Content validation of the nursing diagnosis “inadequate social support network”

A methodological study of the content validation type, carried out with 23 judges who evaluated the adequacy of the title, definition, class and domain of the nursing diagnosis “inadequate social support network”. The judges also assessed the relevance of 28 clinical indicators and 32 etiological factors, which were considered valid when the Content Validity Index was ≥ 0.9.

Results:

The judges agreed with the proposed title and suggested changes to the definition of the nursing diagnosis. They recommended its inclusion in Domain 7 – “Roles and relationships” and Class 3 – “Role performance” of the NANDA-I taxonomy. In addition, 19 clinical indicators and 27 etiological factors were considered relevant.

Conclusion:

The nursing diagnosis “inadequate social support network” had its theoretical structure validated in terms of content, which can support the practice of nurses in the operationalization of the Nursing Process.

DESCRIPTORS
Social Support; Nursing Diagnosis; Validation Study; Social Network; Nursing Process

Definition	n = 23	%
Definition 1 – Network of interpersonal contacts and organizational systems unable to mobilize to provide the necessary support.	7	30.4
Definition 2 – Inability of network members to establish social interactions that generate support for meeting the needs of the person, family and community.	13	56.5
Definition 3 – Inability of network members to establish social interactions that provide support.	3	13.0
Total	23	100

Clinical Indicators	Shapiro-Wilk test		CVI
Clinical Indicators	W	p-value	Median	CI 95%
Feeling abandoned	0.33	<0.001	1.00	1.00	1.00
Decreased emotional support	0.45	<0.001	1.00	1.00	1.00
Inadequate information support	0.27	<0.001	1.00	1.00	1.00
Lack of instrumental support from health services	0.24	<0.001	1.00	1.00	1.00
Imposition of appropriate behavior	0.62	<0.001	1.00	0.75	1.00
Support offered different from that expected	0.46	<0.001	1.00	1.00	1.00
Fragile bonds	0.39	<0.001	1.00	1.00	1.00
Negative social interactions	0.45	<0.001	1.00	1.00	1.00
Prejudice	0.44	<0.001	1.00	1.00	1.00
Neglect of demands for support	0.45	<0.001	1.00	1.00	1.00
Encouragement of negative behavior	0.45	<0.001	1.00	1.00	1.00
Underestimation of the person’s self-efficacy	0.56	<0.001	1.00	0.88	1.00
Blaming attitudes	0.42	<0.001	1.00	1.00	1.00
Invasion of privacy	0.46	<0.001	1.00	1.00	1.00
Loss of confidentiality	0.33	<0.001	1.00	1.00	1.00
Overburdening the main caregiver	0.34	<0.001	1.00	1.00	1.00
Unwillingness to offer social support	0.53	<0.001	1.00	0.87	1.00
Devaluation of the social support received	0.47	<0.001	1.00	1.00	1.00
Low reciprocity	0.58	<0.001	1.00	0.63	1.00
Low situational self-esteem	0.6	<0.001	0.88	0.88	1.00
Conditioned support	0.65	<0.001	0.88	0.87	1.00
Scarcity of possible sources of social support	0.6	<0.001	0.88	0.87	1.00
Too many insignificant interpersonal contacts	0.63	<0.001	0.88	0.75	1.00
Little social support	0.66	<0.001	0.87	0.75	1.00
Perception that the person’s problem is normal	0.68	<0.001	0.75	0.75	1.00
Excess of information and interaction of the social network	0.65	<0.001	0.75	0.75	1.00
Lack of material goods	0.68	<0.001	0.63	0.5	0.88
Depression	0.74	<0.001	0.5	0.5	0.5
ALL CI	0.79	<0.001	0.75	0.75	0.87

Etiological factors	Shapiro-Wilk test		CVI
Etiological factors	W	p-value	Median	CI 95%
Low social network density	0.3	<0.001	1.00	1.00	1.00
Smaller social network	0.49	<0.001	1.00	1.00	1.00
Insufficient commitment from health professionals	0.33	<0.001	1.00	1.00	1.00
Impersonal relations between health professional and patient	0.51	<0.001	1.00	0.88	1.00
Intrusive practices by health professionals	0.53	<0.001	1.00	0.88	1.00
Weak organization of institutional services into a network	0.38	<0.001	1.00	1.00	1.00
Shortage of health professionals	0.49	<0.001	1.00	0.88	1.00
Difficulties in geographical access to secondary social network services	0.41	<0.001	1.00	1.00	1.00
Excessive demand for support	0.26	<0.001	1.00	1.00	1.00
Fear of the person seeking support	0.42	<0.001	1.00	1.00	1.00
Mistrust of the other person’s competence	0.5	<0.001	1.00	1.00	1.00
Lack of sociability	0.22	<0.001	1.00	1.00	1.00
Refusal of support	0.22	<0.001	1.00	1.00	1.00
Unable to access the secondary social network services	0.45	<0.001	1.00	1.00	1.00
Social isolation	0.42	<0.001	1.00	1.00	1.00
Moving house	0.38	<0.001	1.00	1.00	1.00
Cultural differences	0.22	<0.001	1.00	1.00	1.00
Centralization of responsibility for care	0.38	<0.001	1.00	1.00	1.00
Restriction of the role of a member of the social network	0.33	<0.001	1.00	1.00	1.00
Disregard for the role of supporter	0.55	<0.001	1.00	0.88	1.00
Lack of strong ties	0.42	<0.001	1.00	1.00	1.00
Broken ties	0.26	<0.001	1.00	1.00	1.00
Dependency-generating ties	0.34	<0.001	1.00	1.00	1.00
Lack of recognition of the support offered	0.41	<0.001	1.00	1.00	1.00
Lack of reciprocity for the support received	0.34	<0.001	1.00	1.00	1.00
Unwillingness to support	0.55	<0.001	1.00	0.88	1.00
Lack of theoretical and practical knowledge about the person’s needs	0.49	<0.001	1.00	0.88	1.00
Larger social network	0.65	<0.001	0.88	0.75	1.00
Mental health problems	0.61	<0.001	0.88	0.63	1.00
Consumption of the person’s resources	0.6	<0.001	0.88	0.75	1.00
Unexpected events	0.63	<0.001	0.88	0.75	1.00
High degree of complexity in organizations	0.73	<0.001	0.75	0.50	0.87
ALL EF	0.73	<0.001	0.87	0.87	0.88

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Michelline Santos de França R. Jaguaribe, s/n, Timbó 53510-520 – Abreu e Lima, PE, Brazil michelline.franca@abreuelima.ifpe.edu.br