Procedures for a Transpyloric Feeding Tube Inserted Into Newborns and Infants: A Systematic Review.

BACKGROUND: Enteral feeding by a transpyloric tube in critically ill infants is indicated when there is a failure in gastric feeding. However, there is a wide variability regarding the insertion technique. PURPOSE: To perform a systematic review of the methods for inserting a transpyloric feeding tube in newborns and infants. DATA SOURCES: Nine databases, without date or language restrictions, accessed in September 2021. STUDY SELECTION: A systematic review of experimental and nonexperimental studies, according to the "Patient/problem; Intervention; Comparison; Outcome" strategy and the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. The clinical question was about the measurement and insertion techniques, as well as the success rates of properly placing a transpyloric tube in newborns and infants. DATA EXTRACTION: Two authors (N.M.Q. and J.F.S.) analyzed 6 observational descriptive prospective studies, all of them published in peer-reviewed indexed medical journals and one in the official journal of the National Association of Neonatal Nurses. RESULTS: The success rate varied between 70% and 100%. There was an important variability in the type of tube, measurement method, and insertion techniques. It was found that the most common strategies to achieve proper positioning were glabella-calcaneal measurements, gastric air insufflation, and right lateral decubitus. IMPLICATIONS FOR PRACTICE: A transpyloric catheter insertion protocol needs to be established in each neonatal unit, according to the literature findings. IMPLICATIONS FOR RESEARCH: Randomized controlled studies that evaluate the gastric air insufflation technique and other adjuvant measures could elucidate the knowledge gap concerning the correct positioning of transpyloric tubing in newborns and infants.

The Use of Ultrasonography for Verifying Gastric Tube Placement in Newborns.

BACKGROUND: The use of gastric tubes in newborns admitted to a neonatal intensive care unit is fairly high, and there is a risk of serious complications related to this procedure. PURPOSE: Considering the need to find a method that does not involve the patient's exposure to radiation, this study aimed to evaluate the diagnostic accuracy of ultrasonography for verifying gastric tube placement in newborns. METHODS: This was a prospective, double-blind, observational study performed in a neonatal intensive care unit, in which 159 infants had gastric intubation using ultrasound examination and radiological imaging, to verify positioning. Results were analyzed in terms of diagnostic accuracy. RESULTS: The tubes were correctly positioned in 157 cases (98.7%), according to radiological images, and in 156 cases (98.1%), according to ultrasound. The sensitivity analysis was 0.98 and the positive predictive value was 0.99. It was not possible to perform a specificity analysis, as there were not enough negative cases in the sample. IMPLICATIONS FOR PRACTICE: The use of ultrasonography to identify correct positioning of gastric tubes in infants and newborns shows good sensitivity. IMPLICATIONS FOR RESEARCH: It was not possible to evaluate the ultrasonography specificity; further studies with greater samples are probably necessary, so that this objective can be achieved.Video Abstract available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=29&autoPlay=true.

Brazilian Neonatal Nurses' Palliative Care Experiences.

The purpose of palliative care (PC) is to minimize suffering and improve quality of life. Although PC has been well studied, the experience of neonatal intensive care unit (NICU) nurses in Brazil, where little PC training is provided, requires further investigation. The objective of this study was to explore the PC experiences of Brazilian NICU nurses. An exploratory, qualitative, descriptive study was conducted using semistructured, individual interviews with NICU nurses. This study was conducted in a 30-bed NICU in a teaching hospital in Sao Paulo, Brazil. A convenience sample of registered nurses (N = 9) was recruited. Interviews were recorded and transcribed verbatim, and thematic analysis was used to analyze the data. Four themes were identified: (a) living with the grief, (b) identifying with the family, (c) providing humane care, and (d) feeling unprepared. Nurses experienced intense grief while providing PC. They closely identified with the families and aimed to provide humane care that respected the families' values and the infants as human beings. The nurses also felt they lacked adequate training in PC and expressed a need for additional education and emotional support. NICU nurses need adequate education and emotional support to ensure quality nursing care for this vulnerable population of infants and their families.

Validation of the Échelle Douleur Inconfort Nouveau-Né for Brazilian culture. / Validação da Échelle Douleur Inconfort Nouveau-Né para a cultura brasileira.

