J Vis Exp. 2026 May 15;(231). doi: 10.3791/70768.
ABSTRACT
"Ineffective Peripheral Tissue Perfusion" is a recognized NANDA-I nursing diagnosis, but its diagnostic accuracy for diabetic foot patients lacks evidence-based support. This study aimed to evaluate the diagnostic accuracy of this nursing diagnosis in hospitalized diabetic foot patients. A retrospective study of 89 diabetic foot patients was conducted from January 2023 to December 2024. Trained nurses independently applied the NANDA-I diagnosis. Transcutaneous oxygen pressure (TcPO₂) < 30 mmHg served as the gold standard. Receiver operating characteristic (ROC) curves were plotted to calculate the area under the curve (AUC), sensitivity, and specificity for the overall diagnosis and for each of its 12 defining characteristics. The top three characteristics were combined into a new diagnostic model. Compared to the TcPO₂ gold standard, the nursing diagnosis showed a sensitivity of 83.33% and a specificity of 86.96%, with an AUC of 0.851. Among the diagnostic performances of the 12 defining characteristics, "Color does not return to lowered limb after 1 min leg elevation" had the best performance (AUC=0.881), followed by "Edema" (AUC=0.835), and "Absence of peripheral pulses" had moderate performance (AUC=0.712). The combined diagnosis had a sensitivity of 84.85%, a specificity of 91.30%, PLR and NLR values of 9.76 and 0.17, respectively, and an increased AUC of 0.904, indicating superior overall diagnostic performance of the combined diagnosis. The AUC of the combined diagnosis was 0.053 higher than that of the nursing diagnosis, with a statistically significant difference (p=0.048). The nursing diagnosis "Ineffective Peripheral Tissue Perfusion" is a valid tool for assessing diabetic foot patients. However, a focused assessment for "Color does not return to lowered limb after 1 min leg elevation," "Edema," and "Absence of peripheral pulses" provide even greater diagnostic accuracy.
PMID:42224126 | DOI:10.3791/70768