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Dantas AVVC, Farias LJR, de Paula SJ, Moreira RP, da Silva VM, Lopes MVDO, Guedes NG. Nursing Diagnosis of Neonatal Jaundice: Study of Clinical Indicators. J Pediatr Nurs 2018; 39:e6-e10. [PMID: 29248302 DOI: 10.1016/j.pedn.2017.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 12/01/2017] [Accepted: 12/02/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to identify the defining characteristics of, and examine their association with, the nursing diagnosis (ND) of Neonatal Jaundice (00194) in sample of hospitalized newborns. DESIGN AND METHODS A cross-sectional study developed with 100 newborns aged between 24h and ten days. Data collection was performed in a public hospital of tertiary health care between March and June of 2016. RESULTS The ND of Neonatal jaundice was present in 31% of the sample. The most frequent defining characteristics were yellow-orange skin color (65%) and abnormal blood profile (75%). Yellow mucous membranes, yellow-orange skin color and bruised skin showed statistically significant sensitivity and specificity. Yellow mucous membranes, yellow sclera and yellow-orange skin color were statistically associated with Neonatal jaundice. Yellow mucous membranes showed the best diagnostic accuracy measurements. CONCLUSIONS The clinical indicators that best predicted and increased the probability of developing jaundice were identified. PRACTICE IMPLICATIONS These clinical indicators increase the ability of nurses to clinically infer nursing diagnoses. This allows nurses to identify signs and symptoms of health conditions in a sensible and definitive manner, decreasing the possibility of errors.
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Pascoal LM, de Oliveira Lopes MV, Chaves DBR, Beltrão BA, Nunes MM, da Silva VM, de Sousa Freire VEC. Impaired Gas Exchange: Prognostic Clinical Indicators of Short-Term Survival in Children with Acute Respiratory Infection. Int J Nurs Knowl 2018; 30:87-92. [PMID: 29427536 DOI: 10.1111/2047-3095.12203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To establish prognostic indicators of survival for impaired gas exchange (IGE) (00030). METHODS Secondary analysis of data from an open prospective cohort developed with a group of 136 children with acute respiratory infection (ARI). FINDINGS On Day 1, IGE (00030) was present in 42.6% of the sample. New cases arose until the last day of evaluation. With regards to defining characteristics, only hypoxemia and abnormal skin color were associated with a higher risk of developing diagnosis. CONCLUSIONS Children with ARI who exhibit hypoxemia and abnormal skin color had a worse prognosis for IGE (00030). IMPLICATIONS FOR NURSE PRACTICE Nurses can use the research findings as a predictive marker of the evolution of the patient's health status.
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Aquino WKMD, Lopes MVDO, Silva VMD, Fróes NBM, Menezes APD, Almeida ADAP, Sobreira BA. Accuracy of the defining characteristics in nursing diagnoses of Hyperthermia in newborns. Rev Bras Enferm 2018; 71:357-362. [PMID: 29412294 DOI: 10.1590/0034-7167-2017-0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/30/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to clinically validate the accuracy of the defining characteristics in nursing diagnoses of Hyperthermia in newborns. METHOD a cross-sectional study conducted in units of medium and high risk in a maternity from the city of Fortaleza-CE. A total of 216 newborns were evaluated to identify the defining characteristics of diagnoses. A latent class model with random effects was used to measure sensitivity and specificity. RESULTS Hyperthermia was present in 5.6% of the sample. The characteristics lack of suction maintenance (31.3%); skin warm to touch (25.5%); lethargy (24.2%); and tachypnea (21.4%) were the most frequent. Stupor presented higher sensitivity (99.9%) and specificity (100%) while vasodilation characteristics, irritability and lethargy only showed significant values for specificity (92.7%, 91.6% and 74.3%, respectively). CONCLUSION four characteristics of high specificity contribute to Hyperthemia. However, stupor is the only one with significant sensitivity to identify it at its early-stage.
