Diagnostic accuracy of clinical indicators of Imbalanced nutrition in pediatric patients submitted to chemotherapy.

To analyze the accuracy of clinical indicators of nursing diagnosis, Imbalanced nutrition: less than the body requirements in pediatric patients undergoing chemotherapy. A cross-sectional study was carried out in a pediatric oncohematology unit. A total of 123 children aged 5-18 years were evaluated. The Standards for Reporting Diagnostic Accuracy Studies (STARD) protocol was used. Latent class analysis was performed to obtain sensitivity and specificity of clinical indicators. The diagnosis was identified in six children (5.23%). The most frequent clinical indicator in the study was report of food intake less than recommended daily allowance (n = 61; 49.6%), followed by excessive hair loss (n = 49; 39.8%), misperception (n = 42; 34.1%), satiety immediately upon ingesting food (n = 32; 26%), lack of information (n = 30; 24.4%), and pale mucous membranes (n = 22; 17.9%). The 10 indicators that sensitivity and specificity were statistically superior to 50% were food intake less than recommended daily allowance, misperception, insufficient interest in food, lack of food, hyperactive bowel sounds, body weight 20% or more below ideal weight range, insufficient muscle tone, food aversion, abdominal cramping, and misinformation. The clinical indicators Food intake less than recommended daily allowance and Misperception can be considered the most important indicators for the initial inference of the diagnosis due to their high values of specificity and sensitivity. It is essential that nurses provide targeted and qualified assistance based on the signs and symptoms presented by patients, as they will be able to design appropriate interventions to obtain the desired results.

Simultaneous concept analysis of nursing diagnoses related to respiratory function.

AIM: To perform a simultaneous concept analysis of the concepts associated to nursing diagnoses ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange. BACKGROUND: Concepts about respiratory manifestations need to be well defined, especially in the current pandemic scenario. For that, the simultaneous concept analysis can help in the clarity and differentiation of similar concepts. METHODS: A concept analysis using the Walker and Avant approach and an integrative review. Data were collected by a group of nurses through a literature review. The group identified 10 articles that met the inclusion criteria and complemented the understanding of the concepts analysed through the sequential description of respiratory physiology in technical books. RESULTS: The final list included 28, 22, and 21 clinical indicators for ineffective breathing pattern, impaired gas exchange, and ineffective airway clearance, respectively. The former, the final proposal incorporated 13 indicators that were pointed out by the group and 15 defining characteristics of NANDA-International. For Impaired gas exchange, the indicator "decreased oxygen saturation" was included; among the defining characteristics of NANDA-International, "abnormal arterial blood gases" was excluded, and "abnormal breathing pattern" was subdivided into "alterations in respiratory depth," "bradypnea," "tachypnea," and "change in respiratory rhythm." The latter, only the "wide-eyed" was removed from the final list of clinical indicators, which subsequently consisted of nine indicators suggested by the group and 12 defining characteristics. CONCLUSION: This concept analysis may aid in the process of differentiation for ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange, and aid in safer diagnostic inference. This concept analysis can support the understanding of respiratory nursing diagnoses, helping nurses to identify and differentiate them more safely.

Validade de conteúdo dos indicadores clínicos de desobstrução ineficaz de vias aéreas / Validez de contenido de los indicadores clínicos de desobstrucción ineficaz de las vías aéreas / Content validity of ineffective airway clearance clinical indicators

Resumo Objetivo Identificar os indicadores clínicos mais relevantes para o Diagnóstico de Enfermagem Desobstrução ineficaz de vias aéreas. Método Estudo metodológico de análise de conteúdo organizado em três fases: definição conceitual do fenômeno de interesse, construção da estrutura do fenômeno de interesse e análise dos juízes sobre a estrutura construída. Resultados Foram identificados 21 indicadores clínicos. Apenas Sons respiratórios aumentados e Retração subcostal não foram indicadores significativamente relevantes para o diagnóstico. Conclusão Os indicadores de maior relevância para o diagnóstico Desobstrução ineficaz de vias aéreas foram: Dispneia, Mudanças no ritmo respiratório, Ruídos adventícios respiratórios, Taquipneia, Acúmulo excessivo de muco, Tosse ineficaz, Sons respiratórios diminuídos, Ortopneia, Cianose, Inquietação, Dificuldade para verbalizar e Uso da musculatura acessória para respirar.