OBJECTIVE: To evaluate the reliability and validity of the Brazilian version of the Échelle Douleur Inconfort Nouveau-Né, which measures prolonged pain in neonates. METHOD: A methodological study carried out with 96 neonates. The Brazilian versions of the Échelle Douleur Inconfort Nouveau-Né and the Children's and Infants' Postoperative Pain Scale were used for data collection. For reliability, equivalence measured by intraobserver agreement and homogeneity were considered. To evaluate the validity, the convergent construct approach was considered correlating the Brazilian versions of the Échelle Douleur Inconfort Nouveau-Né and the Children's and Infants' Postoperative Pain Scale. RESULTS: In assessing reliability, the coefficient of agreement between observers varied between 0.64 and 0.85 for the items that make up the instrument, and 0.96 for the total score. Cronbach's alpha was 0.82. Regarding the convergent validity evaluation, Spearman correlation coefficient between the values found for both scales was 0.79 (p< 0.0001). CONCLUSION: The Brazilian version of the Échelle Douleur Inconfort Nouveau-Né is a reliable and valid instrument for assessing prolonged pain in neonates.

Factors related to Nursing workload in the Oncology assistance provided to hospitalized women.

OBJECTIVE: to evaluate the Nursing workload and its related factors in the assistance provided to hospitalized women with gynecological and breast cancers, according to the Nursing Activities Scores adapted for cancer patients. METHOD: a cross-sectional and epidemiological study. The participants were women with gynecological and/or breast cancer, over 18 years of age, and hospitalized for a minimum period of 24 hours. The following was collected from the medical records: sociodemographic and clinical data, Karnofsky Performance Status and workload, according to the adapted Nursing Activities Score. The factors related to workload were analyzed by means of multiple linear regression. RESULTS: the mean Nursing Activities Scores was 29.3%, denoting seven hours of daily care per patient. The factors related to workload differed according to the breast or gynecological cancer diagnosis (ß=-0.01; p<0.001), clinical or surgical treatment (ß=-0.03; p<0.001) and functional capacity at admission (ß=0.07; p<0.001), as per the Karnofsky Performance Status. CONCLUSION: there was greater workload for the care of women with gynecological cancer undergoing clinical treatment and with lower functional capacity at admission. The findings reveal directions for optimization of resources and improvements in work processes and flows, in order to promote a favorable work environment and good quality assistance. BACKGROUND: (1) A pioneer study in using the NAS instrument, adapted for Hospital Oncology. BACKGROUND: (2) The clinical treatment of gynecological/breast cancer demands a greater workload. BACKGROUND: (3) Functional capacity at the admission of women with cancer influences workload. BACKGROUND: (4) Gynecological cancer demands a greater Nursing workload than breast cancer.

Knowledge, attitudes and practice on sudden infant death: study protocol of a scoping review.

INTRODUCTION: Sudden infant death syndrome (SIDS) is the unexpected death of an infant less than 1 year old, which occurs without presentation of any signs of mortality risk and it is not explained even after investigation, necropsy and review of the site of death. The nurse is an essential healthcare professional working with children and families who can contribute to preventing avoidable deaths of infants. Because SIDS is preventable, permanent education of the healthcare team, family members and infant caregivers is necessary. OBJECTIVE: To explore the scientific literature about knowledge, attitudes and practice on SIDS. METHODS AND ANALYSIS: A scoping review will be conducted. Quantitative or qualitative primary studies, theses, dissertations and technical and governmental documents in English, Spanish, French or Portuguese will be considered, without a time limit for selection with search, in the databases: Pubmed, Embase, Scopus, Virtual Health Library, Digital Library of Theses and Dissertations of the Brazilian Institute and Cochrane. A search strategy will be elaborated with the keywords in the following themes: knowledge, attitudes, practice, sudden infant death and healthcare. The eligibility criteria will be applied to references of selected articles to identify new studies. The studies selected will be subjected to thematic content analysis, which allows data interpretation through a systematic classification process for coding themes to the analysis of quantitative and qualitative studies and meta-aggregation. NVIVO V.14 software will be used to organise, code and validate the data. ETHICS AND DISSEMINATION: Ethics approval is not required. The results will be disseminated to the health science community through professional networks, conference presentations and publication in a scientific journal.

Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants.

