Validity Evidence for the Nursing Diagnosis "Ineffective Lymphedema Self-Management" in Women who Underwent Mastectomy.

Aim: To verify the evidence of content validity of the nursing diagnosis "Ineffective Lymphedema Self-Management" in women who underwent mastectomy.

Design

Methodological study of content validation by expert judges. Method: Content validation was conducted between July and October 2023 through a semi-structured online questionnaire sent to 80 expert judges, of whom 52 participated. The study was approved by the Research Ethics Committee (CAAE No. 63063922.0.0000.5078). Elements identified in a preceding concept analysis were evaluated for relevance using Aiken's V coefficient (V ≥ 0.90) with 95% confidence intervals. Cronbach's alpha was used to assess internal consistency. The sample size (n = 47) was determined using a precision estimation formula for content validity indices.

Results

Of the 47 terms submitted for evaluation, 31 were considered valid as defining characteristics and related factors. The terms "psychological and cognitive limitations" and "patients who underwent a mastectomy" were validated for associated conditions and at-risk population, respectively. Expert judges suggested the inclusion of "female breast cancer survivors," "access to health services," and "lack of medical information." Cronbach's alpha was 0.97 (95% CI: 0.96-0.98).

Conclusion

The nursing diagnosis "Ineffective Lymphedema Self-Management" was partially validated. New elements were identified that may elevate the evidence level of this diagnosis and refine its applicability in clinical practice. Implications for Nursing Practice: The validated elements provide nurses with a structured framework for identifying and managing lymphedema in women who underwent mastectomy, contributing to early detection and targeted interventions.