Concept, Content, and Clinical Validation of the Nursing Diagnosis Impaired Skin Integrity (00046): An Integrative...

PurposeTo identify and synthesize the scientific evidence available in the literature on the NANDA-I nursing diagnosis Impaired Skin Integrity (00046), with a focus on the analysis of its concept validity, content validity, and clinical validity.MethodsAn integrative review with a critical synthesis approach was conducted to investigate the nursing diagnosis Impaired Skin Integrity (00046). The literature search was performed in databases using controlled and free-text terms related to impaired skin integrity and nursing diagnoses. Studies addressing concept analysis, content validation, or clinical validation of the diagnosis were included, with no time restrictions. Data extraction encompassed methodological characteristics, type of validation, diagnostic indicators, and contributions to taxonomic refinement.FindingsFive studies published between 1994 and 2025 met the inclusion criteria, four conducted in Brazil and one originating from the United States. The evidence demonstrated a predominance of content validation studies and clinical validation investigations. No studies addressing concept validation were identified. Across all studies, defining characteristics related to epidermal or cutaneous disruption, impaired skin continuity, and exposure to moisture or mechanical forces were consistently supported. However, variability was observed in the relevance of diagnostic indicators across different populations and care settings. Limited empirical evidence was found regarding related factors, indicating gaps in the etiological structure of the diagnosis.ConclusionThe nursing diagnosis Impaired Skin Integrity shows advanced conceptual development but remains at an intermediate level of empirical maturity. Although defining characteristics are relatively well established, the limited number of clinical validation studies and the insufficient exploration of related factors restrict diagnostic accuracy and taxonomic robustness.