Ineffective airway clearance in adult patients after thoracic and upper abdominal surgery.

AIM: The aim of this study is to analyze the accuracy of the defining characteristics of ineffective airway clearance (IAC) in patients after thoracic and upper abdominal surgery. BACKGROUND: Although numerous studies have described the most prevalent respiratory NANDA-I diagnoses, only few investigates the precision of nursing assessments. METHODS: A cross-sectional study was conducted with 192 patients in a surgical clinic. Accuracy measures were obtained by the latent class analysis method. RESULTS: IAC was present in 46.73% of the sample. The defining characteristics with better predictive capacity were changes in respiratory rate and changes in respiratory rhythm. However, other defining characteristics also had high specificity, such as restlessness, cyanosis, excessive sputum, wide-eyed, orthopnea, adventitious breathing sounds, ineffective cough, and difficulty vocalizing. CONCLUSION: Results can contribute to the improvement of nursing assessments by providing information about the key clinical indicators of IAC.

Ineffective breathing pattern in cardiac postoperative patients: Diagnostic accuracy study.

PURPOSE: The aim of this study was to analyze the accuracy of the defining characteristics of ineffective breathing pattern (IBP) in postoperative cardiac patients. METHODS: A diagnostic accuracy study was performed with 98 patients. Measures of sensitivity, specificity, predictive values, likelihood ratios, diagnostic odds ratio, and area under the ROC curve were calculated. RESULTS: IBP was present in 23.5% of the patients. Alterations in depth of breathing (sensitivity 96%, negative likelihood ratio 0.11%) and pursed-lip breathing (sensitivity 99%, negative likelihood ratio 0.07%) were the most sensitive defining characteristics for IBP, while altered chest excursion (specificity 97%, positive likelihood ratio 11.41%) and prolonged expiration phase (specificity 99%, positive likelihood ratio 42.39%) were the most specific. CONCLUSION: Some clinical indicators were more related to the presence or absence of IBP than others. Knowledge of such measures can help nurses to assess patients more accurately.

Systematic review and meta-analysis of the accuracy of clinical indicators for ineffective airway clearance.

AIM: To report quantitative evidence for the accuracy of the defining characteristics of ineffective airway clearance in different settings and populations. BACKGROUND: Defining characteristics are tests used by nurses to clinically indicate the presence or absence of a particular nursing diagnosis. A few studies have reported the accuracy of certain defining characteristics of ineffective airway clearance, but these studies address specific populations with particular needs. DESIGN: A systematic review with meta-analysis was conducted to provide a synthesis and critical appraisal of the included studies. DATA SOURCES: The electronic databases CINAHL, PubMed, Scopus and LILACS were searched using a systematic search strategy for studies published in any year. The last search was performed on 31 July 2013. REVIEW METHODS: Using the recommendations from Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy and the Standards for Reporting of Diagnostic Accuracy (STARD), a systematic review was conducted using studies investigating the presence of ineffective airway clearance and its defining characteristics. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was used to evaluate the quality of the studies. RESULTS: Seven papers met the search criteria. The studies were developed in different clinical settings and most of them fulfilled QUADAS criteria. Summary measures indicated the following defining characteristics with higher accuracy values: adventitious breath sounds, changes in respiratory rate, difficult vocalizing, diminished breath sounds, dyspnoea, ineffective cough, orthopnoea and restlessness. CONCLUSION: This systematic review showed that the variability in clinical indicators of ineffective airway clearance is related to differences in the clinical settings and patients.

Defining the key clinical indicators for ineffective breathing pattern in paediatric patients: a meta-analysis of accuracy studies.

