Effects of the nursing intervention Fall prevention in older adults with arterial hypertension using NANDA-I, NIC, and NOC.

PURPOSE: To measure the effects of the NIC intervention fall prevention on the magnitude of the NANDA-I Risk for falls' risk factors and of NOC indicators related to falls in older adults with arterial hypertension. BACKGROUND: Nurses can use nursing taxonomies to provide effective care in preventing falls in specific populations. METHODS: Clinical, randomized, open, parallel, and multicenter trial following the CONSORT recommendations for nonpharmacological trials. The clinical trial was registered. The research was conducted with 118 older adults allocated to intervention and control groups and matched by sex and age. The intervention was conducted in the participants' homes in three different moments and consisted of nursing activities belonging to the NIC Fall prevention and implemented with the aid of a protocol with operational definitions. FINDINGS: Three months after the intervention, there was a significant intergroup difference in the frequency of Risk for falls and of the following factors/conditions: cluttered environment, unfamiliar setting, exposure to unsafe weather-related condition, insufficient anti-slip material in the bathroom, history of falls, acute illness, orthostatic hypotension, hearing impairment, and impaired vision. There was also a positive change in the magnitude of the following NOC indicators: risk control, cognitive orientation, knowledge: fall prevention, safe home environment, comfort level, vision compensation behavior, and leisure participation. CONCLUSIONS: The NIC intervention Fall prevention was effective in modifying risk factors belonging to Risk for falls and NOC indicators related to falls in older adults. IMPLICATIONS FOR NURSING PRACTICE: The tested intervention is important and should be instituted, mainly by nurses from primary care services who make home visits to older adults.

Elaboração e validação de instrumento para avaliação do conhecimento de enfermeiros oncológicos sobre cateter totalmente implantado / Development and validation of an instrument to assess the knowledge of oncology nurses about a fully implanted catheter

RESUMO Objetivo elaborar e validar um instrumento para avaliação do conhecimento de enfermeiros oncológicos sobre o cateter venoso central totalmente implantado. Métodos trata-se de pesquisa metodológica. O instrumento foi construído com base em uma revisão integrativa e contemplou 25 questões (10 a respeito dos aspectos gerais do dispositivo e punção; 10 sobre heparinização e complicações; e 5 sobre o curativo). Após a construção, o instrumento foi avaliado por cinco especialistas, em rodada única, em quatro itens, sobre adequação das questões aos objetivos do instrumento, à valoração das questões, ao conteúdo e à clareza de cada questão. A adequação foi confirmada pelo Índice de Concordância mínimo de 80%. Resultados todos os itens das questões sobre heparinização e complicações foram considerados adequados, e duas questões sobre aspectos gerais e punção e uma questão sobre curativo obtiveram Índice de Concordância de 60%. Foram realizadas alterações conforme sugestões dos especialistas. Conclusão o instrumento, em sua maior parte, apresentou questões claras, relevantes e que atendem à finalidade. Contribuições para a prática espera-se contribuir com instituições e com um cuidado seguro dos enfermeiros que assistem pacientes oncológicos portadores do cateter totalmente implantado.

ABSTRACT Objective to develop and validate an instrument to assess the knowledge of oncology nurses about the fully implanted central venous catheter. Methods this is a methodological study. The instrument was built based on an integrative review and included 25 questions (10 about general aspects of the device and puncture; 10 about heparinization and complications; and 5 about the dressing). After construction, the instrument was evaluated by five experts, in a single round, in four items, on the adequacy of the questions to the objectives of the instrument, the valuation of the questions, the content and the clarity of each question. Adequacy was confirmed by the minimum Concordance Index of 80%. Results all items in the questions about heparinization and complications were considered adequate, and two questions about general aspects and puncture and one question about dressing had an agreement rate of 60%. Changes were made as suggested by experts. Conclusion the instrument, for the most part, presented clear, relevant questions that serve the purpose. Contributions to practice it is expected to contribute with institutions and with a safe care of nurses who assist cancer patients with fully implanted catheters.

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.

Desinfecção de incubadoras usadas em Unidades de Cuidados Intensivos Neonatais: revisão integrativa / Desinfección de incubadoras usadas en Unidades de Cuidados Intensivos Neonatales: revisión integradora / Disinfection of incubators used in Neonatal Intensive Care Units: an integrative review

Resumo Objetivo Analisar as evidências científicas de práticas de desinfecção de incubadoras usadas em Unidades de Cuidados Intensivos Neonatais. Métodos Revisão integrativa de literatura, realizada de junho a julho de 2020, nas bases de dados: LILACS, SciELO, CINAHL, SCOPUS, Web of Science e MEDLINE. Os achados foram organizados conforme o fluxograma PRISMA e discutidos de acordo com a literatura pertinente. Resultados Dos 780 artigos encontrados, apenas cinco contemplaram os critérios de inclusão. Os saneantes utilizados foram: cloreto de didecildimetilamônio, polihexametilenobiguanida e Peróxido de Hidrogênio (VHP); cloreto de didecildimetilamônio; N-(3-aminopropyl)-N-dodécylpropane-1,3-diamine; cloreto de didecildimetilamônio e limpeza a vapor; água com detergente para limpeza no balde e água sanitária (200mg/L) e desinfectante Umonium38® a 2,5%. Há diversidade de opções para desinfecção das incubadoras, com variação de métodos e frequência de limpeza. Os saneantes utilizados foram eficazes, apontando para redução da carga microbiana. Conclusão Observou-se uma variedade de procedimentos e produtos que podem ser utilizados para limpeza e desinfecção das incubadoras. Os procedimentos de desinfecção favoreceram a redução da contaminação da superfície. No entanto, a presença de micro-organismos, mesmo que reduzida, alerta sobre o risco à segurança do paciente.

