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Purpose: This review aimed to analyze the use of differential validation of nursing diagnosis., Methods: Integrative literature review with search on international databases. The diagnoses, the type of the diagnosis differential validation, the sample, the method, main results, and the limitations were extracted. Ten studies were included., Findings: Differential diagnostic validation publication dates from 1994, and Brazil was the predominant country., Conclusions: This method seems helpful in improving diagnosis accuracy, particularly those related to subjective, behavioral, or complex human responses., Implications for Nursing Practice: Using this model may facilitate understanding the specificity of nursing diagnosis, which is critical for teaching clinical reasoning and for new opportunities to research., (© 2021 NANDA International, Inc.)

Purpose: To apply the Rasch model to test the psychometric assessment of the nursing outcome Swallowing status among poststroke patients., Methods: Cross-sectional study was conducted with 227 poststroke patients, which were evaluated by a nurse. The Rasch model was used to examine psychometric properties., Findings: Indicators fit the Rasch model and presented good reliability and good ability for separation index. The 5-point Likert scale did not present adequate discrimination and classification levels were compiled into three., Conclusions: Data evidenced the use of a robust method to perform a clinical validity of the Swallowing status, complementing previous validation studies., Relevance to Clinical Practice: Using Rasch analysis serve as reference points to assess Swallowing status on a single scale., Objetivo: Aplicar o modelo Rasch para testar as medidas psicométricas do resultado de enfermagem Estado da deglutição em pacientes acometidos por acidente vascular cerebral. MÉTODOS: Estudo transversal, realizado com 227 pacientes após AVC avaliados por um único enfermeiro. O modelo Rasch foi usado para examinar propriedades psicométricas., Resultados: Os indicadores se ajustaram ao modelo Rasch e apresentam boa confiabilidade e boa capacidade de separação. A escala Likert de 5 pontos não apresentou discriminação adequada e os níveis de classificação foram compilados em três pontos. CONCLUSÃO: Os dados evidenciaram o uso de um método robusto para a validade clínica do Estado da deglutição, complementando os estudos de validação anteriores. RELEVÂNCIA PARA A PRÁTICA CLÍNICA: O uso do modelo Rasch serve como ponto de referência para avaliar o Estado da deglutição em uma única escala., (© 2018 NANDA International, Inc.)

Aims and Objectives: To validate clinically the nursing outcome "Swallowing status"., Methods: The adjustment of the nursing outcome was investigated according to the Classical and Item Response Theories. The models were compared regarding information loss, goodness-of-fit, and differential item functioning. Stability and internal consistency were examined., Results: The nursing outcome has the best fit in the generalized partial credit model with different discrimination parameters. Strong correlations among the scores of each indicator were observed. There was no differential item functioning of the outcome indicators. The scale presented high internal consistency (Cronbach's α = .954) and stability (and > .800)., Conclusions: This study presents a valid nursing outcome., Relevance to Clinical Practice: Most accurate monitoring of sensitivity to an intervention., Objetivo: Validar clinicamente o resultado de enefermagem "Estado da Deglutição". MÉTODOS: O ajustamento do resultado foi investigado de acordo com as teorias Clássica e de Resposta ao Item. Os modelos foram comparados assumindo parâmetros de itens cruzados de igual discriminação. Investigaram-se as propriedades de bondade do ajuste, funcionamento diferencial dos itens, estabilidade e consistência interna., Resultados: O resultado se ajustou melhor a partir do Modelo de crédito parcial generalizado, o qual demonstrou unidimensionalidade do resultado e forte correlação entre os escores de cada indicador. Não houve funcionamento diferencial dos indicadores. A consistência interna para a escala global (Cronbach's α = .954) e a estabilidade (>.800) mantiveram-se elevadas. CONCLUSÃO: O estudo apresenta um resultado de enfermagem válido. RELEVÂNCIA PARA A PRÁTICA CLÍNICA: Maior acurácia para monitorar a sensibilidade da intervenção., (© 2017 NANDA International, Inc.)