AIMS AND OBJECTIVES: The purpose of this study was to identify the key clinical indicators of ineffective breathing pattern among paediatric patients. BACKGROUND: When nurses perform clinical reasoning, certain characteristics represent the clinical indicators necessary to confirm the presence of a particular diagnosis. Some quantitative studies have reported the prevalence of ineffective breathing pattern in different samples of patients. However, these findings should be synthesised. DESIGN: Meta-analysis of quantitative nursing studies. METHODS: Studies were identified via systematic searches of CINAHL, LILACS, PubMed and Scopus using the key search terms 'ineffective', 'breathing' and 'pattern'. Additional quality-related inclusion criteria were gleaned from the Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy, the Standards for Reporting of Diagnostic Accuracy and the Quality Assessment of Diagnostic Accuracy Studies. The pertinent results from each study were extracted and analysed via meta-analysis. RESULTS: Six studies using paediatric populations met the inclusion criteria. Summary measures indicated that the following defining characteristics had the highest accuracy values for ineffective breathing pattern among children: bradypnoea, dyspnoea, nasal flaring, orthopnoea, tachypnoea and the use of accessory muscles to breathe. CONCLUSION: This meta-analysis provides information regarding the accuracy of the clinical indicators of ineffective breathing pattern from studies sampling diverse paediatric populations. RELEVANCE TO CLINICAL PRACTICE: Nurses can better use clinical indicators to infer the presence of ineffective breathing pattern when they are aware of the most relevant defining characteristics. Nursing students and professionals can also improve their critical thinking abilities and diagnostic reasoning based on these findings.

Clinical indicators of 'caregiver role strain' in caregivers of stroke patients.

The main objectives of this study were to investigate the prevalence of the nursing diagnosis caregiver role strain (CRS) in caregivers of patients with stroke and to identify the accuracy of this diagnosis's clinical indicators. A total of 42 stroke patient caregivers who provided in-home care services in a city in north-eastern Brazil. The sensitivity, specificity, and predictive value of clinical indicators of nursing diagnosis 'CRS' were analyzed. Study participants were mostly female, married and the daughters of stroke patients. CRS was present in 73.8% of caregivers. The presence of the clinical indicators, specifically, lack of time to meet personal needs (p = 0.011), increased emotional lability (p = 0.001), withdrawal from social life (p = 0.002), and changes in leisure activities (p = 0.002), presented high values for statistical measures of diagnostic accuracy.

Accuracy of the Defining Characteristics of the Sexual Dysfunction Nursing Diagnosis in Women with Breast Cancer.

PURPOSE: To analyze the accuracy of the defining characteristics of the nursing diagnosis of sexual dysfunction in women undergoing pharmacological treatment for breast cancer. METHODS: A cross-sectional accuracy study with statistical analysis. FINDINGS: Alteration in sexual satisfaction was the defining characteristic with the highest sensitivity value, while perceived sexual limitation was the defining characteristic with the highest value for both sensitivity and specificity. CONCLUSIONS: Perceived sexual limitation is a good clinical indicator to infer initial stages of sexual dysfunction and to confirm its presence. IMPLICATIONS FOR NURSING PRACTICE: Accurate diagnostics allow devising an action plan directed to the patients' real needs, helping prescribe and deliver the appropriate nursing interventions.

Developing and Testing of a Software Prototype to Support Diagnostic Reasoning of Nursing Students.

PURPOSE: To design and test educational software to improve nursing students' diagnostic reasoning through NANDA-I-based clinical scenarios. METHODS: A mixed method approach was used and included content validation by a panel of 13 experts and prototype testing by a sample of 56 students. FINDINGS: Experts' suggestions included writing adjustments, new response options, and replacement of clinical information on the scenarios. Percentages of students' correct answers were 65.7%, 62.2%, and 60.5% for related factors, defining characteristics, and nursing diagnoses, respectively. CONCLUSION: Full development of this software shows strong potential for enhancing students' diagnostic reasoning. IMPLICATIONS FOR NURSING PRACTICE: New graduates may be able to apply diagnostic reasoning more rapidly by exercising their diagnostic skills within this software.

