Concept analysis of Neonatal Near Miss

OBJECTIVE

To analyze the concept of Neonatal Near Miss (NNM) using Walker and Avant's method.

METHOD

This study employs conceptual analysis following Walker and Avant's model, involving concept selection, objective definition, identification of potential uses, determination of attributes, model case creation, additional case consideration, antecedent identification, consequent analysis, and empirical reference examination. To elucidate the concept, a scoping review was conducted across journals indexed in scientific databases such as Web of Science, EMBASE, SCOPUS, and MEDLINE/PubMed.

RESULTS

The analysis encompassed 43 articles, revealing diverse definitions of neonatal near miss across different contexts. A comprehensive definition emerged from identified antecedents: risk of death, susceptibility to adverse outcomes, and potential adverse events. These antecedents were categorized into maternal conditions, neonatal conditions, and healthcare assistance.

CONCLUSION

The analysis and definition of the NNM concept was successful, and its antecedents, attributes, and consequences were delineated.

IMPLICATIONS

Identifying the risk factors associated with NNM cases may contribute to reducing infant morbidity and mortality and improving the quality of care, facilitating future research and improving the use of the NNM concept.

Deficient knowledge in patients with heart failure: A study of diagnostic accuracy and etiological relationships

PURPOSE

To evaluate the accuracy of defining characteristics and causal relationships of the etiological factors of the nursing diagnosis deficient knowledge in individuals with heart failure .

DATA SOURCES

An analytical, cross-sectional study on the diagnostic accuracy of the defining characteristics and causal relationships of the etiological factors of the nursing diagnosis. The sample consisted of 140 patients with chronic HF and in outpatient follow-up. The latent class analysis method was used to test the accuracy of measurements and estimate the prevalence of the diagnosis. The calculation of subsequent probabilities and the odds ratio ( were also parameters employed. The study was approved by the Research Ethics Committee of the Federal University of Pernambuco.

DATA SYNTHESIS

The diagnosis had an estimated prevalence of 38.57% in the sample. The inaccurate statements about the disease and/or therapy, self-care deficient performance, and inadequate behavior were the clinical indicators that best predicted the presence of the diagnosis and demonstrated the same sensitivity value (1.0000), specificity (1.0000), and 95% confidence interval (0.9999-1.0000) for all. The populations at risk was elderly (OR = 2.12, confidence interval 95% = 1.05-4.27), and illiterate individuals (OR = 2.07, confidence interval 95% = 1.03-4.16) had an approximately twofold great chance of developing havening deficient knowledge.

CONCLUSION

The evaluation of the accuracy of clinical indicators, corresponding to the defining characteristics in the study, contributed to screening and diagnostic establishment capacity in clinical practice, and to the translation of theoretical and practical knowledge.

IMPLICATIONS FOR NURSING PRACTICE

Accurate clinical indicators of the nursing diagnosis deficient knowledge facilitate the clinical reasoning of nurses and favor the professional's role in the development of health education strategies focused on the acquisition of knowledge about the disease by patients, family members, and caregivers.

Content validation of the nursing diagnosis "inadequate social support network"

OBJECTIVE

To evaluate evidence of content validity of the nursing diagnosis "inadequate social support network".

METHOD

A methodological study of the content validation type, carried out with 23 judges who evaluated the adequacy of the title, definition, class and domain of the nursing diagnosis "inadequate social support network". The judges also assessed the relevance of 28 clinical indicators and 32 etiological factors, which were considered valid when the Content Validity Index was ≥ 0.9.

RESULTS

The judges agreed with the proposed title and suggested changes to the definition of the nursing diagnosis. They recommended its inclusion in Domain 7 - "Roles and relationships" and Class 3 - "Role performance" of the NANDA-I taxonomy. In addition, 19 clinical indicators and 27 etiological factors were considered relevant.

CONCLUSION

The nursing diagnosis "inadequate social support network" had its theoretical structure validated in terms of content, which can support the practice of nurses in the operationalization of the Nursing Process.

Content analysis of the nursing diagnosis of ineffective peripheral tissue perfusion in patients with diabetic foot

AIM

To analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.

DESIGN

A methodological study with a quantitative approach was performed.

METHODS

The analysis was performed between January and May 2021 by 34 nurses with clinical/theoretical/research experience with diabetes or nursing diagnoses. These nurses evaluated the relevance, clarity and precision of 12 diagnosis-specific etiological factors, 22 clinical indicators and their conceptual and operational definitions.

FINDINGS

All 12 etiological factors analysed were considered relevant to diagnostic identification. However, five showed inconsistencies regarding the clarity or precision of the operational definitions, requiring adjustments. Regarding the 22 clinical indicators evaluated, all of them presented a Content Validity Index (CVI) that was statistically significant. However, in the indicators, the colour does not return to lowered limb after 1 min of leg elevation, and cold foot had Content Validity Index (CVI) <0.9 regarding relevance and accuracy of operational definitions.

CONCLUSIONS

Twelve etiological factors and 22 clinical indicators were validated. Thus, this study revealed new and relevant aspects characterising peripheral perfusion in patients with diabetic foot that have not yet been clinically validated.

IMPLICATIONS FOR NURSING PRACTICE

This study contributes to support the professional practice of nurses through the early identification of etiological factors and clinical indicators in persons with diabetic foot. As a proposal, we suggest the inclusion of new defining characteristics and related factors for the nursing diagnosis ineffective peripheral tissue perfusion in the NANDA-I taxonomy.

IMPACT

The research highlights new and relevant aspects such as etiological factors and clinical indicators to characterise peripheral perfusion in patients with diabetic foot. Based on these findings, clinical validation is recommended to confirm the relevance of the proposed elements in the population studied for greater reliability and improved diagnostic assessment for the professional practice of nurses.

REPORTING METHOD

EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Accuracy of the defining characteristics of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot

OBJECTIVE

To evaluate the accuracy of the defining characteristics of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.

METHOD

A diagnostic accuracy study with a cross-sectional design was carried out with patients with type 2 diabetes mellitus on outpatient diabetic foot treatment. We evaluated 134 patients with diabetic foot to determine the accuracy of the defining characteristics of ineffective peripheral tissue perfusion. A latent class model with random effects was used to establish the sensitivity and specificity of the defining characteristics assessed.

RESULTS

Ineffective peripheral tissue perfusion was present in 83.79% of the patients. The defining characteristics color does not return to lowered limb after 1-minute leg elevation and edema had high sensitivity (0.8370 and 0.7213) and specificity (0.9991 and 0.9995).

CONCLUSION

The defining characteristics color does not return to lowered limb after 1-minute leg elevation and edema are good clinical indicators that can be used for screening and confirming ineffective peripheral tissue perfusion in patients with diabetic foot.