Resumen Objetivo Analizar las evidencias científicas de prácticas de desinfección de incubadoras usadas en Unidades de Cuidados Intensivos Neonatales. Métodos Revisión integradora de literatura, realizada de junio a julio de 2020, en las bases de datos: LILACS, SciELO, CINAHL, SCOPUS, Web of Science y MEDLINE. Los resultados fueron organizados de acuerdo con el diagrama de flujo PRISMA y discutidos de acuerdo con la literatura pertinente. Resultados De los 780 artículos encontrados, solamente cinco contemplaron los criterios de inclusión. Los desinfectantes utilizados fueron: cloruro de didecildimetilamonio, polihexametilen biguanida y peróxido de hidrógeno (VHP); cloruro de didecildimetilamonio; N-(3-aminopropil)-N-dodecilpropano-1,3-diamina; cloruro de didecildimetilamonio y limpieza a vapor; agua con detergente para limpieza en el balde y cloro (200mg/L) y desinfectante Umonium38® al 2,5 %. Existe una diversidad de opciones para la desinfección de las incubadoras, con variación de métodos y frecuencia de limpieza. Los desinfectantes utilizados fueron eficaces, lo que indica una reducción de la carga microbiana. Conclusión Se observó una variedad de procedimientos y de productos que se pueden utilizar para la limpieza y la desinfección de las incubadoras. Los procedimientos de desinfección favorecieron la reducción de la contaminación de la superficie. Sin embargo, la presencia de microorganismos, aunque reducida, alerta respecto al riesgo a la seguridad del paciente.

Abstract Objective To analyze the scientific evidence of incubator disinfection practices used in Neonatal Intensive Care Units. Methods This is an integrative literature review, conducted from June to July 2020, in the LILACS, SciELO, CINAHL, Scopus, Web of Science and MEDLINE databases. The findings were organized according to the PRISMA flowchart and discussed according to pertinent literature. Results Of the 780 articles found, only five met the inclusion criteria. The sanitizers used were: didecyldimethylammonium chloride, PHMB and vaporized hydrogen peroxide (VHP); didecyldimethylammonium chloride; N-(3-aminopropyl)-N-dodecylpropane-1,3-diamine; didecyldimethylammonium chloride and steam cleaning; water with detergent for cleaning in the bucket and bleach (200 mg/L) and 2.5% Umonium38® disinfectant. There is a diversity of options for disinfection of incubators, with variation of methods and frequency of cleaning. The sanitants used were effective, pointing to reduction of microbial load. Conclusion A variety of procedures and products were observed that can be used for cleaning and disinfection of incubators. Disinfection procedures favored the reduction of surface contamination. However, the presence of microorganisms, even if reduced, alerts about the risk to patient safety.

Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects.

OBJECTIVE: To estimate the content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects. METHOD: Methodological study in two stages: 1) integrative literature review; 2) content validation, with 23 nurses. An instrument with 10 related factors and 21 defining characteristics for data collection was used. The analysis by the evaluators was carried out using the relevance criteria. The Content Validity Index was used. Valid results were those above 0.9 with a Wilcoxon test above 0.05. RESULTS: The final proposal incorporates nine from the ten causal factors. From them, five do not belong in the NANDA-I list. Regarding the defining characteristics, they were all considered to be relevant, and five are not among the list of signs and symptoms of the NANDA-I taxonomy. CONCLUSION: The findings of this study include specific elements of the pediatric population with congenital heart defect which are not present in the structure of the diagnostic being studied.

Diagnostic indicators of risk-prone health behaviors in pregnant adolescents.

PURPOSE: This study aimed to identify diagnostic indicators associated with the nursing diagnosis risk-prone health behaviors in pregnant adolescents. METHODS: We conducted a cross-sectional study. The sample consisted of 181 pregnant adolescents. A latent class analysis was conducted to verify associations between the defining characteristics of risk-prone health behaviors and diagnostic accuracy measures. Logistic regression was used to identify factors associated with the manifestation of risk-prone health behavior. FINDINGS: The prevalence of risk-prone health behaviors in this sample was 31.04%. The defining characteristics failure to take action that prevents health problems and inappropriate eating habits achieved a high sensitivity. The related factors such as insufficient social support, stressors, low self-efficacy, social anxiety, isolated region of residence, and restricted access to health services presented significant associations with risk-prone health behavior. CONCLUSIONS: The diagnostic indicators associated with the nursing diagnosis of risk-prone health behavior were failure to take action that prevents health problems inappropriate eating habits, insufficient social support, stressors, low self-efficacy, social anxiety, isolated region of residence, and restricted access to health services. IMPLICATIONS FOR NURSING PRACTICE: This study contributes to knowledge about the diagnostic indicators of risk-prone health behavior, which may help nurses reach the proper diagnosis. This will facilitate the application of clinical judgment in nursing care to assist pregnant adolescents.

The factors related to a sedentary lifestyle: A meta-analysis review.

