Cross-cultural adaptation for Brazil and validity of a guide to assist nursing students' clinical reasoning.

PURPOSE: To assess the validity of a Written Clinical Reasoning Prompt (WCRP) to help nursing students' clinical reasoning (CR). METHOD: This is a methodological study of translation and cross-cultural adaptation into Brazilian Portuguese of instruments that aim to promote CR improvement, composed of (1) WCRP; (2) two case studies; (3) a questionnaire about students' perceptions during decision-making in case studies; (4) a scoring rubric for correcting case studies. For translation and cross-cultural adaptation, stages 1-8 of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network were adopted. Agreement values among experts >80% and content validity coefficient (CVC) > 0.8 were considered satisfactory. For the pretest, a randomized clinical trial was carried out with 24 nursing students (intervention group, n = 14, using the WCRP to solve case studies; control group, n = 10, without using the WCRP). FINDINGS: The WCRP was translated and adapted into Brazilian Portuguese, requiring minimal adjustments to obtain agreement among the judges above 80% and CVC above 0.80. Regarding face validation, an adequate agreement was obtained in the assessment by students. There was no difference in the accuracy of nursing diagnoses between the intervention and control groups in the pretest. CONCLUSION: The WCRP was translated and adapted into Brazilian Portuguese and had adequate face and content validity estimates; however, there was no association with improving nursing students' diagnostic accuracy. IMPLICATIONS FOR NURSING PRACTICE: The translated and adapted versions of all instruments into Brazilian Portuguese had adequate evidence of content and face validity. The use of WCRP was not associated with a significant improvement in nursing students' diagnostic accuracy. New studies with larger samples, a sample power of at least 80%, and a level of significance of 5% are needed.

Development and validation of an educational video on nasopharyngeal and oropharyngeal suctioning.

OBJECTIVE: The objective of this study was to develop and validate an educational video on nasopharyngeal and oropharyngeal suctioning. BACKGROUND: The use of videos in nursing education can improve students' skills in performing procedures. DESIGN: This was a methodological study. METHODS: This study was performed in five steps: (1) development of the script for an educational video on nasopharyngeal and oropharyngeal suctioning; (2) content validation of the script by 10 nurse specialists; (3) development of the video; (4) content validation of the video by six nurse specialists; (5) cognitive testing by 51 nursing students regarding the understanding of the items, until the following requirements were met: (1) mean and median scores ≥4, with significant inter-rater agreement, according to the Wilcoxon test; (2) 95% confidence intervals >80 for the proportion of maximum scores, according to the binomial distribution. p values <0.05 were considered significant. RESULTS: After four rounds of evaluation by the specialists, the script was considered validated. The video was considered validated after two rounds of evaluation by specialists and students (p < 0.001). The video addressed the following topics: concept, indications, contraindications, required materials, appropriate technique, nursing notes and complications. CONCLUSIONS: The video script was created by using the Storyboard technique and validated by specialist nurses using the Delphi technique. Nursing students watched, analyzed and understood the video which may support them to improve their technical skills of this procedure.

Symptom Status Questionnaire - Heart Failure - Brazilian Version: cross-cultural adaptation and content validation.

BACKGROUND: In Brazil, there are no instruments available to measure the presence, frequency, severity and distress related to heart failure (HF) symptoms. AIMS: To adapt the Symptom Status Questionnaire - HF (SSQ-HF) into Brazilian Portuguese and to examine the content validity of the adapted version. METHODS: The instrument was translated, back-translated and evaluated by an expert committee for semantic, idiomatic, cultural, and conceptual equivalences. An agreement ≥80% was considered adequate. The adapted version was evaluated by both an expert committee (n = 9) for clarity, theoretical relevance and practical relevance (acceptable content validity coefficient (CVC): ≥0.70), and by a patient committee regarding understanding (n = 40). RESULTS: The adapted version obtained 100% agreement regarding the equivalences. The total instrument CVC was 0.99. All patients understood the items. CONCLUSION: The SSQ-HF-Brazilian version has satisfactory evidence of equivalence and content validity. Additional psychometric tests are deemed to confirm that the instrument can be used in Brazil.

Efficacy of a video during bed bath simulation on improving the performance of psychomotor skills of nursing undergraduates: A randomized clinical trial.

BACKGROUND: Studies have shown the efficacy of videos used in isolation to retain knowledge, acquire skills, and establish students' self-confidence. A few studies have investigated the efficacy of videos associated with simulations, while none of these studies have addressed bed bathing, one of the first procedures learned by nursing students. OBJECTIVE: To test the efficacy of a video-assisted bed bath simulation on improving the performance of psychomotor skills of undergraduate nursing students. DESIGN: A randomized clinical trial. SETTING: A Teaching Skills and Simulation Center at a Federal University in Brazil. PARTICIPANTS: All students regularly enrolled in the second year of the nursing undergraduate program at a Federal University, aged 18 years old, who had never performed a bed bath and had attended a theoretical class addressing the procedure (n = 56). METHODS: The students were randomized into two groups: the Control group (n = 28) simulated a bed bath with the instructions of a tutor, while the Intervention group (n = 28) watched a video during the bed bathing simulation, under the supervision of a tutor. The performance of students concerning bed bathing was assessed twice (before and after the simulation) using a previously validated instrument. RESULTS: The psychomotor skills of both groups significantly improved in the second assessment, and the Intervention group scored higher (p = 0.003). CONCLUSIONS: The use of a video during bed bath simulations was efficacious for improving the performance of psychomotor skills of undergraduate nursing students.

Experts for Validation Studies in Nursing: New Proposal and Selection Criteria.

