Conceptual and Operational Definitions of the Defining Characteristics and Related Factors of the Diagnosis Ineffective Health Management in People With Heart Failure

Cross-mapping of nursing diagnoses and interventions in decompensated heart failure

OBJECTIVE

To map the terms recorded in medical records of patients with decompensated heart failure for nursing diagnoses and interventions from the NANDA International and Nursing Interventions Classification.

METHOD

This is an exploratory and descriptive research, carried out by a cross-mapping study. Data were collected from 107 medical records of a Hospital Institute in the city of Rio de Janeiro/Brazil, in a period between October 2017 to February 2019. The diagnoses and interventions mapped were assessed by four clinical experts. Data analysis was performed using the content validation index and the Fleiss Kappa.

RESULTS

The most frequent nursing diagnoses were: risk for infection (74.8%), decreased cardiac output (55.1%) and excessive fluid volume (49.5%). The interventions were: vital signs monitoring (79.4%), fluid monitoring (72.9%) and positioning (52.3%).

CONCLUSION

The research mapped 32 titles of nursing diagnoses from NANDA-I and 21 nursing interventions from NIC. The diagnoses and interventions mapped will contribute to the quality of the nurses' records and patient safety.

Mapeamento cruzado dos diagnósticos e intervenções de enfermagem na insuficiência cardíaca descompensada

RESUMO Objetivo Mapear os termos registrados em prontuários de pacientes com insuficiência cardíaca descompensada para diagnósticos e intervenções de enfermagem da NANDA Internacional e Classificação de Intervenções de Enfermagem. Método Pesquisa exploratória, descritiva, realizada através do mapeamento cruzado. Os dados foram coletados em 107 prontuários de um hospital do município do Rio de Janeiro/RJ, no período entre outubro de 2017 e fevereiro de 2019. Os diagnósticos e intervenções mapeados foram avaliados por quatro peritos. A análise dos dados foi realizada pelo índice de validação de conteúdo e o Kappa de Fleiss. Resultados Os diagnósticos de enfermagem mais frequentes foram: risco de infecção (74,8%), débito cardíaco diminuído (55,1%) e volume de líquidos excessivo (49,5%). As intervenções foram: monitoração de sinais vitais (79,4%), monitoração hídrica (72,9%) e posicionamento (52,3%). Conclusão A pesquisa mapeou 32 títulos de diagnósticos de enfermagem da NANDA-I e 21 intervenções de enfermagem da NIC. Os diagnósticos e intervenções mapeados irão contribuir para a qualidade do registro de enfermeiros e segurança do paciente.

Ineffective health management: A systematic review and meta-analysis of related factors

PURPOSE

A standardized language system can support the elaboration of clinical guidelines by matching information from similar patterns of response to people. To identify the factors that are related to a higher likelihood of an ineffective health management nursing diagnosis.

METHODS

We conduct a systematic review and meta-analysis. An electronic search was conducted in MEDLINE databases via PubMed, Web of Science, SciELO, CINAHL, SCOPUS, and Embase between October and November 2020. Descriptive data were extracted from each article. The odds ratios for each etiological factor related to ineffective health management were directly extracted from the articles or calculated from the data described in the articles. The analysis of the measurements of exposure and the magnitude of the effect was performed using the statistical software R, and a forest plot was constructed for each etiological factor.

FINDINGS

Ten studies were included, and 15 related factors were recovered from the primary studies. The factors that significantly increased the likelihood of an ineffective health management nursing diagnosis were insufficient knowledge of the therapeutic regimen, perceived barriers, powerlessness, economic disadvantage, and difficulty managing complex treatment regimens. No effect was verified with the following factors: decision conflict, family pattern of healthcare, and inadequate number of cues to action.

CONCLUSION

Factors related to a higher likelihood of ineffective health management may be the focus of early and targeted nursing interventions, contributing to an improved quality of care.

CLINICAL RELEVANCE

Understanding exposure to these factors can improve diagnostic reasoning at different population levels.

Construction and validation of conceptual and operational definitions of the defining characteristics of the nursing diagnosis "Ineffective health self-management" in people living with HIV/AIDS

PURPOSE

Build and validate the content of conceptual and operational definitions of the defining characteristics of the nursing diagnosis of NANDA-I "Ineffective health self-management" in people living with HIV/AIDS.

