Clinical validation of the nursing diagnosis of dysfunctional family processes related to alcoholism

Publisher: John Wiley & Sons Inc

E-ISSN: 1365-2648|72|10|2401-2412

ISSN: 0309-2402

Source: JOURNAL OF ADVANCED NURSING, Vol.72, Iss.10, 2016-10, pp. : 2401-2412

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Abstract

Abstract

AimsTo evaluate the clinical validity indicators for the nursing diagnosis of dysfunctional family processes related to alcohol abuse.
BackgroundAlcoholism is a chronic disease that negatively affects family relationships. Studies on the nursing diagnosis of dysfunctional family processes are scarce in the literature. This diagnosis is currently composed of 115 defining characteristics, hindering their use in practice and highlighting the need for clinical validation.
DesignThis was a diagnostic accuracy study.
MethodsA sample of 110 alcoholics admitted to a reference centre for alcohol treatment was assessed during the second half of 2013 for the presence or absence of the defining characteristics of the diagnosis. Operational definitions were created for each defining characteristic based on concept analysis and experts evaluated the content of these definitions. Diagnostic accuracy measures were calculated from latent class models with random effects.
Results/findingsAll 89 clinical indicators were found in the sample and a set of 24 clinical indicators was identified as clinically valid for a diagnostic screening for family dysfunction from the report of alcoholics. Main clinical indicators with high specificity included sexual abuse, disturbance in academic performance in children and manipulation. The main indicators that showed high sensitivity values were distress, loss, anxiety, low self‐esteem, confusion, embarrassment, insecurity, anger, loneliness, deterioration in family relationships and disturbance in family dynamics.
ConclusionEighteen clinical indicators showed a high capacity for diagnostic screening for alcoholics (high sensitivity) and six indicators can be used for confirmatory diagnosis (high specificity).