OBJECTIVE: To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. METHOD: Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). RESULTS: Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. CONCLUSION: Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

[Mother role conflicts in studies with mothers of hospitalized newborns: an integrative review]. / Conflito no desempenho do papel de mãe em estudos com mães de recém-nascidos hospitalizados: revisão integrativa.

The hospitalization of a newborn separates mother and child at a time when their contact is essential for developing the mother's role. Therefore, mothers tend to feel incapable of meeting their child's needs, and face difficulties in dealing with their personal feelings and the demands of their family. The objective of this study was to identify the defining characteristics of the nursing diagnosis Conflict in performing the role of mother in studies addressing the experience of being a mother in the neonatal unit. This is an integrative literature review, which utilized 15 qualitative studies published between 2004 and 2009, in journals indexed in the Latin American and Caribbean Health Sciences Literature and on the Medical Literature and Retrieval System Online. This diagnosis is a nursing phenomenon to be studied by neonatal nurses so they are able to recognize and propose interventions to meet the mothers' needs, considering that nine out of ten defining characteristics were identified in the mothers' statements.

Nursing Process in Primary Care: perception of nurses.

OBJECTIVES: to understand the perception of Primary Health Care nurses about the application of the Nursing Process. METHODS: this is a qualitative, descriptive study. Data was collected through semi-structured interviews with Primary Health Care nurses from a city in the interior of the state of São Paulo, analyzed by Content Analysis under the theoretical framework of Work Process. RESULTS: three categories were obtained: Extrinsic factors to the Nursing Process; Intrinsic factors to the Nursing Process; and Knowledge. FINAL CONSIDERATIONS: the nurses considered the Nursing Process relevant for the profession, but historical, political, and social issues related to nursing, and health, as well as conflicts regarding its concept and academic training, hinder its application.

Assessment of women's satisfaction with labor and childbirth at a teaching hospital.

OBJECTIVE: To assess the satisfaction of puerperal women regarding labor and childbirth. METHOD: Analytical and cross-sectional research carried out with puerperal women at a teaching hospital. Data were collected from October to December 2020 by a sociodemographic and obstetric questionnaire and the Mackey Childbirth Satisfaction Rating Scale. The scale has 34 items divided into six domains, with a minimum score of 34 and a maximum of 170 points. RESULTS: The mean score was 141 points in a sample of 243 puerperal women, with a standard deviation of 16.8. There was high satisfaction among women in all domains of the scale and low adherence to the best practices in labor and childbirth care currently recommended. CONCLUSION: The women were satisfied upon the experience. The limitation of the health education process during prenatal care may reduce the parturient' discernment and critical judgment.

[Planning the hospital discharge of patients with diabetes: the construction of a proposal]. / Planejamento da alta hospitalar do paciente diabético: construção de uma proposta.

The acute and chronic complications that patients with diabetes and their families have to deal with after hospital discharge may be a consequence of the deficiencies in the educational process across hospitalization and the formal preparation for discharge. The objective of this study is to present a proposal of the plan for hospital discharge of adult patients with diabetes. A literature review on the hospital discharge of the assessed population was performed, including articles published between 2004 and February 2009. Taking the literature into consideration, a flier was created to guide the discharge process. The flier lists the information that should be collected and worked with the patient during the first four days of hospitalization, considering their individual needs and the Ineffective self health management. The discharge must be inserted in the Nursing Process, as nurses have an essential role in identifying the needs of patients and their families. The flier helps to identify the patient's needs and the actions to be performed by the team.

Adaptation of an instrument to classify neonatal patients into care categories.

OBJECTIVE: To adapt and validate a patient classification instrument for neonatal units. METHOD: Methodological study, with adaptation of the Pediatric Patients Classification Instrument for neonatal patients. After content validation by judges, the instrument was tested for reliability, applied to 33 neonates by two nurses, simultaneously. To assess the agreement among nurses regarding the scores of each patient on the classification scale, an intraclass agreement coefficient was applied. To assess the agreement regarding the classification in care categories, the weighted Kappa coefficient was calculated. RESULTS: The adapted instrument consisted of a total of nine indicators, with three care categories: high dependence on care, semi-intensive care and intensive care. The Content Validity Index varied between 0.85 and 0.92 for items of the instrument. The intraclass agreement was 0.87 and the weighted Kappa for care categories was 0.56. CONCLUSION: An instrument that allows neonatal patients to be classified into care categories, with satisfactory reliability was validated to support the dimensioning of the nursing team.

