Spanish registered nurses was recruited from August-December 2011. Reliability was evaluated through internal consistency and test-retest reliability. Construct validity, using both exploratory factor analysis and the known-group technique, and concurrent validity were assessed. FINDINGS: The Position on Nursing Diagnosis-Spanish Version was obtained from the cross-cultural adaptation process. High internal consistency and satisfactory test-retest reliability over a two week period (n = 240) were found. In the principal component analysis, all items loaded strongly on a single-factor which accounted for adequate variance, supporting the unidimensionality of the scale. A statistically significant difference was found comparing the scores of nurses who were members of the Spanish Association of Nomenclature, Taxonomy and Nursing Diagnosis and those who were not. Concurrent validity was supported by the significant correlation found between the scores and the degree of nursing diagnosis utilization and attendance to training sessions. CONCLUSION: The findings support the validity and reliability of the Position on Nursing Diagnosis-Spanish Version for its use among Spanish registered nurses as a measurement of their attitude towards the nursing diagnosis concept.

[A short form of the positions on nursing diagnosis scale: development and psychometric testing]. / Desarrollo y evaluación psicométrica de una forma abreviada de la escala de posicionamiento ante el diagnóstico enfermero.

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.

Romanian nurses' beliefs on nursing diagnosis. A survey study based on the theory of planned behavior.

PURPOSE: To identify clusters of beliefs about nursing diagnosis (ND) among Romanian hospital nurses and to ascertain variations in attitudes, intention to use, behavior associated with the use of ND, and sociodemographic characteristics. METHODS: A cross-sectional online survey study was conducted on a convenience sample of 498 hospital nurses in Romania. The questionnaire comprises six scales measuring normative, behavioral, and control beliefs, intention to use, attitudes, and behavior toward ND. Results were reported through cluster analysis. FINDINGS: Three clusters were identified: highly positive, average, and highly negative beliefs about ND. Romanian nurses have more homogeneous beliefs regarding ND than nurses from other countries. Comparisons among clusters showed significant differences in intention [H(2) = 111.59, p < 0.001], attitudes [H(2) = 145.27, p < 0.001], and reported behavior [H(2) = 43.84, p < 0.001]. The stronger the attitude toward ND, the intention to use it, and the behavior of using ND, the more favorable the beliefs and vice versa. Significant disparities among clusters were discovered regarding education in ND, whereas differences were not observed regarding years of experience, age, and gender. CONCLUSION: Nurses exhibited different belief patterns about ND. Those with more positive beliefs demonstrated a more favorable attitude, a higher intention, and a more frequent behavior in using ND. Training in ND facilitates positive beliefs about it. IMPLICATIONS FOR NURSING PRACTICE: When designing interventions to promote ND in clinical practice, policymakers, administrators, and educators should consider addressing and potentially changing these beliefs. Modifying nurses' attitudes could positively impact patient care quality during their hospital stay and post-discharge.

Needs of patients with multi-morbidity and heart failure for the development of a mHealth to improve their self-management: A qualitative analysis.

Objective: To provide practical information regarding needs, preferences of content and format of an app to assist the self-management in patients with multi-morbidity and heart failure (HF). Methods: The three-phase study was conducted in Spain. Six integrative reviews, a qualitative methodology based on Van Manen's hermeneutic phenomenology through semi-structured interviews and user stories were used. Data collection continued until data saturation was reached. All data were transcribed verbatim and analysed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes. Results: Integrative reviews conducted included practical recommendations to include in the content and format of the App and helped create the interview guide. Interviews revealed 15 subthemes that captured the meaning of narratives offering contextual insights into the development of the App. The main effective mechanisms of multicomponent interventions for patients with HF must contain (a) components that increase the patient's understanding of HF, (b) self-care, (c) self-efficacy and participation of the family/informal caregiver, (4) psychosocial well-being and (5) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), nutritional information (70%), type of exercises in order to improve their physical condition (75%) and information about food and drug interaction (60%). The importance of motivation messages (60%) was highlighted by transversal way. Conclusions: The three-phase process integrating theoretical basis, evidence from integrative reviews and research findings from target users has been considered a guide for future app development.

Development and content validation of an NOC-based instrument for measuring knowledge and self-care behaviors in hypertensive disorders of pregnancy: CoNOCiTHE.

PURPOSE: The aim of this study is to design and validate the content of an instrument based on the Nursing Outcomes Classification (NOC) "Knowledge: disease process" and "Risk control: hypertension" to measure pregnant women's knowledge and self-care behaviors about hypertensive disorders. METHODS: The study was carried out in three phases: (a) content validity of the indicators, (b) construction, and (c) content validity of the instrument. FINDINGS: The instrument contains 72 items with an average content validity ratio and representativeness of 0.92. The items that did not reach the established values were eliminated or reformulated according to the observations made by the experts. CONCLUSIONS: This study provides the first instrument for perinatal maternal care designed from the NOC that has demonstrated adequate content validity and representativeness of the NOCs on which it is based. The next phase in the development of the instrument is to test its validity and reliability. IMPLICATIONS FOR NURSING PRACTICE: CoNOCiTHE is a tool that can be useful in assessing pregnant women's knowledge and self-care behaviors about hypertensive disorders, contributing to the documentation and quality of maternal perinatal nursing care.