OBJETIVO: Desenvolver e testar um protótipo de software educativo para melhorar o raciocínio diagnóstico de estudantes de enfermagem. MÉTODOS: Uma abordagem mista foi utilizada e incluiu validação de conteúdo por 13 experts e testagem do protótipo por 56 estudantes. RESULTADOS: Sugestões dos experts incluíram ajustes na escrita, inclusão de novas opções de resposta e substituição de dados clínicos nos cenários. Os percentuais de respostas corretas dos estudantes foram 65,7%, 62,2% e 60,5% para fatores relacionados, características definidoras e diagnósticos de enfermagem respectivamente. CONCLUSÃO: O desenvolvimento deste software tem um forte potencial para melhorar o raciocínio diagnóstico de estudantes. IMPLICAÇÕES PARA A PRÁTICA EM ENFERMAGEM: Através deste software, enfermeiros poderão ser capazes de exercitar o raciocínio diagnóstico e aplicá-lo mais rapidamente.

Accuracy of the defining characteristics of the nursing diagnosis for fatigue in women under radiotherapy.

OBJECTIVE: To evaluate the accuracy of the defining characteristics of the nursing diagnosis for "fatigue in women with breast cancer under radiotherapy". METHOD: Study of diagnostic accuracy, with cross-sectional design, performed in 130 women with breast cancer under radiation treatment. A data collection instrument was used to evaluate clinical socio-demographics and to investigate the presence or absence of defining characteristics for fatigue. The latent class analysis model was applied to assess accuracy measurements of the characteristics identified. RESULTS: Fatigue diagnosis was present in 21.9% of the women. The characteristic which showed the highest sensitivity was "Impaired capacity in maintaining the usual level of physical activity", while "Impaired capacity in maintaining usual routines" and "Lack of interest about the surrounding environment" presented greater specificity. CONCLUSION: Accurate diagnostics allow devising an action plan directed to the patients' real needs.

Respiratory status of adult patients in the postoperative period of thoracic or upper abdominal surgeries.

OBJECTIVE: to evaluate the respiratory status of postoperative adult patients by assessing the nursing outcome Respiratory Status. METHOD: descriptive, cross-sectional study developed with 312 patients. Eighteen NOC indicators were assessed and rated using a Likert-scale questionnaire and definitions. Descriptive and correlative analysis were conducted. RESULTS: the most compromised clinical indicators were coughing (65.5%), auscultated breath sounds (55%), and respiratory rate (51.3%). Factors associated with worse NOC ratings in specific clinical indicators were sex, age, pain, and general anesthesia. CONCLUSIONS: certain clinical indicators of respiratory status were more compromised than others in postoperative patients. Patient and context-related variables can affect the level of respiratory compromise.

Clinical Indicators of Impaired Gas Exchange in Cardiac Postoperative Patients.

PURPOSE: To analyze the accuracy of the defining characteristics of impaired gas exchange (IGE). METHODS: Cross-sectional study carried out in 93 cardiac postoperative adult patients. The 19 NANDA-I defining characteristics related to IGE were evaluated. FINDINGS: Ten defining characteristics were found in the sample. The best accuracy values, including specificity, diagnostic odds ratio, and likelihood ratios, inter alia, were found to decreased carbon dioxide, abnormal arterial blood gases, abnormal arterial pH, and abnormal breathing. CONCLUSION: Some clinical indicators predict the presence/absence of IGE more accurately than others. IMPLICATIONS FOR NURSING PRACTICE: Knowledge of the accuracy of defining characteristics allows an early identification of particular nursing diagnoses, which can prevent complications.

Fatores associados à coinfecção tuberculose/HIV no período 2001-2011 / Tuberculosis/HIV coinfection associated factors regarding the 2001-2011 timeframe

