Content validation study of nursing interventions intended to prevent cardiovascular events in diabetic patients.

AIMS AND OBJECTIVES: To validate nursing interventions from the Nursing Interventions Classification for preventing cardiovascular events in outpatients with diabetes. BACKGROUND: Cardiovascular disease is the main cause of death among diabetic patients. Although nurses play an important role in preventing cardiovascular events in this population, their specific contribution is difficult to measure. Documenting nursing interventions using a standardised nursing system may provide nursing visibility. However, there are no studies that analysed which nursing interventions would be the most relevant, based on expert opinion, aimed at preventing cardiovascular events in diabetic patients. DESIGN: This is a content validation study, which was designed as a descriptive one. METHODS: For this content validation study, we used the Fehring model. Nursing interventions were selected from the Nursing Intervention Classification. Experts were asked to analyse the degree of relevance of 225 nursing interventions regarding the prevention of cardiovascular events in diabetic patients, considering its title and definition. We considered nursing interventions which obtained weighted arithmetic averages >0·80 to be valid. RESULTS: Among 50 invited experts, 14 (71·4% female; 36·5 + 9·7 years) responded and agreed to participate in this study. They analysed 225 preselected nursing interventions, and validated 29. CONCLUSION: The validated nursing interventions included documentation as well as biological, social and spiritual issues. RELEVANCE TO CLINICAL PRACTICE: The validated nursing interventions encompass a wide range of nursing knowledge, and these results provide empirical evidence for further studies.

Lower functional capacity is associated with higher cardiovascular risk in Brazilian patients with intermittent claudication.

The purpose of this study was to examine the association between cardiovascular risk estimated by the Framingham Risk Score and functional capacity in patients with peripheral artery disease using a 6-minute walk test. Fifty-six participants with intermittent claudication were recruited. The Framingham Risk Score was calculated and used to split the participants into two groups: Group A (mild and moderate risk) and group B (severe risk). The ankle-brachial index (ABI) was calculated for each leg using a handheld Doppler probe. Walking ability was verified by a 6-minute walk test. Descriptive statistics were used to describe the sample's demographic and clinical characteristics. To compare clinical data between the two groups, a t test or Mann-Whitney test was used as appropriate according to the type of variable being analyzed. The Pearson coefficient was used to verify the association between cardiovascular risk and functional capacity. Group A had 19 participants (60.5 ± 6.3 years; 36.8% male) and group B had 37 participants (63.4 ± 8.7 years; 73% male). No differences were observed when comparing the ABI between both groups. The total distances covered by the men in group A were shorter compared with those of group B (331.4 + 51.5 vs 257.9 + 84.0; P = .02). The cardiovascular risk score was negative and was significantly correlated with total distances for men (r = -0.53; P = .001) and with pain-free distances for women (r = -0.46; P = .03). Functional capacity, evaluated through a 6-minute walk test, seems to be associated with 10-year total mortality risk.

Validity, reliability and accuracy of oscillometric devices, compared with Doppler ultrasound, for determination of the Ankle Brachial Index: an integrative review / Validade, confiabilidade e acurácia dos dispositivos oscilométricos em comparação ao Doppler, para determinação do Índice Tornozelo-Braquial: revisão integrativa

INTRODUCTION: The conventional method for measuring the ankle-brachial index (ABI) requires a vascular Doppler machine and a trained professional, which is a barrier to the examination becoming more widely adopted across health services. For this reason, the possibility of substituting Doppler monitors for other types of device has been investigated. The objective of this study was to assess the validity, reliability and accuracy of taking ABI measurement using oscillometric devices and compare them to vascular Doppler. METHODS: This is an integrative literature review of four articles. RESULTS: There was very little uniformity between the four studies in terms of ample populations or the methodological procedures used to measure systolic pressures. The results for sensitivity, specificity and positive and negative predictive values varied and so did measures of reliability. CONCLUSIONS: The results of these studies do not provide a basis from which conclusions can be drawn on the validity, reliability or accuracy of employing oscillometric devices as a substitute for Doppler for determination of ABI. .

INTRODUÇÃO: A necessidade do Doppler vascular e da capacitação profissional para a realização do método convencional para medida do índice tornozelo-braquial (ITB) é uma barreira à disseminação desse tipo de avaliação nos serviços de saúde. Nesse contexto, a substituição do Doppler por outros dispositivos tem sido investigada. O objetivo deste trabalho foi avaliar a validade, a confiabilidade e a acurácia da determinação do ITB com o uso de dispositivo oscilométrico comparado ao Doppler vascular. MÉTODO: Esta revisão integrativa da literatura incluiu quatro artigos. RESULTADOS: Os estudos foram bastante heterogêneos com relação à população estudada e aos procedimentos metodológicos para aferição das pressões sistólicas. Variações nos valores de sensibilidade e especificidade, e valores preditivos positivo e negativo foram observadas, assim como nas medidas de confiabilidade. CONCLUSÃO: Os resultados dos estudos não permitiram tecer conclusões acerca da validade, da confiabilidade e da acurácia da utilização do dispositivo oscilométrico em substituição ao Doppler, para determinação do ITB. .

Distances walked in the six-minute walk test: suggestion of defining characteristic for the nursing diagnosis Ineffective Peripheral Tissue Perfusion.

Distances walked in walking tests are important functional markers, although they are not accepted as defining characteristics of Ineffective Peripheral Tissue Perfusion. The aims of this study were to verify the distances participants with and without this nursing diagnosis walked in the six-minute walk test and if these measures may be considered defining characteristics of this phenomenon. Participants with (group A; n=65) and without (group B; n=17) this nursing diagnosis were evaluated regarding physical examination, vascular function and functional capacity. Participants of group A seemed to have worse vascular function and functional capacity compared with those of group B. Pain-free travelled distance was predictive of the nursing diagnosis. These results are important for the refinement of this diagnosis. In conclusion, this study provides evidences that the distances walked in the six-minute walk test may be considered defining characteristics of Ineffective Peripheral Tissue Perfusion.

Defining characteristics of decreased cardiac output: a literature review.

OBJECTIVE: The study aims to proceed a literature review of defining characteristics (DCs) of decreased cardiac output (DCO). METHODS: Medline database was used to perform this study. The descriptors used were "low cardiac output" and "nursing diagnosis." RESULTS: Seventy-nine DCs were identified. Among them, 28 have already been approved by NANDA-I. Some data from microcirculation assessment such as high levels of serum lactate and decreased oxygen venous saturation were identified as indicators of this nursing diagnosis. CONCLUSIONS: Some of the approved DCs were identified through literature review but others seem to be new as they have not been cited in the NANDA-I classification. PRACTICAL IMPLICATIONS: Further content and clinical validations are needed to confirm if data from microcirculation might be considered as DCs of DCO.

[Comparative study on the identification of occupational risks for nursing workers at 2 basic health units of the municipality of Sao Paulo]. / Um estudo comparativo sobre a identificação dos riscos ocupacionais por trabalhadores de enfermagem de duas unidades básicas de saúde do município de São Paulo.

Occupational risks of nursing work in Basic Health Units have not been study frequently, so it stimulate us to develop this paper, whose objective are: to compare the perception of nursing workers of two Basic Health Units about these risks and to establish a parallel between the health problems with their exposition to occupational risks. Data were collected by an interview and were analyzed according to their frequencies. Biological risks were observed more frequently. The conclusions show that nursing workers have difficult to understand the genesis of occupational risks.