Representing nursing activities within a concept-oriented terminological system: Evaluation of a type definition

Objective: A type definition, as a component of the categorical structures of a concept-oriented terminology, must support nonambiguous concept representations and, consequently, comparisons of data that are represented using different terminologies. The purpose of the study was to evaluate the adequacy and utility of a proposed type definition for nursing activity concepts. Design: Nursing activity terms (n = 1039) from patient charts and intervention terms from two nursing terminologies (Home Health care Classification and Omaha System) were decomposed into the attributes of the proposed type definition--Delivery Mode, Activity Focus, and Recipient. Measurements: Attributes of the type definition were coded as present or absent for each term by multiple raters. In addition, Delivery Mode was rated as Explicit or Implicit and Recipient was rated as Explicit, Implicit, or Ambiguous. The data were summarized using descriptive statistics. Inter-rater reliabilities were calculated for each attribute of the type definition. Results: All attributes of the type definition were present in 73.9 percent of the chart terms, 91.3 percent of Home Health Care Classification intervention terms, and 63.5 percent of Omaha System intervention terms. While Delivery Mode and Activity Focus were almost universally present, Recipient was problematic. It was rated as ambiguous in 4.8 percent of the chart terms, 8.7 percent of Home Health Care Classification intervention terms, and 36.5 percent of Omaha System intervention terms. Conclusions: The study findings supported the adequacy and utility of the type definition. Further research is needed' to refine the type definition and its use for representing nursing activity concepts within a concept-oriented terminological system.