Objetivo: Analisar os fatores associados à coinfecção tuberculose/HIV e determinar a prevalência máxima e mínima da positividade do teste anti-HIV entre casos de tuberculose no Maranhão, no período de 2001 a 2011. Métodos: Estudo transversal realizado mediante consulta aos dados do Sistema de Informação de Agravos de Notificação. Para identificar associações, utilizou-se a regressão de Poisson com ajuste robusto da variância. Resultados: A prevalência da coinfecção tuberculose/HIV foi de 15,1%. Na análise bruta, as associações significativas para coinfecção foram sexo masculino, faixas etárias de 20 a 39 anos e de 40 a 59 anos, escolaridade inferior a oito anos, entrada por transferência e encerramento por abandono/óbito. Na análise ajustada, sexo masculino, faixa etária de 29 a 30 anos, escolaridade inferior a oito anos e encerramento por abandono/óbito permaneceram associados à coinfecção. Conclusão: Foi observada alta taxa de coinfecção tuberculose/HIV no estado do Maranhão e associações com diversos fatores relacionados à saúde

Objective: To analyze the factors associated with Tuberculosis/HIV coinfection and to determine the maximum and minimum prevalence of HIV test positivity among tuberculosis cases in Maranhão from 2001-2010. Methods: Cross-sectional study of data from the Notifiable Diseases Information System. Poisson regression was used with robust variance adjustment to identify associations. Results: Tuberculosis/ HIV coinfection prevalence was 15.1%. In the raw analysis, the significant associations for coinfection were male sex, age groups from 20-39 years and from 40-59 years, schooling less than 8 years, entry by transfer and closure by abandonment/death. In the adjusted analysis, male gender, age range of 29 to 30 years, schooling less than 8 years and closure due to abandonment/death remained associated with coinfection. Conclusion: Tuberculosis/HIV coinfection rate was high in the state of Maranhão and associations with several factors related to health

Objetivo: Analizar los factores asociados a la coinfección TB/VIH y determinar la prevalencia máxima y mínima de la prueba del VIH positiva entre los casos de TB en Maranhao, de 2001 a 2011. Métodos: Estudio transversal, realizado en consulta con los datos del Sistema de Información de Agravios y Notificaciones. Para identificar asociaciones, se utilizó regresión de Poisson con ajuste robusto de la varianza. Resultados: La prevalencia de la coinfección TB/VIH fue del 15,1%. En el análisis crudo, asociaciones significativas para la coinfección fueron sexo masculino, edades de 20-39 años y 40-59 años, educación menos de ocho años y cierre de la entrada por abandono/muerte. En el análisis ajustado, sexo, edad 29-30 años, educación menos de 8 años y final por abandono/ muerte se mantuvo asociado con la coinfección. Conclusión: Hubo una alta tasa de coinfección TB/VIH en el estado de Maranhão y asociaciones con diversos factores relacionados a la salud

Clinical indicators of ineffective airway clearance for patients in the cardiac postoperative period.

BACKGROUND: The accuracy of an indicator determines the direct relationship between a defining characteristic and the presence or absence of a specific nursing diagnosis. AIMS: To analyse the accuracy of the clinical indicators of ineffective airway clearance in patients during the postoperative period of cardiac surgery. METHODS: A total of 98 patients recruited from a postoperative unit were included in the study. An analysis of sensitivity, specificity, predictive value, likelihood ratio, diagnostic odds ratio, accuracy, and area under the ROC curve was used to determine the accuracy of these clinical indicators. RESULTS: Four clinical indicators showed the highest levels of accuracy by statistical measure: dyspnoea, adventitious breath sounds, ineffective cough, and retained secretions. The indicators retained secretions and ineffective cough showed high diagnostic odds ratios (62.8 and 28.1, respectively). CONCLUSION: The results suggest that there are differences between the ineffective airway clearance indicators as accuracy measures.

Accuracy of the defining characteristics of the nursing diagnosis for fatigue in women under radiotherapy / Precisión de las características definidoras del diagnóstico de enfermería fatiga en las mujeres durante radioterapia / Acurácia das características definidoras do diagnóstico de enfermagem fadiga em mulheres durante radioterapia

ABSTRACT Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis for "fatigue in women with breast cancer under radiotherapy". Method: Study of diagnostic accuracy, with cross-sectional design, performed in 130 women with breast cancer under radiation treatment. A data collection instrument was used to evaluate clinical socio-demographics and to investigate the presence or absence of defining characteristics for fatigue. The latent class analysis model was applied to assess accuracy measurements of the characteristics identified. Results: Fatigue diagnosis was present in 21.9% of the women. The characteristic which showed the highest sensitivity was "Impaired capacity in maintaining the usual level of physical activity", while "Impaired capacity in maintaining usual routines" and "Lack of interest about the surrounding environment" presented greater specificity. Conclusion: Accurate diagnostics allow devising an action plan directed to the patients' real needs.