AIMS: To compare factors associated with the sedentary lifestyle described in the literature with the factors listed in NANDA International. DESIGN: Systematic review with meta-analysis of factors associated with a sedentary lifestyle in adolescents, adults and older people. DATA SOURCES: An electronic search of PubMed, Scopus, CINAHL and Latin America and the Caribbean Literature on Health and Science databases conducted in May 2016. REVIEW METHODS: Descriptive data were extracted according to a standardized form. The odds ratios for each etiological factor associated with a sedentary lifestyle were extracted directly from the articles or calculated from the data described therein. The meta-analysis was conducted for factors that were investigated in more than one study. RESULTS: Thirty-five articles were included. The statistically significant factors were: lack of social support, of physical space, of time, of motivation, of sports skills and of interest in physical activity, intolerance to activity, being retired, living in a low-income country, laziness, not having a job/studying, low socioeconomic status and level of knowledge about physical activity, female gender, living in an urban area, negative self-perception of health, using public transportation, being in the oldest age group in the study and perceived physical disability. CONCLUSION: The new factors associated with a sedentary lifestyle and those already included in the NANDA International classification will lead to better clinical guidance for nurses. IMPACT: Knowledge about these factors can contribute directly to public health policies.

Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects / Validez de contenido del diagnóstico de enfermería Estándar Respiratoria Ineficaz en niños con cardiopatías congénitas / Validade de conteúdo do diagnóstico de enfermagem Padrão Respiratório Ineficaz em crianças com cardiopatias congênitas

ABSTRACT Objective: To estimate the content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects. Method: Methodological study in two stages: 1) integrative literature review; 2) content validation, with 23 nurses. An instrument with 10 related factors and 21 defining characteristics for data collection was used. The analysis by the evaluators was carried out using the relevance criteria. The Content Validity Index was used. Valid results were those above 0.9 with a Wilcoxon test above 0.05. Results: The final proposal incorporates nine from the ten causal factors. From them, five do not belong in the NANDA-I list. Regarding the defining characteristics, they were all considered to be relevant, and five are not among the list of signs and symptoms of the NANDA-I taxonomy. Conclusion: The findings of this study include specific elements of the pediatric population with congenital heart defect which are not present in the structure of the diagnostic being studied.

RESUMEN Objetivo: Estimar validez de contenido del diagnóstico de enfermería Estándar Respiratoria Ineficaz en niños con cardiopatías congénitas. Métodos: Estudio metodológico realizado en dos etapas: 1) revisión integrativa de literatura; 2) validez del contenido, con 23 enfermeros. Utilizó instrumento conteniendo 10 factores relacionados y 21 características definidoras para recogida de datos. Jueces realizaron el análisis con base en criterio de relevancia. Utilizado Índice de Validez de Contenido diagnóstico, considerado válido si superior a 0,9 y si test de Wilcoxon mayor que 0,05. Resultados: Propuesta final incorpora nueve de los diez factores causales. De ellos, cinco no pertenecen a la lista de la NANDA-I. Cuanto a características definidoras, todas han consideradas relevantes, y cinco no pertenecen al rol de señales y síntomas de la taxonomía NANDA-I. Conclusión: Los hallados de esto estudio incluyen elementos específicos de población pediátrica con cardiopatía congénita que no están presentes en la estructura del diagnóstico en estudio.

RESUMO Objetivo: Estimar a validade de conteúdo do diagnóstico de enfermagem Padrão Respiratório Ineficaz em crianças com cardiopatias congênitas. Métodos: Estudo metodológico realizado em duas etapas: 1) revisão integrativa da literatura; 2) validade do conteúdo, com 23 enfermeiros. Utilizou-se instrumento contendo 10 fatores relacionados e 21 características definidoras para coleta de dados. Os juízes realizaram a análise com base no critério de relevância. Foi utilizado o Índice de Validade de Conteúdo diagnóstico, considerado válido se superior a 0,9 e se teste de Wilcoxon maior que 0,05. Resultados: A proposta final incorpora nove dos dez fatores causais. Deles, cinco não pertencem à lista da NANDA-I. Quanto às características definidoras, todas foram consideradas relevantes, e cinco não pertencem ao rol de sinais e sintomas da taxonomia NANDA-I. Conclusão: Os achados deste estudo incluem elementos específicos da população pediátrica com cardiopatia congênita que não estão presentes na estrutura do diagnóstico em estudo.

Health control for celiac patients: an analysis according to the Pender Health Promotion model / Control de la salud en celíacos: un análisis según el modelo de Promoción de la Salud de Pender / Controle de saúde de celíacos: análise segundo o modelo de Promoção da Saúde de Pender

ABSTRACT Objectives: to describe the health control habits that influence the daily life of celiac patients and to analyze the practice of actions related to health control and its determinants, from the perspective of the first component of the Pender Health Promotion Model. Method: a cross-sectional study conducted through interviews with instrument with 83 individuals from Ceará and diagnosed with celiac disease. Data was analyzed using the characteristics and individual experiences component of Pender's theoretical model. Results: of the celiac patients, 96.4% did not follow the gluten-free diet; 80.7% had inappropriate behaviors to reduce risk factors; 72.3% made ineffective choices in daily life to achieve health goals and; and 25.3% could not keep the gluten free diet in their daily life. Conclusion: according to the theoretical model, celiac patients did not adhere to the proper diet and presented factors inherent to daily life and social issues, characterized as barriers to an effective health control.