Diagnostic accuracy of clinical indicators of Imbalanced nutrition in pediatric patients submitted to chemotherapy

To analyze the accuracy of clinical indicators of nursing diagnosis, Imbalanced nutrition: less than the body requirements in pediatric patients undergoing chemotherapy. A cross-sectional study was carried out in a pediatric oncohematology unit. A total of 123 children aged 5-18 years were evaluated. The Standards for Reporting Diagnostic Accuracy Studies (STARD) protocol was used. Latent class analysis was performed to obtain sensitivity and specificity of clinical indicators. The diagnosis was identified in six children (5.23%). The most frequent clinical indicator in the study was report of food intake less than recommended daily allowance (n = 61; 49.6%), followed by excessive hair loss (n = 49; 39.8%), misperception (n = 42; 34.1%), satiety immediately upon ingesting food (n = 32; 26%), lack of information (n = 30; 24.4%), and pale mucous membranes (n = 22; 17.9%). The 10 indicators that sensitivity and specificity were statistically superior to 50% were food intake less than recommended daily allowance, misperception, insufficient interest in food, lack of food, hyperactive bowel sounds, body weight 20% or more below ideal weight range, insufficient muscle tone, food aversion, abdominal cramping, and misinformation. The clinical indicators Food intake less than recommended daily allowance and Misperception can be considered the most important indicators for the initial inference of the diagnosis due to their high values of specificity and sensitivity. It is essential that nurses provide targeted and qualified assistance based on the signs and symptoms presented by patients, as they will be able to design appropriate interventions to obtain the desired results.

Middle range theory for the nursing phenomenon Ineffective social support network

PURPOSE

To describe a middle range theory (MRT) with conceptual and explicative capacity of cause and effect situations of Ineffective social support network in nursing.

DATA SOURCES

Descriptive study developed through the Lopes, Silva, and Herdman theoretical-causal validity method, using five steps for theory construction: definition of the approach for constructing the MRT, definition of the main concepts, development of the pictorial diagram, construction of propositions, and establishment of causal relationships and evidence for practice. The foundation of these steps and the development of a predictive nursing theory occurred through Sanicola's Social Network Theory combined with studies from an integrative literature review using the six steps proposed by Whittemore and Knafl.

DATA SYNTHESIS-FINDINGS

The theory presents etiological factors and clinical indicators for Ineffective social support network, connecting situations related to the person, the members and the configuration of this network, and external situations. The pictogram, symbolically created, represents the hierarchical classification of proximal, intermediate, and distal etiological factors, and their relationship with clinical indicators.

CONCLUSIONS

The MRT, predictive for the nursing phenomenon Ineffective social support network, provides understanding of the person from an interpersonal perspective, which interferes with and is affected by a network of virtues and vicissitudes, and has negative influences on health outcomes. Due to its practical vocation, this theory represents an advance in the science and praxis of nursing.

IMPLICATIONS FOR CLINICAL PRACTICE

The findings of this study will contribute to the understanding of the nursing phenomenon Ineffective social support network and consequently support the identification of the nursing diagnosis Ineffective social support network, proposed for inclusion in the NANDA-I classification.

Specific causal validation of nursing diagnosis Risk for thrombosis: A case-control study

PURPOSE

This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification.

METHODS

This is a case-control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included-344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee.

FINDINGS

The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25-8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77-6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29-3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03-7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69-39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85-18.37), atherosclerosis (OR:2.07; 95% CI: 1.32-3.27), critical illness (OR: 2.28; 95% CI: 1.42-3.70), and immobility (OR: 2.09; 95% CI: 1.10-4.12).

CONCLUSIONS

The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I.

IMPLICATIONS FOR NURSING PRACTICE

The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.

Ocular dryness in intensive care: proposal for a new nursing diagnosis

OBJECTIVE

to analyze the concept associated with diagnostic proposition Ocular dryness in adult patients hospitalized in an Intensive Care Unit, identifying its attributes, antecedents and consequences.

METHODS

a methodological study carried out through concept analysis, operationalized by scoping review.

RESULTS

the analysis of 180 studies allowed the identification of two attributes, 32 antecedents and 12 consequences. The attributes were tear film deficiency and ocular signs and/or symptoms. The prevalent antecedents were incomplete eyelid closure (lagophthalmos) and blinking mechanism decrease. Major consequences included conjunctival hyperemia and decreased tear volume.

CONCLUSIONS

this study allowed constructing nursing diagnosis Ocular dryness, part of domain 11, class 2, with 12 defining characteristics, 12 related factors, seven populations at risk and 13 associated conditions. This problem-focused proposal may provide targeted care by promoting early detection and implementing interventions that reduce the risk of ocular damage.

Structural validity of nursing diagnosis insomnia in older adults of a community center

PURPOSE

Insomnia is an important sleep disorder in older persons. Conceptual analysis studies on this nursing diagnosis have been developed, but the diagnostic accuracy has not been verified. This study aimed to verify the diagnostic accuracy of the nursing diagnosis of Insomnia (00095) in older adults in a community center in Brazil.

METHODS

A validation study for diagnostic accuracy of the defining characteristics of the nursing diagnosis Insomnia. Data were collected through telephone interviews with 90 participants. Latent class analysis was used to verify the sensitivity and specificity of the defining characteristics. Poisson regression was used to assess the prevalence of the association of factors related to the nursing diagnosis of insomnia.

FINDINGS

A 47.42% prevalence of insomnia in the sample was identified. Defining characteristics such as expresses dissatisfaction with sleep and nonrestorative sleep-wake cycle showed the best accuracy values for insomnia, with a specificity of 0.92 (0.78-1.00) and 0.89 (0.74-1.00), respectively. Related factors such as stressors and frequent naps during the day were more likely to develop insomnia in individuals.

CONCLUSIONS

This study indicates diagnostic accuracy of nursing diagnosis of insomnia in community-dwelling older people from a community center. The findings highlighted the importance of the defining characteristics of nursing diagnosis insomnia and its main related factors contributing to accurate diagnostic identification.

IMPLICATIONS FOR NURSING PRACTICE

This study can contribute to providing objective clinical indicators of insomnia in the older population to guide nurses in early diagnostic confirmation for the selection of health interventions. In addition, it can be a consistent contribution to theoretical and conceptual reviews of this diagnosis.

Analysis of the health advocacy concept from the perspective of the evolutionary method

OBJECTIVE

To analyze the concept of Health Advocacy from the methodological framework of the Evolutionary Model.

METHOD

The concept of interest was evaluated from the perspective of published studies identified in the databases: Web of Science, CINAHL, EMBASE, SCOPUS, MEDLINE and articles of interest. The attributes were determined from 19 scientific productions. Data were analyzed using thematic analysis, proposed by Bardin.

RESULTS

The following operational definition was obtained: Health Advocacy is an intentional action, implemented jointly and in favor of individuals and communities, especially for those who suffer from health inequalities, with the aim of preserving and improving health, well-being and empowerment for health promotion.

FINAL CONSIDERATIONS

Thus, a broader concept of Health Advocacy was abstracted, from the micro to the macro, which contemplates the development of the patient's autonomy; includes individuals and groups in care plans and involves them in political activities as possibilities to provide assistance and correct health inequalities.

Analysis of etiological factors of nursing diagnosis of impaired comfort in children and adolescents with cancer

AIM

To analyse the etiological factors of the nursing diagnosis of impaired comfort in children and adolescents with cancer.

DESIGN

This cross-sectional study was carried out in the referral unit for the treatment of childhood cancer in a tertiary hospital located in northeastern Brazil.