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Rocha SR, Santos MCL, Lopes MVDO, Rodrigues AB, Sousa VECD, Aquino CBDQ, Mendes CRS. Accuracy of the defining characteristics of the nursing diagnosis for fatigue in women under radiotherapy. Rev Bras Enferm 2018; 71:1445-1452. [DOI: 10.1590/0034-7167-2017-0549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/13/2017] [Indexed: 01/24/2023] Open
Abstract
ABSTRACT Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis for “fatigue in women with breast cancer under radiotherapy”. Method: Study of diagnostic accuracy, with cross-sectional design, performed in 130 women with breast cancer under radiation treatment. A data collection instrument was used to evaluate clinical socio-demographics and to investigate the presence or absence of defining characteristics for fatigue. The latent class analysis model was applied to assess accuracy measurements of the characteristics identified. Results: Fatigue diagnosis was present in 21.9% of the women. The characteristic which showed the highest sensitivity was “Impaired capacity in maintaining the usual level of physical activity”, while “Impaired capacity in maintaining usual routines” and “Lack of interest about the surrounding environment” presented greater specificity. Conclusion: Accurate diagnostics allow devising an action plan directed to the patients' real needs.
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Seganfredo DH, Beltrão BA, Silva VMD, Lopes MVDO, Castro SMDJ, Almeida MDA. Analysis of ineffective breathing pattern and impaired spontaneous ventilation of adults with oxygen therapy. Rev Lat Am Enfermagem 2017; 25:e2954. [PMID: 29211196 PMCID: PMC5738874 DOI: 10.1590/1518-8345.1950.2954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 08/27/2017] [Indexed: 12/05/2022] Open
Abstract
Objective: to analyze the manifestation of the defining characteristics of the nursing
diagnoses of ineffective breathing pattern and impaired spontaneous ventilation,
of the NANDA International and the defining characteristics identified in the
literature for the concept of “ventilation” in adult patients hospitalized in an
intensive care unit with use of oxygen therapy. Method: clinical diagnostic validation study, conducted with 626 patients in intensive
care using oxygen therapy, in three different modalities. Multiple correspondence
analysis was used to verify the discriminative capacity of the defining
characteristics and latent class analysis to determine the diagnostic accuracy of
them, based on the severity level defined by the ventilatory mode used. Results: in the multiple correspondence analysis, it was demonstrated that the majority of
the defining characteristics presented low discriminative capacity and low
percentage of explained variance for the two dimensions (diagnoses). Latent class
models, separately adjusted for the two diagnoses, presented a worse fit, with
sharing of some defining characteristics. Models adjusted by level of severity
(ventilation mode) presented better fit and structure of the component defining
characteristics. Conclusion: clinical evidence obtained in the present study seems to demonstrate that the set
of defining characteristics of the two nursing diagnoses studied fit better in a
single construct.
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Nunes MM, Leandro TA, Lopes MVDO, Silva VMD. Clinical indicators for nursing diagnosis Ineffective protection in adolescents with cancer. Rev Bras Enferm 2017; 70:1330-1336. [DOI: 10.1590/0034-7167-2016-0571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/09/2017] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To investigate scientific evidence related to the term protection and clinical indicators and etiologic factors for nursing diagnosis Ineffective protection in adolescents with cancer. Method: Integrative literature review in the databases of Scopus, Web of Science, National Library of Medicine and National Institutes of Health (PubMed) and Cochrane; by intersection of the descriptors protection and childhood cancer, which resulted in seven articles. These were insufficient for a comprehension of the term protection and aspects related to its impairment, therefore it was necessary to include a further three reference books. Results: Five clinical indicators and three etiologic factors associated to Ineffective protection were identified some of which were not cited in NANDA-International. Conclusions: There are clinical and etiologic factors important for the identification of ineffective protection in adolescents with cancer.
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Monteiro FPM, Araujo TLD, Costa FBC, Leandro TA, Cavalcante TF, Lopes MVDO. Clinical validation of nursing diagnosis "Willingness for improved infant development". Rev Bras Enferm 2017; 69:855-863. [PMID: 27783727 DOI: 10.1590/0034-7167-2015-0131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/20/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: to conduct the clinical validation of nursing diagnosis "Willingness for improved infant development". Method: a cross-sectional study, conducted in a Centro de Saúde da Família (Family Health Care center), with 45 healthy breastfed infants. The instrument for collecting the data was prepared based on the literature and validated by nurses. It contained the following variables: sociodemographic, gestational, and obstetrical variables; breastfed infant's nutritional profile; evaluation of the defining characteristics of the proposed nursing diagnosis. Results: all the defining characteristics were found to have high sensitivity values (>90%), positive predictive values (>65%), negative predictive values (>66%); however, low specificity values (<32%). In this study, the defining characteristics we found to have estimates (>0.50) within the ROC curve, which provides good sensitivity and specificity. Conclusion: this study verified the structural elements of the proposed nursing diagnosis to be relevant in the clinical context, which justifies the need for its being employed with children, taking into account its contribution to improving nursing care.