RESUMEN Objetivo: Evaluar la precisión de las características definidoras del diagnóstico de enfermería "fatiga en mujeres con cáncer de mama en radioterapia". Método: Estudio de precisión diagnóstica con delineamiento transversal realizado en 130 mujeres con cáncer de mama en tratamiento radioterápico. Se ha utilizado un instrumento de recogida de datos para la evaluación sociodemográfica clínica y para la investigación de la presencia o de la ausencia de las características definidoras de la fatiga. Se ha aplicado el modelo de análisis de clase latente para la evaluación de las medidas de precisión de las características identificadas. Resultados: El diagnóstico de fatiga ha estado presente en el 21,9% de las mujeres. La característica que ha presentado la mayor sensibilidad ha sido "la capacidad perjudicada para mantener el nivel habitual de actividad física", mientras "la capacidad perjudicada para mantener las rutinas habituales" y "el desinterés cuanto al ambiente que lo rodea" presentaron especificidad más grande. Conclusión: Diagnósticos precisos permiten la construcción de un plan de acciones direccionado para las reales necesidades de los pacientes.

RESUMO Objetivo: Avaliar a acurácia das características definidoras do diagnóstico de enfermagem "fadiga em mulheres com câncer de mama em radioterapia". Método: Estudo de acurácia diagnóstica com delineamento transversal realizado em 130 mulheres com câncer de mama em tratamento radioterápico. Utilizou-se um instrumento de coleta de dados para avaliação sociodemográfica clínica e para investigação da presença ou ausência das características definidoras da fadiga. Aplicou-se o modelo de análise de classe latente para avaliação das medidas de acurácia das características identificadas. Resultados: O diagnóstico de fadiga esteve presente em 21,9% das mulheres. A característica que apresentou maior sensibilidade foi "capacidade prejudicada para manter o nível habitual de atividade física", enquanto "capacidade prejudicada para manter as rotinas habituais" e "desinteresse quanto ao ambiente que o cerca" apresentaram maior especificidade. Conclusão: Diagnósticos acurados permitem a construção de um plano de ações direcionado para as reais necessidades dos pacientes.

[Situational low self-esteem in pregnant women: an analysis of accuracy]. / Baixa autoestima situacional em gestantes: uma análise de acurácia.

To investigate the accuracy of defining characteristics of Situational low self-esteem we developed a cross-sectional study, with 52 pregnant women assisted in a family centre. The NANDA-I taxonomy was used as well as the Rosenberg's scale. The diagnosis was present in 32.7% of the sample and all characteristics presented statistical significance, except "Reports verbally situational challenge to its own value". The characteristics "Indecisive behavior" and "Helplessness expressions" had 82.35% of sensitivity. On the other hand, the characteristics "Expression of feelings of worthlessness" and "Reports verbally situational challenge to its own value" were the more specific, with 94.29% of specificity. These results can contribute with the nursing practice because the identification of accurate characteristics is essential to a secure inference.

Significados de ser familiar cuidador numa unidade de internação psiquiátrica / Meanings of being a family caregiver in a psychiatric hospitalization unit

Objetivos: compreender os significados e sentimentos de familiares cuidadores de pacientes internados em uma unidade psiquiátrica e conhecer essa relação de convívio entre familiares e cuidadores. Método: estudo descritivo, de abordagem qualitativa, com 26 acompanhantes, realizada na Unidade de Internação Psiquiátrica do Hospital Dr. Estevam Ponte, Sobral (CE), Brasil. Os dados foram produzidos a partir de uma entrevista semiestruturada. Para a análise de dados seguiu-se a análise temática. Resultados: foi encontrado um alto nível de sobrecarga pelos familiares, proveniente do cuidar. Conclusão: faz-se necessário a elaboração de pesquisas que se dirijam ao desenvolvimento e a análise de estratégias que venham ajudar a reduzir as dificuldades diárias dos cuidadores, promovendo a diminuição do desgaste mental na atividade do cuidado.

