Content validation of the defining characteristics of the nursing diagnosis "impaired swallowing" using the Delphi technique: A study with dysphagia nursing experts in Japan.

IF 1.4 4区 医学 Q3 NURSING
Kazuyoshi Nishizawa, Ikumi Honda, Tomoko Doi
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引用次数: 0

Abstract

Purpose: Nurses' clinical reasoning skills regarding impaired swallowing can help prevent patient complications and maintain quality of life. Clinical reasoning skills need content-validated defining characteristics (DCs). We aimed to validate the content of these DCs for nursing diagnosis "impaired swallowing."

Methods: Content validation of the DCs was performed by 275 dysphagia nursing experts in Japan, using 3 rounds of the Delphi technique and Fehring's Diagnostic Content Validation (DCV) model. Three rounds of questionnaires on 84 DCs were completed via printed mail.

Findings: The valid response rates for each round were as follows: round 1, 90.2%; round 2, 77.8%; and round 3, 71.3%. Of the 84 DCs, 77 that met the consensus criteria were categorized as major (n = 18), minor (n = 45), and excluded (n = 14). There were four minor DCs other than the oral, pharyngeal, and esophageal phases. DCs listed from outside NANDA-I included 12 major, 16 minor, and 3 excluded characteristics. Of the NANDA-I DCs, 5 were no consensus and 11 were excluded. The total DCV score for the 63 major and minor DCs was 0.8.

Conclusions: Our results recommend the addition of 28 DCs and the exclusion of 11 for the NANDA-I nursing diagnosis "impaired swallowing" (00103). Major DCs were prominent indicators of impaired swallowing and signs of aspiration or pharyngeal residuals. Minor DCs included not only the three phases but also other signs necessary for a comprehensive understanding of impaired swallowing.

Implications for nursing practice: This validation study strengthens the clinical usefulness of the DCs for impaired swallowing, which can improve nurses' clinical reasoning skills. Major and minor DCs can increase the awareness of impaired swallowing and enable accurate intervention, thereby preventing patient complications and maintaining quality of life.

使用德尔菲技术对护理诊断 "吞咽障碍 "的定义特征进行内容验证:日本吞咽困难护理专家的研究。
目的:护士在吞咽功能受损方面的临床推理技能有助于预防患者的并发症并保持生活质量。临床推理技能需要经过内容验证的定义特征(DCs)。我们旨在验证护理诊断 "吞咽功能受损 "的定义特征的内容:日本的 275 名吞咽困难护理专家采用德尔菲技术和 Fehring 诊断内容验证(DCV)模型,对 DCs 的内容进行了三轮验证。通过印刷邮件完成了对 84 个 DC 的三轮问卷调查:每轮问卷的有效回复率如下:第一轮,90.2%;第二轮,77.8%;第三轮,71.3%。在 84 个区议会中,符合共识标准的 77 个区议会被分为主要区议会(18 个)、次要区议会(45 个)和排除区议会(14 个)。除口腔、咽部和食道阶段外,还有 4 个轻微 DC。NANDA-I 以外的 DC 包括 12 个主要 DC、16 个次要 DC 和 3 个排除 DC。在 NANDA-I DC 中,5 个未达成共识,11 个被排除在外。63 个主要和次要 DC 的 DCV 总分为 0.8:我们的结果建议在 NANDA-I 护理诊断 "吞咽功能受损"(00103)中增加 28 个 DCs,排除 11 个 DCs。主要 DC 是吞咽功能受损的显著指标,以及吸入或咽部残留物的迹象。次要DC不仅包括这三个阶段,还包括全面了解吞咽功能受损所需的其他体征:这项验证研究加强了吞咽障碍 DCs 的临床实用性,可提高护士的临床推理能力。主要和次要的吞咽功能障碍指标可提高对吞咽功能障碍的认识,从而进行准确的干预,防止患者出现并发症,维持患者的生活质量。
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来源期刊
CiteScore
2.90
自引率
14.30%
发文量
47
审稿时长
>12 weeks
期刊介绍: The International Journal of Nursing Knowledge, the official journal of NANDA International, is a peer-reviewed publication for key professionals committed to discovering, understanding and disseminating nursing knowledge. The Journal aims to clarify the knowledge base of nursing and improve patient safety by developing and disseminating nursing diagnoses and standardized nursing languages, and promoting their clinical use. It seeks to encourage education in clinical reasoning, diagnosis, and assessment and ensure global consistency in conceptual languages. The International Journal of Nursing Knowledge is an essential information resource for healthcare professionals concerned with developing nursing knowledge and /or clinical applications of standardized nursing languages in nursing research, education, practice, and policy. The Journal accepts papers which contribute significantly to international nursing knowledge, including concept analyses, original and applied research, review articles and international and historical perspectives, and welcomes articles discussing clinical challenges and guidelines, education initiatives, and policy initiatives.
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