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D'Eça A, Dos Santos Rodrigues L, de Menezes HF, Noleto Dos Santos W, Lopes CT, da Silva RAR. 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. Int J Nurs Knowl 2021; 33:169-179. [PMID: 34519447 DOI: 10.1111/2047-3095.12345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Aurean D'Eça
- Federal University of Maranhão, Nursing Department, São Luís, Maranhão, Brazil
| | | | - Harlon França de Menezes
- Federal Fluminense University, Aurora de Afonso Costa School of Nursing, Niterói, Rio de Janeiro, Brazil
| | | | - Camila Takáo Lopes
- Federal University of São Paulo, Nursing Department, São Paulo, São Paulo, Brazil
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Hammoud DA, Sinharay S, Steinbach S, Wakim PG, Geannopoulos K, Traino K, Dey AK, Tramont E, Rapoport SI, Snow J, Mehta NN, Smith BR, Nath A. Global and regional brain hypometabolism on FDG-PET in treated HIV-infected individuals. Neurology 2018; 91:e1591-e1601. [PMID: 30258017 DOI: 10.1212/wnl.0000000000006398] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/16/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To quantitatively measure brain glucose metabolism in treated HIV-positive individuals with [18F]-labeled fluorodeoxyglucose (FDG) PET/CT. METHODS We performed a cross-sectional comparison of FDG uptake in 47 treated HIV+ individuals, 10 age-matched controls (HIV-) sharing many of the comorbid conditions seen in the HIV+ group, and 19 age-matched healthy controls (HCs). We compared whole-brain (WB) and regional FDG standardized uptake values (SUVs) of select subcortical/central structures among the groups and correlated the values to clinical and neuropsychological assessments. A variable selection model was used to predict SUVs in HIV+ (n = 47) and in combined HIV+ and HIV- participants (n = 57). RESULTS We found lower WB SUVmax in HIV+ participants compared to HCs but not to HIV- participants. Among the relative SUVmean measurements (regional SUVmean/WB SUVmean), only relative thalamic uptake values were lower in HIV+ compared to HIV- participants. When HIV+ and HIV- participants were grouped, cardiovascular disease risk scores best predicted WB SUVmean and SUVmax, while HIV status best predicted thalamic relative SUVmean. CONCLUSIONS We identified an important role for cardiovascular disease in neuronal loss/dysfunction, as measured by FDG-PET, in treated HIV+ patients. This underscores the need for shifting the focus of clinical intervention in this vulnerable population from HIV effects alone to a wider set of comorbid conditions, mainly cardiovascular disease. Only the thalamus showed significantly lower relative uptake in the HIV+ compared to the HC and HIV- groups. This needs to be further evaluated for underlying pathophysiology and potential association with memory, executive functioning, and attention deficits seen in the HIV+ population.
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Affiliation(s)
- Dima A Hammoud
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD.
| | - Sanhita Sinharay
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Sally Steinbach
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Paul G Wakim
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Katrina Geannopoulos
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Katherine Traino
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Amit K Dey
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Edmund Tramont
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Stanley I Rapoport
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Joseph Snow
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Nehal N Mehta
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
| | - Bryan R Smith
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD.
| | - Avindra Nath
- From the Center for Infectious Disease Imaging, Radiology and Imaging Sciences (D.A.H., S. Sinharay), Clinical Center, National Institute of Neurological Diseases and Stroke (S. Steinbach, K.G., B.R.S., A.N.), Biostatistics and Clinical Epidemiology Service (P.G.W.), Clinical Center, National Institute of Mental Health (K.T., J.S.), National Heart, Lung, and Blood Institute (A.K.D., N.N.M.), National Institute for Allergy and Infectious Diseases (E.T.), and National Institute on Alcohol Abuse and Alcoholism (S.I.R.), NIH, Bethesda, MD
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