Cateterização venosa periférica por profissionais de enfermagem: estudo observacional / Intravenous cannulation by nursing professionals: observational study

Objetivo: caracterizar a realização do cateterismo venoso periférico por profissionais de enfermagem e avaliar sua adequação com base em um protocolo. Método: estudo observacional, de abordagem quantitativa, realizado com enfermeiros e técnicos de um hospital terciário, que foram observados durante a inserção e remoção de cateteres periféricos com base em um protocolo de procedimentos padronizados. Resultados: a amostra foi constituída por 46 profissionais dos quais 73,9% não tinham curso de capacitação específico para o procedimento, 86,3% lavaram as mãos antes do procedimento, todos utilizaram equipamento de proteção e50% afirmaram que o tempo máximo para uso do garrote é 1 minuto. Dezenove profissionais utilizaram álcool a 70% para a higienização do local de inserção do cateter. A média de tempo despendido no procedimento foi 17 minutos. Conclusão: a equipe de enfermagem utilizou medidas de proteção durante os procedimentos, porém há pontos que denotam a necessidade de atualização dos profissionais.

Respiratory status of adult patients in the postoperative period of thoracic or upper abdominal surgeries / Estado respiratório de pacientes adultos no período pós-operatório de cirurgias torácicas ou abdominal superior / Estado respiratorio de pacientes adultos en el postoperatorio de cirugías torácicas o de abdomen superior

ABSTRACT Objective: to evaluate the respiratory status of postoperative adult patients by assessing the nursing outcome Respiratory Status. Method: descriptive, cross-sectional study developed with 312 patients. Eighteen NOC indicators were assessed and rated using a Likert-scale questionnaire and definitions. Descriptive and correlative analysis were conducted. Results: the most compromised clinical indicators were coughing (65.5%), auscultated breath sounds (55%), and respiratory rate (51.3%). Factors associated with worse NOC ratings in specific clinical indicators were sex, age, pain, and general anesthesia. Conclusions: certain clinical indicators of respiratory status were more compromised than others in postoperative patients. Patient and context-related variables can affect the level of respiratory compromise.

RESUMO Objetivo: avaliar o estado respiratório de pacientes adultos no pós-operatório por meio da análise do resultado de enfermagem Estado Respiratório. Método: estudo descritivo e transversal desenvolvido com 312 pacientes. Dezoito indicadores da Classificação dos Resultados de Enfermagem (Nursing Outcomes Classification - NOC) foram avaliados e classificados utilizando um questionário contendo escalas Likert e definições. Foram realizadas análises descritivas e de correlações. Resultados: os indicadores clínicos mais comprometidos foram tosse (65,5%), ausculta de sons respiratórios (55%) e frequência respiratória (51,3%). Fatores associados com escores NOC comprometidos para indicadores clínicos específicos foram gênero, idade, dor e anestesia geral. Conclusões: certos indicadores clínicos do estado respiratório foram mais comprometidos do que outros em pacientes no pós-operatório. O paciente e as variáveis relacionadas aos pacientes e ao contexto podem afetar o nível de comprometimento respiratório.

