title: [Utility and validity of indicators from the Nursing Outcomes Classification as a support tool for diagnosing Ineffective Self Health Management in patients with chronic conditions in primary health care].
abstract: BACKGROUND
  Self-care and management of therapeutic regime (drugs adherence, preventive behaviours and development of healthy life-styles) are key components for managing chronic diseases. Nursing has standardized languages which describe many of these situations, such as the diagnosis "Ineffective Self Health Management" (ISHM) or many of the Nursing Outcomes Classification (NOC) indicators. The aims of this study were to determine the interobserver reliability of a NOC-based instrument for assessment and aid in diagnosis of the ISHM in patients with chronic conditions in Primary Health Care, to determine its diagnostic validity and to describe the prevalence of patients with this problem.
  
  
  METHODS
  Cross-sectional validation study developed in the provinces of Málaga, Cádiz and Almería from 2006 to 2009. Each patient was assessed by 3 independent observers: the first two observers evaluated scoring of the NOC indicators and the third one acted as the "gold-standard".
  
  
  RESULTS
  Two hundred and twenty-eight patients were included, 37.7% of them with more than one chronic condition. NOC indicators showed a high interobserver reliability (ICC>0,70) and a consistency (Cronbach's alpha: 0.81). With a cut-point of 10.5, sensitivity was 61% and specificity 85%, and the area under the curve was 0.81 (CI95%: 0.77 to 0.85). The prevalence of patients with ISHM was 36% (CI 95%: 34 to 40).
  
  
  CONCLUSIONS
  The use of NOC indicators allows evaluation of management of the therapeutic regime in people with chronic conditions with a satisfactory validity and it provides new approaches for dealing with this problem.
authors.affiliation: Atención Primaria de Málaga. Escuela Andaluza de Salud Pública, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: Morilla-Herrera
authors.forename: J M
authors.initials: JM
authors.lastname: Morales-Asencio
authors.forename: M C
authors.initials: MC
authors.lastname: Fernández-Gallego
authors.forename: E Berrobianco
authors.initials: EB
authors.lastname: Cobos
authors.forename: A Delgado
authors.initials: AD
authors.lastname: Romero
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009733:Nursing Diagnosis / Q000706:statistics & numerical data; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011320:Primary Health Care; D012648:Self Care