From validity to the construction of levels of evidence
a contemporary history of a methodological shift
DOI:
https://doi.org/10.51234/here.2026.v17.532Keywords:
History of Nursing, Nursing Diagnosis, Nursing Research, Standardized Nursing Terminology, Validation StudyAbstract
Objective: to historically analyze the process of constructing and developing the levels of evidence of nursing diagnoses within the international classification system, with emphasis on the conceptual, methodological, and institutional shifts that integrated validity, expertise, causality, and nursing diagnosis research. Method: a qualitative historical-documentary study grounded in contemporary history, intellectual history, the social history of science, and the history of concepts. The corpus comprised unpublished narrative sources, scientific publications, diagnostic classification system editions, methodological studies, literature on validity, measurement theory, expertise, and judgment aggregation, as well as available institutional documents. The sources underwent external and internal criticism, were organized into a chronological-thematic matrix, and were triangulated to identify milestones, key actors, academic networks, continuities, discontinuities, and conceptual changes. Results: the documentary reconstruction showed that the revision of levels of evidence resulted from a historical and methodological maturation process that integrated critiques of classical validity methods, the reassessment of experts’ role, theories of validity and measurement, diagnostic causality, middle-range theories, and the international dissemination of Brazilian research groups. Final considerations: levels of evidence constitute scientific, methodological, institutional, and historical artifacts characterized by continuities and discontinuities in nursing diagnosis research.
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