Resumen Objetivo Identificar a los indicadores clínicos más relevantes para el Diagnóstico de Enfermería Desobstrucción ineficaz de las vías aéreas. Métodos Estudio metodológico de análisis de contenido organizado em tres fases: definición conceptual del fenómeno de interés, construcción de la estructura del fenómeno de interés y análisis de los jueces sobre la estructura construida. Resultados Se identificaron 21 indicadores clínicos. Únicamente Sonidos respiratorios aumentados y Retracción subcostal no fueron indicadores significantemente relevantes para el diagnóstico. Conclusión Los indicadores de mayor relevancia para el diagnóstico Desobstrucción ineficaz de las vías aéreas fueron: Disnea, Cambios en el ritmo respiratorio, Ruidos adventicios respiratorios, Taquipnea, Acúmulo excesivo de mucosidad, Tos ineficaz, Sonidos respiratorios disminuidos, Ortopnea, Cianosis, Inquietud, Dificultad para verbalizar y Uso de la musculatura accesoria para respirar.

Abstract Objective To identify the most relevant clinical indicators for the Ineffective airway clearance Nursing Diagnosis. Method This is a methodological study of content analysis organized into a conceptual definition of the phenomenon of interest, construction of the phenomenon of interest structure and analysis by judges on the constructed structure. Results Twenty-one clinical indicators were identified. Only Increased breath sounds and Subcostal retraction were not significantly relevant for the diagnosis. Conclusion The most relevant indicators for the Ineffective airway clearance diagnosis were: Dyspnea, Alteration in respiratory rate, Adventitious respiratory noises, Tachypnea, Excessive sputum, Ineffective cough, Decreased breathing sounds, Orthopnea, Cyanosis, Restlessness, Difficulty verbalizing and Use of accessory muscles to breathe.

In vitro biocompatibility and wound healing properties of latex proteins dressing.

The chronification of ulcers or sores may result in a dramatic outcome such as amputation. Currently, the search for plant based treatments of various diseases/disorders, including complicated ones, is getting the attention of researchers worldwide. The soluble latex protein fraction (CpLP) obtained from Calotropis procera (Apocynaceae) was previously demonstrated to accelerate wound healing by topical application or when incorporated in a polyvinyl alcohol biomembrane (BioMemCpLP). Here, in vitro assays were performed to investigate and characterize the biocompatibility and bioactivity of latex proteins dressing. Macrophages (RAW 264.7), fibroblasts (L929) and keratinocytes (HaCaT) cell lines were used to evaluate the effect of CpLP. These cell lines were exposed to concentrations of CpLP comparable to those found in BioMemCpLP during 24-72 h. The cytotoxicity, proliferation, release of wound healing mediators (TGF-ß, VEGF, IL-10, IL-6, IL-1ß, TNF-α and NO) and migration of cells (E-cadherin and ß-catenin) incubated with CpLP was assessed and the cell adhesion to BioMemCpLP as well. The results showed that CpLP has no cytotoxic effects. It induced a suitable balance between pro- and anti-inflammatory mediators, enhanced proliferation and re-epithelialization in all cell lines, but the intensity of each effect was different at various doses in all cell strains. The BioMemCpLP stimulated cell adhesion to PVA substrate. The CpLP-PVA based biomembrane can be a good option for healing of different wounds.

Influência da espiritualidade na qualidade de vida de idosos hemodialíticos / Influence of spirituality on the quality of life of elderly people on hemodialysis / Influencia de la espiritualidad en la calidad de vida de los ancianos hemodialíticos

Objetivo: analisar o conhecimento científico existente acerca da influência da espiritualidade na qualidade de vida de idosos em Terapia Renal Substitutiva do tipo hemodiálise. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa, com delimitação temporal de 2013 a 2019. Realizou-se uma busca eletrônica nas bases de dados da Biblioteca Virtual de Saúde por meio de descritores controlados contemplados no Descritores de Ciências da Saúde. Selecionaram-se os estudos por título e resumo, com posteriores extrações de informações por meio de instrumento apropriado, hierarquizando-os de acordo com o seu nível de evidência. Resultados: perceberam-se três pontos importantes que compilam as evidências da influência da espiritualidade na qualidade de vida de idosos submetidos à hemodiálise, a saber: promoção da saúde mental; renovação de esperanças para um futuro promissor; promoção do autocuidado. Conclusão: percebe-se que a espiritualidade influencia a qualidade de vida, permitindo mudanças na saúde mental do idoso, estimulando o seu senso de esperanças na cura e suscitando meios para que ele se torne ativo no processo de autocuidado.(AU)

