Acurácia das características definidoras do diagnóstico de enfermagem integridade do complexo mamilo-areolar prejudicada em puérperas

Abstract

The nursing diagnosis, understood as a technological tool within the health work process, constitutes a structured resource that guides clinical reasoning, organizes care practice, and enhances decision-making. The nursing diagnosis Nipple-areolar complex injury (00320) was recently included in the NANDA-International taxonomy. The analysis of the accuracy of defining characteristics is essential for clinical reasoning and diagnostic inference, enabling effective interventions that support the promotion of breastfeeding. The aim of this study was to analyze the accuracy of the defining characteristics of the Nipple-areolar complex injury diagnosis in postpartum women. This is a diagnostic accuracy study conducted in the rooming-in units of the Assis Chateaubriand Teaching Maternity Hospital, in Fortaleza, Ceará, between January and June 2025, with a sample of 317 postpartum women. Data were obtained using a data collection instrument and photographic records of the breasts, evaluated by three independent examiners. Analyses were performed using R software, applying the Latent Class Analysis method to estimate sensitivity and specificity of the defining characteristics. The study followed all ethical guidelines and was approved under opinion number 7.351.519. The prevalence of the diagnosis was 61.5%. The characteristics “Expresses pain” and “skin fissure” were the most accurate, with sensitivities of 100% and 87.7% and specificities of 97.5% and 100%, respectively. These indicators demonstrated high predictive capacity and were considered key markers for diagnostic inference. An association was also found between the diagnosis and marital status, showing a lower likelihood of occurrence among married women or those in stable unions. It is concluded that the characteristics “localized nipple pain” and “skin fissure” are the most accurate indicators for the Nipple-areolar complex injury diagnosis, reinforcing its clinical validity. These findings strengthen evidence-based practice and support the planning of nursing interventions aimed at preventing nipple lesions and maintaining breastfeeding. Based on the results, further longitudinal studies are suggested to follow women throughout the postpartum period to assess the progression of nipple lesions, as well as intervention studies aimed at reducing the prevalence of the diagnosis. Research in other healthcare contexts, such as human milk banks and primary care units, is also recommended to follow postpartum women after hospital discharge.