Cultural Adaptation and Psychometric Evaluation of the Spanish Version of the Nursing Outcome “Pain Control” in Primary Care Patients with Chronic Pain

Role of the health literacy assessment in healthcare: Content validation of "Health Literacy Behaviour" nursing outcome

PURPOSE

To validate the content of the "Health Literacy Behaviour" nursing outcome (NO).

METHODS

A content validation study was conducted during 2022. Each indicator was included in the NO, and its response levels were operationally defined. The initial version of each indicator and its response levels were refined and validated through the Delphi method. A panel of health literacy (HL) and nursing taxonomies experts evaluated the content through two content validity indicators. The content validity of the NO and each index was determined by calculating the content validity index (CVI). A qualitative analysis of the recommendations provided by the experts was carried out to improve the understanding of the indicators and their levels.

FINDINGS

A total of 108 experts participated in this study. Mostly females with more than 10 years of professional experience. The results demonstrated a high CVI of the indicators and the NO "Health Literacy Behaviour." All indicators achieved excellent (CVI ≥ 0.80) relevance and clarity. The CVI universal average method (CVI-p) of the NO achieved an excellent result of 0.90.

CONCLUSIONS

The indicators included in the NO "Health Literacy Behaviour" have content validity.

IMPLICATIONS FOR NURSING PRACTICE

These findings provide evidence-based indicators to measure the patient's actions to obtain, process, and understand information about health and disease, interact with the health system, and make informed health decisions. The validation of this NO would identify populations with low HL, allowing the health of this community to be promoted. Health literacy should be a priority objective of health management and policies.

Content and Clinical Validation of the Nursing Outcome "Health Literacy Behaviour": A Validation Protocol

Health literacy (HL) is a result of health promotion and education that has been included as a nursing intervention since 2013. It was proposed, as a nursing activity, to "determine health literacy status at initiation of contact with the patient through informal and/or formal assessments". Because of that, the outcome 'Health Literacy Behaviour' has been incorporated in the sixth edition of the Nursing Outcomes Classification (NOC). It collects the patient's different HL levels and allows them to be identified and evaluated in a social and health context. Nursing outcomes are helpful and provide relevant information for the evaluation of nursing interventions.

OBJECTIVES

To validate the contents of the nursing outcome 'Health Literacy Behaviour (2015)' in order to use them in nursing care plans, and to evaluate their psychometric properties, application level, and effectiveness in nursing care to detect low health literacy patients.

METHODS

a methodological two-phased study: (1) an exploratory study and content validation by expert consensus, who will evaluate revised content of nursing outcomes; (2) methodological design by clinical validation.

CONCLUSION

The validation of this nursing outcome in NOC will enable the generation of a helpful tool that would facilitate nurses to set individualised and efficient care interventions and identify low health literacy populations.

The Nurse-Patient Outcome Content Validation Method

PURPOSE

To describe a new method of validating nursing outcomes and indicators that incorporates nurses' and patients' perspectives.

METHODS

The Nurse-Patient Outcome Content Validation Method was developed in light of the experience of conducting the content validation of the nursing outcome Knowledge: Heart Failure Management (1835). It was developed based on Fehring's content validation model used for the validation of NANDA International nursing diagnoses. It expands the concept of who is an expert in the validation of nursing outcomes.

FINDINGS

The Nurse-Patient Outcome Content Validation Method is a new method in which the concept of experts is expanded to gather patients' as well as healthcare professionals' perspectives on the importance of indicators to measure an outcome. Based on the importance ratios, the indicators are grouped into three categories: critical, supplemental, or unnecessary. To validate the outcome, importance ratios of critical and supplemental indicators are summed and divided by the total number of the indicators to calculate the outcome content validity (OCV) score of the nursing outcome.

CONCLUSION

The Nurse-Patient Outcome Content Validation Method is a new method of content validation of nursing outcome and indicators that incorporates the patient perspective.

IMPLICATIONS FOR NURSING PRACTICE

The Nurse-Patient Outcome Content Validation Method provides a mechanism to include nurses' and patients' perspectives to content validity research of nursing outcomes. It supports patient empowerment since the patient is viewed as an expert regarding the experience of living and managing his/her clinical condition.

Clinical Validation of the Nursing Outcome "Pain: Disruptive Effects" in People With Chronic Pain in Spain

BACKGROUND AND PURPOSE

The measurement of the effects of chronic pain on the patients is a challenge for nurses. The purpose was to translate into Spanish and to assess the psychometrics of the indicators of the nursing outcome "Pain: disruptive effects."

METHODS

A three-stage study: (a) translation and cultural adaptation, (b) content validation, (c) clinical validation in 10 healthcare centers.

RESULTS

The Spanish version of the outcome "Pain: disruptive effects" has high content validity (CVI = .90) with 17 indicators organized into three factors. The Inter-observer agreement was good (kappa = .66) and the internal consistency high (alpha = .90).

CONCLUSIONS

The 17 indicators of the outcome "Pain: disruptive effects" has evidence of reliability and validity for assessing the harmful effects of chronic pain.

Psychometric Evaluation of the Nursing Outcome Knowledge: Pain Management in People with Chronic Pain

Pain has a major impact on health and quality of life. Since the level of knowledge of painful conditions can influence how these are addressed and managed, assessing this knowledge in patients becomes crucial. As a result, it is necessary to have culturally adapted and validated instruments that specifically measure patients' knowledge of chronic pain management. The objective of this study was to carry out the Spanish cultural adaptation and the validation of the outcome Knowledge: Pain Management of the Nursing Outcomes Classification (NOC) in patients with chronic pain, defined as extent of understanding conveyed about causes, symptoms, and treatment of pain. A three-stage study was designed: 1) translation and cultural adaptation through an expert panel, 2) content validation, 3) clinical validation. This study provides nurses with a Spanish version of this scale adapted to their context, as well as a set of structured indicators to measure patients' knowledge about chronic pain. The results indicated that the culturally adapted Spanish version of the outcome Knowledge: Pain Management had a high level of content validity (CVI = 0.92), with 27 indicators being distributed between two factors. This version has been shown to be reliable in terms of inter-observer agreement (κ = 0.79) and internal consistency (α = 0.95). In conclusion, Knowledge: Pain Management has been shown to be reliable and valid to measure knowledge of chronic pain.

Psychometric Evaluation of the Nursing Outcome "Pain: Adverse Psychological Response" in Patients With Chronic Pain

PURPOSE

To culturally adapt into Spanish and validate the outcome "Pain: Adverse psychological response" (code 1306) in patients with chronic pain.

METHODS

A three-stage study was conducted: (a) translation and cultural adaptation, (b) content validation, and (c) clinical validation.

FINDINGS

The Spanish version of the outcome "Pain: Adverse psychological response" has high content validity ( 0.91). Fourteen indicators were organized into two factors. This version offers good reliability in both inter-observer agreement (kappa = 0.72) and internal consistency (alpha = 0.89).

CONCLUSIONS

The Spanish adaptation of "Pain: Adverse psychological response" is a reliable and valid instrument for the measurement of emotional aspects of chronic pain.

IMPLICATIONS FOR NURSING PRACTICE

The Spanish adaptation of this outcome offers nurses a set of structured indicators to measure the adverse emotional impact of chronic pain.