Objective: to analyze the existing scientific knowledge about the influence of spirituality on the quality of life of elderly people undergoing hemodialysis. Method: this is a bibliographic, descriptive, integrative review type study, with temporal delimitation from 2013 to 2019. An electronic search was conducted in the databases of the Virtual Health Library through controlled descriptors contemplated in the Descriptors of Health Sciences. Studies were selected by title and abstract, with subsequent extraction of information through an appropriate instrument, ranking them according to their level of evidence. Results: three important points were perceived that compile the evidence of the influence of spirituality on the quality of life of elderly people undergoing hemodialysis, namely: promotion of mental health; renewal of hope for a promising future; promotion of self-care. Conclusion: it is perceived that spirituality influences quality of life, enabling changes in the mental health of the elderly, stimulating their sense of hope for healing and raising means for them to become active in the self-care process.(AU)

Objetivo: analizar el conocimiento científico existente sobre la influencia de la espiritualidad en la calidad de vida de ancianos sometidos a Terapia Renal Sustitutiva del tipo hemodiálisis. Método: se trata de un estudio bibliográfico, descriptivo, tipo revisión integradora, con una delimitación temporal de 2013 a 2019. Se realizó una búsqueda electrónica en las bases de datos de la Biblioteca Virtual en Salud utilizando descriptores controlados incluidos en los Descriptores de Ciencias de Salud. Los estudios fueron seleccionados por título y resumen, con posteriores extracciones de informaciones mediante un instrumento adecuado, jerarquizándolos según su nivel de evidencia. Resultados: se percibieron tres puntos importantes que recogen las evidencias de la influencia de la espiritualidad en la calidad de vida de los ancianos en hemodiálisis, a saber: promoción de la salud mental; renovación de esperanzas para un futuro prometedor; promoción del autocuidado. Conclusión: Se percibe que la espiritualidad influye en la calidad de vida, permitiendo cambios en la salud mental de los ancianos, estimulando su sentido de esperanza en la cura y abriéndoles caminos para que se vuelvan activos en el proceso de autocuidado.(AU)

Prognostic Indicators of Delayed Surgical Recovery in Patients Undergoing Cardiac Surgery.

PURPOSE: The purpose of this study was to analyze the prognostic capacity of the clinical indicators of a delayed surgical recovery nursing diagnosis throughout the hospital stay of patients having cardiac surgery. DESIGN: A prospective cohort design was adopted. A sample of inpatients undergoing elective cardiac surgery was followed during the immediate preoperative period and hospitalization. This research was conducted in the southeast region of Brazil at a national reference institution that treats highly complex diseases and performs cardiac surgeries. Data were collected from July 2017 to July 2018. METHODS: At the end of 1 year of data collection, 181 patients were followed in this study. The Kaplan-Meier method was used to calculate the survival time related to delayed surgical recovery. In addition, an extended Cox model of time-dependent covariates was adjusted to identify the clinical signs that influenced the change in the nursing diagnosis status. RESULTS: A delayed surgical recovery nursing diagnosis was present in 23.2% of the sample studied. With an expected length of stay of 8 to 10 days, most new cases of delayed surgical recovery were observed on the 10th postoperative day, and the survival rate after this day was decreased until the 29th postoperative day, when the nursing diagnosis no longer appeared. Interrupted healing of the surgical area, loss of appetite, and atrial flutter were indicators related to an increased risk for delayed surgical recovery. CONCLUSIONS: Timely recognition of selected clinical indicators demonstrates a promising prognostic capacity for delayed surgical recovery. CLINICAL RELEVANCE: Accurate identification of prognostic factors allows nurses to identify early signs of postoperative complications. Consequently, the professional can develop an individualized plan of care, aiming at the satisfactory clinical recovery of the patient.

Content analysis of clinical indicators for Impaired gas exchange.

OBJECTIVE: To analyze the relevance of clinical indicators and the clarity and precision of conceptual and operational definitions of the diagnosis Impaired gas exchange. METHODS: Content analysis, by 39 nurse judges, divided into the phases of conceptual definition of the phenomenon of interest, construction of the structure of the phenomenon of interest and analysis of the judges on the built structure. RESULTS: From the 22 indicators, 21 were considered relevant Impaired gas exchange. The indicators that obtained absolute relevance were Cyanosis, Hypercapnia, Hypoxemia and Tachycardia. The indicator Headache upon waking did not show any statistically significant relevance for the diagnosis. All conceptual and operational definitions were clear and precise. CONCLUSION: The indicators listed for Impaired gas exchange were relevant to the phenomenon, except Headache upon waking because it does not correspond to a safe manifestation to identify the diagnosis, according to the analysis of the judges. Each conceptual and operational definition was adequate for its indicator.

A Content Analysis of Clinical Indicators of the Nursing Diagnosis Ineffective Breathing Pattern.