RESUMEN Objetivo: evaluar el estado respiratorio de pacientes adultos en postoperatorio por la evaluación del resultado de enfermería Estado Respiratorio. Método: estudio descriptivo transversal realizado con 312 pacientes. Dieciocho indicadores de la Clasificación de Resultados en Enfermería (Nursing Outcomes Classification - NOC) fueron evaluados y calificados utilizando un cuestionario conteniendo escalas Likert y definiciones. Análisis descriptivos y de correlaciones fueron realizados. Resultados: los indicadores clínicos más comprometidos fueron tos (65,5%), auscultación de sonidos respiratorios (55%) y frecuencia respiratoria (51,3%). Factores asociados con puntuaciones NOC comprometidas en indicadores clínicos específicos fueron género, edad, dolor y anestesia general. Conclusiones: ciertos indicadores clínicos de estado respiratorio fueron más comprometidos que otros en pacientes postoperatorios. El paciente y las variables relacionadas con el paciente y el contexto pueden afectar el nivel de compromiso respiratorio.

[Scales for evaluation of the overload of caregivers of patients with stroke]. / Escalas para avaliação da sobrecarga de cuidadores de pacientes com acidente vascular encefálico.

The objective of the study was to evaluate the available productions in literature about scales to measure the overload of caregivers of patients with stroke. It was carried out a bibliographical revision in three databases: LILACS, CINAHL and SCOPUS. In 23 works, 24 different scales were identified, and the most cited were: the Caregiver Strain Index, the Caregiver Burden Scale, the Caregiver Reaction Assessment, the Sense of Competence Questionnaire, the Relatives Stress Scale and the Zarit Burden Interview. The use of scales to measure the overload is an important tool to evaluate the context in which the caregiver is inserted, but is more trustworthy to use more than one measure instrument than use only one. Therefore, the validation of scales becomes important for this population.

[Follow-up study of respiratory nursing diagnoses in children with acute respiratory infection]. / Estudio longitudinal de los diagnósticos de enfermería respiratorios en niños con infección respiratoria aguda.

OBJECTIVE: To determine the baseline prevalence and incidence rates of Impaired Gas Exchange (IGE), Ineffective Airway Clearance (IAC) and Ineffective Breathing Pattern (IBP) in children with acute respiratory infection. METHOD: A prospective open cohort study was conducted in two public hospitals specialized in child care in the months from January to June of 2011. The sample consisted of 136 children with acute respiratory infection, which lasted a minimum of six and maximum of ten consecutive days. The data were collected through examination of the child and interviews with their parents. The diagnostic inference process was developed by trained nurses. RESULTS: The three diagnoses showed high rates at the beginning of follow-up period, with a reduction in the days after. There were similar rates of IBP and IGE. The temporal development of IBP was similar to that of IAC, but in lower proportions. Incidence rates in cases per 100 person / day were to IAC 39.28, 17.04 for DIG, and 13.31 for PRI. CONCLUSION: The three diagnoses studied appeared early and in high proportions. New cases of IAC appear more quickly when compared to the other two diagnoses.

Cuidado ao lactente para mães em consultas de puericultura: intervenção em sala de espera / Care for lactating mothers in puericulture consultations: intervention in the waiting room

Objetivo: relatar a experiência da realização de sessões educativas para mães acerca do cuidado ao lactenteem sala de espera de consultas de puericultura. Método: estudo qualitativo, descritivo, tipo relato deexperiência, em que ocorreram as sessões educativas em uma Unidade de Atenção Primária à Saúde, cujacoleta de dados ocorreu de agosto de 2015 a março de 2017. Resultados: foram realizadas seis sessõeseducativas verificando o conhecimento pré-existente, implementando estratégias de educação em saúde e,posteriormente, verificando o conhecimento. Destaca-se o tópico “posicionamento da criança no momento daamamentação e das características da pega correta”. Verificou-se que, das mães, 40% (pré-teste) jáconheciam a temática e, após as explanações, o percentual acresceu para 75% (pós-teste), apresentandosignificância de p<0,016. Outro tópico em destaque foi “Vitamina D”; o quantitativo de acertos foi de 7,69%(pré-teste) para 76,92% (pós-teste), com valor significante (p<0,04). Conclusão: as sessões educativasassumiram uma conotação valorosa, tendo em vista que possibilitaram melhorar o conhecimento das mães.