Content validity and nursing sensitivity of community-level outcomes from the Nursing Outcomes Classification (NOC)

Document Type


Peer Reviewed


Publication Date


NLM Title Abbreviation

J Nurs Scholarsh

Journal/Book/Conference Title

Journal of nursing scholarship

PubMed ID


DOI of Published Version


Start Page


End Page



PURPOSE: To evaluate the content validity and nursing sensitivity of six community-level outcomes from the Nursing Outcomes Classification (NOC; Johnson, Maas, & Moorhead, 2000). DESIGN AND METHODS: A survey research design was used. Questionnaires were mailed to 300 public health nursing experts; 102 nurses responded. Experts evaluated between 11 and 30 indicators for each of the six outcomes for: (a) importance of the indicators for measuring the outcome, and (b) influence of nursing on the indicators. Content validity and nursing sensitivity of the outcomes were estimated with a modified Fehring technique. FINDINGS: All outcomes were deemed important; only Community Competence had an outcome content validity score < .80. The outcome sensitivity score for Community Health: Immunity was .80; other outcome scores ranged from .62-.70. Indicator ratios for all 102 indicators met the study criterion for importance, with 87% designated as critical and 13% as supplemental. Sensitivity ratios reflected judgments that 45% of the indicators were sensitive to nursing intervention. CONCLUSIONS: The study provided evidence of outcome content validity and nursing sensitivity of the study outcomes; further validation research is recommended, followed by testing of the study outcomes in clinical practice. Community-level nursing-sensitive outcomes will potentially enable study of the efficacy and effectiveness of public health interventions focused on improving health of populations and communities.


Attitude of Health Personnel, Chronic Disease/nursing, Clinical Competence/standards, Communicable Disease Control/standards, Health Status, Humans, Immunization/standards, Lead Poisoning/etiology/prevention & control, Nurse's Role, Nurses/psychology, Nursing Evaluation Research/methods/standards, Outcome Assessment (Health Care)/classification/methods/standards, Public Health Nursing/education/organization & administration, Quality Indicators, Health Care/classification/standards, Questionnaires, Risk Factors, Sensitivity and Specificity

Published Article/Book Citation

Journal of nursing scholarship, 36:3 (2004) pp.251-259.

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