PURPOSE: To verify the relevance of the clinical indicators, the clarity and precision of the conceptual, and operational definitions for Ineffective breathing pattern (IBP). METHODS: A content analysis by 39 judges. FINDINGS: The results showed 28 clinical indicators for IBP. However, only seven were not considered relevant for the diagnosis. These are not listed in NANDA International taxonomy. All conceptual and operational definitions were adequate, according to the analysis of the judges. CONCLUSION: The list of 28 clinical indicators of IBP was submitted for analysis by judges, which then resulted in the validation of 21 of these elements. IMPLICATIONS FOR NURSING PRACTICE: This study clarifies that gaps in the structure of diagnoses, helping nurses' diagnostic reasoning process in clinical practice.

Content analysis of clinical indicators for Impaired gas exchange / Análisis de contenido de indicadores clínicos para Deterioro del intercambio gaseoso / Análise de conteúdo dos indicadores clínicos para Troca de gases prejudicada

ABSTRACT Objective To analyze the relevance of clinical indicators and the clarity and precision of conceptual and operational definitions of the diagnosis Impaired gas exchange. Methods Content analysis, by 39 nurse judges, divided into the phases of conceptual definition of the phenomenon of interest, construction of the structure of the phenomenon of interest and analysis of the judges on the built structure. Results From the 22 indicators, 21 were considered relevant Impaired gas exchange. The indicators that obtained absolute relevance were Cyanosis, Hypercapnia, Hypoxemia and Tachycardia. The indicator Headache upon waking did not show any statistically significant relevance for the diagnosis. All conceptual and operational definitions were clear and precise. Conclusion The indicators listed for Impaired gas exchange were relevant to the phenomenon, except Headache upon waking because it does not correspond to a safe manifestation to identify the diagnosis, according to the analysis of the judges. Each conceptual and operational definition was adequate for its indicator.

RESUMEN Objetivo Analizar la relevancia de los indicadores clínicos y la claridad y precisión de las definiciones conceptuales y operativas del diagnóstico Deterioro del intercambio gaseoso. Métodos Análisis de contenido, realizado por 39 jueces enfermeros, dividido en las fases de definición conceptual del fenómeno de interés, construcción de la estructura del fenómeno de interés y análisis de los jueces sobre la estructura construida. Resultados De los 22 indicadores, 21 fueron considerados relevantes Deterioro del intercambio gaseoso. Los indicadores que obtuvieron relevancia absoluta fueron Cianosis, Hipercapnia, Hipoxemia y Taquicardia. El indicador Cefalea al despertar no mostró relevancia estadísticamente significativa para el diagnóstico. Todas las definiciones conceptuales y operativas fueron claras y precisas. Conclusión Los indicadores enumerados para Deterioro del intercambio gaseoso fueron relevantes para el fenómeno, excepto Cefalea al despertar porque no corresponde a una manifestación segura para identificar el diagnóstico, según el análisis de los jueces. Cada definición conceptual y operativa fue adecuada para su indicador.

RESUMO Objetivo Analisar a relevância dos indicadores clínicos e a clareza e precisão das definições conceituais e operacionais do diagnóstico Troca de gases prejudicada. Métodos Análise de conteúdo, por 39 juízes enfermeiros, dividida nas fases de definição conceitual do fenômeno de interesse, construção da estrutura do fenômeno de interesse e análise dos juízes sobre a estrutura construída. Resultados Dos 22 indicadores, 21 foram considerados relevantes Troca de gases prejudicada. Os indicadores que obtiveram relevância absoluta foram Cianose, Hipercapnia, Hipoxemia e Taquicardia. O indicador Cefaleia ao acordar não apresentou relevância estatisticamente significante para o diagnóstico. Todas as definições conceituais e operacionais foram claras e precisas. Conclusão Os indicadores elencados para Troca de gases prejudicada foram relevantes ao fenômeno, exceto Cefaleia ao acordar pois não corresponde a uma manifestação segura para identificar o diagnóstico, conforme a análise dos juízes. Cada definição conceitual e operacional foi adequada para seu referido indicador.

Prognostic indicators of short-term survival of ineffective airway clearance in children with acute respiratory infection: a longitudinal study.