METHODS

A total of 200 children and adolescents who were undergoing cancer treatment were included in this study. Data collection instruments and protocols were constructed with operational and conceptual definitions of clinical indicators and etiological factors for the nursing diagnosis of impaired comfort. A latent class model with adjusted random effects was used to determine impaired comfort and measures of sensitivity and specificity of clinical indicators. A univariate logistic regression analysis was performed for each etiological factor of impaired comfort.

RESULTS

The analysis of etiological factors for the nursing diagnosis of impaired comfort in children and adolescents with cancer showed the high prevalence of four factors: noxious environmental stimuli, insufficient situational control, insufficient resources and insufficient environmental control. Illness-related symptoms, noxious environmental stimuli, and insufficient environmental control increased the chance of impaired comfort occurring.

CONCLUSION

The etiological factors with the highest prevalence and most significant impact on the occurrence of impaired comfort were noxious environmental stimuli, insufficient situational control and illness-related symptoms.

IMPACT

The results obtained in this investigation can support more accurate nursing diagnostic inference of impaired comfort in children and adolescents with cancer. Moreover, the results can inform direct interventions for the modifiable factors that trigger this phenomenon to avoid or minimize the signs and symptoms of the nursing diagnosis.

Fatigue in patients with heart failure: A study of diagnostic accuracy fatigue in patients with heart failure

PURPOSE

To analyze the accuracy of defining characteristics of the NANDA International nursing diagnosis, fatigue (00093), in patients with heart failure.

METHODS

A cross-sectional study on the diagnostic accuracy of the defining characteristics of the nursing diagnosis. The sample consisted of 96 patients with heart failure in treatment in a public hospital. The latent class analysis method was used to test the accuracy measurements and estimate the prevalence of the diagnosis. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte.

RESULTS

The prevalence of the fatigue nursing diagnosis was 42.54%. Increased physical symptoms (0.9988) and tiredness (0.9988) were the sensitive defining characteristics. Disinterested in surroundings (0.9999) was the specific defining characteristics.

CONCLUSIONS

A set of three defining characteristics of the nursing diagnosis of fatigue was accurate in patients with heart failure. Thus, this set can be used by nurses to confirm nursing diagnosis fatigue in patients with heart failure.

IMPLICATIONS FOR NURSING PRACTICE

This research contributes by providing accurate defining characteristics of fatigue in patients with heart failure. Thus, nurses should recognize the nursing diagnosis of fatigue in patients with heart failure through accurate defining characteristics and propose rapid and effective nursing interventions that have positive health results.

Clinical validation of the nursing diagnostic proposition perioperative thirst

OBJECTIVE

to verify the clinical validity of the proposition of a new nursing diagnosis called perioperative thirst, based on the diagnostic accuracy of its clinical indicators, including the magnitude of effect of its etiological factors.

METHOD

clinical diagnostic validation study with a total of 150 surgical patients at a university hospital. Sociodemographic variables and clinical indicators related to thirst were collected. The latent class analysis technique was used.

RESULTS

two models of latent classes were proposed for the defining characteristics. The model adjusted preoperatively included: dry lips, thick saliva, thick tongue, desire to drink water, caregiver report, dry throat and constant swallowing of saliva. In the postoperative period: dry throat, thick saliva, thick tongue, constant swallowing of saliva, desire to drink water, bad taste in the mouth. The factors related to "high ambient temperature" and "dry mouth" are associated with the presence of thirst, as well as the associated conditions "use of anticholinergics" and "intubation". The prevalence of thirst was 62.6% in the pre and 50.2% in the immediate postoperative period.

CONCLUSION

the diagnostic proposition of perioperative thirst showed good accuracy parameters for its clinical indicators and etiological effects. This proposition in a nursing taxonomy will allow greater visibility, appreciation and treatment of this symptom.(1) Evaluates the accuracy of the proposition of the nursing diagnosis perioperative thirst; (2) Allows refined diagnosis for use in clinical practice, teaching and research; (3) Strengthens the systematization of perioperative nursing care; (4) Highlights thirst management as part of care, considering its high prevalence and discomfort; (5) Presents a structure with good accuracy parameters which are representative of thirst.

Accuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients

OBJECTIVES

to analyze the accuracy of the clinical indicators of ineffective airway clearance in adult intensive care unit patients.

METHODS

diagnostic accuracy study, performed in the intensive care unit of a university hospital in northeastern Brazil. The sample consisted of 104 patients hospitalized between June and October 2019.

RESULTS

the prevalence of ineffective airway clearance was 36.54%. The indicators with high specificity included absence of cough (0.8326), orthopnea (0.6817), adventitious breath sounds (0.8175), and diminished breath sounds (0.8326). The clinical indicators with high sensitivity and specificity were alteration in respiratory rate (0.9999) and alteration in respiratory pattern (0.9999).

CONCLUSIONS

six clinical indicators provided an accurate identification of ineffective airway clearance. The clinical indicators alteration in respiratory rate and alteration in respiratory pattern were the most accurate for critical adult patients. The findings of this study contribute to accurate diagnostic inferences and to prevention of respiratory complications in these patients.

Knowledge, Attitude and Practice survey on healthy lifestyle in people with HIV

Abstract Objective to develop and assess a Knowledge, Attitude and Practice survey on healthy lifestyle in people with human immunodeficiency virus. Method a development study, with the elaboration of survey through of an integrative review and analysis of the guidelines; content and appearance analysis by 22 expert judges; and semantic analysis by 22 outpatients. The proportion of positive assessments of the items was measured, considering a percentage equal to or greater than 85%. Results the survey had three domains and seven axes: chronic diseases in people with human immunodeficiency virus; body weight control; healthy eating; physical exercise; avoiding smoking, alcohol and illicit drugs; stress control/reduction; antiretroviral and other medication compliance. Knowledge and attitude domains had 10 questions, and practice domains had 11. In the assessment by expert judges, nurses, doctors and nutritionists participated, with positive agreement of items above 85%. Patients underwent semantic analysis, with 100% positive agreement in the domains. Conclusion and implications for practice the survey had adequate evidence of validity, to be used by nurses and other health professionals, to support care, educational strategies and research with people living with the human immunodeficiency virus.

Ineffective health management in people with hypertension: Accuracy study

PURPOSE

To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension.

METHODS

This is a cross-sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability.

RESULTS

Ineffective health management is probably present in 37.5% of people with hypertension. 'Failure to include treatment regimen in daily living' was the clinical indicator with the highest sensitivity value, and 'failure to take action to reduce risk factor' had the highest specificity value.

CONCLUSIONS

Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario.

IMPLICATIONS FOR NURSING PRACTICE

This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing.

