Purpose: Use of the nursing process is foundational in nursing. As standardized nursing terminologies developed for problems, outcomes, and interventions, associating these concepts became important in nursing. Thus, the term linkage appeared and has been around for the last twenty-five years. As linkages has evolved, different steps in the formulation have developed. The purpose of this paper is to review similarities and differences of methods used by researchers worldwide. This paper provides a linkage development process, which enhances linkage work through a more standardized approach. Methods: In-depth reviews were conducted on solicited papers presenting linkages focusing on selected nursing diagnoses or clinical conditions. In total, the third linkage book (2012) and eight papers were reviewed to articulate the steps used by authors in linkage development. Findings: Methodologies were generally consistent. The similarities were selecting experts; conducting literature reviews; selecting nursing diagnoses, separating problem and risk focused diagnoses, selecting outcomes and interventions for appropriate diagnoses category, reviewing definitions of nursing diagnoses, outcomes, and interventions to ensure consistency among the linkage elements, and a final session to reach consensus on the linkages. While the similarities represented most of the steps in the development process, the variations were used to identify the nursing diagnoses. Some scholars conducted an extensive literature review and rated the relevance of specific classification components already identified through research that were significant in the nursing care of clinical condition. Others used models of nursing care as the framework for nursing diagnoses identification. Conclusion: Linkages demonstrate the relationships among the elements of the nursing process. With the continued evolving of standardized languages, it is crucial for terminology scholars and researchers to develop methods for the construction of linkages to ensure credible examples for use in practice, education, and research, to support nursing care.
Purpose To analyze the concept of planetary health self-management and establish its theoretical foundation for developing the nursing diagnosis Readiness for enhanced planetary health self-management. Methods Concept analysis was conducted using the Walker and Avant method and was informed by a scoping review. Following the concept analysis, the findings were critically interpreted in accordance with the multiaxial structure of the NANDA International taxonomy and translated into the context of health-promotion nursing diagnoses. Findings The results defined the concept as a framework for managing attitudes, behaviors, and lifestyle changes that promote integration between human health and the Earth's natural systems, while respecting the planet's ecological limits, developing a construct of “self-management of planetary health”. Based on this construct, the health-promotion nursing diagnosis Readiness for enhanced planetary health self-management was proposed to identify individuals who demonstrate the willingness and capacity to strengthen attitudes, behaviors, and lifestyle choices that simultaneously promote human health and environmental sustainability. Conclusions Through conceptual analysis, this study developed the disciplinary construct of “self-management of planetary health” and provided a theoretical basis for developing the nursing diagnosis “Readiness for enhanced planetary health self-management”, which contributes to the profession's capacity to educate about sustainable health practices, advocate for health policies, and promote behaviors that improve human and planetary health. Implications for Nursing Practice Contributes to the advancement of the discipline in the area of nursing diagnoses, establishing the concept of planetary health self-management through concept analysis and allowing for the improvement of nursing diagnosis taxonomies.
Objective To clinically validate the nursing diagnosis “Risk for shock” in patients with acute myocardial infarction (AMI) admitted to an Intensive Care Unit (ICU). Method A retrospective case-control study conducted at a high-complexity university hospital in Brazil. The sample consisted of 116 medical records of adult patients with AMI, equally distributed between the case group (with cardiogenic shock; n = 58) and the control group (without cardiogenic shock; n = 58). Diagnostic accuracy measures (sensitivity, specificity, predictive values, and likelihood ratios) were calculated, and multivariate binary logistic regression using the Stepwise Forward method was applied to identify independent predictors and control for confounders. Results In the accuracy analysis, the indicator “Unstable blood pressure” showed the best clinical balance, with a sensitivity of 85.0% (95% CI: 76.2–93.8) and a specificity of 83.6% (95% CI: 74.4–92.8). “Hyperthermia” and “Inadequate fluid volume” showed the highest individual specificities (90.1% and 80.3%, respectively). After adjusting the logistic regression model (Nagelkerke R 2 = 0.614; Hosmer-Lemeshow p = 0.782), only four factors remained significant as independent predictors of the outcome: unstable blood pressure (aOR = 7.80; 95% CI: 3.10–19.60; p < 0.001), hypoxia (aOR = 3.70; 95% CI: 1.50–9.20; p = 0.006), hypoxemia (aOR = 2.90; 95% CI: 1.40–6.10; p = 0.004), and inadequate fluid volume (aOR = 2.10; 95% CI: 1.00–4.50; p = 0.048). Thermal and hemorrhagic indicators lost significance after adjustment. Conclusion The study clinically validated the diagnosis and confirmed a robust predictive model composed of four indicators. Prioritizing the monitoring of these risk factors enables critical care nurses to anticipate hemodynamic collapse, support targeted care protocols, and optimize multiprofessional decision-making at the bedside.
Background Breast cancer survivors live with heterogeneous recurrence risks. Recurrence-related nursing guidance often combines follow-up, adherence, symptom monitoring, lifestyle behaviors, and fear management under broad self-care language, limiting precision for nursing assessment and language development. Purpose To analyze the concept of risk-informed self-care for recurrence risk reduction among breast cancer survivors and clarify its relevance for nursing language development. Methods Walker and Avant's method guided the analysis. Literature searches were updated on 5 July 2026 in PubMed, CINAHL, Scopus, ScienceDirect, ProQuest, Google Scholar, and guideline sources. English-language literature from 2013–2026 was prioritized; older landmark theory and instrument sources were retained when conceptually necessary. Thirty-four core sources were mapped to concept uses, attributes, antecedents, consequences, empirical referents, and possible nursing language descriptors. Results The concept is defined as a supported process through which breast cancer survivors use credible recurrence-related information and survivorship recommendations to maintain treatment continuity, participate in appropriate surveillance, manage modifiable survivorship-related determinants, monitor symptoms proportionally, and seek help when needed. Five attributes were identified: risk-calibrated understanding, guideline-concordant treatment continuity and surveillance participation, management of modifiable survivorship-related determinants, proportional symptom monitoring and timely help-seeking, and adaptive self-care management decision-making. Conclusions Risk-informed self-care for recurrence risk reduction offers a more precise construct than general survivor self-care. It may inform recurrence-related nursing assessment, diagnostic reasoning, care planning, documentation, outcomes evaluation, and future standardized nursing language development.
Purpose To clinically apply the Nursing Outcome Client Satisfaction: Birth Process to postpartum women in a rooming-in setting. Methods A descriptive-analytical study was conducted in a philanthropic hospital in southwestern Brazil to assess the Nursing Outcome Client Satisfaction: Birth Process in 125 postpartum women. The outcome data were collected at 24 h postpartum, 7 days later, and again at 45 days postpartum using a mobile application. Associations between sociodemographic variables and satisfaction scores (Likert 4–5) were analyzed using the chi-square test and Fisher's exact test ( p < .05). Longitudinal changes over time were assessed using Poisson regression with Generalized Estimating Equations. Results Satisfaction was high immediately postpartum but declined over time, especially for pain relief, vaginal exams, labor interventions, waiting time, continuity of care, cleanliness, and staff consideration, with lower scores among low-income and brown or black women. Conclusions Maternal satisfaction changes over the postpartum period and is affected by care quality and social inequities, with the Nursing Outcome proving effective in capturing women's perceptions. Implications for Nursing Practice: Standardized nursing outcomes facilitate the evaluation of the quality of obstetric care and support ongoing monitoring of women's experiences, thereby reinforcing woman-centered and respectful maternity care in practice.
