Análise do conteúdo de diagnósticos de enfermagem sobre desenvolvimento infantil / Content analysis of nursing diagnoses about child development

Dispor de diagnósticos de enfermagem que respondam à complexidade do desenvolvimento infantil (DI) é fundamental para subsidiar o enfermeiro na elaboração de planos de cuidado integral à criança. O objetivo deste trabalho foi apresentar a análise do conteúdo de três novos diagnósticos sobre DI para a NANDA-I. Pesquisa metodológica, de método misto. Etapa quantitativa com juízes, mediante questionário estruturado, com análise de concordância simples; e etapa qualitativa de análise das discordâncias em grupo focal com peritos, para obtenção de consenso. Dezoito juízes responderam ao questionário, com concordância acima de 80% para os diagnósticos "Atraso no Desenvolvimento Infantil" e "Risco de Atraso no Desenvolvimento Infantil"; o diagnóstico "Disposição para Desenvolvimento Infantil Melhorado" teve 61% de concordância do enunciado e acima de 80% na maioria das características definidoras. Oito peritos analisaram as discordâncias até produção de consensos. A elevada concordância dos juízes e consenso dos peritos validaram o conteúdo dos diagnósticos propostos.

Having nursing diagnoses which answer to the complexity of child development (CD) is fundamental for nurses to ground the formulation of comprehensive care to children. The objective of the present study was to present a content analysis of three new diagnoses about CD for the NANDA-I. It consisted of a methodological, mixed- method study. The quantitative phase was carried out with judges and a structured questionnaire, with simple concordance analysis, and the qualitative phase of the analysis of discrepancies was performed in a focus group, with experts, to obtain a consensus. Eighteen judges answered the questionnaire, and analysis of the results showed an agreement higher than 80% for the "Delayed Child Development" and "Risk for Delayed Child Development" diagnoses; the "Readiness for Enhanced Child Development" diagnosis achieved 61% of agreement regarding the statement and more than 80% of concordance in most defining characteristics. Eight experts analyzed disparities until consensuses were reached. The high agreement among judges and consensus among experts validated the content of the suggested diagnoses.

Adaptation and validation of the instrument positions on the nursing process.

OBJECTIVE: estimate the psychometric properties in the adaptation of the instrument Positions on Nursing Diagnosis to assess nursing staff members' attitudes towards the nursing process. METHOD: methodological study with a non-probabilistic sample of 973 nursing assistants and 632 baccalaureate nurses from 35 hospitals and outpatient clinics affiliated with the São Paulo State Health Secretary. The validity of the 20-items instrument was checked through confirmatory factor analysis, which identified a more generally secondary-level factor, constituted by the three classical attitude factors. Reliability corresponded to 0.954 for the total instrument. RESULTS: the validity and reliability of the instrument Posições sobre o Processo de Enfermagem are appropriate . CONCLUSIONS: further research is needed to verify whether the items behave differently according to the respondent's professional category and to verify the instrument's behavior when applied to student samples.

Ineffective peripheral tissue perfusion: Clinical validation in patients with hypertensive cardiomiopathy.

PURPOSE: To validate defining characteristics of ineffective peripheral tissue perfusion using vasomotor function assessment. METHODS: Twenty-four patients with hypertensive cardiomiopathy were evaluated for 18 defining characteristics of ineffective peripheral tissue perfusion and underwent vasomotor function assessment with induction of reactive hyperemia, intra-arterial infusion of acetylcholine, and pulse wave velocity measurement. The Student's t test and Kruskall-Wallis test were used to assess the significance of relationships between defining characteristics and vasomotor function data. FINDINGS: Diminished lower extremity pulses were associated with diminished forearm blood flow during acetylcholine infusion; left ventricular overload, intermittent claudication, and diminished skin moisture were associated with elevated pulse wave velocity values. CONCLUSION: The defining characteristics of ineffective peripheral tissue perfusion were highly associated with vasomotor function data as "gold standards" for that diagnosis. PRACTICE IMPLICATIONS: Nurses should be able to accurately assess diminished lower extremity pulses, intermittent claudication, and diminished skin moisture as relevant characteristics of ineffective peripheral tissue perfusion in patients with hypertensive cardiomiopathy.

[Therapeutic intervention scoring system-28 (TISS-28): directions for application]. / Therapeutic intervention scoring system-28 (TISS-28): diretrizes para aplicação.

Therapeutic Intervention Scoring System-28 (TISS-28) is a tool that enables the measurement of the nursing work load in Intensive Care Units and the estimate of how grave the disease is. In this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.

Decreased cardiac output: validation with postoperative heart surgery patients.

This study was done to analyze the association between defining characteristics of decreased cardiac output (DCO) identified by noninvasive methods and the cardiac index (CI) estimated by thermodilution. Two defining characteristics were associated with DCO: decreased peripheral pulse and decreased peripheral perfusion. This study points out the relevance of peripheral circulation assessment in postoperative cardiac surgery patients.