{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T23:55:15Z","timestamp":1784332515260,"version":"3.55.0"},"reference-count":56,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["JP20K19228"],"award-info":[{"award-number":["JP20K19228"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Nursing Knowledge"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Nurses\u2019 clinical reasoning skills regarding impaired swallowing can help prevent patient complications and maintain quality of life. Clinical reasoning skills need content-validated defining characteristics (DCs). We aimed to validate the content of these DCs for nursing diagnosis \u201cimpaired swallowing.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Content validation of the DCs was performed by 275 dysphagia nursing experts in Japan, using 3 rounds of the Delphi technique and Fehring's Diagnostic Content Validation (DCV) model. Three rounds of questionnaires on 84 DCs were completed via printed mail.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      The valid response rates for each round were as follows: round 1, 90.2%; round 2, 77.8%; and round 3, 71.3%. Of the 84 DCs, 77 that met the consensus criteria were categorized as major (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u00a018), minor (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u00a045), and excluded (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u00a014). There were four minor DCs other than the oral, pharyngeal, and esophageal phases. DCs listed from outside NANDA-I included 12 major, 16 minor, and 3 excluded characteristics. Of the NANDA-I DCs, 5 were no consensus and 11 were excluded. The total DCV score for the 63 major and minor DCs was 0.8.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results recommend the addition of 28 DCs and the exclusion of 11 for the NANDA-I nursing diagnosis \u201cimpaired swallowing\u201d (00103). Major DCs were prominent indicators of impaired swallowing and signs of aspiration or pharyngeal residuals. Minor DCs included not only the three phases but also other signs necessary for a comprehensive understanding of impaired swallowing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for nursing practice<\/jats:title>\n                    <jats:p>This validation study strengthens the clinical usefulness of the DCs for impaired swallowing, which can improve nurses\u2019 clinical reasoning skills. Major and minor DCs can increase the awareness of impaired swallowing and enable accurate intervention, thereby preventing patient complications and maintaining quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/2047-3095.12471","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T01:03:16Z","timestamp":1716166996000},"page":"158-168","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Content validation of the defining characteristics of the nursing diagnosis \u201cimpaired swallowing\u201d using the Delphi technique: A study with dysphagia nursing experts in Japan"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0545-582X","authenticated-orcid":false,"given":"Kazuyoshi","family":"Nishizawa","sequence":"first","affiliation":[{"name":"Department of Nursing, School of Health Sciences, Toyohashi Sozo University, Toyohashi, Japan"},{"name":"Department of Nursing Science, Nagoya University Graduate School of Medicine, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikumi","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Nursing Science, Nagoya University Graduate School of Medicine, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-2810","authenticated-orcid":false,"given":"Tomoko","family":"Doi","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Nagoya University of Arts and Sciences, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0193841X9101500201"},{"issue":"12","key":"e_1_3_3_3_1","first-page":"784","article-title":"Dysphagia in the elderly","volume":"9","author":"Aslam M.","year":"2013","unstructured":"Aslam M., Vaezi M. 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