[Assessment of self-esteem in pregnant women using Rosenberg's Self-Esteem Scale]. / Avaliação da autoestima de gestantes com uso da Escala de Autoestima de Rosenberg.

The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenberg's Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the sociodemographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant women's low self-esteem. Other associations between variables were not statistically significant.

Randomized Clinical Trial Comparing Two Methods of Measuring Insertion Length of Nasogastric Tubes in Newborns.

INTRODUCTION: The selection of a method for measuring the insertion length of nasogastric tubes in newborns is an important factor in establishing the safe use of this device. OBJECTIVE: The objective was to verify whether there is a difference in the proportion of correctly placed nasogastric tubes when using the nose, earlobe, mid-umbilicus (NEMU) method and the weight-based equation for measuring the insertion length. METHODS: This study is a randomized, controlled, blinded study comparing 2 methods of nasogastric insertion at a neonatal unit, with intensive and intermediate care, on 162 randomized individuals. Radiological assessment and pH test were conducted to verify tube placement. Data were collected on sex, birth weight, gestational age, and days of life. A log-binomial model was used to verify whether there were placement differences between investigated methods. RESULTS: Of the patients, 56.1% were male, who had a mean birth weight of 1886.8 g and gestational age of 32.9 weeks and were 10.8 days old. Radiological images demonstrated that tubes were properly placed in the gastric body in 67.5% of patients using the NEMU method and in 91.5% using the weight-based equation: the weight-based equation was superior to the NEMU method, with a prevalence ratio of 1.36 (95% CI, 1.15-1.44). There was no difference between the 2 methods, according to pH test (P-value: .7179). CONCLUSION: Based on radiographic confirmation, the weight-based equation for measuring the insertion length of the nasogastric tube in newborns resulted in significantly more nasogastric tubes being placed in the correct intragastric location.

Childhood colic management under the optics of mothers and of the family health team.

OBJECTIVE: to unveil the interrelation of childhood colic management by mothers and Family Health Strategy professional. METHODS: a qualitative, exploratory and descriptive research carried out with 4 Family Health Strategy teams and 31 mothers who experienced childhood colic. Data collection included, respectively, focus group and individual unstructured interview. Symbolic Interactionism was adopted as the theoretical framework, and Narrative Research as methodological. RESULTS: two themes emerged: "Colic approach" and "Social support and care". Professional childhood colic management is based on diagnosis and drug interventions. For mothers, the child's suffering and impotence in the face of the disease stand out. FINAL CONSIDERATIONS: childhood colic is socially widespread because it is a physiological and self-limiting event. Mothers felt helpless in the face of childhood colic. Professionals felt the need to expand their care, with a view to achieving maternal suffering and alleviating it.

Conceptual and operational definition of nursing outcomes regarding the breastfeeding establishment.

OBJECTIVE: to construct conceptual and operational definitions of Nursing Outcomes "Breastfeeding establishment: infant (1000)" and "Breastfeeding establishment: maternal (1001)". METHOD: integrative literature review in the following databases: PUBMED (United States National Library of Medicine); LILACS (Latin American and Caribbean Health Sciences Literature); CINAHL (Cumulative Index to Nursing and Allied Health Literature); SciVerse SCOPUS; Web of Science; BDENF (Brazilian Nursing Database) and EMBASE (Excerpta Medica Database). The gray literature was explored to elucidate topics not covered by the articles. Of 3242 articles, 96 were selected to be read in full, and 43 were used for constructing the definitions. Five theses, three dissertations, three books and two manuals were selected. RESULTS: all the results were reviewed. The definitions facilitated the improvement of the content proposed by the Nursing Outcomes Classification, favoring its application in clinical practice and supporting the development of research and teaching. CONCLUSION: it was proposed to change the definition of the two outcomes, as well as to change the title of one of them to "Breastfeeding establishment: newborn & infant" (1000), modifying seven of its indicators and excluding one. For the outcome related to the mother, it was proposed to modify two indicators and exclude one.

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.