Background: Studies that establish the indicators of clinical status deterioration of Ineffective airway clearance remain scarce. Prognostic studies provide data for nurses identify clinical indicators that suggest a higher chance of early development of a nursing diagnosis. Objective: To identify the prognostic indicators of short-term survival of ineffective airway clearance (IAC) in children with acute respiratory infection (ARI). Design: A prospective open cohort study. Methods: This study was with a group of 136 children with acute respiratory infection who were followed for a minimum of six and a maximum of ten consecutive days. Children who had not completed six days of monitoring or who were carriers of diseases that would alter the specific symptoms of respiratory infection were excluded. The survival rate of ineffective airway clearance was calculated using Nelson-Aalen's method. A Cox regression model was used to analyze the influence of clinical indicators on survival time of this diagnosis. Results: The diagnosis survival rate was extremely low (only 0.4% on the 5th day of follow-up). The greatest reduction in survival rate was observed in the first 48 h (survival rate = 2.5%). Four defining characteristics associated with a worse prognosis of IAC among children with ARI: ineffective cough (RR = 5.86; 95% CI: 3.53-9.72), absence of cough (RR = 2.92; 95% CI: 1.68-5.08), adventitious breath sounds (RR = 2.47; 95% CI: 2.01-3.03), and diminished breath sounds (RR = 1.23; 95% CI: 1.05-1.45). Conclusion: Four clinical indicators showed a strong relationship with an increased risk of worsening clinical status associated with this nursing diagnosis. Impact statement: Clinical deterioration related to ineffective airway clearance among children with acute respiratory infection is fast and requires particular attention from nurses.

Capacidade funcional de idosos longevos: análise transversal baseada em um modelo de decisão / Functional capacity in the oldest old: cross-sectional analysis based on a decision model

INTRODUÇÃO: Idosos com 80 anos ou mais, ou longevos, são o subgrupo etário que mais cresce no mundo. Nesse segmento, a incapacidade funcional (IF) é mais prevalente que em outras faixas etárias. OBJETIVO: Caracterizar a capacidade funcional e analisar potenciais associações em idosos longevos de uma capital brasileira, com base em um modelo de decisão. MÉTODO: Estudo transversal com 100 idosos longevos, não institucionalizados, assistidos pela Estratégia Saúde da Família do Recife (PE), selecionados por amostra probabilística. Foram avaliados dados sociodemográficos, econômicos e clínicos coletados por meio de entrevistas domiciliares, aferição de medidas antropométricas e buscas nos prontuários. Para análise bivariada, foi empregado o teste χ2 de Pearson, considerando o nível de significância p < 0,05, e para a multivariada foi construída uma árvore de decisão com base em um algoritmo Exhaustive CHAID. RESULTADOS: A prevalência de IF na amostra correspondeu a 67,0%. Na análise bivariada, contribuíram para esse desfecho: renda (p = 0,032), situação previdenciária (p < 0,01), situação nutricional (p = 0,010), doenças neurológicas (p < 0,01), neoplasias (p < 0,01), saúde autopercebida (p = 0,025) e rede de apoio social (p = 0,032), permanecendo na análise multivariada: renda (p = 0,003), rede de apoio social (p = 0,032) e situação nutricional (p = 0,040). A árvore de decisão possibilitou a identificação das variáveis mais associadas ao desfecho, sendo capaz de prever adequadamente a dependência moderada, com assertividade de 72,1%. CONCLUSÃO: O modelo de decisão mostrou-se uma ferramenta oportuna na dedução dos determinantes mais relevantes da IF. Seu uso potencialmente contribui para ampliar a precisão diagnóstica e identificação de populações de risco.

INTRODUCTION: The oldest old adults, aged 80 years and above, is the fastest growing age group in the world. In this section of the population, functional disability (FD) is more prevalent compared to other age groups. OBJECTIVE: To characterize functional capacity and analyze potential associations in the oldest old from a Brazilian capital city, based on a decision model. METHODS: Cross-sectional study of 100 non-institutionalized oldest old participants assisted at the Family Health Strategy of Recife, in the Brazilian northeastern state of Pernambuco, selected by probabilistic sample. Sociodemographic, economic, and clinical data were collected by means of home interviews, anthropometric measurements, and medical records. For bivariate analysis, Pearson's chi-square test was used, establishing significance at p < 0.05. For the multivariate analysis, a decision tree was built from the Exhaustive CHAID algorithm. RESULTS: The prevalence of FD in the sample corresponded to 67.0%. In the bivariate analysis, the following data contributed to this outcome: income (p = 0.032), social security status (p < 0.01), nutritional status (p = 0.010), neurological diseases (p < 0.01), neoplasms (p < 0.01), self-perceived health (p = 0.025) and social support network (p = 0.032), remaining in the multivariate analysis: income (p = 0.003), social support network (p = 0.032), and nutritional status (p = 0.040). The decision tree allowed the identification of the variables most strongly associated with the outcome, being able to adequately predict moderate dependence, with 72.1% assertiveness. CONCLUSION: The decision model proved to be a timely tool in deducing the most relevant determinants of FD. Its use potentially contributes to increase the accuracy of the diagnosis and to identify populations at risk.

Development of middle-range theories in nursing.

OBJECTIVE: To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. METHOD: Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles. RESULTS: All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews. FINAL CONSIDERATIONS: The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.

