Validação de conteúdo do diagnóstico de enfermagem “enfrentamento ineficaz” no contexto da violência doméstica

Abstract

Content validation studies on nursing diagnoses are essential because they enable well-directed care. Thus, the objective of this study is to verify the content validity of the nursing diagnosis Ineffective Coping, developed in two stages, namely: construction of a Specific Situation Theory and content validation by judges. The first part was the construction of the Specific Situation Theory according to the following steps: definition of the approach for construction of the Specific Situation Theory; definition of theoretical-conceptual models; definition of key concepts; construction of a pictorial diagram; construction of propositions and establishment of cause-and-evidence relationships based on practice. In this stage, 13 antecedent elements and 23 consequent elements were identified. For the second stage, regarding content validation with judges in the areas of interest of the study, the Predictive Diversity Theorem was adopted as a reference for the selection of judges, with a focus on collective wisdom. The profile of the judges was formed through the classification adopted by Benner, Tanner and Chesla, regarding academic and practical experiences. The elements of the theory were evaluated according to their relevance to Ineffective Coping. The sample for this stage consisted of 51 judges. A descriptive analysis that includes absolute frequencies and percentages is presented for each qualitative variable. For the quantitative variables, measures of central tendency (mean and median) and measures of dispersion (standard deviation and interquartile range) are presented. Regarding the definition proposed by NANDA-I for ineffective coping, there was 78% agreement. For the analysis of the indices, measures of asymmetry and kurtosis of the values attributed by the experts for each etiological factor and defining characteristic are presented with the respective confidence intervals, and the robust Jarque-Bera test to verify adherence to the normal distribution. To analyze the relevance of each item in relation to the diagnosis, eight different aggregation indices were presented with their respective confidence intervals. Thus, of the 13 related factors, 11 were relevant, while two of them, Impaired spirituality and Inability to conserve adaptive energies, were not statistically significant for the phenomenon. Of the 23 defining characteristics, 20 were considered relevant, while three, Low tolerance to frustration, Impaired ability to meet role expectations, and Inadequate follow-through of goal-oriented behavior, did not present statistically significant values. Regarding reliability, the judges' analyses showed high internal consistency. In the global content validity, the set of retained items adequately represents the antecedents and consequences of Ineffective Coping. Therefore, the elements of these two stages represent the study population and it is recommended that the results be submitted to clinical validation with the study population. Such

research becomes relevant regarding the impact on the clinical practice of the nursing professional with women who have experienced domestic violence, in which the validation of this diagnosis becomes fundamental to ensure a concrete care plan for the identification and diagnosis and possible interventions to be operated in the clinical practice of the nurse.