Inquérito de Conhecimento, Atitude e Prática sobre estilo de vida saudável em pessoas com HIV

Resumo Objetivo desenvolver e avaliar um inquérito de Conhecimento, Atitude e Prática sobre estilo de vida saudável em pessoas com vírus da imunodeficiência humana. Método estudo de desenvolvimento, com elaboração do inquérito por meio de revisão integrativa e análise das diretrizes; análise de conteúdo e aparência por 22 juízes especialistas; e análise semântica por 22 pacientes em acompanhamento ambulatorial. Mensurada a proporção de avaliações positivas dos itens, considerando-se percentual igual ou maior a 85%. Resultados o inquérito teve três domínios e sete eixos: doenças crônicas em pessoas com vírus da imunodeficiência humana; controle do peso corporal; alimentação saudável; prática de exercício físico; evitar fumo, álcool e drogas ilícitas; controle/redução do estresse; adesão aos antirretrovirais e outros medicamentos. Domínios conhecimento e atitude tiveram 10 perguntas, e o de prática, 11. Na avaliação pelos juízes especialistas, participaram enfermeiros, médicos e nutricionista, com concordância positiva dos itens acima de 85%. Os pacientes fizeram a análise semântica, com concordância positiva nos domínios de 100%. Conclusão e implicações para a prática o inquérito teve evidência de validade adequada, para ser utilizado por enfermeiros e outros profissionais de saúde, para subsidiar a assistência, estratégias educativas e pesquisas com pessoas vivendo com o vírus da imunodeficiência humana.

Clinical validation of the nursing diagnosis "Ineffective health self-management" in people living with HIV

OBJECTIVE

Check diagnostic accuracy of the defining characteristics of the nursing diagnosis "Ineffective health self-management" in people living with HIV.

METHODS

Methodological study conducted in a specialized public service for people living with HIV in Northeastern Brazil, between February and April 2021, with a sample of 203 people. Latent class analysis was used to calculate the accuracy measurements of the defining characteristics, as well as the sensitivity and specificity values with their respective 95% confidence intervals. The likelihood ratio test (G² ) was applied to evaluate the adequacy of the fit of the models obtained (p > 0.05).

RESULTS

The prevalence of Ineffective health self-management estimated through the latent class model was 67.5%. "Exacerbation of diseases symptoms," "failure to take action that reduces risk factor," "exacerbation of diseases signs," and "ineffective choices in daily living for meeting health goal" had the highest sensitivity values (0.80-0.9429). "Exhibits disease sequelae," "inattentive to diseases signs," and "inattentive to disease symptoms" had the highest specificity values (0.9999-1.0000).

CONCLUSIONS

The useful characteristics for discriminating PLHIV with and without diagnosis are "exacerbation of diseases symptoms," "failure to take action that reduces risk factor," "exacerbation of diseases signs," and "ineffective choices in daily living for meeting health goal." The diagnosis can be confirmed by the indicators "exhibits disease sequelae", "inattentive to diseases signs," and "inattentive to disease symptoms."

IMPLICATIONS FOR NURSING PRACTICES

The study demonstrates the levels of importance of the defining characteristics of "Ineffective health self-management" in people living with HIV contributes to suspicion and accurate diagnostic identification of nurses and researchers.

Simultaneous concept analysis of nursing diagnoses related to respiratory function

AIM

To perform a simultaneous concept analysis of the concepts associated to nursing diagnoses ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange.

BACKGROUND

Concepts about respiratory manifestations need to be well defined, especially in the current pandemic scenario. For that, the simultaneous concept analysis can help in the clarity and differentiation of similar concepts.

METHODS

A concept analysis using the Walker and Avant approach and an integrative review. Data were collected by a group of nurses through a literature review. The group identified 10 articles that met the inclusion criteria and complemented the understanding of the concepts analysed through the sequential description of respiratory physiology in technical books.

RESULTS

The final list included 28, 22, and 21 clinical indicators for ineffective breathing pattern, impaired gas exchange, and ineffective airway clearance, respectively. The former, the final proposal incorporated 13 indicators that were pointed out by the group and 15 defining characteristics of NANDA-International. For Impaired gas exchange, the indicator "decreased oxygen saturation" was included; among the defining characteristics of NANDA-International, "abnormal arterial blood gases" was excluded, and "abnormal breathing pattern" was subdivided into "alterations in respiratory depth," "bradypnea," "tachypnea," and "change in respiratory rhythm." The latter, only the "wide-eyed" was removed from the final list of clinical indicators, which subsequently consisted of nine indicators suggested by the group and 12 defining characteristics.

CONCLUSION

This concept analysis may aid in the process of differentiation for ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange, and aid in safer diagnostic inference. This concept analysis can support the understanding of respiratory nursing diagnoses, helping nurses to identify and differentiate them more safely.

Content validity of the nursing diagnosis low self-efficacy in health

PURPOSE

The purpose of this study was to verify the validity of the content of the proposal for the nursing diagnosis of low self-efficacy in health.

METHODS

Content validation study using the approach proposed by Lopes, a panel of 47 experts on the phenomenon of interest analyzed the content of the diagnosis using a Likert-type scale to evaluate the relevance of 16 clinical indicators and 18 etiological factors of the nursing diagnosis under investigation. These components were previously identified and defined through a middle-range theory. Based on the predictive diversity model, the experts' verifications were weighted according to their level of expertise. The pseudomedian and 95% confidence intervals were calculated. A content validity index above 0.9 was considered valid, and the Wilcoxon test was used to validate each pseudomedian with a p-value above 0.05.

FINDINGS

Thirteen clinical indicators were considered relevant, demonstrating the importance of these elements for the clinical identification of low self-efficacy in health. Three clinical indicators were excluded because they were not representative for this diagnosis. The eighteen etiological factors analyzed were considered relevant.

CONCLUSION

The findings of the present study may help nurses to identify low self-efficacy in health early and direct effective interventions to increase people's confidence in their abilities to promote their health.

IMPLICATIONS FOR NURSING PRACTICE

A new diagnostic framework is presented with peer-reviewed content, representing a phenomenon frequently reported by clinicians. This new diagnosis can guide nursing care and produce better health outcomes that depend on patients' confidence in their ability to take care of their own health.

Accuracy of clinical indicators of the nursing diagnosis of dysfunctional gastrointestinal motility in infants

This study aimed to analyze the accuracy of the clinical indicators of the nursing diagnosis of dysfunctional gastrointestinal motility in infants from neonatal units and identify their association with clinical variables. This is a study of the diagnostic accuracy of clinical indicators of the diagnosis of dysfunctional gastrointestinal motility, with a cross-sectional design, performed on 228 hospitalized infants in neonatal units. A high prevalence of dysfunctional gastrointestinal motility was identified in the studied population. Regarding accuracy measures, clinical indicators such as increased gastric residual, changes in bowel sounds, bile-colored gastric residual, regurgitation, absence of flatus, and hard and formed stool were useful to discriminate between infants with and without dysfunctional gastrointestinal motility. The findings can help nurses during the diagnostic process, as they identify which defining characteristics can be used to confirm or rule out the probability of occurrence of the diagnosis.

Clinical indicators of the nursing diagnosis ineffective health management: Systematic review and meta-analysis

BACKGROUND

Nursing diagnoses should reasonably represent global nursing practice phenomena, organizing indicators in their clinical structure that represent different scenarios and populations. However, few studies have summarized the evidence of these indicators, mainly for behavioral diagnoses.

AIM

This systematic review aimed to identify the best clinical indicators (CI) to determine the presence or absence of the nursing diagnosis "Ineffective Health Management" (IHM).

METHOD

A systematic review with meta-analysis was utilized. Six electronic databases were consulted to retrieve studies that identified the nursing diagnosis IHM, with at least one CI. The period of data collection was between September and October 2020. The research group independently conducted the selection, quality assessment, data extraction, and analysis of all included studies. Fixed-effect measures and meta-analyses summarized sensitivity, specificity measures, and diagnostic odds ratios using the statistical software R. The preferred reporting items for systematic reviews and meta-analyses and standards for reporting studies of diagnostic accuracy guidelines were used to guide this review, and quality assessment of diagnostic accuracy studies was used for the critical appraisal of the methodological quality of the included studies.

