Validation of the nursing diagnosis of impaired walking in elderly

Abstract

Background The increase in longevity causes restriction of activity in the elderly, causing changes on the execution of daily activities and consequently on the quality of life [1]. Walk is an activity that requires using a variety of skills and can be highly complex particularly for the elderly people [2]. The nursing diagnosis impaired walking is part of NANDA International since 1998 and requires further validation to improve the clinical evidence [3]. Objective To validate the nursing diagnosis impaired walking in a sample composed of elderly. Methods Observational, cross-sectional and quantitative study. After the first research phase of systematic literature review several defining characteristics and related factors of the diagnosis impaired walking have been listed.2 Then, the translation, linguistic and cultural adaptation of the nursing diagnosis was conducted, and finally, the clinical validation of the diagnosis using the clinical validation model of Richard Fehring [4], in a sample of elderly and counting on the collaboration of registered nurses and rehabilitation nurses to collect the data and fill the questionnaires, which comprised demographic data, the defining characteristics, related factors and falls efficacy scale international [5]. The study was approved by the ethical committee of SESARAM. E.P.E (Madeira Island Healthcare System). Results In the systematic literature review 17 defining characteristics and 34 etiological factors of impaired walking have been identified. A European Portuguese version was obtained to validate in a sample of 126 elderly, whose average age was 73.86 years, mostly female, with the primary school, in a situation of retirement, widowed and with history of falls. The prevalence of “impaired walk” was 64.3% according to the expert's opinion and 67.5% according to the elderly. All defining characteristics and related factors have been validated. The most sensitive defining characteristic was nine (e.g. impaired ability of gait speed) and also four related factors (fear of falling, physical deconditioning, medication and feminine gender). Conclusions This study justifies the need to review the defining characteristics and related factors of impaired walking. The identification of the most sensitive defining characteristics facilitates nurses’ clinical reasoning and interventions towards effective nursing outcomes.