Empowerment and Community Process Diagnosis to Promote Epidemiological Surveillance of Nursing Diagnoses: A MAIEC-Based Study in the Autonomous Region of the Azores, Portugal

Epidemiological Surveillance of Nursing Diagnoses (ESND) represents an emerging field within Community and Public Health Nursing, aiming to strengthen the visibility of nursing‑sensitive phenomena in health information systems. This study applied the Community Assessment, Intervention and Empowerment Model (MAIEC) to evaluate the empowerment level and diagnose the community process of a Primary Health Care Island Unit in the Autonomous Region of the Azores, Portugal, regarding the promotion of ESND. A descriptive, cross‑sectional design was used, combining documental analysis, a community empowerment assessment, and a structured questionnaire administered to 172 nurses. Results revealed substantial gaps in community leadership, including low levels of knowledge about ESND, the Local Health Diagnosis, and documentation in priority ICNP® foci. Community participation indicators showed limited clarity of the ESND process, low awareness of organizational structures and partnerships, and a lack of visible formal leadership. Community coping was characterized by minimal prior ESND experience and low training levels, although more than half of participants identified contextual strengths. Overall, the findings indicate a community with developmental potential but requiring targeted interventions to strengthen leadership, participation, and coping capacities. Enhancing training, communication, and organizational structures will be essential to support the sustainable implementation of ESND and reinforce the contribution of nursing to public health surveillance.