RESULTS

The systematic review included 11 studies on people with chronic conditions, the elderly, and pregnant women. The analyzed four CI showed diagnostic odds ratios statistically higher than the unit value, highlighting the "Failure to include the treatment regimen in daily living" (DOR = 45.53; CI = 10.1, 205.6).

LINKING EVIDENCE TO ACTION

Overall, findings showed that all CI of the IHM nursing diagnosis had good sensitivity, specificity, and diagnostic odds ratio measures to identify their presence correctly. These findings can contribute to better accuracy in nurses' decision-making process, providing indicators to infer the IHM nursing diagnosis early in different population spectra based on the best measures of diagnostic accuracy.

Analysis of the content of the nursing diagnosis deficient knowledge in individuals with heart failure

OBJECTIVE

To analyze the content of the nursing diagnosis deficient knowledge in individuals with heart failure.

METHODS

Methodological study to validate the content of a nursing diagnosis based on the predictive model of diversity, carried out through the organization of the phenomenon of interest and analysis by judges using the collective wisdom model. The NANDA-I Knowledge Deficient diagnosis was evaluated by 48 judges and considered valid when it presented a median content validity index ≥ 0.8 in the confidence intervals.

RESULTS

Note that 66.6% of the judges indicated that the new definition proposed was more adequate than the definition adopted by NANDA-I. After the experts' analysis, the following defining characteristics were considered valid: inaccurate statements about the disease and/or therapy, inadequate performance in the management of intercurrences, increase in hospital readmissions, worsened quality of life, deficit in self-care performance, and follow-up of inadequate instruction; related factors are as follows: inadequate guidance offered by health professionals, nonparticipation of the patient in the planning of their health care, weakened relationship between professional and individual; populations at risk-elderly and low level of education of the individual and/or caregiver and the associated condition, mild cognitive impairment. Anxiety, depression, and impaired social interaction were elements considered not relevant to the content domain.

CONCLUSION

The validation of the content of the aforementioned diagnosis in patients with heart failure, through the analysis of judges with different degrees of expertise, made it possible to improve the definition and expansion of new diagnostic indicators.

IMPLICATIONS FOR NURSING PRACTICE

Updated diagnostic elements for the nursing diagnosis deficient knowledge in individuals with heart failure will facilitate accurate clinical judgment and the establishment of a therapeutic plan aimed at etiological factors modifiable by nurses.

Excessive fluid volume risk middle-range theory

ABSTRACT Objective to construct a middle range theory for developing the excessive fluid volume risk diagnostic proposition in patients undergoing hemodialysis. Method this is a methodological study, developed for the theoretical-causal validity of a nursing diagnosis. The study was carried out in four stages: study selection, identification of the main concepts of the theory, pictogram construction and proposition elaboration. These steps were operationalized through an integrative literature review, with a sample of 82 articles selected from the Web of Science, PubMed, CINAHL, Scopus and Science Direct databases. Results the data extracted from the sample articles enabled identifying five essential terms to define excessive fluid volume risk. Furthermore, 31 etiological factors of excessive fluid volume risk were identified, in addition to a pictogram and 12 propositions. Conclusion and implications for practice the construction of a middle-range theory focused on excessive fluid volume risk in patients undergoing hemodialysis refines terminology and expands the understanding of nursing phenomena. Thus, the data from this research will provide clear and robust knowledge for the conduct of nurses’ actions in clinical practice.

Accuracy of the defining characteristics of the nursing diagnosis hypothermia in patients on hemodialysis

ABSTRACT Objective: to analyze the accuracy of the defining characteristics of hypothermia in patients on hemodialysis. Methods: a diagnostic accuracy study was assembled within a cross-sectional study with 124 patients from two dialysis centers. A latent class model was used for data analysis. Results: the nursing diagnosis hypothermia was present in 13 (10.48%) study participants. The most prevalent defining characteristics were hypoxia (100%), decrease in blood glucose level (83.1%), hypertension (65.3%), piloerection (45.2%), and skin cool to touch (41.1%). The defining characteristics acrocyanosis (99.96%) and cyanotic nail beds (99.98%) had a high sensitivity. Acrocyanosis (91.8%), skin cool to touch (64.8%), and peripheral vasoconstriction (91.8%) had high specificity. Conclusion: specific and sensitive indicators of hypothermia work as good clinical indicators for confirming this diagnosis in patients on hemodialysis. The study findings can assist nurses in their clinical reasoning for a correct inference of hypothermia.

Teoria de médio alcance do risco de volume de líquidos excessivo

RESUMO Objetivo construir uma teoria de médio alcance para o desenvolvimento da proposição diagnóstica risco de volume de líquidos excessivo em pacientes em hemodiálise. Método trata-se de um estudo metodológico, desenvolvido para a validade teórico-causal de um diagnóstico de enfermagem. O estudo foi realizado em quatro etapas: seleção dos estudos, identificação dos conceitos principais da teoria, construção do pictograma e elaboração das proposições. Essas etapas foram operacionalizadas por meio de uma revisão integrativa da literatura, com uma amostra de 82 artigos selecionados nas bases de dados Web of Science, PubMed, CINAHL, Scopus e Science Direct. Resultados os dados extraídos dos artigos da amostra possibilitaram a identificação de cinco termos essenciais para a definição do risco de volume de líquidos excessivo. Além disso, foram identificados 31 fatores etiológicos do risco de volume de líquidos excessivo, além de construídos um pictograma e 12 proposições. Conclusão e implicações para a prática a construção de uma teoria de médio alcance voltada para o risco de volume de líquidos excessivo em pacientes em hemodiálise refina as terminologias e amplia a compreensão dos fenômenos da enfermagem. Assim, os dados desta pesquisa fornecerão conhecimentos claros e robustos para a condução das ações do enfermeiro na prática clínica.

Knowledge, attitude and practice of people with HIV regarding a healthy lifestyle: clinical trial

ABSTRACT Objective: To evaluate the effectiveness of an educational booklet on the knowledge, attitude and practice of a healthy lifestyle in people with HIV. Methods: Randomized clinical trial with 75 intervention group patients using the booklet, and 75 control group patients undergoing usual service care. Data collection occurred in four moments, with a Survey pertaining Knowledge, Attitude and Practice. Nonparametric analysis of variance of repeated measures was used. Results: 70 participants in the intervention group and 74 in the control group completed the study. In terms of knowledge, there was no difference between groups, the booklet impact came late, increasing after reassessments. In attitudes, there was a difference between groups in the two- and four-month reassessments compared to the baseline. In practices, there was a difference in the intervention group compared to the control group at two, four, and six months compared to baseline. Conclusion: The booklet was effective in improving healthy lifestyle knowledge, attitudes, and practices in people with HIV.

