Nursing diagnoses and outcomes related to the circulatory-system terms (ICNP®) represented in an ontology

Abstract

The aim of the present study was to develop titles of Nursing Diagnoses and Outcomes (ND/NO) through the relationship between the terms of the Focus axis, limited to the Circulatory System Process, and the terms of other ICNP® axes and to integrate these terms into an ontology. Titles were developed linking 17 terms of the focus axis, which were evaluated by expert nurses in five Brazilian cities. Titles whose use concordance was above 0.80 were included in the ontology. In total, 89 titles for ND/NO were supported in the literature, and 19 were not supported; 37 were assessed as eligible for use in healthcare practice and were included in the ontology. The construction of ND/NO titles based on the ICNP® and using a formal representation of knowledge is a task that requires deepening concepts used for nursing and adequate classification revisions. The elaborated titles will facilitate the composition of diagnostics that are more consistent with practice. DESCRIPTORS Nursing diagnosisClassification Cardiovascular system Vocabulary controlled Nursing process RESUMENEl objetivo del estudio fue elaborar títulos de diagnósticos y resultados de enfermería (DE/ RE), utilizando la relación entre los términos del Proceso del sistema circulatorio del eje central, y términos de otras líneas de la CIPE® e integrarlas en una ontología. Fueron construidos títulos haciendo el enlace de 17 tér-minos del eje central, los cuales fueron evaluados por enfermeras especialistas de cinco ciudades brasileñas. Se incluyeron en la ontología los títulos cuya concordancia de uso fue superior a 0,80. Fueron elaborados 89 títulos de DE/RE sostenidos por la literatura y 19 sin apoyo sostenido, 37 fueron evaluados como posibles ítems para su utilización en la prác-tica asistencial e incluidos en la ontología. La construcción de los títulos de DE/RE sobre la base de la CIPE® y utilizando una representación formal del conocimiento es una tarea que requiere una mayor profundización de los conceptos utilizados por la enfermería y adecuación a las diversas revisiones de la clasificación. Los títulos elaborados facilitarán la composición de diagnósticos más coherentes con la práctica. DESCRIPTORES

Terms of international classification for Nursing Practice in motor and physical rehabilitation

“…The Delphi technique accounts for the results depending on the level of experts; as there is no ideal number of judges, the group's composition varies according to the subject under study and criteria set by the researcher for the selection of these specialists. In the case of this study, the convenience sample was defined by 50 nurses, and the specificity of the rehabilitation area, the ICNP ® and studies that used experts for validation (6,10,(12)(13) were considered. The following criteria for the inclusion of experts were used: a) title of Master's of Nursing; b) title of Master's of Nursing with dissertation regarding content related to physical-motor rehabilitation, terminology, nursing process or nursing classifications; c) a research publication regarding physical-motor rehabilitation, terminology, nursing process or nursing classifications, with content relevant to the area; d) publication of an article on physical-motor rehabilitation, terminology, nursing process or nursing classifications in a reference journal; e) doctoral thesis regarding physical-motor rehabilitation, terminology, nursing process or nursing classifications; f ) clinical practice of at least two years in physical-motor rehabilitation; g) relevant clinical practice certificate in physical-motor rehabilitation (specialist in nursing rehabilitation).…”

“…To calculate the concordance index (CI) among judges, a Likert scale was used considering the following scales as agreement: "5=Extremely relevant", "4=Very relevant" and "3=Relevant"; and as disagreement: "2 = Little relevant" and "1=Not relevant." The calculation of CI was carried out from the formula CI=C/(NC+C), where C is the number of agreements and NC the number of disagreements (13) . Although the Delphi technique requires a concordance index ≥ 0.70, it was decided to consider validated terms that reached a CI ≥ 0.80, as this is the value considered ideal in the literature.…”

“…89 definitions of terms that did not reach the CI ≥ 0.80 in the first round were then revised based on suggestions submitted by participants and were sent to a second validation round, in which consensus among experts was reached (12)(13) . At the end of the process, all 226 terms were validated.…”

Ontology elements identified in different nursing classification systems

“…In Brazil, the CIPESC® has been used in primary health care in order to stimulate the clinical and epidemiological reasoning, which contributes to the analysis of needs relating to health-disease process of the individual, family and social group (Cavalcante et al, 2016). The CIPESC® ontology comprised the representation of concepts of different versions of the ICNP® and terms included in the CIPESC® vocabulary inventory and in the dissertations developed at PUCPR (Silva, Malucelli & Cubas, 2009;Mattei, 2011;Cubas, Brondani & Malucelli, 2013;Bisetto & Cubas, 2015). An ontology is a formal (which means machine-processed) specification (Studer, Benjamins & Fensel, 1998) of a given worldview shared by a community (Borst, 1997).…”

“…The CIPESC® vocabulary inventory was released in 2010, and it seeks to represent the dimensions, diversity, and broadness of nursing practices (Garcia & Nóbrega, 2010). Aiming at including the Brazilian contribution to the development of the ICNP®, investigators from the Graduate Program in Health Technology of the Pontifical Catholic University of Paraná (Pontifícia Universidade Católica do Paraná -PUCPR) partially elaborated an ontology -the CIPESC® ontology (Silva, Malucelli & Cubas, 2009;Mattei, 2011;Cubas, Brondani & Malucelli, 2013;Bisetto & Cubas, 2015). Considering the use of ontology in the elaboration of the ICNP® and the proposal to include the Brazilian contribution to it, this article demonstrates the relevance of the identification of ontology elements in the aforementioned classification systems to understand how they might be used to represent the elements of nursing practice in an automated manner.…”