A Content Analysis of Clinical Indicators and Etiological Factors of Ineffective Infant Feeding Patterns.

PURPOSE: To analyze the content of the concepts present in the nursing diagnosis of Ineffective infant feeding pattern. DESIGN AND METHODS: Content validation of nursing diagnosis based on the predictive diversity model. A methodological study of the content validation of a nursing diagnosis was based on the predictive diversity model and performed in the following three stages: conceptual definition of the phenomenon of interest; organization of the phenomenon of interest; and analysis by judges of the concepts of the phenomenon of interest. RESULTS: The first two stages identified 13 clinical indicators and 12 etiological factors, which were evaluated by 23 judges. The analyses of judgments were performed according to the level of expertise of the judges. All the clinical indicators were relevant to nursing diagnosis under study. Nine causal factors were analyzed, including the level of importance to the occurrence of Ineffective infant feeding pattern. CONCLUSIONS: This study analyzed the diagnostic structure of Ineffective infant feeding pattern, which were considered representative of the phenomenon of interest after evaluation by the judges. PRACTICE IMPLICATIONS: The use of nursing diagnosis with accurate elements facilitates clinical reasoning and favors the development of an adequate care plan.

Development of middle-range theories in nursing / Desarrollo de las teorías de medio alcance en enfermería / Desenvolvimento das teorias de médio alcance na enfermagem

ABSTRACT Objective: To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. Method: Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles. Results: All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews. Final considerations: The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.

RESUMEN Objetivo: Identificar en la literatura cómo las Teorías de Medio Alcance (TMA) se están desarrollando en enfermería. Método: Revisión integrativa en las bases de datos: LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science y PubMed, utilizando la palabra clave middle range theory, el descriptor nursing y sus equivalentes en portugués (LILACS) y el operador booleano AND. La muestra constó de 25 artículos. Resultados: Todos los artículos presentaron conceptos relacionados con las TMA. La mayoría desarrolló un cuadro resumen. Algunas teorías presentaron proposiciones, plantearon hipótesis y nombres específicos. Solamente 16 artículos citaban el referencial metodológico, mientras que 22 utilizaban teorías o modelos en la fundamentación teórica y 11 hicieron revisión de la literatura. Consideraciones finales: El desarrollo de las TMA incluyó la presentación de conceptos fundamentales, de cuadro resumen, de proposiciones, hipótesis y nombre específico. Se reconocen las TMA como forma de desarrollar conocimiento para orientar la práctica en enfermería.

RESUMO Objetivo: Identificar na literatura como as Teorias de Médio Alcance (TMA) têm sido desenvolvidas na enfermagem. Método: Revisão integrativa nas bases Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science e portal PubMed, utilizando a palavra-chave middle range theory, o descritor nursing, seus correspondentes em português (Lilacs) e o operador booleano AND. A amostra incluiu 25 artigos. Resultados: Todos os artigos apresentaram conceitos relacionados às TMA. A maioria desenvolveu quadro síntese. Algumas teorias formularam proposições, hipóteses e nomes específicos. Apenas 16 artigos citavam o referencial metodológico, enquanto 22 usavam teorias ou modelos para fundamentação teórica e 11 utilizavam revisão na literatura. Considerações finais: O desenvolvimento das TMA incluiu apresentação de conceitos fundamentais, quadro síntese, proposições, hipóteses e nome específico. Reconhece-se as TMA como forma de desenvolver conhecimento para orientar a prática de enfermagem.

Perfil de pacientes obstétricas admitidas na unidade de terapia intensiva de um hospital público / Perfil de pacientes obstétricas ingresadas en la unidad de cuidados intensivos de un hospital público / Profile of obstetric patients admitted to the intensive care unit of a public hospital

Objetivo: analisar o perfil de pacientes obstétricas admitidas na Unidade de Terapia Intensiva Adulto. Método: estudo quantitativo, descritivo-retrospectivo, desenvolvido por meio da busca e obtenção dos dados referentes ao perfil socioeconômico e clínico dos prontuários das pacientes gestantes ou puérperas internadas por causa obstétrica, entre janeiro 2017 e dezembro de 2018, na Unidade de Terapia Intensiva de um hospital público de Pernambuco, Brasil. Os resultados foram analisados pelo programa Statistical Package for the Social Science. Resultados: as mulheres tinham, em sua maioria, idade entre 19 e 29 anos (56,1%), e cor parda (88,6%). A maioria foi internada no pós-parto (75,6%), o tipo de parto mais prevalente foi o cesáreo (87,2%), as síndromes hipertensivas foram a maior causa do internamento (61,8%). O principal distúrbio hipertensivo apresentado é pré-eclâmpsia (39,8%). Conclusão: as pacientes adultas jovens, puérperas de parto cesáreo, com síndromes hipertensivas são internadas com mais frequência na Unidade de Terapia Intensiva.