Effect of educational intervention on clinical reasoning skills in nursing: A quasi-experimental study

This study evaluated the effect of an educational intervention based on virtual clinical simulation and problem-based learning using a mobile application in a clinical nursing education context as a tool to improve clinical reasoning skills of students on the second year of nursing graduation. A prospective quasi-experimental study was conducted in the year 2018, and assessments were performed before and after the educational intervention. A random convenience sample (n = 32) of nursing students in the second year of a public university in Brazil was divided equally into experimental and control groups. The experimental group underwent educational intervention about clinical reasoning skills and measured the quality of the Diagnostician Nurse software by LORI 2.0 instrument. The control group experienced the conventional class on clinical reasoning skills. Four clinical cases were used to assess reasoning skills before and after the educational intervention. The data were analyzed using descriptive and inferential statistics. The experimental group showed a statistically significant difference regarding the prioritization of nursing diagnoses (p = 0.014) and a higher final score. There was a statistically significant difference in performance between the pre- and post-test in the grades of the students who participated in the intervention (p = 0.003). The control group also showed statistical significance in the score attributed to the clinical reasoning process (p = 0.015). In addition, the Diagnostician Nurse software had excellent usability and quality evaluations (SUS 87.81 and LORI 4.66, respectively). It is concluded that educational intervention based on virtual clinical simulation and learning problems using the Diagnostician Nurse software is effective as a tool to improve clinical reasoning skills and can support early detection of patients. The educational intervention developed was of high quality and attractive and improved students' motivation for the teaching-learning process.

Mortality, survival and prognostic factors of people with AIDS in intensive care unit

OBJECTIVE

To analyze mortality, survival and prognostic factors of patients with AIDS in Intensive Care Unit (ICU).

METHOD

Retrospective cohort study with a sample of 202 patients with AIDS in ICU, whose sociodemographic, epidemiological, and clinical characteristics were obtained from medical records and assessed.

RESULTS

Patients were mostly male (73.8%) and drug users (59.4%), with no regular health follow-up (61.4%) and no adherence to antiretrovirals (40.6%), presenting low CD4+ T lymphocyte count (94.0%) and high viral load (44.6%). The main causes of hospitalization were sepsis and respiratory and renal insufficiency. The mean duration of hospitalization was 11.9 days (p = 0.0001), with a 41.6% survival; 58.5% died in the ICU. Sepsis upon admission (p < 0.001), pressure injury (p = 0.038), sexual exposure (p = 0.002), high viral load (p = 0.00001) and prolonged hospitalization (p < 0.001) increased the risk of death.

CONCLUSION

Most patients had no regular health follow-up, were drug users and presented low CD4+ T lymphocyte count and high viral load. The high mortality indicated that antiretroviral adherence is essential to reduce viral resistance, opportunistic diseases, and mortality.

Impact of the Peace Agreement on the social determinants of health in Colombia

OBJECTIVES

to analyze the impact of the Colombian Peace Agreement on the structural social determinants of health.

METHODS

a descriptive, ecological study, based on documentary data from 2008 to 2018. The records of victims, epidemiological indicators, and structural social determinants of health in Colombia were analyzed.

RESULTS

there was a correlation between the period in which the Peace Agreement process was developed and the indicators of structural determinants in health with p<0.05. With the Poisson regression analysis, the favorable correlations between the peace process and the determinants were confirmed, besides allowing the understanding of the changes in these indicators before the Peace Agreement.

CONCLUSIONS

the implementation of the peace process has a positive impact on structural social determinants of health, which is observed by the beginning of the decrease of economic, educational, health, and social inequalities and inequities, a fact that offers the possibility of living in peace.

Clinical indicators and aetiological factors of sedentary lifestyle in patients with arterial hypertension

AIMS

The aim of this study is to verify the clinical validity of clinical indicators and aetiological factors of sedentary lifestyle in individuals with arterial hypertension.

BACKGROUND

Diagnostic validation is performed to expand nursing taxonomies and to revise or confirm the described concepts. New elements listed in the literature and those identified by the NANDA International definition for sedentary lifestyle need to be evaluated.

DESIGN

This is a cross-sectional and diagnostic validation study. The STROBE guidelines were used in this study.

METHODS

Two hundred and fifty subjects aged over 18 years were evaluated. The diagnostic status of the participants was obtained by latent class analysis. Logistic regression was used to identify aetiological factors with the manifestation of sedentary lifestyle, considering a significance level of 5%.

RESULTS

A total of 57.8% of the study participants met the diagnostic criteria for sedentary lifestyle. The clinical indicators with high sensitivity were as follows: "Average daily physical activity is less than recommended for gender and age"; "Does not perform physical activity during leisure time"; "Preference for activity low in physical activity" and "Overweight." The significantly related factors associated with the diagnosis of sedentary lifestyle were as follows: "Insufficient knowledge on physical activity," "Lack of time," "Negative self-perception of health," "Lack of security," "Lack of appropriate place," "Lack of motivation," "Activity intolerance," "Lack of sports ability," "Having a partner," "Using public transportation," "Perception of physical disability," "Pain," "Having a job/studying," "Laziness," "Impaired mobility," "Living in an urban area," "Education in a public institution," "Female gender," "Lack of confidence to practice physical exercise," "Education level," "Age" and "Lack of social support for the practice of physical exercise."

CONCLUSION

Four out of eight clinical indicators had a good adjustment by the latent class analysis. Of the 27 aetiological factors, 22 were significantly associated with sedentary lifestyle.

RELEVANCE TO PRACTICE

The correct identification of sedentary lifestyle and its elements supports care planning, especially for health promotion and disease prevention.

Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects

OBJECTIVE

To estimate the content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects.

METHOD

Methodological study in two stages: 1) integrative literature review; 2) content validation, with 23 nurses. An instrument with 10 related factors and 21 defining characteristics for data collection was used. The analysis by the evaluators was carried out using the relevance criteria. The Content Validity Index was used. Valid results were those above 0.9 with a Wilcoxon test above 0.05.

RESULTS

The final proposal incorporates nine from the ten causal factors. From them, five do not belong in the NANDA-I list. Regarding the defining characteristics, they were all considered to be relevant, and five are not among the list of signs and symptoms of the NANDA-I taxonomy.

CONCLUSION

The findings of this study include specific elements of the pediatric population with congenital heart defect which are not present in the structure of the diagnostic being studied.

Content validation of the nursing diagnosis Risk for disturbed maternal-fetal dyad

OBJECTIVE

To validate the content of the diagnosis Risk for disturbed maternal-fetal dyad in high-risk pregnant women.

METHOD

Nursing diagnosis content analysis study in which 48 nurses evaluated agreement regarding title, definition, class, and domain of the studied nursing diagnosis, as well as the relevance of its antecedents. The items were considered relevant when the Confidence Interval of the Content Validity Index was 0.8 or higher. When lower, the item was modified or excluded according to the experts' suggestions.

RESULTS

Out of 21 antecedents, 14 were considered relevant. The labels of five elements considered irrelevant were changed, and one item was excluded. The experts did not choose the title and definition proposed by NANDA-I, preferring instead the ones suggested in this study. The experts agreed with the class and domain proposed by the taxonomy.

CONCLUSION

Ten risk factors, four populations at risk, and six associated conditions for this nursing diagnosis were maintained; these may provide a basis for nursing practice. The phase of clinical validation is suggested to be conducted to corroborate this study's results.