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Oliveira-Kumakura ARDS, de Araujo TL, Costa AGDS, Cavalcante TF, Lopes MVDO, Carvalho EC. Clinical Validation of the Nursing Outcome "Swallowing Status" in People with Stroke: Analysis According to the Classical and Item Response Theories. Int J Nurs Knowl 2017; 29:234-241. [PMID: 28926191 DOI: 10.1111/2047-3095.12184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/27/2017] [Accepted: 07/07/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To validate clinically the nursing outcome "Swallowing status". METHODS The adjustment of the nursing outcome was investigated according to the Classical and Item Response Theories. The models were compared regarding information loss, goodness-of-fit, and differential item functioning. Stability and internal consistency were examined. RESULTS The nursing outcome has the best fit in the generalized partial credit model with different discrimination parameters. Strong correlations among the scores of each indicator were observed. There was no differential item functioning of the outcome indicators. The scale presented high internal consistency (Cronbach's α = .954) and stability (and > .800). CONCLUSIONS This study presents a valid nursing outcome. RELEVANCE TO CLINICAL PRACTICE Most accurate monitoring of sensitivity to an intervention. OBJETIVO Validar clinicamente o resultado de enefermagem "Estado da Deglutição". MÉTODOS: O ajustamento do resultado foi investigado de acordo com as teorias Clássica e de Resposta ao Item. Os modelos foram comparados assumindo parâmetros de itens cruzados de igual discriminação. Investigaram-se as propriedades de bondade do ajuste, funcionamento diferencial dos itens, estabilidade e consistência interna. RESULTADOS O resultado se ajustou melhor a partir do Modelo de crédito parcial generalizado, o qual demonstrou unidimensionalidade do resultado e forte correlação entre os escores de cada indicador. Não houve funcionamento diferencial dos indicadores. A consistência interna para a escala global (Cronbach's α = .954) e a estabilidade (>.800) mantiveram-se elevadas. CONCLUSÃO: O estudo apresenta um resultado de enfermagem válido. RELEVÂNCIA PARA A PRÁTICA CLÍNICA: Maior acurácia para monitorar a sensibilidade da intervenção.
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de Aquino WKM, Lopes MVDO, da Silva VM, Fróes NBM, de Menezes AP, Almeida ADAP, Sobreira BA. Accuracy of the Defining Characteristics of the Nursing Diagnosis Hypothermia in Newborns. Int J Nurs Knowl 2017; 30:21-27. [PMID: 28922580 DOI: 10.1111/2047-3095.12188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To analyze the accuracy of the defining characteristics of hypothermia in newborns and to verify associations between defining characteristics and clinical variables. METHODS A cross-sectional accuracy study with statistical analysis. FINDINGS Slow capillary refill, decrease in ventilation, peripheral vasoconstriction, and insufficient weight gain were the defining characteristics with the highest specificity values, while slow gastric emptying, skin cool to touch, irritability, and bradycardia were the defining characteristics with the highest values for both sensitivity and specificity. CONCLUSION Slow gastric emptying, skin cool to touch, irritability, and bradycardia are good clinical indicators to infer initial stages of hypothermia and to confirm its presence. IMPLICATIONS FOR NURSING PRACTICE Accuracy measures may contribute to the improvement of the diagnostic inferential process. OBJETIVO Analisar acurácia das características definidoras de Hipotermia em recém-nascidos e identificar a associação delas com variáveis clínicas. MÉTODO: Estudo de acurácia transversal com análise estatística. RESULTADOS Preenchimento capilar lento, diminuição da ventilação, vasoconstrição periférica e ganho de peso insuficiente apresentaram valores altos de especificidade enquanto esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia apresentaram valores elevados de sensibilidade e especificidade. CONCLUSÃO: Esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia são úteis para inferir estágios iniciais de hipotermia e para confirmação diagnóstica. IMPLICAÇÕES PARA PRÁTICA DE ENFERMAGEM: Medidas de acurácia podem contribuir para o processo de inferência do diagnóstico hipotermia.