Tackling perinatal loss, a participatory action research approach: research protocol.

AIM: The aim of this study was to promote changes to improve the care provided to parents who have experienced a perinatal loss through participatory action research. BACKGROUND: The birth of a child is a joyful event for most families, however, unfortunately some pregnancies end in loss. Perinatal loss creates a heavy emotional impact not only on parents but also on health professionals, where in most cases there is an evident lack of skills, strategies and resources to cope with these kinds of situations. DESIGN: Participatory action research is the methodology proposed to achieve the purpose of this study. METHODS: Participatory action research consists of five stages: outreach and awareness, induction, interaction, implementation and systematization. The working group will include professionals from the Mother and Child Unit for patients at a tertiary level public hospital in Spain. The duration of the study will be 3 years since the approval of the protocol in January 2011. The qualitative techniques used will include group dynamics such as the SWOT analysis the nominal group technique, focus groups and brainstorming, among others that will be recorded and transcribed, generating reports throughout the evolution of the group sessions and about the consensus reached. Content analysis will be conducted on the field diaries kept by the participants and researchers. This project has been funded by the Andalusian Regional Ministry of Health. DISCUSSION: Participatory action research is a methodological strategy that allows changes in clinical practice to conduct a comprehensive transformative action in the care process for perinatal loss.

Cross-Cultural Adaptation and Psychometric Evaluation of the Educational Content Validation Instrument in Health.

Healthcare professionals often use multimedia patient education media, but not all have the same content quality. This study aimed to cross-culturally adapt the Educational Content Validation Instrument in Health to the Spanish setting and assess its psychometric properties. A methodological validation study was carried out between January and September 2020. Data collection took place from May to June 2020. A translation, back translation, committee review, and pre-testing was carried out. Subsequently, reliability (internal consistency), and validity (factorial and convergent) were assessed by requiring 210 Healthcare Professionals to complete the instrument based on video material. In addition, a refinement of the instrument was conducted based on the modification indexes. The instrument showed adequate internal consistency, although some redundancy in the items (α = .93). Exploratory factor analysis suggested a unifactorial structure that explained an adequate variance (47.37%). Convergent validity was poor (r = .11; P = .05). After analysis, 6 items were deleted without impairing the validity results and eliminating redundancy. Therefore, a 12-item version of the instrument was created. It can help to assess more objectively the contents of the materials prescribed, facilitating the choice of those of higher quality and potentially improving their patients' health outcomes. Further studies are needed to confirm the previous results and reassess some of the shortcomings.

Development and Effectiveness of a Mobile Health Intervention in Improving Health Literacy and Self-management of Patients With Multimorbidity and Heart Failure: Protocol for a Randomized Controlled Trial.

BACKGROUND: Patients with multimorbidity and complex health needs are defined as a priority by the World Health Organization (WHO) and the European Union. There is a need to develop appropriate strategies with effective measures to meet the challenge of chronicity, reorienting national health systems. The increasing expansion of mobile health (mHealth) interventions in patient communication, the reduction of health inequalities, improved access to health care resources, adherence to treatment, and self-care of chronic diseases all point to an optimistic outlook. However, only few mobile apps demonstrate their effectiveness in these patients, which is diminished when they are not based on evidence, or when they are not designed by and for users with different levels of health literacy (HL). OBJECTIVE: This study aims to evaluate the efficacy of an mHealth intervention relative to routine clinical practice in improving HL and self-management in patients with multimorbidity with heart failure (HF) and complex health needs. METHODS: This is a randomized, multicenter, blinded clinical trial evaluating 2 groups, namely, a control group (standard clinical practice) and an intervention group (standard clinical practice and an ad hoc designed mHealth intervention previously developed), for 12 months. RESULTS: The contents of the mHealth intervention will address user-perceived needs based on the development of user stories regarding diet, physical exercise, cardiac rehabilitation, therapeutic adherence, warning signs and symptoms, and emotional management. These contents have been validated by expert consensus. The creation and development of the contents of the mHealth intervention (app) took 18 months and was completed during 2021. The mobile app is expected to be developed by the end of 2022, after which it will be applied to the experimental group as an adjunct to standard clinical care during 12 months. CONCLUSIONS: The trial will demonstrate whether the mobile app improves HL and self-management in patients with HF and complex health needs, improves therapeutic adherence, and reduces hospital admissions. This study can serve as a starting point for developing other mHealth tools in other pathologies and for their generalization to other contexts. TRIAL REGISTRATION: ClinicalTrials.gov NCT04725526; https://tinyurl.com/bd8va27w. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35945.

Correction: Development and Effectiveness of a Mobile Health Intervention in Improving Health Literacy and Self-management of Patients With Multimorbidity and Heart Failure: Protocol for a Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/35945.].

