Risk for Unstable Blood Pressure in Hospitalized Cardiac Patients - A Multi-Aggregation Content Analysis

AimTo analyze the content of the nursing diagnosis 'Risk for Unstable Blood Pressure' in hospitalized cardiac patients by reviewing the terminological structure (label, definition, and risk factors) in NANDA-I classification.DesignA methodological study with a quantitative approach was performed.MethodFrom September 2023 to January 2024, 54 nurses and physicians with relevant expertise analyzed 18 risk factors for their relevance to the diagnosis, using eight content indices (Weighted Mean, Weighted Median, Aiken's V, Median of Attributions, Hernández-Nieto Content Validity Coefficient, Fehring's Diagnostic Content Validity Index, Content Validity Index - Proposal adapted from Lynn, and Content Validity Ratio - Proposal adapted from Lawshe). Overall content validity was assessed through generalizability theory. EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.ResultsOf the 18 risk factors assessed, 14 were relevant to the causal structure. Reliability measures showed strong internal consistency. The set of risk factors for this nursing diagnosis is high quality, well intercorrelated, and accurately represents the diagnostic content.ConclusionFourteen risk factors were deemed valid and relevant to the causal chain in the context of hospitalization of cardiac patients, based on the aggregation of eight content validity indices. This finding presents new aspects to be managed early by the clinical nurse, in addition to presenting a new methodological approach for studies of this nature.Implications for nursing practiceThis study advances nurses' clinical diagnostic reasoning by supporting professional practice through the early identification of risk factors requiring management during the hospitalization of cardiac patients. It is proposed to add new risk factors, revise terminology, and update the NANDA International definition of this diagnosis.