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Lima ACS, Martins LCG, Lopes MVDO, Araújo TLD, Lima FET, Aquino PDS, Moura ERF. Influence of hormonal contraceptives and the occurrence of stroke: integrative review. Rev Bras Enferm 2017; 70:647-655. [DOI: 10.1590/0034-7167-2016-0056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 11/02/2016] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke. Method: Integrative review of the literature, through database search using the descriptors "contraceptive agents", "contraceptive devices", "contraceptives, Oral" and "Stroke". Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded. Results: Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk. Conclusion: Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe.
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Fernandes MIDCD, Soares CDS, Tinôco JDDS, Delgado MF, Paiva MDGMND, Lopes MVDO, Lira ALBDC. Excess fluid volume: sociodemographic and clinical analysis in haemodialysis patients. Rev Bras Enferm 2017; 70:15-21. [DOI: 10.1590/0034-7167-2015-0138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 07/17/2016] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyse the defining characteristics and related factors in the nursing diagnosis Excess fluid volume and its relationship to sociodemographic and clinical variables in haemodialysis patients. Method: Cross-sectional study, conducted using a form and physical examination, with a sample of 100 patients, between December 2012 and April 2013 at a university hospital and a dialysis clinic. Results: It was found 10 significant statistical associations between the defining characteristics/ related factors of Excess fluid volume and the sociodemographic and clinical variables. Conclusion: The defining characteristics and related factors of Excess fluid volume could be influenced by sociodemographic and clinical variables in haemodialysis clientele.
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Pascoal LM, Lopes MVDO, da Silva VM, Beltrão BA, Chaves DBR, Herdman TH, Lira ALBDC, Teixeira IX, Costa AGDS. Clinical indicators of ineffective airway clearance in children with acute respiratory infection. J Child Health Care 2016; 20:324-32. [PMID: 26311487 DOI: 10.1177/1367493515598648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The identification of clinical indicators with good predictive ability allows the nurse to minimize the existing variability in clinical situations presented by the patient and to accurately identify the nursing diagnosis, which represents the true clinical condition. The purpose of this study was to analyze the accuracy of NANDA-I clinical indicators of the nursing diagnosis ineffective airway clearance (IAC) in children with acute respiratory infection. This was a prospective cohort study conducted with a group of 136 children and followed for a period of time ranging from 6 to 10 consecutive days. For data analysis, the measures of accuracy were calculated for clinical indicators, which presented statistical significance in a generalized estimated equation model. IAC was present in 91.9% of children in the first assessment. Adventitious breath sounds presented the best measure of accuracy. Ineffective cough presented a high value of sensitivity. Changes in respiratory rate, wide-eyed, diminished breath sounds, and difficulty vocalizing presented high positive predictive values. In conclusion, adventitious breath sounds showed the best predictive ability to diagnose IAC in children with respiratory acute infection.
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Leandro TA, Araujo TLD, Cavalcante TF, Lopes MVDO, Oliveira TMFD, Lopes ACM. [Nursing diagnoses of urinary incontinence in patients with stroke]. Rev Esc Enferm USP 2016; 49:924-32. [PMID: 27419675 DOI: 10.1590/s0080-623420150000600007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/23/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Identifying the prevalence of Stress urinary incontinence (SUI), Urge urinary incontinence (UUI), Functional urinary incontinence (FUI), Overflow urinary incontinence (OUI) and Reflex urinary incontinence (RUI) nursing diagnoses and their defining characteristics in stroke patients. METHOD A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference. RESULTS 92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%), followed by FUI (53.2%), RUI (50.0%), UUI (41.0%) and SUI (37.8%). Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified. CONCLUSION The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.
