Diagnósticos de enfermagem angústia espiritual e resiliência comprometida em pessoas em tratamento de fertilidade: estudo de validação clínica

Introduction: Human responses to infertility highlight spiritual distress and the ability of individuals to be resilient. In this regard, most diagnoses listed in NANDA-I have a low level of evidence and requires clinical validation in specific populations, such as people with infertility. This doctoral thesis arises from a diagnostic improvement necessary for an effectively integrative, holistic nursing intervention focused on the uniqueness of the Portuguese persons who face this condition and its treatment. Objectives: To conduct a clinical validation of NANDA-I nursing diagnoses of “Spiritual Distress (00066)” and “Impaired Resilience (00210)” in people undergoing fertility treatment. Method: It was an exploratory, quantitative, observational, cross-sectional study, and clinical validation of the mentioned nursing diagnoses, based on the Rasch model. Data collection took place between September 2019 and June 2020 in a sample of 104 Portuguese adults undergoing fertility treatment or on the verge of treatment, through an online questionnaire made available on fertility websites. It was a non-probabilistic and convenience sampling. Ethical principles were guaranteed and safeguarded, and an informed consent form was presented. Results: Twenty-two defining characteristics of the nursing diagnosis “Spiritual Distress (00066)” were validated and the diagnosis had a prevalence of 23.6% in this sample;“Perceived suffering” was the most sensitive defining characteristic (94.1%); “Anger over Power greater than self” (87.3%) and “Feeling unloved” (87.3%) were the most specific.“Impaired Resilience (00210)” had a prevalence of 15.4% in the sample, with seven defining characteristics having been validated. “Renewed elevation of distress” (93.8%) and “Low self-esteem” (93.8%) were the most sensitive characteristics, and “Social isolation” was the most specific (71.6%). Conclusions: This study contributes to increase the level of evidence of the NANDA-I diagnoses studied. Similar methodological procedures are proposed in other studies that would help to prove the scientific robustness of these results, in larger and heterogeneous samples to allow generalization, and/or longitudinal studies capable of observing the changes that occur in different phases of fertility treatment.