The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated, and their associated activities, for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their new-born babies.
This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second. validation of the preliminary home health care interventions. and third. application of the home care interventions.
In the first phases, diagnoses fiom 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998, and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification.
In the second phase. using the selected diagn ores. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list ir. SIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first fora rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts particip;3ted using the Fehring"s Delphi technique. The ext~ert group evaluated and defined the set of preliminary nursing interventions.
In th.e third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients refer-red to ~~he home health care agency at P. medical center between October 1998 and March 1999 were the sul:~jects for this phase. Each of the activities were tested using dichotomous question method.
The results of the study are as follows :
1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnosesintever~tions links in NIC, .and from 1.465 associated nursing activities. From the 63 interventions, the nurses expert group developed 18 interventions and 258 activities as the preliminary intervenl;ion list through afive-round validity test
2. For the fifth content validity test using Fehring"s model for determining ICV (Intervention Content Validity). a five point Likert scale was used v~~ith values converted to weights as follows: 1=0.0, 2=0.25, 3=0.50. 4=0.75. 5=1.0. Activities of less than 0.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions, 0.98-0.77 and for the nr,~rsing activities. 0.95-0.85. By Fehring´s met-hod. all of these were included in the preliminary intervention list.
3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health. care nurses applied each nursing diagnoses to every client, and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore, 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as fiom the nursing records and textbooks and three were new fiom the clinical application.
The final list included ´Anxiety´, ´Aspiration, risk foi´. ´Infant behavior, potential for enhanced. organized". "Infant feeding pattern, ineffective´. Infection´. ´Knowledge deficit´, ´Nutrition. less than body requirements. altered´, ´Pain´. ´Parenting. ´Skin integrity. risk for, impared", and ´Risk for activity intolerance". ´Self-esteem disturbance´. "Sleep pattern disturbance´.
4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more inte-rvent.ion added from the clinical setting. "Body image enhancement". Fot 265 associated nut~sin g activities, clinical application tests were also don e. The intervention rate of 19 interventions was fio m 81.6o to 100%, so all 19 interventions were in cl-uded in the validated intervention set. From t he 265 nursing activities. 261(98.5%) were accept ed and four activities were deleted. those with an implimentation tate of less than 50%.
5. In conclusion. 13 diagnoses, 19 interventions and 261 activities were validated for the final validated nursing intervention set.
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