METHODS

Methodological study, with a quantitative approach. The validation was performed by 26 specialist nurses selected through the Lattes do Brazil platform. The process followed two steps: (a) proposal of new defining characteristics to the Nursing Diagnosis "Ineffective Health Self-Management" and elaboration of conceptual and operational definitions; (b) content validation of the new defining characteristics of the Nursing Diagnosis "Ineffective Health Self-Management" and the conceptual and operational definitions. Data were collected between October 2020 and May 2021.

FINDINGS

The researchers included six defining characteristics as components of the diagnosis, adding to the 10 already existing in the NANDA-I version (2021-2023). Then, the experts judged these components and 13 defining characteristics were validated using the binominal test with adequacy ratio above 85% and p value <0.05. After this stage, the conceptual and operational definitions of these defining characteristics were constructed, validating them by the content validation index ≥0.80 by the expert nurses.

CONCLUSIONS

Three new defining characteristics for Ineffective health self-management were proposed and validated by specialists. Conceptual and operational definitions of the new and current defining characteristics were elaborated and validated for people living with HIV/AIDS.

IMPLICATIONS FOR NURSING PRACTICE

The knowledge and study of the conceptual and operational definitions of nursing diagnoses can contribute to good nursing practices, assisting in the care and evaluation of nurses in the provision of care to people living with HIV/AIDS, and can avoid misunderstandings and inappropriate interpretations and can guarantee assertive clinical judgment.

SEARCH TERMS

Nursing diagnosis, validation studies, nursing processes, acquired immunodeficiency syndrome.

Validation of the definitions of nursing diagnoses for individuals with Aids

OBJECTIVES

to develop and validate conceptual and operational definitions of nursing diagnoses of the International Classification for Nursing Practice for people living with Aids.

METHODS

methodological study with 100 individuals with Aids, in a hospital school. In addition, 19 nurses selected from the Lattes platform acted as experts in the validation process. The research was conducted, using three moments: identification and validation of the nursing diagnoses; construction of the conceptual and operational definitions of the diagnoses, and content validation, using the content validity index.

RESULTS

a total of 35 diagnoses were identified and 18 had their conceptual and operational definitions validated, with validity index of ≥ 0.8.

CONCLUSIONS

the construction of the conceptual and operational definitions enables nurses to analyze the clinical inferences and endorse the nursing diagnosis, contributing to its predictive capacity.

Development and Validation of the Operational Definitions of the Defining Characteristics of the Nursing Diagnosis of Insomnia in the Occupational Health Setting

PURPOSE

To develop and validate the operational definition (ODs) for each defining characteristic (DC) contained in the Nursing Diagnosis (ND) "insomnia" (00095) in the occupational health context.

METHODS

Methodological study carried out in two stages, including a consensus of experts to develop the ODs (Stage 1) and an online Delphi panel, performed in two rounds, to validate them (Stage 2).

FINDINGS

The 15 ODs proposed in Stage 1 were narrowed down to six validated ODs in the first round (diagnostic content validity index [DCVI] = 0.80-0.89). In the second round, five ODs were validated (DCVI = 0.80-0.94). Finally, the remaining four ODs were validated by the general consensus of experts.

CONCLUSIONS

The ODs were validated, although there remains some doubt as to whether some of the DCs can be applied to the field of occupational health.

IMPLICATIONS FOR NURSING PRACTICE

The ODs developed and validated could improve the diagnostic accuracy of the ND "insomnia" (00095) in the context of occupational health.

Accuracy of the clinical indicators of ineffective health management in celiac people

OBJECTIVE

to analyze the accuracy of clinical indicators of "Ineffective health management" in celiac patients and to verify associations between sociodemographic characteristics and clinical indicators.

METHOD

a cross-sectional study, conducted from May to September 2017, with 83 celiac patients, through an interview. Accuracy measures were defined by latent class model.

RESULTS

there was a prevalence of "Ineffective health management" of 55.69%. "Failure to take action to reduce risk factor" and "Failure to include treatment regimen in daily living" better predict this diagnosis. Paid occupation reduces the chance of the presence of "Difficulty with prescribed regimen". Participation in support association reduces the chance of the presence of "Difficulty with prescribed regimen", "Ineffective choices in daily living for meeting health goal" and "Failure to take action to reduce risk factor".

CONCLUSION

accurate clinical indicators identification assists clinical reasoning for diagnostic inference in specific health contexts.