The accurate identification of the nursing diagnoses and the corresponding measurement of their indicators will depend on the elements in the standardized language systems., Objective: To analyze the correspondence between elements of four NANDA-I nursing diagnoses and outcomes suggested by the nursing outcomes classification (NOC) for the resolution of these diagnoses., Method: A methodological study consisting of cross-mapping was performed in the first stage between definitions, defining characteristics (DCs), and related factors (RFs) of impaired oral mucous membrane, impaired tissue integrity, spiritual distress, and delayed surgical recovery and outcome definitions and indicators to measure results of diagnoses resolution and an analysis of its relevance by experts in the second stage., Results: It found partial correspondence between outcome indicators, DCs, RFs, and definitions., Conclusion: The data evidence the relevance of this review for a reliable application of these taxonomies and demonstrated partial correspondence between concepts analyzed. A identificação precisa dos diagnósticos de enfermagem e a medida correspondente dos seus indicadores dependerá dos elementos nos sistemas de linguagem padronizados., (© 2016 NANDA International, Inc.)

Objective: Validate the nursing diagnosis spiritual distress in cancer patients., Methods: Cross-sectional approach using Richard Fehring's Clinical Diagnostic Validity Model., Findings: The prevalence of diagnosis was 40.8% in a sample of 170 patients. A total of 16 defining characteristics were validated. Expresses suffering had the highest sensitivity value and lack of meaning in life had the highest specificity value., Conclusions: The diagnosis was validated. Cancer patients in spiritual distress are in a state of suffering related to lack of meaning in life., Implications for Practice: Sensitive diagnosis tools and language are required for nurses to make accurate judgments in situations of spiritual distress. Validation in different contexts would increase the clinical evidence of this diagnosis., (© 2015 NANDA International, Inc.)

Objective: To identify the definition and defining characteristics (DCs) of spiritual distress (00066)., Method: Integrative literature review., Results: Thirty-seven articles and 35 DCs were identified. Spiritual distress as a response to health problems in the context of nursing care is different from an impaired ability to experience and integrate meaning in life., Conclusions: The diagnosis misses some DCs that emerged from the literature review and lacks comprehensiveness. The domain and the class are reductionist toward its meaning. The taxonomy lacks a spiritual domain to include this and other diagnoses currently dispersed in other domains., Implications for Practice: Further content and clinical validation is needed, as well as an assessment, to determine the diagnosis' class and domain., (© 2013, The Authors. International Journal of Nursing Knowledge © 2013, NANDA International.)

The mechanism of isoproterenol-induced myocardial damage is unknown, but a mismatch of oxygen supply vs. demand following coronary hypotension and myocardial hyperactivity is the best explanation for the complex morphological alterations observed. Severe alterations in the structural integrity of the sarcolemma of cardiomyocytes have been demonstrated to be caused by isoproterenol. Taking into account that the sarcolemmal integrity is stabilized by the dystrophin-glycoprotein complex (DGC) that connects actin and laminin in contractile machinery and extracellular matrix and by integrins, this study tests the hypothesis that isoproterenol affects sarcolemmal stability through changes in the DGC and integrins. We found different sensitivity of the DGC and integrin to isoproterenol subcutaneous administration. Immunofluorescent staining revealed that dystrophin is the most sensitive among the structures connecting the actin in the cardiomyocyte cytoskeleton and the extracellular matrix. The sarcomeric actin dissolution occurred after the reduction or loss of dystrophin. Subsequently, after lysis of myofilaments, gamma-sarcoglycan, beta-dystroglycan, beta1-integrin, and laminin alpha-2 expressions were reduced followed by their breakdown, as epiphenomena of the myocytolytic process. In conclusion, administration of isoproterenol to rats results in primary loss of dystrophin, the most sensitive among the structural proteins that form the DGC that connects the extracellular matrix and the cytoskeleton in cardiomyocyte. These changes, related to ischaemic injury, explain the severe alterations in the structural integrity of the sarcolemma of cardiomyocytes and hence severe and irreversible injury induced by isoproterenol.