RESUMEN Objetivos: describir los hábitos de control de la salud que influyen sobre la vida diaria de los celíacos y analizar la práctica de acciones relacionados con el control de la salud y sus factores determinantes, bajo la óptica del primer componente del Modelo de Promoción de la Salud de Pender. Método: estudio transversal realizado a través de entrevistas con instrumento con 83 individuos del estado de Ceará diagnosticados con la enfermedad celíaca. Los datos se analizaron mediante el componente de características y experiencias individuales del modelo teórico de Pender. Resultados: de los celíacos, el 96,4% no seguía la dienta sin gluten; el 80,7% presentaba comportamiento inadecuados para reducir factores de riesgo; el 72,3% realizaba elecciones ineficaces en la vida diaria para alcanzar las metas de salud y el 25,3% no lograba mantener la dieta sin gluten en su vida diaria. Conclusión: de acuerdo con el modelo teórico, los celíacos no respetaban la dieta adecuada y presentaron factores inherentes a la vida diaria y a las cuestiones sociales, caracterizados como obstáculos para un control eficaz de la salud.

RESUMO Objetivos: descrever os hábitos de controle de saúde que influenciam no cotidiano dos celíacos e analisar a prática de ações relacionadas ao controle da saúde e seus determinantes, sob o prisma do primeiro componente do Modelo de Promoção da Saúde de Pender. Método: estudo transversal, realizado com 83 indivíduos com diagnóstico de doença celíaca, do Estado do Ceará, através de entrevistas com instrumento. Os dados foram analisados mediante o componente características e experiências individuais do modelo teórico de Pender. Resultados: dos celíacos, 96,4% não seguiam a dieta isenta de glúten; 80,7% possuíam comportamentos inadequados para reduzir fatores de risco; 72,3% faziam escolhas na vida diária ineficazes para atingir as metas de saúde; e 25,3% não conseguiam manter a dieta isenta de glúten na sua vida diária. Conclusão: de acordo com o modelo teórico, os celíacos não aderiam à dieta adequada e apresentaram fatores inerentes ao cotidiano e às questões sociais, caracterizados como barreiras para o controle eficaz da saúde.

Anxiety and depression: a study of psychoaffective, family-related, and daily-life factors in celiac individuals.

OBJECTIVE: To identify the prevalence of anxiety and depression and its association with psychoaffective, family-related, and daily-life variables of celiac individuals. METHODS: Crosssectional study, developed with 83 celiac patients in Fortaleza. An instrument was applied with variables grouped in the categories: psychoaffective, family-related, and daily-life. RESULTS: It was found that 52 celiac patients (62.7%) had anxiety and 29 (34.9%) had depression. The clinical conditions found and the number of symptoms increased the chance of anxiety/depression. The predominant factors in those with anxiety were Lack of control of the celiac disease (98.1%), Perceived clinical condition (75.0%), Daily obstacles for maintaining a gluten-free diet (63.4%), and Daily activities (55.8%). In those with depression, there was a higher prevalence of Lack of control of the celiac disease (100.0%), Perceived clinical condition (82.2%), and Daily obstacles for maintaining a gluten-free diet (69.0%). CONCLUSION: Celiac individuals with anxiety and depression frameworks presented a higher frequency of Perceived clinical condition, Insufficient social support (psychoaffective factors) and Daily obstacles for maintaining a gluten-free diet (daily-life factor).

Accuracy of the clinical indicators of ineffective health management in celiac people.

OBJECTIVE: to analyze the accuracy of clinical indicators of "Ineffective health management" in celiac patients and to verify associations between sociodemographic characteristics and clinical indicators. METHOD: a cross-sectional study, conducted from May to September 2017, with 83 celiac patients, through an interview. Accuracy measures were defined by latent class model. RESULTS: there was a prevalence of "Ineffective health management" of 55.69%. "Failure to take action to reduce risk factor" and "Failure to include treatment regimen in daily living" better predict this diagnosis. Paid occupation reduces the chance of the presence of "Difficulty with prescribed regimen". Participation in support association reduces the chance of the presence of "Difficulty with prescribed regimen", "Ineffective choices in daily living for meeting health goal" and "Failure to take action to reduce risk factor". CONCLUSION: accurate clinical indicators identification assists clinical reasoning for diagnostic inference in specific health contexts.

Clinical Indicators of Impaired Swallowing in Children with Neurological Disorders.

OBJECTIVE: To investigate the clinical indicators of the nursing diagnosis impaired swallowing in children with neurological disorders. METHODS: An integrative review was performed on the Scopus, Web of Science, PubMed, Lilacs and Cinahl databases; by crossing the terms impaired degluition, dyphagia, deglutition disorders, cerebral palsy, microcephaly, which resulted in 45 articles. RESULTS: Eighteen indicators were identified in the oral phase, ten in the pharyngeal phase, and nine in the esophageal phase. There was a percentage of 80.4% of the indicators cited in NANDA-International, especially those referring to the oral phase. CONCLUSIONS: There are clinical indicators in both phases of impaired swallowing in children with neurological dysfunctions presenting heterogeneous distribution.

OBJETIVO: investigar os indicadores clínicos do diagnóstico de enfermagem Deglutição prejudicada em crianças com disfunções neurológicas. MÉTODO: Realizou-se uma revisão integrativa nas bases de dados Scopus, Web of Science, PubMed, Lilacs e Cinahl; por meio do cruzamento dos termos Impaired Degluition, Dyphagia, Deglutition Disorders, Cerebral Palsy, Microcephaly, que resultou em 45 artigos. RESULTADOS: Foram identificados dezoito indicadores na fase oral, dez na fase faríngea e nove na fase esofágica. Observou-se um percentual de 80.4% dos indicadores citados na NANDA-Internacional destacando-se os referentes a fase oral. CONCLUSÕES: existem indicadores clínicos em ambas as fases da deglutição prejudicada em crianças com disfunções neurológicas apresentando distribuição de forma heterogênea. DESCRITORES: Deglutição; Paralisia Cerebral; Microcefalia; Criança; Diagnóstico de Enfermagem.

