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Nursing in Cardiology

Theoretical considerations and validation of the diagnosis decreased cardiac output: a brazilian study

Jesus Cristine A C; Carvalho Emília C; Nogueira Maria S; Stuchi Rosimeire A G

Department of Nursing
University of Brasilia
Brasilia. Brazil
College of Nursing at Ribeirão Preto
University of São Paulo
São Paulo - Brazil


Introduction and objective:
The nursing diagnosis "decreased cardiac output" is highly complex and difficult to be featured. The objective was to validate this diagnosis by expert nurses.
Methods: For the validation of the possible Defining Characteristics (DC) of this diagnosis we applied a data collection tool to 13 cardiology expert nurses in different hospitals of Ribeirão Preto - Brazil. The data were analysed based on the Diagnostic Content Validity model (DCV) proposed by FEHRING. The experts rate each DC of the diagnosis on a scale of 1 to 5, where 1 = not at all characteristic or indicative of the diagnosis to 5 = very characteristic. We calculated weighted ratios for each DC and those with weighted ratios >= 0.80 was considered as "major"; those with ratios < 0.80 but > 0.50 was labeled as "minor" and those ratios <= 0.50 should not be included in the total score.
Results: From 49 possible DC presented, 36 were validated. Of these 6 had DCV scores >= 0.80 (major DC): labile blood pressure, cool extremities, abnormal arterial blood gases, abnormal chest radiography, decreased cardiac output and elevated pulmonary artery pressure; 30 had DCV scores between 0.51 and 0.79 (minor DC), and 13 had no score to be validated (<= 0.50). The Total DCV score was 0.67.
Conclusions: From the 23 DC suggested by NANDA, 18 (78,3%) were validated in this study, just one was classified as major and the others (17) were labeled as minor. The minor DC identified must be better analysed because they presented large variability in this study. Further research, in our country, of the diagnosis decresead cardiac output are necessary, not only using validation by experts, but mainly those using the clinical validation.


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