Empathy, Burnout, and Attitudes towards Mental Illness among Spanish Mental Health Nurses.

Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.

A New Instrument for Measuring Dietary Knowledge in Patients With Diabetes: Psychometric Testing of the CoNOCidiet-Diabetes.

PURPOSE: To determine the psychometric properties of the CoNOCidiet-Diabetes, a new instrument based on nursing outcome "Knowledge: prescribed diet." METHODS: Methodological design. The participant were 359 patients diagnosed with diabetes visiting 27 primary healthcare centers in Spain. Reliability (internal consistency and test-retest), validity (convergent criterion validity, concurrent content validity and known-groups validity), and sensitivity to change was tested. FINDINGS: CoNOCidiet-Diabetes has shown evidence of acceptable psychometric properties as instrument but some items should be revised. CONCLUSIONS: This research provides a new instrument developed to specifically measure dietary knowledge in individuals with diabetes. IMPLICATIONS: For nursing practice: The literalness of the CoNOCidiet-Diabetes with the nursing outcome "Knowledge: prescribed diet" facilitate its measurement using the patient's statements.

OBJETIVO: Determinar las propiedades psicométricas del CoNOCidiet-Diabetes, un nuevo instrumento basado en el resultado enfermero "Conocimiento: dieta prescrita". MÉTODOS: Diseño metodológico. Los participantes fueron 359 pacientes diagnosticados de diabetes que acudieron a 27 centros de atención primaria de salud en España. Se comprobó la fiabilidad (consistencia interna y test-retest), la validez (validez de criterio convergente, validez de contenido concurrente y validez de grupos conocidos) y la sensibilidad al cambio. RESULTADOS: El CoNOCidiet-Diabetes ha mostrado evidencias de tener unas propiedades psicométricas aceptables como instrumento, pero algunos ítems deben ser revisados. CONCLUSIONES: Esta investigación proporciona un nuevo instrumento desarrollado para medir específicamente el conocimiento sobre dieta en personas con diabetes. IMPLICACIONES PARA LA PRÉCTICA ENFERMERA: La literalidad del CoNOCidiet-Diabetes con el resultado enfermero "Conocimiento: dieta prescrita" facilita la medición de este último utilizando las declaraciones del paciente.

Nursing Diagnosis of Grieving in Cases of Perinatal Loss: A Preliminary Clinical Validation.

PURPOSE: To develop a preliminary clinical validation the NANDA-I nursing diagnosis "Grieving" in cases of perinatal loss. METHODS: Descriptive cross-sectional study using the Fehring model. FINDINGS: The overall clinical validity index for the diagnosis was 0.15. Only four defining characteristics and five manifestations identified in the literature were validated. CONCLUSIONS: The variability of manifestations identified in the study participants is considered to be detrimental to the overall clinical validity index. IMPLICATIONS FOR NURSING PRACTICE: The clinical validity of the diagnosis could not be substantiated by the preliminary results of this study and, therefore, additional research is necessary to determine the ability of the diagnosis to adapt to perinatal loss situations in real contexts. Some manifestations have been proposed to NANDA-I for inclusion as defining characteristics in the nursing diagnosis of grieving. OBJETIVO: Validar clínicamente de forma preliminar el diagnóstico enfermero NANDA-I duelo en caso de pérdida perinatal. MÉTODOS: Estudio descriptivo transversal usando el modelo de Fehring. RESULTADOS: El índice de validez clínica global del diagnóstico fue de 0.15. Se validaron únicamente cuatro características definitorias y cinco manifestaciones identificadas en la literatura. CONCLUSIONES: Se considera que la variabilidad de las manifestaciones presentadas por los participantes actuó en detrimento del índice de validación clínica global. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: La validez clínica del diagnóstico no pudo ser corroborada por los resultados preliminares de este estudio y, por tanto, se necesita investigación adicional para terminar la capacidad de este diagnóstico para adaptarse a las situaciones de pérdidas perinatales en contexto reales. Se han propuesto a NANDA-I algunas manifestaciones para que sean incluidas como Características Definitorias del diagnóstico enfermero Duelo.

Development and Content Validation of a NOC-Based Instrument for Measuring Dietary Knowledge in Patients with Diabetes: CoNOCidiet-Diabetes.

PURPOSE: To construct a questionnaire for measuring knowledge of a diabetic diet and validate its contents. METHODS: This study was carried out in three stages: (a) generation of items, (b) apparent and content validation, (c) cognitive pilot test. FINDINGS: An 88-item questionnaire was obtained with a content validity index and a representativeness index of 0.87. The experts modified the items that did not reach the preset values. The cognitive test was shown to be feasible, with good exploratory values of reliability and concurrent validity. CONCLUSIONS: The CoNOCidiet-Diabetes questionnaire was obtained from the NOC outcome "Knowledge: Prescribed Diet" and its contents were validated. IMPLICATIONS FOR NURSING PRACTICE: This research shows the usefulness of the NOC for generating tools to measure health outcomes sensitive to nursing interventions.