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PURPOSE: The purpose of this study was to verify the validity of the content of the proposal for the nursing diagnosis of low self-efficacy in health. METHODS: Content validation study using the approach proposed by Lopes, a panel of 47 experts on the phenomenon of interest analyzed the content of the diagnosis using a Likert-type scale to evaluate the relevance of 16 clinical indicators and 18 etiological factors of the nursing diagnosis under investigation. These components were previously identified and defined through a middle-range theory. Based on the predictive diversity model, the experts' verifications were weighted according to their level of expertise. The pseudomedian and 95% confidence intervals were calculated. A content validity index above 0.9 was considered valid, and the Wilcoxon test was used to validate each pseudomedian with a p-value above 0.05. FINDINGS: Thirteen clinical indicators were considered relevant, demonstrating the importance of these elements for the clinical identification of low self-efficacy in health. Three clinical indicators were excluded because they were not representative for this diagnosis. The eighteen etiological factors analyzed were considered relevant. CONCLUSION: The findings of the present study may help nurses to identify low self-efficacy in health early and direct effective interventions to increase people's confidence in their abilities to promote their health. IMPLICATIONS FOR NURSING PRACTICE: A new diagnostic framework is presented with peer-reviewed content, representing a phenomenon frequently reported by clinicians. This new diagnosis can guide nursing care and produce better health outcomes that depend on patients' confidence in their ability to take care of their own health.

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OBJECTIVES: to analyze the impact of the Colombian Peace Agreement on the structural social determinants of health. METHODS: a descriptive, ecological study, based on documentary data from 2008 to 2018. The records of victims, epidemiological indicators, and structural social determinants of health in Colombia were analyzed. RESULTS: there was a correlation between the period in which the Peace Agreement process was developed and the indicators of structural determinants in health with p<0.05. With the Poisson regression analysis, the favorable correlations between the peace process and the determinants were confirmed, besides allowing the understanding of the changes in these indicators before the Peace Agreement. CONCLUSIONS: the implementation of the peace process has a positive impact on structural social determinants of health, which is observed by the beginning of the decrease of economic, educational, health, and social inequalities and inequities, a fact that offers the possibility of living in peace.

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ABSTRACT Objectives: to analyze the impact of the Colombian Peace Agreement on the structural social determinants of health. Methods: a descriptive, ecological study, based on documentary data from 2008 to 2018. The records of victims, epidemiological indicators, and structural social determinants of health in Colombia were analyzed. Results: there was a correlation between the period in which the Peace Agreement process was developed and the indicators of structural determinants in health with p<0.05. With the Poisson regression analysis, the favorable correlations between the peace process and the determinants were confirmed, besides allowing the understanding of the changes in these indicators before the Peace Agreement. Conclusions: the implementation of the peace process has a positive impact on structural social determinants of health, which is observed by the beginning of the decrease of economic, educational, health, and social inequalities and inequities, a fact that offers the possibility of living in peace.

RESUMEN Objetivos: analizar el impacto del Acuerdo de Paz de Colombia en los determinantes sociales estructurales de la salud. Métodos: estudio descriptivo, ecológico, a partir de datos documentales del periodo de 2008 a 2018. Se analizaron los registros de víctimas, indicadores epidemiológicos y determinantes sociales estructurales en salud de Colombia. Resultados: correlación entre el periodo de tiempo en que se desarrollaron el proceso del Acuerdo de Paz y los indicadores de los determinantes estructurales en salud con p <0,05. Mediante el análisis de regresión de Poisson, se confirmaron las correlaciones favorables entre el proceso de paz y los determinantes mencionados, además de permitir explicar los cambios en dichos indicadores frente al Acuerdo de Paz. Conclusiones: la implementación del proceso de paz impacta favorablemente en los determinantes sociales estructurales de la salud, lo que refleja en el inicio la reducción de las desigualdades e inequidades económicas, educacionales, de salud y sociales, hecho que ofrece la posibilidad de vivir en paz.

RESUMO Objetivos: analisar o impacto do Acordo de Paz da Colômbia nos determinantes sociais estruturais da saúde. Métodos: estudo descritivo, ecológico, a partir de dados documentais do período de 2008 a 2018. Analisaram-se os registros de vítimas, indicadores epidemiológicos e determinantes sociais estruturais em saúde da Colômbia. Resultados: correlação entre o período de tempo em que se desenvolveram o processo de Acordo de Paz e os indicadores dos determinantes estruturais em saúde com p<0.05. Com a análise da regressão de Poisson, confirmaram-se as correlações favoráveis entre o processo de paz e os mencionados determinantes, além de permitir explicar as mudanças nesses indicadores perante o Acordo de Paz. Conclusões: a implementação do processo de paz tem impacto favorável nos determinantes sociais estruturais da saúde, o que reflete no início da redução das desigualdades e iniquidades econômicas, educacionais, de saúde e sociais, fato que oferece a possibilidade de viver em paz.

RESUMO

OBJECTIVES: theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct. METHODS: construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles. RESULTS: eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health. CONCLUSIONS: the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined.

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ABSTRACT Objectives: theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct. Methods: construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles. Results: eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health. Conclusions: the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined.

RESUMO Objetivo: validação teórica do conceito de baixa autoeficácia em saúde como um construto diagnóstico de enfermagem. Métodos: construção de uma teoria de médio alcance para validação de diagnósticos compreendendo cinco etapas: definição da abordagem para a construção de teoria, definição de conceitos-chaves, construção de um diagrama pictórico, formulação de proposições, estabelecimento de relações causais e evidências para a prática. Os principais conceitos foram descritos por meio de uma revisão de literatura. Os estudos foram retirados das bases de dados LILACS, SCOPUS, CINAHL e PubMed/MEDLINE obtendo uma amostra final de 92 artigos. Resultados: foram identificados dezoito fatores etiológicos e dezesseis indicadores clínicos, caracterizados em antecedentes e as manifestações para a inferência diagnóstica de baja autoeficácia em saúde. Conclusões: foram identificados e definidos os conceitos relacionados ao novo diagnóstico de enfermagem de baixa autoeficácia em saúde a ser aplicado na prática clínica de enfermagem.

RESUMEN Objetivos: validación teórica del concepto de baja autoeficacia en salud como un constructo diagnóstico de enfermería Métodos: construcción de una teoría de rango medio para validación de diagnósticos que comprende cinco etapas: definición del abordaje de construcción de la teoría, definición de los conceptos principales, construcción de un pictograma, formulación de proposiciones, establecimiento de las relaciones de causalidad y la evidencia para la práctica. Los conceptos principales fueron descritos por medio de una revisión de literatura. Los estudios fueron tomados de las bases de datos LILACS, SCOPUS, CINAHL y PubMed/MEDLINE. Obteniendo la muestra final de 92 artículos. Resultados: se identificaron dieciocho factores etiológicos y dieciséis indicadores clínicos; caracterizados en antecedentes y las manifestaciones para la inferencia diagnóstica de baja autoeficacia en salud. Conclusiones: se identificaron y definieron los conceptos relacionados del nuevo diagnóstico de enfermería de baja autoeficacia en salud, para ser aplicados en la práctica clínica de enfermería.