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Pascoal LM, de Carvalho JPA, de Sousa VEC, Santos FDRP, Lima Neto PM, Nunes SFL, Lopes MVDO. Ineffective airway clearance in adult patients after thoracic and upper abdominal surgery. Appl Nurs Res 2016; 31:24-8. [PMID: 27397814 DOI: 10.1016/j.apnr.2015.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/19/2015] [Accepted: 11/24/2015] [Indexed: 11/25/2022]
Abstract
AIM The aim of this study is to analyze the accuracy of the defining characteristics of ineffective airway clearance (IAC) in patients after thoracic and upper abdominal surgery. BACKGROUND Although numerous studies have described the most prevalent respiratory NANDA-I diagnoses, only few investigates the precision of nursing assessments. METHODS A cross-sectional study was conducted with 192 patients in a surgical clinic. Accuracy measures were obtained by the latent class analysis method. RESULTS IAC was present in 46.73% of the sample. The defining characteristics with better predictive capacity were changes in respiratory rate and changes in respiratory rhythm. However, other defining characteristics also had high specificity, such as restlessness, cyanosis, excessive sputum, wide-eyed, orthopnea, adventitious breathing sounds, ineffective cough, and difficulty vocalizing. CONCLUSION Results can contribute to the improvement of nursing assessments by providing information about the key clinical indicators of IAC.
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de Sousa VEC, de Oliveira Lopes MV, Keenan GM, Lopez KD. Developing and Testing of a Software Prototype to Support Diagnostic Reasoning of Nursing Students. Int J Nurs Knowl 2016; 29:124-132. [DOI: 10.1111/2047-3095.12145] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/23/2016] [Accepted: 04/04/2016] [Indexed: 11/29/2022]
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91
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Mangueira SDO, Lopes MVDO. Clinical validation of the nursing diagnosis of dysfunctional family processes related to alcoholism. J Adv Nurs 2016; 72:2401-12. [DOI: 10.1111/jan.12999] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
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Castelo Guedes Martins L, Venícios de Oliveira Lopes M, Gomes Guedes N, Paixão de Menezes A, de Oliveira Farias O, Alves Dos Santos N. Classification tree for the assessment of sedentary lifestyle among hypertensive. INVESTIGACION Y EDUCACION EN ENFERMERIA 2016; 34:113-119. [PMID: 28569980 DOI: 10.17533/udea.iee.v34n1a13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 12/04/2015] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To develop a classification tree of clinical indicators for the correct prediction of the nursing diagnosis "Sedentary lifestyle" (SL) in people with high blood pressure (HTN). METHODS A cross-sectional study conducted in an outpatient care center specializing in high blood pressure and Mellitus diabetes located in northeastern Brazil. The sample consisted of 285 people between 19 and 59 years old diagnosed with high blood pressure and was applied an interview and physical examination, obtaining socio-demographic information, related factors and signs and symptoms that made the defining characteristics for the diagnosis under study. The tree was generated using the CHAID algorithm (Chi-square Automatic Interaction Detection). RESULTS The construction of the decision tree allowed establishing the interactions between clinical indicators that facilitate a probabilistic analysis of multiple situations allowing quantify the probability of an individual presenting a sedentary lifestyle. The tree included the clinical indicator Choose daily routine without exercise as the first node. People with this indicator showed a probability of 0.88 of presenting the SL. The second node was composed of the indicator Does not perform physical activity during leisure, with 0.99 probability of presenting the SL with these two indicators. The predictive capacity of the tree was established at 69.5%. CONCLUSION Decision trees help nurses who care HTN people in decision-making in assessing the characteristics that increase the probability of SL nursing diagnosis, optimizing the time for diagnostic inference.
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Medeiros ABDA, Frazão CMFDQ, Fernandes MIDCD, Andriola IC, Lopes MVDO, Lira ALBDC. Association of socioeconomic and clinical factors and tissue integrity outcome of patients with ulcers. REVISTA GAUCHA DE ENFERMAGEM 2016; 37:e54105. [PMID: 26934612 DOI: 1590/1983-1447.2016.01.54105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 09/30/2015] [Indexed: 11/24/2022]
Abstract
Objective to analyze the association between socioeconomic and clinical factors and indicators of the tissue integrity outcome in nursing among patients with venous ulcers. Methods a cross-sectional study at a university hospital in Natal, RN, Brazil, from February to June 2012, with 50 individuals. To analyze the variables, we used the Spearman correlation test and the Mann-Whitney and Kruskal-Wallis tests at a level of 5%. Results there was a correlation of low intensity between age and the indicators hydration and skin peeling, and family income and necrosis. There was also an association between gender and the indicators temperature, amount of body hair and exudation. Conclusion the associated variables provide important information for the treatment of patients with venous ulcers, and can help reduce ulcer time and the consequent discomfort, limitations and costs. This information should be considered when providing care for patients with a nursing diagnosis of impaired skin integrity and/or impaired tissue integrity.
