Abstract
Nurses play an important role in healthcare, and the Nursing Outcomes Classification is a key tool for the standardization of care. This study aims to validate the nursing outcome “Neurological Status” for patients with cerebrovascular diseases. A methodological study was performed in four phases. In Phase 1, the relevance of the indicators was evaluated by seven specialists and the modified kappa coefficient and content validity index were calculated. In Phase 2, conceptual and operational definitions were formulated. In addition, their content was validated with a focus group in Phase 3. In Phase 4, the results were applied in clinical practice and convergence with the National Institute of Health Stroke Scale was verified. The reliability was measured by Cronbach’s alpha. Of the 22 initial indicators, 6 were excluded. The focus group suggested changes in the definitions and the exclusion of two indicators. In Phase 4, only 13 indicators were validated due to the impossibility of measuring intracranial pressure. A strong correlation between the two scales and agreement among all the indicators were observed. Following the specialists’ review, the nursing outcome was reliable and clinically validated with 13 indicators: consciousness, orientation, language, central motor control, cranial sensory and motor function, spinal sensory and motor function, body temperature, blood pressure, heart rate, eye movement pattern, pupil size, pupil reactivity, and breathing pattern.
Highlights
Stroke is a severe, disabling cerebrovascular disease (CVD) that can lead to serious impairment and death
There were changes to the title of four indicators, for the specialists argued that even though they are relevant to the assessment, the terminology used was not common in clinical practice (Table 1)
This study presented the validation process of the nursing outcomes (NO) “Neurological Status” that proved viable to evaluate patients with cerebrovascular diseases with different levels of severity
Summary
Stroke is a severe, disabling cerebrovascular disease (CVD) that can lead to serious impairment and death. It requires immediate multi-professional intervention in health services, with rapid diagnosis and individualized, specialized, and quality nursing care. It is necessary to use the nursing process and neurological assessment scales to facilitate nursing care planning for stroke patients [1,2]. The Nursing Outcomes Classification (NOC) stands out for identifying nursing outcomes (NO) with indicators and scales capable of evaluating the patient’s condition along the continuum and the effectiveness of the care plan [3,4]. The scales allow measurement at any point on the continuum so that the fifth point reflects the condition of the patient that is most desired, facilitating the identification of changes in their state through different scores throughout time. The use of the NOC makes it possible, in this way, to monitor the improvement, worsening, or stagnation of the patient’s condition [5]
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