OBJECTIVE: To propose new criteria for expert selection for validation studies in nursing in Brazil. METHODS: (a) Literature review on terms related to expertise and criteria for expert selection; and (b) development of new consensus criteria for expert selection and consensus building. RESULTS: Definitions for the terms novice, advanced beginner, competent, proficient, and expert were found. In the second phase, criteria to rank the experts (junior, senior, and master) were developed and validated according to a score of 5-20. CONCLUSION AND IMPLICATIONS FOR NURSING PRACTICE: The new criteria valued clinical experience over academic experience. The use of these criteria by researchers in the country should reduce uncertainties, difficulties, and limitations imposed by the modification/current adaptation of already existing criteria.

Defining Characteristics and Related Factors of Decreased Cardiac Tissue Perfusion: Proposal of a New Nursing Diagnosis.

PURPOSE: To identify the possible defining characteristics (DCs) and related factors of the nursing diagnosis (ND) decreased cardiac tissue perfusion. METHODS: Cross-sectional study using medical charts of adults admitted to an emergency department with the chief complaint of chest pain in a hospital in São Paulo, Brazil. FINDINGS: DCs identified: crushing chest pain, elevated markers of myocardial necrosis, ischemic electrocardiogram changes, sweating, nausea, and vomiting. Related factors identified: interruption of arterial blood flow and coronary spasm. CONCLUSION: This ND was clinically identified due to significant differences in the DCs of patients with and without the diagnosis. PRACTICE IMPLICATIONS: The clinical indicators identified in this study can be the starting point for the DCs for this ND.

Construction and validation of a data collection tool for the clinical assessment of human responses of outpatients with chronic cardiovascular diseases.

PURPOSE: To develop and test the content validity of a nursing assessment tool for data collection (NATDC) based on NANDA-I for use in outpatients with chronic cardiovascular diseases. METHODS: Construction based on the literature, refinement with a pilot group of hypertensive outpatients and content validation by experts. FINDINGS: The NATDC questions were divided into demographic information of the patient and family, clinical data, physical examination, and interview according to NANDA-I domains. CONCLUSION: The NATDC was constructed and validated. IMPLICATIONS FOR NURSING PRACTICE: This tool can be used in patients with chronic illnesses who experience a variety of human responses seeking nursing care in an outpatient setting because it is based in human responses within a structured framework for nursing assessment.

Hospital discharge plan for patients with congestive heart failure / Plano de alta hospitalar a pacientes com insuficiência cardíaca congestiva / Plan del alta hospitalaria para pacientes con insuficiencia cardíaca congestiva

This integrative review investigates how nurses plan the hospital discharge of patients with Congestive Heart Failure (CHF) since an inadequate discharge plan and patients’ subsequent non-adherence to instruction provided upon discharge are indicated as potential factors for re-hospitalization. A total of 24 papers were found in a search carried out in the LILACS and MEDLINE databases between 2004 and 2008, which given the inclusion criteria, were reduced to 14 papers. The papers were analyzed and categorized into ‘Health Education’, and ‘Nursing Care’. The synthesis of results indicates that the discharge plan devised by nurses is based on two categories. The actions of nurses to promote health education can enable patients with CHF to improve self-care.

Trata-se de artigo de revisão integrativa que teve por objetivo identificar como as enfermeiras têm planejado a alta dos pacientes com insuficiência cardíaca congestiva, pois o inadequado plano de alta e o não seguimento das orientações dadas são apontados como possíveis fatores de re-hospitalização. Através da busca nas bases de dados LILACS e MEDLINE, abrangendo o período de 2004 a 2008, foram encontrados 24 artigos que, pelo critério de seleção da amostra, resultaram em 14. Os artigos foram analisados e categorizados em Educação em Saúde e Cuidado de Enfermagem. Com isso, foi possível sintetizar os resultados e identificar que o plano de alta realizado pelos enfermeiros está baseado nessas duas categorias, pois as condutas do enfermeiro para promover a educação em saúde podem proporcionar ao paciente com insuficiência cardíaca congestiva melhora no autocuidado.

Artículo de revisión integradora que tiene por objetivo identificar como las enfermeras han planificado el alta de los pacientes con Insuficiencia Cardíaca Congestiva, ya que el plan de alta inadecuado y el no seguimiento de las orientaciones dadas son apuntados como posibles factores de rehospitalización. A través de la búsqueda en las bases de datos LILACS y MEDLINE, abarcando el período de 2.004 a 2.008, fueron encontrados 24 artículos, que por el criterio de selección de la muestra resultaron en 14. Los artículos fueron analizados y categorizados en Educación en Salud y Cuidado de Enfermería. Con eso fue posible sintetizar los resultados e identificar que el plan de alta realizado por los enfermeros está basado en estas dos categorías, ya que a través de las conductas del enfermero para promover la educación en salud será posible proporcionar al paciente con Insuficiencia Cardíaca Congestiva una mejoría en el autocuidado.

Hospital discharge plan for patients with congestive heart failure.

This integrative review investigates how nurses plan the hospital discharge of patients with Congestive Heart Failure (CHF) since an inadequate discharge plan and patients' subsequent non-adherence to instruction provided upon discharge are indicated as potential factors for re-hospitalization. A total of 24 papers were found in a search carried out in the LILACS and MEDLINE databases between 2004 and 2008, which given the inclusion criteria, were reduced to 14 papers. The papers were analyzed and categorized into "Health Education", and "Nursing Care". The synthesis of results indicates that the discharge plan devised by nurses is based on two categories. The actions of nurses to promote health education can enable patients with CHF to improve self-care.