The middle-range theory of the nursing diagnosis "ineffective health self-management".
Rebecca Stefany da Costa, Harlon França de Menezes, Nanete Caroline da Costa Prado and 4 others
PMID 40667911WHAT IT FOUND
A nursing framework for people living with HIV describes ineffective health self-management as difficulty, failure, abandonment, or refusal to reach agreed health goals.
It maps factors such as stigma, mental disorders, and access barriers to outcomes including viral resistance.
Key findings
01The scoping review identified five essential attributes of ineffective health self-management in people living with HIV.
02The framework defined ineffective health self-management as difficulty, failure, abandonment, or refusal to achieve agreed-upon health goals.
03The framework mapped factors that precede and follow the diagnosis across four adaptation modes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a theory development paper, not a study of patients or nurses, so it does not test whether the framework works. The framework has not been validated against empirical data. The review relied on secondary, open-access articles, so original data were not reassessed and the sample may be small. The included studies were heterogeneous and varied in quality, which limits how firmly the concepts can be generalized. The paper reports inconsistent counts for antecedents and consequences in different sections.
The easy way to misread this
Do not read this framework as proof that assessing these factors or applying the theory improves HIV self-management, adherence, or health outcomes. The paper develops a theory from published articles and states it has not been validated against empirical data.