Validação de conteúdo dos diagnósticos de enfermagem “amamentação exclusiva conturbada” e “risco de amamentação exclusiva conturbada”

Abstract

Objective: To validate the content of the Nursing Diagnoses Disturbed Exclusive Breastfeeding (00347) and Risk for Disturbed Exclusive Breastfeeding (00382) from the 13th edition of NANDA-I®, through the construction of operational definitions, expert analysis, and the presentation of the revised content to NANDA-I®. Method: A methodological content validation study developed in two stages: an integrative literature review and validation by a committee of experts via an online focus group. The review included 36 scientific articles, as well as textbooks, clinical protocols, and official documents, which supported the development of the operational definitions. Twenty-three expert nurses participated, selected for their expertise in breastfeeding, nursing diagnoses, and NANDA-I® taxonomy. The elements were evaluated for simplicity, clarity, and relevance, with the calculation of the Content Validity Index (CVI). Results: Operational definitions were established for 76 diagnostic elements. Considering the total items evaluated, scores ranged from 0.52 to 1.0. It was observed that 78% achieved a CVI ≥ 0.80 in at least two criteria, with the relevance criterion being the most prominent. Elements related to pain, fatigue, injured nipples, support networks, technical knowledge, breastfeeding opportunities at work, and breast engorgement showed the highest consensus. Items with low clinical specificity, especially those related to transient infant conditions, were recommended for revision or exclusion. The process resulted in conceptual adjustments, groupings, and reallocations that increased diagnostic coherence. Conclusion: The validation contributed to the conceptual and operational refinement of the diagnoses, promoting greater accuracy and strengthening evidence-based clinical practice in breastfeeding care.