Objetivo: analizar el perfil de las pacientes obstétricas ingresadas en la Unidad de Cuidados Intensivos. Método: estudio cuantitativo, descriptivo y retrospectivo, desarrollado por medio de la búsqueda y la recuperación de los datos del perfil socioeconómico y clínico del registro médico de pacientes embarazadas o en posparto ingresadas por causa obstétrica, entre enero de 2017 y diciembre de 2018, en la Unidad de Cuidados Intensivos de un hospital público en el estado de Pernambuco, Brasil. Los resultados fueron analizados mediante el Statistical Package for the Social Sciences. Resultados: las mujeres tenían, en su mayoría, edades comprendidas entre los 19 y 29 años (56,1%), y pardas (88,6%). La mayoría fue hospitalizada en el posparto (75,6%), el tipo de parto por cesárea fue el más frecuente (87,2%), síndromes hipertensivos fueron la principal causa de hospitalización (61,8%). El principal trastorno hipertensivo presentado es la pre-eclampsia (39,8%). Conclusión: las pacientes adultas jóvenes, puérperas, cuyo parto fue cesárea, con síndromes hipertensivos son hospitalizadas con mayor frecuencia en las Unidades de Cuidados Intensivos.

Objective: to analyze the profile of obstetric patients admitted to the Intensive Care Unit. Method: quantitative, descriptive and retrospective study, developed through searches and retrieval of data referring to socioeconomic and clinical profile of pregnant or postpartum patients' records admitted for obstetric cause, between January 2017 and December 2018, in the Intensive Care Unit of a public hospital in Pernambuco, Brazil. The results were analyzed using the Statistical Package for the Social Sciences. Results: most women were between 19 and 29 years (56.1%), and pardas (88.6%). The majority was hospitalized in the postpartum (75.6%), the most prevalent delivery type was cesarean section (87.2%), hypertensive syndromes were the major cause of hospitalization (61.8%). The main hypertensive disorder was pre-eclampsia (39.8%). Conclusion: the young adult puerperal patients, whose delivery route was cesarean section, with hypertensive syndromes are hospitalized more frequently in the Intensive Care Unit.

Detection of serum and salivary IgE and IgG1 immunoglobulins specific for diagnosis of food allergy.

Given the growing incidence and prevalence of life-threatening food allergies, health concerns have raised new perspectives for in vivo and in vitro diagnostic methodologies, pointing to saliva as a promising material, already used to diagnose other pathologies. Based on the above considerations, this study aimed to verify the possible use of saliva for the detection of IgE and IgG1 in the diagnosis of food allergy. This was a randomized, cross-sectional clinical study with a quantitative approach, developed at a hospital referral center in allergy in the state of Ceará, from January to July 2015. The sample consisted of 36 children of both sexes, aged between 1 and 60 months, with a diagnosis of cow's milk protein allergy (CMPA) by the RAST test. Children hospitalized or under immunosuppressive drugs were excluded from the study. Serum and saliva samples of the participants were collected and subsequently subjected to the indirect immunoenzymatic assay (ELISA) for the detection of specific serum and salivary immunoglobulins for food: corn, papaya, cow's milk, egg white, wheat, soybeans, peanuts, nuts, kiwi, cacao, fish, shrimp, bananas and tomatoes. For comparison of serum and saliva results, the T-test of independent samples and Mann-Whitney were adopted, for samples with normal and non-normal distribution respectively. A confidence interval of 95% was adopted for significant results. It was observed that 100% (n = 36) of the participants presented cow's milk allergy through the indirect ELISA, detecting IgE or IgG1 in serum and saliva. When serum IgE and IgG1 concentrations were compared, there was no statistical difference (p > 0.05) in 12 of the 14 foods evaluated. The same amount (n = 12) of non-significant differences (p > 0.05) was observed in the comparison of the 14 foods under IgE and IgG1 contractions in saliva. In the verification of the average values of IgE present in the serum and saliva of the foods, only cow's milk, fish and papaya showed statistically significant differences (p < 0.05). Of the total food evaluated, only the average levels of IgG1 present in serum and saliva showed a significant value (p < 0.05) in banana and tomato. These findings indicate that the detection of IgE and IgG1 in saliva proves to be as efficient as in the serum. The use of the salivary technique for use in the diagnosis of food allergy is suggested.

Impaired Gas Exchange: Prognostic Clinical Indicators of Short-Term Survival in Children with Acute Respiratory Infection.