Diagnostic Accuracy of the Defining Characteristics of Impaired Swallowing in Children with Encephalopathy.

The purpose of this study was to analyze the accuracy of the defining characteristics of the nursing diagnosis of impaired swallowing in children with encephalopathy. The measures of diagnostic accuracy for each indicator were verified through latent class analysis. The prevalence of swallowing impairment was 59.76% for a total of 82 children evaluated. The defining characteristics that had good measures of sensitivity (range: 79.59-99.99) and specificity (range: 72.72-99.99) were as follows: food falls from the mouth, tongue action ineffective in forming bolus, prolonged bolus formation, inability to clear the oral cavity, and food refusal. Eight characteristics can be used as warning signs for impaired swallowing because they have high sensitivity values. In addition, ten characteristics presented high specificity and can be used to confirm this diagnosis in children with encephalopathy. Considering the findings of the swallowing pattern assessments through the analysis of the accuracy measures, it is verified that the evidence presented here should guide the pediatrics nurses in the diagnosis decision making. Indicators of high sensitivity should be used as warning signs for swallowing impairment, and the high specificity indicators should be used as a confirmatory sign of this condition and requires immediate intervention.

Efetividade de aplicativos móveis para mudanças comportamentais em saúde: revisão sistemática / Effectiveness of mobile applications for behavioral changes in health: a systematic review

RESUMO Objetivo avaliar a efetividade de aplicativos móveis para mudanças comportamentais com foco na saúde. Métodos revisão sistemática, a partir do PubMed, SCOPUS, Cochrane, PsycINFO, CINAHL e Medline. Os descritores utilizados foram: Mobile applications e Health. Utilizou-se do protocolo Preferred Reporting Items for Systematic reviews and Meta-Analyses e para avaliação da qualidade metodológica, o instrumento do Instituto Joanna Briggs®. A amostra final foi composta por oito artigos. Resultados a maioria dos ensaios clínicos randomizados mostrou que intervenções com aplicativos são estratégias potencialmente efetivas na mudança de comportamento em saúde, principalmente quando associadas a outras estratégias, adequadas a um contexto/população específica. Os artigos incluídos na revisão contemplaram positivamente pelo menos nove dos treze questionamentos da avaliação da qualidade metodológica. Conclusão o uso de aplicativos tem impacto na mudança de comportamento e favorece resultados positivos no estado de saúde.

ABSTRACT Objective to evaluate the effectiveness of mobile applications for behavioral changes focused in health. Methods systematic review, from the PubMed, SCOPUS, Cochrane, PsycINFO, CINAHL, and Medline. The descriptors used were: Mobile applications and Health. The study used the protocol Preferred Reporting Items for Systematic reviews and Meta-Analyses, and the methodological quality was evaluated using the Joanna Briggs Institute® instrument. The final sample was made up of eight articles. Results most randomized clinical trials showed that interventions with applications are potentially effective strategies to change behavior in health, especially when associated to other strategies in accordance to the specific population/context. The articles included in the review were in accordance to at least nine of the thirteen questions of methodological quality evaluation. Conclusion the use of applications has impacts on behavioral change and contributes for positive results in the state of health.

Anxiety and depression: a study of psychoaffective, family-related, and daily-life factors in celiac individuals / Cuadros de ansiedad y depresión: estudio de factores psicoafectivos, familiares y cotidianos en indivíduos celíacos / Quadros de ansiedade e depressão: estudo de fatores psicoafetivos, familiares e cotidianos em indivíduos celíacos

ABSTRACT Objective: To identify the prevalence of anxiety and depression and its association with psychoaffective, family-related, and daily-life variables of celiac individuals. Methods: Crosssectional study, developed with 83 celiac patients in Fortaleza. An instrument was applied with variables grouped in the categories: psychoaffective, family-related, and daily-life. Results: It was found that 52 celiac patients (62.7%) had anxiety and 29 (34.9%) had depression. The clinical conditions found and the number of symptoms increased the chance of anxiety/depression. The predominant factors in those with anxiety were Lack of control of the celiac disease (98.1%), Perceived clinical condition (75.0%), Daily obstacles for maintaining a gluten-free diet (63.4%), and Daily activities (55.8%). In those with depression, there was a higher prevalence of Lack of control of the celiac disease (100.0%), Perceived clinical condition (82.2%), and Daily obstacles for maintaining a gluten-free diet (69.0%). Conclusion: Celiac individuals with anxiety and depression frameworks presented a higher frequency of Perceived clinical condition, Insufficient social support (psychoaffective factors) and Daily obstacles for maintaining a gluten-free diet (daily-life factor).

