Representing nursing activities within a concept-oriented terminological system: evaluation of a type definition

Area of Science:

• Nursing Informatics
• Terminology Development
• Data Standardization

Background:

• Concept-oriented terminologies require robust type definitions for unambiguous concept representation.
• Comparing data across different terminologies necessitates standardized concept structures.

Purpose of the Study:

• To evaluate the adequacy and utility of a proposed type definition for nursing activity concepts.
• To assess the effectiveness of the type definition in supporting nonambiguous concept representations.

Main Methods:

• Decomposed 1039 nursing activity terms from patient charts and two terminologies (Home Health Care Classification, Omaha System) into proposed type definition attributes: Delivery Mode, Activity Focus, and Recipient.
• Coded attribute presence/absence, Delivery Mode (Explicit/Implicit), and Recipient (Explicit/Implicit/Ambiguous) by multiple raters.
• Calculated inter-rater reliability and summarized data using descriptive statistics.

Main Results:

• The type definition's attributes were present in 73.9% of chart terms and over 90% of Home Health Care Classification terms, but only 63.5% of Omaha System terms.
• Delivery Mode and Activity Focus were consistently present; Recipient was problematic, rated ambiguous in 4.8% (chart), 8.7% (HHCC), and 36.5% (Omaha) of terms.
• Inter-rater reliability calculations indicated varying levels of agreement for attribute coding.

Conclusions:

• The proposed type definition demonstrated adequacy and utility for representing nursing activity concepts.
• Further research is recommended to refine the type definition, particularly the Recipient attribute, for improved use in concept-oriented terminological systems.
• The findings support the development of standardized nursing terminologies for enhanced data interoperability.