Nursing diagnosis "Terminality Syndrome": a content analysis

OBJECTIVES

to validate the nursing diagnosis "Terminality Syndrome" with experts.

METHODS

a quantitative research of content validation type based on collective wisdom approach. An online semi-structured questionnaire was used as an instrument for data collection, and Content Validity Index and Wilcoxon test were used for comparing possible differences.

RESULTS

the questionnaire was answered by 89 professionals after judges' assessment in relation to the structural components of the diagnosis proposed. The mean Content Validity Index of items was above that recommended, except for title, which was ≥ 0.8. The suggestions were reviewed and accepted, being forwarded for a new analysis, reaching 83.7% of agreement among participants.

CONCLUSIONS

the diagnosis' content proved to be valid by judges. With that, it is expected to contribute with a useful nursing diagnosis for nursing practice documentation in palliative care.

Content analysis of clinical indicators for Impaired gas exchange

OBJECTIVE

To analyze the relevance of clinical indicators and the clarity and precision of conceptual and operational definitions of the diagnosis Impaired gas exchange.

METHODS

Content analysis, by 39 nurse judges, divided into the phases of conceptual definition of the phenomenon of interest, construction of the structure of the phenomenon of interest and analysis of the judges on the built structure.

RESULTS

From the 22 indicators, 21 were considered relevant Impaired gas exchange. The indicators that obtained absolute relevance were Cyanosis, Hypercapnia, Hypoxemia and Tachycardia. The indicator Headache upon waking did not show any statistically significant relevance for the diagnosis. All conceptual and operational definitions were clear and precise.

CONCLUSION

The indicators listed for Impaired gas exchange were relevant to the phenomenon, except Headache upon waking because it does not correspond to a safe manifestation to identify the diagnosis, according to the analysis of the judges. Each conceptual and operational definition was adequate for its indicator.

Middle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health

OBJECTIVES

theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct.

METHODS

construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles.

RESULTS

eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health.

CONCLUSIONS

the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined.

Development and evaluation of a booklet to promote ealthy lifestyle in people with HIV

OBJECTIVE

To develop and evaluate an educational primer to promote healthy lifestyles in people with HIV.

METHODS

Study of technological development in three stages: Development of the booklet, with bibliographical review, illustrations, layout, diagramming, adopting as reference the trans-theoretical model of behavior change; Analysis of content and appearance by 22 judges; Semantic analysis by 22 people with HIV. The proportion of positive evaluations of the items was measured, considering a percentage equal to or greater than 85%.

RESULTS

My motivational booklet for change! Practices for promoting a healthy lifestyle" had six areas: Body weight control; Healthy eating; Exercise practice; Smoking, alcohol and other drugs; Stress control; and Drug treatment. Most of the items evaluated agreed with an overall average of 92.4% by the judges and 98.9% by the target audience.

CONCLUSION

The booklet had evidence of adequate validity to be used by people with HIV.

Concept analysis of Perioperative Thirst for the development of a new nursing diagnosis

OBJECTIVES

to analyze the perioperative thirst concept for the development of a new diagnostic structure according to NANDA International.

METHODS

a concept analysis study based on the framework proposed by Walker and Avant, instrumentalized through an integrative literature review based on SCOPUS, CINAHL, PUBMED, LILACS, and WOS. The elaboration of the diagnostic structure followed NANDA International guidelines.

RESULTS

41 studies were analyzed revealing that perioperative thirst is prevalent and intense, having visceral and behavioral attributes as the core of the concept. Antecedents indicate that surgical patients are vulnerable to thirst; and consequents 16 signs and symptoms were organized and model cases were developed. A diagnostic structure has been developed for perioperative thirst.

FINAL CONSIDERATIONS

concept analysis allowed language standardization that describes thirsty patients, helping the identification, planning of actions and communication of perioperative nursing care.

Diagnostic indicators of risk-prone health behaviors in pregnant adolescents

PURPOSE

This study aimed to identify diagnostic indicators associated with the nursing diagnosis risk-prone health behaviors in pregnant adolescents.

METHODS

We conducted a cross-sectional study. The sample consisted of 181 pregnant adolescents. A latent class analysis was conducted to verify associations between the defining characteristics of risk-prone health behaviors and diagnostic accuracy measures. Logistic regression was used to identify factors associated with the manifestation of risk-prone health behavior.

FINDINGS

The prevalence of risk-prone health behaviors in this sample was 31.04%. The defining characteristics failure to take action that prevents health problems and inappropriate eating habits achieved a high sensitivity. The related factors such as insufficient social support, stressors, low self-efficacy, social anxiety, isolated region of residence, and restricted access to health services presented significant associations with risk-prone health behavior.

CONCLUSIONS

The diagnostic indicators associated with the nursing diagnosis of risk-prone health behavior were failure to take action that prevents health problems inappropriate eating habits, insufficient social support, stressors, low self-efficacy, social anxiety, isolated region of residence, and restricted access to health services.

IMPLICATIONS FOR NURSING PRACTICE

This study contributes to knowledge about the diagnostic indicators of risk-prone health behavior, which may help nurses reach the proper diagnosis. This will facilitate the application of clinical judgment in nursing care to assist pregnant adolescents.

The factors related to a sedentary lifestyle: A meta-analysis review

AIMS

To compare factors associated with the sedentary lifestyle described in the literature with the factors listed in NANDA International.

DESIGN

Systematic review with meta-analysis of factors associated with a sedentary lifestyle in adolescents, adults and older people.

DATA SOURCES

An electronic search of PubMed, Scopus, CINAHL and Latin America and the Caribbean Literature on Health and Science databases conducted in May 2016.

REVIEW METHODS

Descriptive data were extracted according to a standardized form. The odds ratios for each etiological factor associated with a sedentary lifestyle were extracted directly from the articles or calculated from the data described therein. The meta-analysis was conducted for factors that were investigated in more than one study.

RESULTS

Thirty-five articles were included. The statistically significant factors were: lack of social support, of physical space, of time, of motivation, of sports skills and of interest in physical activity, intolerance to activity, being retired, living in a low-income country, laziness, not having a job/studying, low socioeconomic status and level of knowledge about physical activity, female gender, living in an urban area, negative self-perception of health, using public transportation, being in the oldest age group in the study and perceived physical disability.

CONCLUSION

The new factors associated with a sedentary lifestyle and those already included in the NANDA International classification will lead to better clinical guidance for nurses.

IMPACT

Knowledge about these factors can contribute directly to public health policies.

Risk for impaired cardiovascular function nursing diagnosis: Content analysis to evaluate women in jail

OBJECTIVE

To analyze the content of the diagnostic proposal, risk for impaired cardiovascular function, focusing on incarcerated women.

METHODS

A methodological study of nursing diagnosis content validation carried out from December/2018 to June/2019. A sample of 24 judges evaluated the proposed definition and the relevance of the proposed etiological factors of risk for impaired cardiovascular function. To determine the content validity of the etiological factors, the Content Validity Index was calculated and a value of 0.9 was adopted, in addition to the Wilcoxon test.

RESULTS

The diagnostic definition was considered consistent with the diagnostic label. All 18 etiological factors were validated with a Content Validity Index statistically >0.9 and categorized into risk factors, associated conditions, and at-risk populations.