RESUMEN Objetivo: Identificar la prevalencia de ansiedad y depresión y la asociación con variables psicoafectivas, familiares y cotidianas en celíacos. Métodos: Estudio transversal, desarrollado con 83 celíacos, en Fortaleza. Se aplicó instrumento con variables agrupadas en las categorías de factores: psicoafectivos, familiares y cotidianos. Resultados: La ansiedad ha sido identificada en 52 celíacos (62,7%); y la depresión, en 29 (34,9%). Condición clínica percibida y Cantidad de síntomas aumentan la ocasión para ansiedad/depresión. Descontrol de la enfermedad celíaca (98,1%), Condición clínica percibida (75,0%), Obstáculos diarios para dieta sin gluten (63,4%) y Actividades cotidianas (55,8%) han sido los factores más predominantes en aquellos con ansiedad. En la presencia de depresión, hubo mayor prevalencia de Descontrol de la enfermedad celíaca (100,0%), Condición clínica percibida (82,8%) y Obstáculos diarios para dieta sin gluten (69,0%). Conclusión: Celíacos con cuadros de ansiedad y depresión presentaron mayor frecuencia de Condición clínica percibida y Apoyo social insuficiente (factores psicoafectivos) y Obstáculos diarios para dieta sin gluten (factor cotidiano).

RESUMO Objetivo: Identificar a prevalência de ansiedade e depressão e a associação com variáveis psicoafetivas, familiares e cotidianas em celíacos. Métodos: Estudo transversal, desenvolvido com 83 celíacos, em Fortaleza. Aplicou-se instrumento com variáveis agrupadas nas categorias de fatores: psicoafetivos, familiares e cotidianos. Resultados: Ansiedade foi identificada em 52 celíacos (62,7%); e depressão, em 29 (34,9%). Condição clínica percebida e Quantidade de sintomas aumentam a chance para ansiedade/depressão. Descontrole da doença celíaca (98,1%), Condição clínica percebida (75,0%), Obstáculos diários para dieta livre de glúten (63,4%) e Atividades cotidianas (55,8%) foram os fatores mais predominantes naqueles com ansiedade. Na presença de depressão, houve maior prevalência de Descontrole da doença celíaca (100,0%), Condição clínica percebida (82,8%) e Obstáculos diários para dieta livre de glúten (69,0%). Conclusão: Celíacos com quadros de ansiedade e depressão apresentaram maior frequência de Condição clínica percebida e Apoio social insuficiente (fatores psicoafetivos) e Obstáculos diários para dieta livre de glúten (fator cotidiano).

Associação do estado nutricional e os desfechos clínicos em cirurgia cardíaca pediátrica / Relación del estado nutricional y los resultados clínicos en cirugía cardíaca pediátrica / Association of nutritional status and clinical outcomes in pediatric cardiac surgery

Resumo Objetivo Verificar a associação do fator pessoal biológico estado nutricional, das crianças submetidas à cirurgia cardíaca, com os seguintes comportamentos: mortalidade/alta hospitalar, tempo de internação na Unidade de Terapia Intensiva (UTI) e tempo de ventilação mecânica (VM). Métodos Estudo transversal, retrospectivo realizado com 786 prontuários de crianças menores de cinco anos, submetidas à cirurgia cardíaca. O modelo de Nola J. Pender foi usado para analisar os dados. Aplicou-se o teste Qui-Quadrado de Pearson para verificar associação entre o fator pessoal biológico e o comportamento mortalidade/alta hospitalar. O teste Kruskal-Wallis foi utilizado para verificar a diferença entre medianas do fator pessoal biológico e os comportamentos tempo de VM e de UTI. Resultados A associação entre os fatores pessoais biológicos (pobre estado nutricional, desnutrição aguda e desnutrição crônica) com o comportamento mortalidade foi de OR 2,18 (1,42 - 3,34), p=0,003, OR 0,75 (0,46 - 1,2), p=0,24 e OR 2,7 (1,77 - 4,12), p<0,0001, respectivamente. A mediana de tempo em dias de uso de VM e tempo em dias de UTI foi, respectivamente de 3 (p<0,0001) e 8 (p<0,0001) para o pobre estado nutricional, 2 (p=0,041) e 6,5 (p=0,006) para a desnutrição aguda, 3 (p<0,0001) e 8 (p<0,0001) para a desnutrição crônica. Conclusão Os fatores pessoais biológicos que tiveram associação significativa com o comportamento mortalidade foram o pobre estado nutricional e desnutrição aguda. Foi verificado que as crianças com déficits nutricionais analisados tiveram uma superior mediana de tempo de VM e tempo de UTI quando comparadas com as crianças sem déficits nutricionais.

Resumen Objetivo Verificar la relación del factor personal biológico estado nutricional de niños sometidos a cirugía cardíaca, con los siguientes comportamientos: mortalidad/alta hospitalaria, tiempo de internación en Unidad de Cuidados Intensivos (UCI) y tiempo de ventilación mecánica (VM). Métodos Estudio transversal, retrospectivo realizado con 786 historias clínicas de niños menores de cinco años sometidos a cirugía cardíaca. Para analizar los datos se utilizó el modelo de Nola J. Pender. Se aplicó la prueba χ2 de Pearson para verificar la relación entre el factor personal biológico y el comportamiento mortalidad/alta hospitalaria. La prueba de Kruskal-Wallis fue utilizada para verificar la diferencia entre medianas del factor personal biológico y los comportamientos tiempo de VM y de UCI. Resultados La relación entre los factores personales biológicos (mal estado nutricional, desnutrición aguda y desnutrición crónica) y el comportamiento mortalidad fue de OR 2,18 (1,42 - 3,34), p=0,003, OR 0,75 (0,46 - 1,2), p=0,24 y OR 2,7 (1,77 - 4,12), p<0,0001, respectivamente. La mediana del tiempo en días de uso de VM y tiempo en días de UCI fue de 3 (p<0,0001) y 8 (p<0,0001) respectivamente para el mal estado nutricional, 2 (p=0,041) y 6,5 (p=0,006) para la desnutrición aguda, 3 (p<0,0001) y 8 (p<0,0001) para la desnutrición crónica. Conclusión Los factores personales biológicos que tuvieron relación significativa con el comportamiento mortalidad fueron el mal estado nutricional y la desnutrición aguda. Se verificó que los niños con deficiencias nutricionales estudiados tuvieron una mediana mayor de tiempo de VM y tiempo de UCI en comparación con niños sin deficiencias nutricionales.

