“Impaired Resilience (00210)” in patients under fertility treatment: clinical validation study

Purpose: The aim of this study was a clinical validation of the NANDA-I nursing diagnosis “Impaired Resilience (00210)” in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics. Methods: A cross-sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility-related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee. Findings: The “Impaired Resilience (00210)” had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are “decreased interest in vocational activities,” “depression,” “impaired health status,” “ineffective coping strategies,” “low self-esteem,” “renewed elevation of distress,” and “social isolation.” No item showed differential item functioning. “Renewed elevation of distress” and “low self-esteem” were the most sensitive defining characteristics and had the highest negative predictive value. “Shame” was the most specific one. Conclusions: The nursing diagnosis “Impaired Resilience (00210)” was validated, and results may improve its accuracy in people going through fertility treatment. Implications for nursing practice: This paper contributes by raising knowledge regarding NANDA-I nursing diagnosis and enhancing the quality of nurses’ critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field.