CONCLUSION

The definition and 18 etiological factors of risk for impaired cardiovascular function were validated.

IMPLICATIONS FOR THE NURSING PRACTICE

The study allowed the new proposal for the risk for impaired cardiovascular function nursing diagnosis to be accepted to return to the taxonomy of NANDA International with an expanded and more consistent structure. The return of the referred nursing diagnosis to the taxonomy favors the nurse's diagnostic reasoning and the documentation of all nursing actions, linked to this diagnosis, which are aimed at minimizing cardiovascular risk.

Content analysis of nursing diagnoses related to urinary incontinence

OBJECTIVE

To analyze the content of nursing diagnoses related to urinary incontinence according to NANDA International and others identified in the literature.

METHOD

Methodological study conducted with judges who were experts in urinary dysfunctions and nursing diagnosis. The analysis included diagnoses of Stress Urinary Incontinence, Urgency Urinary Incontinence, Functional Urinary Incontinence, Urinary Incontinence due to Neurogenic Detrusor Overactivity (previously denominated Reflex Urinary Incontinence in NANDA International's taxonomy), Mixed Urinary Incontinence, and Transient Urinary Incontinence. Wilcoxon test was applied and Content Validity Index ≥ 0.85 was considered appropriate.

RESULTS

Fifty-one judges participated in this study. The judges recommended modifications in elements of all diagnoses (inclusion, exclusion or change of previous element type).

CONCLUSION

The four diagnoses analyzed in NANDA International's taxonomy are recommended to be maintained with modifications; inclusion of nursing diagnoses Mixed and Transient Urinary Incontinence is also recommended.

Brazilian Nursing Process Research Network contributions for assistance in the COVID-19 pandemic

OBJECTIVE

to describe the theoretical construction process of nursing process support documents in COVID-19 care scenarios.

METHODS

an experience report of the joint activity of the Brazilian Nursing Process Research Network (Rede de Pesquisa em Processo de Enfermagem) composed of Higher Education and Health Institution researchers in Brazil.

RESULTS

five instruments were organized collectively, involving the elements of nursing practice (nursing diagnoses, outcomes and interventions) in assistance for community; for patients (with suspected or mild, moderate, and critical COVID-19 and residents in Nursing Homes); for nursing workers' health support, also subsidizing registration and documentation during the COVID-19 pandemic.

FINAL CONSIDERATIONS

valuing the phenomena manifested by families/communities, patients and health professionals is essential for early detection, intervention, and prevention of diseases.

Analysis of the NANDA-I taxonomy "maternal-fetal dyad" concept in high-risk pregnancy: integrative review

OBJECTIVE

to analyze the NANDA-I taxonomy "maternal-fetal dyad" concept in high-risk pregnancy.

METHOD

an integrative literature review based on the Conceptual Analysis model proposed by Walker and Avant. It was conducted at PUBMED, CINAHL, SCOPUS, LILACS and SciELO, with the descriptors: Complications of pregnancy, Risk Factors, and Pregnancy, High-Risk (from 2008-2020).

RESULT

the sample consisted of 44 articles, which identified two attributes and 21 antecedents of the concept.

CONCLUSION

concept analysis allowed to identify the attributes and antecedents of the "maternal-fetal dyad" concept in high-risk pregnancy, in addition to raising and clarifying ideas. It was possible to identify 12 antecedents that are not included in NANDA-I as well as the need to review the definition of the diagnosis proposed by the taxonomy.

Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women

OBJECTIVE

To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women.

METHOD

The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory.

RESULTS

We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them.

CONCLUSION

The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.

Anxiety and depression: a study of psychoaffective, family-related, and daily-life factors in celiac individuals

OBJECTIVE

To identify the prevalence of anxiety and depression and its association with psychoaffective, family-related, and daily-life variables of celiac individuals.

METHODS

Crosssectional study, developed with 83 celiac patients in Fortaleza. An instrument was applied with variables grouped in the categories: psychoaffective, family-related, and daily-life.

RESULTS

It was found that 52 celiac patients (62.7%) had anxiety and 29 (34.9%) had depression. The clinical conditions found and the number of symptoms increased the chance of anxiety/depression. The predominant factors in those with anxiety were Lack of control of the celiac disease (98.1%), Perceived clinical condition (75.0%), Daily obstacles for maintaining a gluten-free diet (63.4%), and Daily activities (55.8%). In those with depression, there was a higher prevalence of Lack of control of the celiac disease (100.0%), Perceived clinical condition (82.2%), and Daily obstacles for maintaining a gluten-free diet (69.0%).

CONCLUSION

Celiac individuals with anxiety and depression frameworks presented a higher frequency of Perceived clinical condition, Insufficient social support (psychoaffective factors) and Daily obstacles for maintaining a gluten-free diet (daily-life factor).

Prognostic indicators of short-term survival of ineffective airway clearance in children with acute respiratory infection: a longitudinal study

Background: Studies that establish the indicators of clinical status deterioration of Ineffective airway clearance remain scarce. Prognostic studies provide data for nurses identify clinical indicators that suggest a higher chance of early development of a nursing diagnosis. Objective: To identify the prognostic indicators of short-term survival of ineffective airway clearance (IAC) in children with acute respiratory infection (ARI). Design: A prospective open cohort study. Methods: This study was with a group of 136 children with acute respiratory infection who were followed for a minimum of six and a maximum of ten consecutive days. Children who had not completed six days of monitoring or who were carriers of diseases that would alter the specific symptoms of respiratory infection were excluded. The survival rate of ineffective airway clearance was calculated using Nelson-Aalen's method. A Cox regression model was used to analyze the influence of clinical indicators on survival time of this diagnosis. Results: The diagnosis survival rate was extremely low (only 0.4% on the 5th day of follow-up). The greatest reduction in survival rate was observed in the first 48 h (survival rate = 2.5%). Four defining characteristics associated with a worse prognosis of IAC among children with ARI: ineffective cough (RR = 5.86; 95% CI: 3.53-9.72), absence of cough (RR = 2.92; 95% CI: 1.68-5.08), adventitious breath sounds (RR = 2.47; 95% CI: 2.01-3.03), and diminished breath sounds (RR = 1.23; 95% CI: 1.05-1.45). Conclusion: Four clinical indicators showed a strong relationship with an increased risk of worsening clinical status associated with this nursing diagnosis. Impact statement: Clinical deterioration related to ineffective airway clearance among children with acute respiratory infection is fast and requires particular attention from nurses.

A Middle-Range Theory for Nurses to Diagnose Ineffective Infant Feeding Patterns

PURPOSE

To construct a middle-range theory, based on the Roy adaptation model, for nurses can diagnose an ineffective infant feeding pattern.

DATA SOURCE

Scientific findings were used through a literature review and the concepts of the Roy model.

DATA SYNTHESIS

The theory indicated new elements for the diagnosis: 12 etiological factors and 13 clinical indicators. Most of those are not contained in the NANDA taxonomy.

CONCLUSION

The middle-range theory for these diagnoses highlights the need for a review of the components present in the taxonomy.

IMPLICATIONS FOR NURSING PRACTICE

This approach guides research on nursing diagnoses to revise the content of the theory and to expand its concepts and elements for the diagnosis of an ineffective infant feeding pattern.