Abstract Objective To find the association of the biological personal factor 'nutritional status' of children undergoing cardiac surgery with the following behaviors: mortality/hospital discharge, length of stay in the Intensive Care Unit (ICU) and time in mechanical ventilation (MV). Methods Cross-sectional, retrospective study of 786 medical records of children under five years of age who underwent cardiac surgery. Nola J. Pender's model was used for data analysis. The Pearson's Chi-Square test was applied to find the association between the biological personal factor and the mortality/hospital discharge behavior. The Kruskal-Wallis test was used to assess the difference between medians of the biological personal factor and the behaviors of time in MV and ICU length of stay. Results The association between personal biological factors (poor nutritional status, acute malnutrition and chronic malnutrition) with mortality behavior was OR 2.18 (1.42 - 3.34), p=0.003, OR 0.75 (0.46 - 1.2), p=0.24 and OR 2.7 (1.77 - 4.12), p<0.0001, respectively. The median time in days of MV use and ICU length of stay in days was, respectively, 3 (p<0.0001) and 8 (p<0.0001) for poor nutritional status, two (p=0.041) and 6.5 (p=0.006) for acute malnutrition, 3 (p<0.0001) and 8 (p<0.0001) for chronic malnutrition. Conclusion The personal biological factors with a significant association with mortality behavior were poor nutritional status and acute malnutrition. Children with analyzed nutritional deficits had a higher median time of MV and time of ICU compared with children without nutritional deficits.

Accuracy of the clinical indicators of ineffective health management in celiac people / Acuridad de los indicadores clínicos de gestión ineficaz de la salud en celíacos / Acurácia dos indicadores clínicos de controle ineficaz da saúde em celíacos

ABSTRACT Objective: to analyze the accuracy of clinical indicators of "Ineffective health management" in celiac patients and to verify associations between sociodemographic characteristics and clinical indicators. Method: a cross-sectional study, conducted from May to September 2017, with 83 celiac patients, through an interview. Accuracy measures were defined by latent class model. Results: there was a prevalence of "Ineffective health management" of 55.69%. "Failure to take action to reduce risk factor" and "Failure to include treatment regimen in daily living" better predict this diagnosis. Paid occupation reduces the chance of the presence of "Difficulty with prescribed regimen". Participation in support association reduces the chance of the presence of "Difficulty with prescribed regimen", "Ineffective choices in daily living for meeting health goal" and "Failure to take action to reduce risk factor". Conclusion: accurate clinical indicators identification assists clinical reasoning for diagnostic inference in specific health contexts.

RESUMEN Objetivo: analizar la exactitud de los indicadores clínicos de "Gestión ineficaz de la salud" en celíacos y verificar asociaciones entre características sociodemográficas e indicadores clínicos. Método: estudio transversal, realizado de mayo a septiembre de 2017, con 83 celíacos, a través de una entrevista. Las medidas de precisión fueron definidas por el modelo de clase latente. Resultados: la prevalencia de "Gestión ineficaz de la salud" fue de 55,69%. El "fracaso al emprender acciones para reducir los factores de riesgo" y "Fracaso al incluir el régimen terapéutico en la vida diaria" mejor dicho este diagnóstico. La ocupación remunerada reduce la posibilidad de la presencia de "Dificultad con el régimen terapéutico prescrito". La participación en la asociación de apoyo reduce la posibilidad de la presencia de "Dificultad con el régimen terapéutico prescrito", "Decisiones ineficaces en la vida diaria para alcanzar los objetivos de salud" y "Fracaso al emprender acciones para reducir los factores de riesgo". Conclusión: la identificación de indicadores clínicos precisos ayuda al raciocinio clínico para inferencia diagnóstica, en contextos de salud específicos.

RESUMO Objetivo: analisar a acurácia dos indicadores clínicos de "Controle ineficaz da saúde" em celíacos e verificar associações entre características sociodemográficas e indicadores clínicos. Método: estudo transversal, realizado de maio a setembro de 2017, com 83 celíacos, através de entrevista. As medidas de acurácia foram definidas pelo modelo de classe latente. Resultados: houve prevalência de "Controle ineficaz da saúde" de 55,69%. "Falha em agir para reduzir fatores de risco" e "Falha em incluir o regime de tratamento à vida diária" melhor predizem esse diagnóstico. Ocupação remunerada reduz a chance da presença de "Dificuldade com regime prescrito". Participação em associação de apoio reduz a chance da presença de "Dificuldade com regime prescrito", "Escolhas na vida diária ineficazes para atingir as metas de saúde" e "Falha em agir para reduzir fatores de risco". Conclusão: a identificação de indicadores clínicos acurados auxilia o raciocínio clínico para inferência diagnóstica, em contextos de saúde específicos.

