Content validation of the symptom control outcome for heart failure patients in palliative care

Afonso, Beatriz Quirino; Ferreira, Natany da Costa; Butcher, Rita de Cassia Gengo e Silva

doi:10.1590/1983-1447.2020.20190427

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Original Article • Rev. Gaúcha Enferm. 41 • 2020 • https://doi.org/10.1590/1983-1447.2020.20190427 copy

Content validation of the symptom control outcome for heart failure patients in palliative care

Validación de contenido del resultado control de síntomas para pacientes con insuficiencia cardiaca en cuidados paliativos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

To estimate the content validity of the Symptom Control nursing outcome for heart failure patients in palliative care and to analyze the influence of experts' experience in the judgment of the relevance of indicators.

Methods:

A methodological study conducted in São Paulo in 2018, with an adaptation of Fehring's validation model. The relevance of the 11 outcome indicators was assessed by 19 experts by means of an electronically submitted survey. The influence of the experts' experience on judgment was analyzed by the Wilcoxon-Mann-Whitney test and by Kendall's Tau correlation.

Results:

The indicators were considered pertinent; with 54.5% classified as critical. There was no association between the weighted means of the indicators and the experts' experience.

Conclusions:

The indicators analyzed are relevant for the evaluation of the Symptom Control outcome in this group of patients. The experts' judgment was not influenced by their area of clinical experience or by their experience with the Nursing Outcomes Classification (NOC).

Keywords
Symptom assessment; Patient outcome assessment; Standardized nursing terminology; Palliative care; Cardiology

Experience	None n (%)	Little n (%)	Reasonable n (%)	Very much n (%)
Use of the nursing process
In care	0 (0.0)	3 (15.79)	3 (15.79)	13 (68.42)
In teaching	1 (5.26)	3 (15.79)	6 (31.58)	9 (47.37)
In research	2 (10.53)	5 (26.31)	6 (31.58)	6 (31.58)
Use of standardized language
In care	0 (0.0)	4 (21.05)	4 (21.05)	11 (57.90)
In teaching	3 (15.79)	1 (5.26)	6 (31.58)	9 (47.37)
In research	1 (5.26)	4 (21.05)	6 (31.58)	8 (42.11)
Use of the Nursing Outcomes Classification
In care	6 (31.58)	4 (21.05)	9 (47.37)	0 (0.0)
In teaching	3 (15.79)	7 (36.84)	7 (36.84)	2 (10.53)
In research	4 (21.05)	8 (42.11)	6 (31.58)	1 (5.26)

Indicators	Weighted mean
Critical indicators
160802 - Monitors symptom persistence	0.91
160801 - Monitors symptom onset	0.88
160804 - Monitors symptom frequency	0.87
160813 - Obtains health care when warning signs occur	0.86
160803 - Monitors symptom severity	0.84
160806 - Uses preventive measures	0.84
Supplementary indicators
160807 - Uses symptom relief measures	0.79
160809 - Uses available resources	0.79
160805 - Monitors symptom variation	0.76
160811 - Reports symptoms controlled	0.76
160810 - Uses diary to monitor symptoms over time	0.72

Indicators	Weighted means		p-value
Indicators	Experience in only one of the specialties	Experience in both specialties	p-value
160802 - Monitors symptom persistence	0.92 (0.13)	0.93 (0.16)	0.65
160801 - Monitors symptom onset	0.91 (0.13)	0.90 (0.17)	0.96
160804 - Monitors symptom frequency	0.88 (0.15)	0.93 (0.16)	0.33
160813 - Obtains health care when warning signs occur	0.86 (0.13)	0.93 (0.10)	0.24
160803 - Monitors symptom severity	0.89 (0.13)	0.83 (0.20)	0.56
160806 - Uses preventive measures	0.81 (0.21)	0.93 (0.16)	0.18
160807 - Uses symptom relief measures	0.90 (0.15)	0.87 (0.21)	0.75
160809 - Uses available resources	0.90 (0.15)	0.87 (0.21)	0.75
160805 - Monitors symptom variation	0.83 (0.18)	0.77 (0.23)	0.56
160811 - Reports symptoms controlled	0.85 (0.20)	0.73 (0.16)	0.25
160810 - Uses diary to monitor symptoms over time	0.77 (0.21)	0.80 (0.18)	0.78

Indicators	Experience in the use of the NOC in care		Experience in the use of the NOC in teaching		Experience in the use of the NOC in research
Indicators	Correlation	p-value	Correlation	p-value	Correlation	p-value
160802 - Monitors symptom persistence	-0.150	0.49	0.01	0.96	0.093	0.66
160801 - Monitors symptom onset	-0.1116	0.59	0.010	0.96	0.112	0.60
160804 - Monitors symptom frequency	-0.067	0.75	0.037	0.86	0.157	0.46
160813 - Obtains health care when warning signs occur	0.085	0.70	0.270	0.21	0.337	0.12
160803 - Monitors symptom severity	-0.207	0.33	-0.060	0.78	0.174	0.41
160806 - Uses preventive measures	0.100	0.63	0.043	0.83	-0.070	0.74
160807 - Uses symptom relief measures	-0.364	0.09	-0.125	0.55	-0.078	0.71
160809 - Uses available resources	-0.364	0.09	-0.125	0.55	-0,078	0.71
160805 - Monitors symptom variation	-0.043	0.84	-0.122	0.55	0.074	0.72
160811 - Reports symptoms controlled	-0.711	0.07	-0.129	0.53	-0.147	0.47
160810 - Uses diary to monitor symptoms over time	-0.084	0.69	0.185	0.36	0.310	0.132

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
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[1] Corresponding author:
Beatriz Quirino Afonso Email: Beatriz.afonso@usp.br