Identification and Development of NANDA-I, NOC, and NIC (NNN) Linkages for the Nursing Diagnosis Chronic Pain Syndrome.

PurposeTo develop NANDA International (NANDA-I), Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC) (NNN) linkages for the Chronic Pain Syndrome (CPS) (00255) nursing diagnosis.MethodsA six-member expert panel, all active members of the NANDA-I Italian Network Group, was purposively selected based on demonstrated expertise in standardized nursing terminologies and clinical or academic background. The study followed the Iowa NNN linkage development process, supported by a narrative literature review across PubMed/MEDLINE, CINAHL, PsycINFO, and Cochrane Library. Panel members developing a structured linkage table, then convening in iterative consensus meetings to reconcile proposals. Final approval required unanimous consensus, followed by a concluding review by the developers of the NOC and NIC classifications (University of Iowa).FindingsThe NNN linkages for the CPS nursing diagnosis were developed. A total of 57 NOC nursing outcomes were identified to guide care based on the syndrome. The following main NOC to measure the resolution of the diagnosis were identified: Comfort Level (2008); Pain Level (2102); Pain: Disruptive Effects (2101); Self-Care: Activities of Daily Living (ADL) (0300); Self-Care: Instrumental Activities of Daily Living (IADL) (0306), along with outcomes addressing defining characteristics, related factors, and 35 nursing interventions, such as Pain Management: Chronic (1415), Relaxation Therapy (6040), Self-Care Assistance (1800), Emotional Support (5270).ConclusionsChronic pain syndrome is a multifaceted condition that significantly affects both individuals and society, and its complexity requires an interdisciplinary approach. Therefore, the identified NNN linkages provide evidence-based guidance for planning and delivering nursing care to effectively manage chronic pain syndrome.Implication for Nursing PracticeThe NNN linkages for the CPS nursing diagnosis serve as a practical, evidence-based resource to improve nursing research, practice and education, as well as support clinical decision-making and documentation. Ultimately, this enhances recognition and visibility of nursing care in the management of patients experiencing chronic pain.