Factors related to Nursing workload in the Oncology assistance provided to hospitalized women / Factores relacionados con la carga de trabajo de enfermería en la atención oncológica de mujeres hospitalizadas / Fatores relacionados à carga de trabalho da enfermagem na assistência oncológica de mulheres hospitalizadas

Objective: to evaluate the Nursing workload and its related factors in the assistance provided to hospitalized women with gynecological and breast cancers, according to the Nursing Activities Scores adapted for cancer patients. Method: a cross-sectional and epidemiological study. The participants were women with gynecological and/or breast cancer, over 18 years of age, and hospitalized for a minimum period of 24 hours. The following was collected from the medical records: sociodemographic and clinical data, Karnofsky Performance Status and workload, according to the adapted Nursing Activities Score. The factors related to workload were analyzed by means of multiple linear regression. Results: the mean Nursing Activities Scores was 29.3%, denoting seven hours of daily care per patient. The factors related to workload differed according to the breast or gynecological cancer diagnosis (β=-0.01; p<0.001), clinical or surgical treatment (β=-0.03; p<0.001) and functional capacity at admission (β=0.07; p<0.001), as per the Karnofsky Performance Status. Conclusion: there was greater workload for the care of women with gynecological cancer undergoing clinical treatment and with lower functional capacity at admission. The findings reveal directions for optimization of resources and improvements in work processes and flows, in order to promote a favorable work environment and good quality assistance.

Objetivo: evaluar la carga de trabajo de enfermería y los factores relacionados con la atención de mujeres hospitalizadas con cáncer ginecológico y de mama, según el Nursing Activities Scores adaptado para pacientes oncológicos. Método: estudio epidemiológico y transversal. Participaron mujeres con cáncer ginecológico y/o de mama, mayores de 18 años, hospitalizadas por un período mínimo de 24 horas. De las historias clínicas se recolectaron datos sociodemográficos y clínicos, Karnofsky Performance Status y carga de trabajo, según el Nursing Activity Score adaptado. Los factores relacionados con la carga de trabajo se analizaron mediante regresión lineal múltiple. Resultados: el puntaje promedio del Nursing Activity Scores fue del 29,3%, lo que indica que se brindan siete horas diarias de atención por paciente. Los factores relacionados con la carga de trabajo difirieron según diagnóstico de cáncer de mama o ginecológico (β=-0,01; p<0,001), tratamiento clínico o quirúrgico (β=-0,03; p<0,001) y capacidad funcional al momento del ingreso (β=0,07; p< 0,001), conforme a la escala Karnofsky Performance Status . Conclusión: hubo una mayor carga de trabajo en la atención a mujeres con cáncer ginecológico en tratamiento clínico y con menor capacidad funcional al momento del ingreso. Los hallazgos revelan información útil para optimizar recursos, mejorar procesos y flujos de trabajo, con el fin de promover un ambiente de trabajo favorable y una atención de calidad.

Objetivo: avaliar a carga de trabalho da enfermagem e seus fatores relacionados na assistência às mulheres hospitalizadas com cânceres ginecológicos e mamários, segundo o Nursing Activities Scores , adaptado a pacientes oncológicos. Método: estudo epidemiológico de corte transversal. Participaram mulheres com câncer ginecológico e/ou mamário, maiores de 18 anos, hospitalizadas por período mínimo de 24 horas. Coletados, do prontuário, dados sociodemográficos, clínicos, Karnofsky Performance Status e carga de trabalho, segundo Nursing Activities Score adaptado. Os fatores relacionados à carga de trabalho foram analisados por regressão linear múltipla. Resultados: pontuação média do Nursing Activities Scores foi 29,3%, denotando sete horas de assistência diária por paciente. Os fatores relacionados à carga de trabalho diferiram conforme diagnóstico de câncer de mama ou ginecológico (β= - 0,01; p<0,001), tratamento clínico ou cirúrgico (β= - 0,03; p<0,001) e capacidade funcional na admissão (β= 0,07; p<0,001), pelo Karnofsky Performance Status . Conclusão: evidenciou-se maior carga de trabalho para atendimento de mulheres com câncer ginecológico sob tratamento clínico e com menor capacidade funcional na admissão. Os achados revelam direcionamentos para otimização de recursos, melhorias em processos e fluxos de trabalho, a fim de promover ambiente laboral favorável e assistência de qualidade.

Attitudes of nurses from a public teaching hospital regarding the nursing process. / Atitude dos enfermeiros de um hospital público de ensino quanto ao processo de enfermagem.

