Update of the Situation-specific Theory for health management in heart failure: Delphi study

Hirano, Gisele Saraiva Bispo; Silva, Viviane Martins da; Barros, Alba Lucia Bottura Leite de

doi:10.1590/1518-8345.7663.4554

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Original Article • Rev. Latino-Am. Enfermagem 33 • 2025 • https://doi.org/10.1590/1518-8345.7663.4554 linkcopy

Update of the Situation-specific Theory for health management in heart failure: Delphi study^*

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: to describe the process of analyzing the intrinsic elements of the Situation-specific Theory for health control in heart failure and present its respective update.

Method: analysis of the intrinsic elements of the theory using the Delphi technique. Nurses whose expertise involved knowledge in Cardiology Nursing, Nursing theories, heart failure and/or Nursing terminology were selected.

Results: the Theory was analyzed by 15 experts in the first round and 14 in the second round; all items evaluated obtained agreement greater than 80% regarding their adequacy, after two rounds of analysis. The theory maintained its original structure; however, the relationship between the factors that influence the health control of individuals with heart failure and the pictogram were updated.

Conclusion: the updated theory offers a better understanding of the factors that can influence the health control of individuals with heart failure and, although the focus of the theory is in the outpatient setting, it assumes the possibility of its application in other settings. The Delphi technique proved to be useful for theoretical validation, considering the specificity of the theme; however, the response time of the experts can be slow, which tends to impact the time to complete the study.

Descriptors:
Nursing Theory; Heart Failure; Standardized Nursing Terminology; Self-care; Delphi Technique; Nursing

Highlights

(1) Use of Delphi for internal validation of Situation-specific Theory. (2) Description of the characteristics of a Situation-specific Theory in nursing. (3) Innovation with the use of standardized languages in theory construction. (4) Advances in knowledge about health control in heart failure. (5) Improvement of nursing care for patients with heart failure.

Items	n ^†	% ^‡	CI 95% ^§
Item 1 - use of non-abstract concepts to explain the health management of patients with heart failure.	15	100.0	74.6 – 100.0
Item 2 - explicit presentation of the specific situation addressed (health management of individuals with heart failure).	15	100.0	74.6 – 100.0
Item 3 - provision of a structure that specifically represents the health management of patients with heart failure.	15	100.0	74.6 – 100.0
Item 4 - integrative approach to theory construction.	12	80.0	51.4 – 94.7
Item 5 - specificity of the theory to the outpatient population with heart failure.	13	86.7	58.4 – 97.6
Item 6 - possibility of connecting the propositions between theory and practice	13	92.9	64.2 – 99.6
Item 7 - provides directions for its use in research.	14	100.0	73.2 – 100.0
Item 8 - allows the establishment of guidelines for practice	14	100.0	73.2 – 100.0
Item 9 - incorporation of cultural, economic and clinical aspects of the patient with HF ^\|\| .	13	86.7	58.4 – 97.6
Item 10 – incorporation of barriers and difficulties encountered by the population with heart failure in controlling their health	15	100.0	74.6 – 100.0
Item 11- filling existing knowledge gap.	14	100.0	73.2 – 100.0
Item 12 – ampliação de um conhecimento existente.	14	93.3	66.0 – 99.6
Item 13 – explicit presentation of the conceptual model from which the theory was derived	15	100.0	74.6 – 100.0
Item 14 - possibility of identifying the interpersonal and psychomotor skills of nurses that are necessary for its application.	15	100.0	74.6 – 100.0
Item 15 - feasibility of implementing clinical protocols derived from theory	15	100.0	74.6 – 100.0
Item 16 – possibility of achieving good results with the Nursing actions proposed by the theory	14	100.0	73.2 – 100.0
Item 17 - the phenomenon studied (health control) is adequately expressed by the concepts	14	93.3	66.0 – 99.6
Item 18- possibility of categorizing and interpreting the phenomenon covered by the theory through concepts	13	86.7	58.4 – 97.6
Item 19 – approach the content in a clear and concise manner	15	100.0	74.6 – 100.0
Item 20 – adequate graphic and visual representation by pictogram	14	93.3	66.0 – 99.6
Item 21 - possibility of better understanding the concepts of the theory through the pictogram	13	92.9	64.2 – 99.6
Item 22 – representation of the main concepts, in the pictogram	14	93.3	66.0 – 99.6
Item 23 – relevance of the pictogram to the theory as a whole	15	100.0	74.6 – 100.0
Item 24 - logical presentation of the relationship between concepts in the pictogram	13	86.7	58.4 – 97.6
Item 25 – possibility of better understanding the text and the relationships between concepts through the pictogram	15	100.0	74.6 – 100.0

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Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3387 / 3315-4407 - Ribeirão Preto - SP - Brazil
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[1] *Total number of experts; ^†n = Total number of experts who responded that they agreed with the item evaluated; ^‡% = Proportion of experts who agreed with the item evaluated; ^§CI95% = 95% confidence interval; ^||HF = Heart failure. Note: Items with n<15 were those that did not receive a response and/or the response “I neither agree nor disagree”

Update of the Situation-specific Theory for health management in heart failure: Delphi study*

Highlights

Update of the Situation-specific Theory for health management in heart failure: Delphi study^*