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Chaves DBR, Beltrão BA, Pascoal LM, Oliveira ARDS, Andrade LZC, Santos ACBD, Moura KKMD, Lopes MVDO, Silva VMD. Características definidoras do diagnóstico de enfermagem "desobstrução ineficaz de vias aéreas". Rev Bras Enferm 2016; 69:92-8. [DOI: 10.1590/0034-7167.2016690114i] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: analisar as características definidoras do diagnóstico de enfermagem "desobstrução ineficaz de vias aéreas" em crianças com infecção respiratória aguda. Método: estudo transversal, descritivo, desenvolvido em dois hospitais especializados no atendimento a crianças. Realizou-se avaliação respiratória detalhada da criança para a identificação das características definidoras do diagnóstico em estudo. Resultados: foram avaliadas 249 crianças, sendo 55,8% do sexo masculino e com mediana de idade de 13,76 meses. Desobstrução ineficaz de vias aéreas foi identificado em 222 crianças (89,2%). As seguintes características definidoras apresentaram associação estatisticamente significante: dispneia, expectoração, ortopneia, ruídos adventícios respiratórios, sons respiratórios diminuídos e tosse ineficaz. Sons respiratórios diminuídos, tosse ineficaz e ruídos adventícios respiratórios compuseram o modelo de regressão logística. Conclusão: as características sons respiratórios diminuídos, tosse ineficaz e ruídos adventícios respiratórios apresentam melhor capacidade de predição para o diagnóstico "desobstrução ineficaz de vias aéreas" em crianças com infecção respiratória aguda.
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Viana Cardoso Dantas AV, Barreto de Castro N, Martins da Silva V, Moreira Leitão Cardoso MVL, Gomes Guedes N, de Oliveira Lopes MV, Oliveira de Araújo N. Educational Booklet On Neonatal Jaundice: An Approach For Caregivers. Int Arch Med 2016. [DOI: 10.3823/2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Pascoal LM, Lopes MVDO, da Silva VM, Chaves DBR, Beltrão BA, Nunes MM, de Moura KKM. Clinical Differentiation of Respiratory Nursing Diagnoses among Children with Acute Respiratory Infection. J Pediatr Nurs 2016; 31:85-91. [PMID: 26346618 DOI: 10.1016/j.pedn.2015.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/27/2015] [Accepted: 08/06/2015] [Indexed: 11/16/2022]
Abstract
The aim of this study was to identify the defining characteristics that allow clinical differentiation of the nursing diagnoses, ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE). A secondary analysis with a cohort design was developed from 1128 records obtained during the hospital stay of 136 children with acute respiratory infection. Groups of defining characteristics with greater differentiation capacity were identified by multiple correspondence analyses. The results showed that the defining characteristics that better differentiate the studied diagnoses are agitation, irritability and diaphoresis for IGE; dyspnea, use of accessory muscles to breathe, orthopnea, and abnormal breathing pattern for IBP and excessive sputum, absence of cough, difficulty verbalizing, nasal flaring, and adventitious breath sounds for IAC. Twelve defining characteristics that can assist clinicians to differentiate the three main respiratory nursing diagnoses among children with acute respiratory infection were identified in this study.