OBJECTIVE: To measure the attitudes of nurses on nursing process at a public teaching hospital. METHOD: A cross-sectional and analytical study conducted with nurses at a tertiary hospital. It was applied an instrument to characterize sample, as well as the Positions on the Nursing Process instrument, which measures nurses' attitudes in relation to the nursing process. There are 20 items to be considered, in which the minimum possible value is 20 and the maximum of 140. The data were submitted to descriptive statistics and the variables of interest were analyzed by the Mann-Whitney, Student's t-test, Chi-square test, Kruskal-Wallis, Spearman's correlation coefficient and hierarchical multiple regression models, as appropriate. RESULTS: In a sample of 226 nurses, 80.5% (182) stated that they performed pdaily. The mean score of the instrument was 102.50 (SD = 21.76). The item "routine/creative" had a lower score (3.54), while "unimportant/important" had a higher score (5.81). CONCLUSION: The nurses reported being in favor and presented positive attitudes about nursing process, in addition to considering it important, but routine, as well as affirming little or no contact with research, classes or events on the subject.

Validação de conteúdo dos elementos do diagnóstico de enfermagem "amamentação ineficaz" / Content validation of the elements of the nursing diagnosis "ineffective breastfeeding" / Validación de contenido de los elementos del diagnóstico de enfermería "lactancia materna ineficaz"

Objetivo: revisar e validar os elementos do Diagnóstico de Enfermagem "Amamentação ineficaz" (00104) a partir da literatura e consenso de especialistas e construir definições operacionais para suas características definidoras. Método: trata-se de uma pesquisa metodológica desenvolvida em duas fases : revisão de escopo, baseada no proposto pelo Joanna Briggs Institute, e validação de conteúdo. Foram considerados validados os itens com Índice de Validade de Conteúdo ≥ 0,80 quanto a relevância, clareza e precisão. Resultados: elementos do Diagnósticos de Enfermagem foram mantidos como estão na atual edição da Classificação de Diagnósticos de Enfermagem da NANDA International (NANDA-I), enquanto outros sofreram modificações. Além disso, foi proposta a inclusão de fatores relacionados, populações de risco e condições associadas. Conclusão: este estudo possibilitou revisão e validação de conteúdo do Diagnóstico de Enfermagem "Amamentação ineficaz", presente na Classificação dos Diagnósticos de Enfermagem da NANDA-I

Objective: to review and validate the elements of the Nursing Diagnosis "Ineffective Breastfeeding" (00104) based on the literature and expert consensus, and to construct operational definitions for its defining characteristics. Method: this is a methodological study carried out in two phases: a scoping review, based on that proposed by the Joanna Briggs Institute, and content validation. Items with a Content Validity Index ≥ 0.80 in terms of relevance, clarity and precision were considered validated. Results: elements of the Nursing Diagnoses were kept as they are in the current edition of the NANDA International Classification of Nursing Diagnoses (NANDA-I), while others were modified. In addition, the inclusion of related factors, risk populations and associated conditions was proposed. Conclusion: this study enabled a review and validation of the content of the Nursing Diagnosis "Ineffective breastfeeding", present in the NANDA-I Classification of Nursing Diagnoses

Objetivos: revisar y validar los elementos del Diagnóstico de Enfermería "Lactancia Ineficaz" (00104) a partir de la literatura y el consenso de expertos, y construir definiciones operativas para sus características definitorias. Método: se trata de un estudio metodológico realizado en dos fases: una revisión de alcance, basada en la propuesta por el Joanna Briggs Institute, y una validación de contenido. Se consideraron validados los ítems con un Índice de Validez de Contenido ≥ 0,80 en términos de relevancia, claridad y precisión. Resultados: se mantuvieron elementos de los Diagnósticos de Enfermería tal y como están en la edición actual de la Clasificación Internacional de Diagnósticos de Enfermería NANDA (NANDA-I), mientras que otros fueron modificados. Además, se propuso la inclusión de factores relacionados, poblaciones de riesgo y condiciones asociadas. Conclusión: este estudio permitió la revisión y validación del contenido del Diagnóstico de Enfermería "Lactancia materna ineficaz", presente en la Clasificación de Diagnósticos de Enfermería NANDA-I