Validação clínica dos fatores associados ao Estilo de vida sedentário em adolescentes / Clinical validation of factors associated with sedentary lifestyle in adolescents

Objetivo: validar clinicamente os fatores associados ao diagnóstico de enfermagem Estilo de vida sedentário em adolescentes. Métodos: estudo transversal, desenvolvido com 158 estudantes adolescentes. Aplicou-se o teste qui-quadrado para identificar a associação entre a presença de Estilo de vida sedentário e respectivos fatores associados. O nível de significância adotado foi p<0,05. Resultados: a prevalência de Estilo de vida sedentário foi de 68,3%. A presença dos fatores associados Conhecimento deficiente sobre os benefícios que a atividade física traz à saúde e/ou sobre as consequências do sedentarismo, Falta de recursos para a prática de exercício físico, Treinamento insuficiente para fazer exercício físico e Intolerância à atividade aumentou a probabilidade da presença de Estilo de vida sedentário (p<0,05). Conclusão: o diagnóstico de enfermagem Estilo de vida sedentário foi prevalente entre os adolescentes e existem fatores específicos que intensificam a probabilidade de desenvolvimento desse diagnóstico. (AU)

Fator de risco dislipidemia em universitários brasileiros e internacionais / Risk factor for dyslipidemia in brazilian and international universities

Objetivo: avaliar o fator de risco dislipidemia do diagnóstico de Enfermagem Risco de função cardiovascular prejudicada em estudantes universitários de países lusófonos. Método: trata-se de um estudo quantitativo, descritivo, transversal com 334 universitários. Realizaram-se, uma entrevista, exame físico e coleta de sangue em jejum. Empregou-se o teste U de Mann-Whitney, de acordo com o comportamento dos dados, estabelecendo-se, para todas as técnicas analíticas, o nível de significância de 0,05. Resultados: apresentou-se associação com significância estatística da dislipidemia com a faixa etária de 18 a 24 anos, a cor da pele amarela, branca ou parda e o estado civil sem companheiro. Apresentaram-se os valores mais elevados do colesterol total associação com o histórico pessoal, obesidade, hipertensão arterial e uso do álcool. Detalha-se que os parâmetros elevados de LDL tiveram associação estatística com a obesidade, hipertensão arterial e diabetes. Conclusão: possibilitou-se avaliar o fator de risco dislipidemia do diagnóstico de Enfermagem Risco de função cardiovascular prejudicada em estudantes universitários de países lusófonos, que poderá ser utilizado para planejamento e implementação de ações voltadas para a promoção da saúde e prevenção dos agravos neste grupo.(AU)

Objective: to evaluate the risk factor dyslipidemia in the nursing diagnosis Risk of impaired cardiovascular function in university students from Lusophone countries. Method: this is a quantitative, descriptive, cross-sectional study with 334 university students. An interview, physical examination and fasting blood were performed. The Mann-Whitney U test was used, according to the behavior of the data, establishing a significance level of 0.05 for all analytical techniques. Results: there was an association with statistical significance of dyslipidemia with the age group of 18 to 24 years, yellow, white or brown skin color and marital status without a partner. The highest values of total cholesterol associated with personal history, obesity, hypertension and alcohol use were presented. High LDL parameters were statistically associated with obesity, hypertension and diabetes. Conclusion: it was possible to evaluate the risk factor dyslipidemia of the nursing diagnosis. Risk of impaired cardiovascular function in university students from Lusophone countries, which can be used to plan and implement actions aimed at health promotion and disease prevention in this group.(AU)

Objetivo: evaluar el factor de riesgo de dislipidemia en el diagnóstico de Enfermería Riesgo de deterioro de la función cardiovascular en estudiantes universitarios de países. Método: este es un estudio cuantitativo, descriptivo, transversal con 334 estudiantes universitarios. Se realizó una entrevista, examen físico y sangre en ayunas. Se utilizó la prueba U de Mann-Whitney, de acuerdo con el comportamiento de los datos, estableciendo un nivel de significancia de 0.05 para todas las técnicas analíticas. Resultados: hubo una asociación con significación estadística de dislipidemia con el grupo de edad de 18 a 24 años, color de piel amarillo, blanco o marrón y estado civil sin pareja. Se presentaron los valores más altos de colesterol total asociados con antecedentes personales, obesidad, hipertensión y consumo de alcohol. Los altos parámetros de LDL se asociaron estadísticamente con obesidad, hipertensión y diabetes. Conclusión: fue posible evaluar el factor de riesgo de dislipidemia del diagnóstico de Enfermería Riesgo de deterioro de la función cardiovascular en estudiantes universitarios de países lusófonos, que se puede utilizar para planificar e implementar acciones dirigidas a la promoción de la salud y la prevención de enfermedades en este grupo.(AU)

Impaired comfort in children and adolescents with cancer.

OBJECTIVE: To determine the strength of the association between the clinical indicators of Impaired Comfort and the evaluation sector in the hospital, age group and sex of patients with cancer. METHOD: Cross-sectional study, conducted in a children's hospital, with 192 children and adolescents. For the collection, we used an instrument developed for the study. RESULTS: The majority of the sample was male, with mean age of 11 years. The indicators most evidenced among the hospitalized patients were Crying, Report of lack of satisfaction with the situation, Report of feeling cold, and Report of feeling uncomfortable. Crying and Fear were more prevalent in children compared with adolescents, and boys were the ones that verbalized the most the Report of lack of satisfaction with the situation. CONCLUSION: This study enabled determining the strength of the association of the indicators of Impaired Comfort expressed by children and adolescents with cancer.