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Tamboril ACR, Alcântara JADS, Áfio ACE, Sousa CSPD, Rebouças LN, Moura ERF, Lopes MVDO. Diagnóstico de enfermagem Conhecimento Deficiente em usuárias de anticoncepcional oral combinado. REVISTA ELETRÔNICA DE ENFERMAGEM 2015. [DOI: 10.5216/ree.v17i4.31786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivou-se analisar a acurácia das características definidoras do diagnóstico de enfermagem “Conhecimento Deficiente” em usuárias de AOC. Estudo transversal realizado com 97 mulheres em idade fértil em centro de saúde da família do nordeste brasileiro. A coleta de dados ocorreu de setembro a outubro de 2011, por meio de entrevista para identificação das características definidoras e dos fatores relacionados da Taxonomia II da NANDA-I 2012. O diagnóstico de enfermagem em questão apresentou prevalência de 58,8%; a característica definidora “seguimento inadequado de instruções” (57,7%) e o fator relacionado “interpretação errônea de informações” (58,8%) foram os mais prevalentes. “Seguimento inadequado de instruções” apresentou maior sensibilidade, 96,61(88.46 - 99.07), elevado valor preditivo positivo (VPP=98,28) e elevado valor preditivo negativo (VPN=95,35). Todas as características definidoras apresentaram a mesma especificidade, 97,62(87.68 - 99.58). Conclui-se que as características definidoras estudadas apresentaram sensibilidade, especificidade, valores preditivos positivos e negativos altos para o diagnóstico de enfermagem analisado.
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Pascoal LM, Lopes MVDO, da Silva VM, Beltrão BA, Chaves DBR, Nunes MM, de Castro NB. Prognostic clinical indicators of short-term survival for ineffective breathing pattern in children with acute respiratory infection. J Clin Nurs 2015; 25:752-9. [DOI: 10.1111/jocn.13064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 11/30/2022]
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Martins LCG, Lopes MVDO, Guedes NG, Nunes MM, Diniz CM, Carvalho PMDO. Estilo de vida sedentário em indivíduos com hipertensão arterial. Rev Bras Enferm 2015; 68:1005-12. [DOI: 10.1590/0034-7167.2015680602i] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/09/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: identificar a prevalência do diagnóstico de enfermagem Estilo de Vida Sedentário (EVS) e analisar sua associação com os indicadores clínicos (IC) e fatores relacionados (FR) em indivíduos com hipertensão arterial (HA). Método: estudo transversal com 285 pacientes com HAS em um centro de referência em atendimento ambulatorial no nordeste do Brasil. Para a coleta de dados, utilizou-se instrumento baseado nas definições operacionais dos IC e FR validados anteriormente. Quatro enfermeiros classificaram EVS como presente ou ausente. Para avaliar a associação entre IC e FR com a presença de EVS aplicou-se o Teste de Qui-quadrado. Calculou-se a razão de prevalência e intervalo de confiança para verificar a magnitude do efeito entre FR e EVS. Resultados: identificou-se EVS em 55,8% da amostra. Cinco IC e seis FR apresentaram associação estatística significante com EVS. Conclusão: o estudo identificou os principais indicadores para inferência de EVS, bem como seus possíveis fatores causais entre pessoas com HAS.
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Carvalho OMC, da Silva VM, Távora RCDO, Chaves DBR, Beltrão BA, Lopes MVDO. [The adequacy of the defining characteristics of the diagnostics "impaired gas exange" and spontaneous ventilation" in asmathic children]. ENFERMERIA CLINICA 2015; 25:296-304. [PMID: 26459372 DOI: 10.1016/j.enfcli.2015.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 07/27/2015] [Accepted: 07/28/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the diagnostic accuracy measures of defining characteristics of respiratory nursing diagnoses "impaired gas exchange" and "impaired spontaneous ventilation" in asmathics children in emergency department. METHODS Observational, descriptive transversal study developed between April and September 2013 in a hospital in northeastern Brazil with a sample of 205 children. Diagnoses were established by nurses trained experts in this field. Measures of sensitivity, specificity, positive and negative value prediction right positive and negative likelihood ratio and diagnostic odds for the defining characteristics identified were calculated. RESULTS 28.8% of the evaluated children had "impaired gas exchange". Dyspnea, abnormal breathing, tachycardia and hypoxemia had higher frequencies. Hypoxemia presented as clinical feature high sensitivity and specificity. 5.9% of the evaluated children had "impaired spontaneous ventilation" and their most frequent defining characteristics were dyspnea, increased heart rate and decreased SaO2. The increasing use of accessory muscles to breathe presented the best measures of validity for this diagnosis. CONCLUSION The hypoxemia and increased use of accessory muscles presented the best measures of the validity respectively to "deterioration in gas exchange" and "impairment of spontaneous ventilation". These characteristics is necessary to provide for adequate definition and use of diagnostics in clinical practice.
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