{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:49:56Z","timestamp":1791809396562,"version":"4.3.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Nursing Knowledge"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\u201c<\/jats:bold>\n                      Impaired Gas Exchange\u201d (NANDA-I 00030) is a prevalent respiratory nursing diagnosis, yet individual validation studies report conflicting findings regarding the frequency and diagnostic accuracy of its defining characteristics (DCs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize evidence on the frequency and diagnostic accuracy of the DCs of the nursing diagnosis \u201cImpaired Gas Exchange\u201d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. A systematic search was performed across six databases, including PubMed, CINAHL, Scopus, Web of Science, Embase, and ProQuest, from each database's start date through December 14, 2025, to find relevant studies. Keywords covered \u201cImpaired Gas Exchange,\u201d \u201cPulmonary Gas Exchange,\u201d \u201cNursing Terminologies,\u201d \u201cNANDA-International,\u201d and \u201cNursing Diagnosis.\u201d Methodological quality was assessed using QUADAS-2. Diagnostic accuracy parameters were pooled using bivariate random-effects models in Meta-DiSc 1.4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies (n\u2009=\u20092,346) were included. Pooled frequencies were calculable for 12 of 19 NANDA-I DCs; the most prevalent were hypoxia (96%; 95% CI: 94\u201398%), tachypnea (48%; 95% CI: 43\u201353%), hypercapnia (44%; 95% CI: 15\u2013100%), and tachycardia (42%; 95% CI: 4\u201380%). Three studies were eligible for diagnostic accuracy meta-analysis across seven DCs. Hypoxemia had the highest sensitivity (0.94). Irritable mood had the highest specificity (0.95). Dyspnea performed poorly (DOR\u2009=\u20090.46).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Objective physiological indicators, particularly hypoxemia, hypoxia, and hypercapnia, were the most frequent and diagnostically accurate DCs. Future multicentre studies using standardized definitions and objective reference standards are needed to refine the diagnostic profile of \u201cImpaired Gas Exchange\u201d.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20473087261460986","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:24:25Z","timestamp":1786544665000},"page":"537-556","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Definition, Validation, and Defining Characteristics of \u201cImpaired Gas Exchange\u201d Nursing Diagnosis: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2219-0817","authenticated-orcid":false,"given":"Sogand","family":"Sarmadi","sequence":"first","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0014-7104","authenticated-orcid":false,"given":"Akbar","family":"Zare-Kaseb","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Sanaie","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitra","family":"Zandi","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Beigzadeh","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0103-21002012000500011"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/2047-3095.12205"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.70050"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-618X.1990.tb00436.x"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547-5069.1998.tb01299.x"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.enfcli.2015.07.007"},{"issue":"1","key":"e_1_3_2_8_1","first-page":"29","article-title":"Systematic review and meta-analysis of the accuracy of \"impaired gas exchange\" defining characteristics","volume":"33","author":"Carvalho de Sousa V. 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