Validação de conteúdo do diagnóstico de enfermagem “síndrome pós-trauma” no contexto da violência contra a mulher

Abstract

Violence Against Women (VAW) while founded as a public health problem by the World Health Organization (WHO) causes from harmful physical outcomes to psychological disorders and death. In view of this, nursing practice hás gained improvements in the care of certain victims and one of the strategies is the diagnostic validation studies, supported by a theoretical basis of consistency. Therefore, this research aims to verify the structural validity of the Post-Trauma Syndrome (PTS) nursing diagnosis through the production of two stages, namely: construction of a Specific Situation Theory (SST), through the phases of a Middle Range Theory (MRT) and content validation by judges. The first stage was carried out between July 2020 and April 2021, with the production of two systematic literature reviews and the foundation of bell hooks’ Feminist Theory. With the results of the studies, 13 antecedent elements (etiological factors) and 15 consequent elements (12 NANDA International nursing diagnoses and three clinical indicators) were identified. For the second stage, developed between July 2021 and January 2022, the elements of the theory and current composition of NANDA-I (2021-2023) were evaluated according to their relevance to Post Trauma Syndrome. The sample of this stage consisted of 48 judges. The Wilcoxon test was applied to the weighted median with a reference value for the null hypothesis with a Content Validity Index value above or equal to 0,85. According to the Wilcoxon test, of the 19 etiological factors (13 of the theory and six of the NANDA-I), Age under 40 years of age, Low level of education, Low level of socioeconomic status, Absence of employment and Body image distress were the theory factors not successfully validated by the judges. The Exaggerated Sense of Responsibility factor was the only NANDA-I factor that failed to validate. As for the 45 clinical indicators (15 of the theory and 30 of the NANDA-I), Obesity and Fatigue were the indicators of the theory that were not approved by the validation and Enuresis, Express Numbness and Gastrointestinal Irritability were the elements of the NANDA-I that did not obtain successful validation. The results of this study prove the structural inconsistency of the Post-Trauma Syndrome diagnosis addressed by the NANDA-I taxonomy, stating the need to produce diagnostic validation through three phases: concept anlysis, content validation and clinical validation. Therefore, it is recommended the results be subject to clinical validation with the study population. Such research becomes relevant regarding the impact on the future clinical practice of professional nurses in women exposed to the trauma of violence, in wich the validation of this diagnosis becomes essential to obtain means and devices that support and effective care plan in the face of identification of possible interventions and nursing outcomes expected and offered to the patient in the nursing practice.