Labor Pain as a New Nursing Diagnosis: Conceptual and Content Validation

Tuesday, 23 July 2013: 1:50 PM

Emilia Campos Carvalho, PhD
Department of General and Specialized Nursing, University of São Paulo - Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
Simone Roque Mazoni, PhD
Nursing Undergraduate Program, Faculdades Integradas Padre Albino, Catanduva, Brazil

Learning Objective 1: The learner will be able to identify the elements of the concept labor pain and how to measure it.

Learning Objective 2: The learner will be able to differentiate the phenomena labor pain and chronic pain

Purpose: Labor pain has different clinical evidence of the Acute Pain nursing diagnosis . Our objectives were to build the concept labor pain and  to develop the content validation.

Methods: Phase A Analysis of concepts as proposed by Walker & Avant (2005). Phase B- The content validation followed the recommendations of Fehring (1986). The diagnosis was submitted to experts in the area of obstetric nursing.

Results: The concept "labor pain" should be included in the Domain 12 – Comfort and to the   Class 1 - Physical Comfort. The definition presents the attributes, antecedents, consequences and empirical antecedents.  The Related Factors proposed are: period of dilatation and period of expulsion. 24 Defining Characteristics (DCs) were identified in the literature. Nine of them were very indicative of the diagnosis (score >0.80): observed evidence of uterine contraction, altered muscle tone, change in respiratory rate, change in heart rate, expressive behavior, facial expression of pain, observed evidence of pain, diaphoresis and verbal or coded report. Another 12 CDs were validated (score >0,50 to = 0,80): change in blood pressure, distraction behavior, protective gestures/defensive behavior, focus on yourself, sleep disturbance, nausea, vomiting, loss of appetite, narrowed focus, antalgic position, changes in urinary function, changes in endocrine function. And 3 DCs were considered not representative.(score < or = 0,50) .


The construction of the concept "labor pain" and the evidences observed in the process of validation justify the proposal of this new diagnosis to the NANDA-I taxonomy.


1-Walker, L. O., & Avant, K. C. (2005). Strategies for theory construction in nursing  (4th edn.). Norwalk, CT: Appleton & Lange.

2-Fehring, R. (1986). Validating diagnostic labels: standardized methodology. Proceedings of the sixth conference: Classification of Nursing Diagnosis, St. Louis, Missouri, USA, 183-190.