Validation to NANDA-I of the Nursing Diagnosis Ineffective Community Process Based on Community Assessment, Intervention and Empowerment Model (MAIEC): A Focus Group Consensus Study

Purpose This study aimed to evaluate the content validity of the proposed nursing diagnosis ‘Ineffective Community Process’ for potential integration into the NANDA-I taxonomy, using the MAIEC model as its theoretical framework. Objective To evaluate expert consensus regarding the content validity of the diagnostic label, definition, diagnostic dimensions, defining characteristics, related factors, populations at risk, and taxonomic placement. Methods A constructivist mixed-methods design was applied. A focus group of seven Brazilian nurses (n = 7) with expertise in Community or Public Health Nursing and experience with standardized nursing classifications participated in the diagnostic validation process and were asked to assess agreement with respect to the diagnostic framework. Consensus was assessed using the Tastle & Wierman Consensus Index (IC), and qualitative contributions were incorporated to refine semantic clarity and conceptual alignment. Results High consensus (IC = 0.8113) was achieved for the diagnostic label Ineffective Community Process, its definition, and the three diagnostic dimensions (Community Leadership, Community Participation, and Community Coping). All defining characteristics across dimensions reached high consensus (IC = 0.8113). Four related factors—low community participation, low literacy, vulnerable socioeconomic conditions, and absence of community leaders—also demonstrated high consensus, while “non-democratic community policies” showed moderate agreement. All indicators of the Portuguese version of the Community Empowerment Assessment Rating Scale (EAVeC) with scores < 3 were validated as criteria for populations at risk. Conclusion Findings provide evidence supporting the content validity of the proposed nursing diagnosis “Ineffective Community Process” and its diagnostic components. The results contribute to the development of community-focused nursing diagnoses and provide a foundation for future international consensus and clinical validation studies. Implications for nursing practice: The proposed nursing diagnosis “Ineffective Community Process” may strengthen nurses’ ability to systematically assess and document community-level diagnoses using standardized language. Its potential integration into NANDA-I may enhance visibility of community nursing work, guide targeted interventions to increase community empowerment, and support epidemiological surveillance and outcome evaluation in public health and community settings.