PURPOSE: To establish prognostic indicators of survival for impaired gas exchange (IGE) (00030). METHODS: Secondary analysis of data from an open prospective cohort developed with a group of 136 children with acute respiratory infection (ARI). FINDINGS: On Day 1, IGE (00030) was present in 42.6% of the sample. New cases arose until the last day of evaluation. With regards to defining characteristics, only hypoxemia and abnormal skin color were associated with a higher risk of developing diagnosis. CONCLUSIONS: Children with ARI who exhibit hypoxemia and abnormal skin color had a worse prognosis for IGE (00030). IMPLICATIONS FOR NURSE PRACTICE: Nurses can use the research findings as a predictive marker of the evolution of the patient's health status.

Avaliação da satisfação de puérperas em relação ao parto / Evaluation about puerperals' satisfaction regarding parturition

Objetivo: analisar a satisfação acerca do trabalho de parto e parto de mulheres que pariram em uma maternidade de alto risco. Método: trata-se de estudo quantitativo, transversal, com 91 puérperas, realizado em um hospital de alta complexidade. Utilizaram-se um questionário sociodemográfico e um modelo adaptado do Questionário de Experiência e Satisfação com o Parto (QUESP). Realizaram-se a análise estatística descritiva e os testes estatísticos de Qui-quadrado e exato de Fisher apresentados em tabelas. Resultados: constataram-se que 61,67% das mulheres apresentaram baixa expectativa e 44%, baixa satisfação em relação ao Trabalho de Parto (TP) e Parto (P). Constatou-se que houve relação estatística significativa entre a expectativa e a satisfação das mulheres com o parto. Conclusão: sugere-se mais investigação sobre essa temática a fim de identificar as determinantes da satisfação, bem como de reorganização da política de assistência obstétrica.(AU)

Classification tree to screen for the nursing diagnosis Ineffective airway clearance.

OBJECTIVE: to identify the defining characteristics of Ineffective airway clearance with better predictive power using classification trees. METHOD: the predictive power of the defining characteristics of Ineffective airway clearance was evaluated based on classification trees generated from the data of 249 children with acute respiratory infection. RESULTS: Ineffective cough and adventitious breath sounds were identified as the main defining characteristics when screening for Ineffective airway clearance in accordance with trees based on three different computational algorithms. CONCLUSION: Ineffective coughing and adventitious breath sounds had better predictive capacity for Ineffective airway clearance in the sample.

Classification tree to screen for the nursing diagnosis Ineffective airway clearance / Árvore de classificação para detecção do diagnóstico de enfermagem Desobstrução ineficaz de vias aéreas / Árbol de clasificación para la detección del diagnóstico enfermero Limpieza ineficaz de las vías aéreas

ABSTRACT Objective: to identify the defining characteristics of Ineffective airway clearance with better predictive power using classification trees. Method: the predictive power of the defining characteristics of Ineffective airway clearance was evaluated based on classification trees generated from the data of 249 children with acute respiratory infection. Results: Ineffective cough and adventitious breath sounds were identified as the main defining characteristics when screening for Ineffective airway clearance in accordance with trees based on three different computational algorithms. Conclusion: Ineffective coughing and adventitious breath sounds had better predictive capacity for Ineffective airway clearance in the sample.

RESUMO Objetivo: identificar as características definidoras de Desobstrução ineficaz de vias aéreas com melhor poder preditivo usando árvores de classificação Método: o poder preditivo das características definidoras da Desobstrução ineficaz de vias aéreas foi avaliado com base em árvores de classificação geradas a partir dos dados de 249 crianças com infecção respiratória aguda. Resultados: tosse ineficaz e ruídos adventícios respiratórios foram identificados como as principais características definidoras na detecção de Desobstrução ineficaz de vias aéreas de acordo com as árvores, com base em três diferentes algoritmos computacionais. Conclusão: Tosse ineficaz e ruídos adventícios respiratórios tiveram melhor capacidade preditiva para Desobstrução ineficaz de vias aéreas na amostra.

RESUMEN Objetivo: identificar las características definitorias de la Limpieza ineficaz de las vías aéreas con un mejor poder predictivo utilizando árboles de clasificación. Método: el poder predictivo de las características definitorias de Limpieza ineficaz de las vías aéreas se evaluó basado en los árboles de clasificación generados a partir de los datos de 249 niños con infección respiratoria aguda. Resultados: La tos ineficaz y los sonidos respiratorios anormales se identificaron como las principales características definitorias cuando se realizaba una Limpieza ineficaz de las vías aéreas de acuerdo con los árboles en función de tres algoritmos computacionales diferentes. Conclusión: La tos ineficaz y los sonidos respiratorios anormales tienen una mejor capacidad predictiva para la Limpieza ineficaz de las vías aéreas en la muestra.