Navegando por Palavras-chave "Nursing Diagnosis"

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    Adaptação transcultural para a língua portuguesa do Brasil de um guia autoinstrucional para avaliação do raciocínio clínico de estudantes de enfermagem
    (Universidade Federal de São Paulo (UNIFESP), 2020-05-28) Guandalini, Lidia Santiago [UNIFESP]; Barros, Alba Lucia Bottura Leite De [UNIFESP]; Universidade Federal de São Paulo
    Introduction The use of clinical reasoning prompts (CRP) for nursing students can increase their diagnostic accuracy during the resolution of case studies, contributing to the teaching-learning process and patient safety. Objective: To estimate the validity of the CRP for assessing the clinical reasoning of nursing students. Method: A methodological study of translation and cross-cultural adaptation into Brazilian Portuguese of: 1) CRP; 2) case studies; 3) a questionnaire on students’ perceptions during decision making in case studies; 4) a scoring manual to correct the case studies. To carry out translation and cross-cultural adaptation, steps 1 to 8 of the Guidelines for Establishing Cultural Equivalency of Instruments of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network were adopted: 1) Translation from the original language to the target language; 2) Synthesis and resolution of discrepancies of the two or more translations; 3) Back translation; 4) Review of back translation by the author of the original instrument; 5) Review and iterative development related to items with translation and back-translation problems; 6) Consolidation of all translation and assessment in a single instrument suitable for internal assessment; 7) Review by a committee of experts regarding cultural equivalence and content validity (clarity and practical relevance). The agreement values among experts > 80% and content validity coefficient (CVC)> 0.8 were considered satisfactory; 8) Preparation of the pre-final instrument and 9) Pre-test: randomized clinical trial with 24 nursing students (Intervention Group, n=14, using CRP to solve case studies and Control Group, n=10, without using the CRP). Results: the GARC was translated and adapted to the Portuguese language in Brazil, being placed for the location of agreement between the judges above 80% and the CVC above 0.80 with respect to content validity. Regarding face validation, adequate agreement was obtained in the assessment by the students. In the pre-test, there was no difference in the accuracy of nursing diagnoses between the Intervention and Control groups. Conclusion: The GARC was translated and adapted to the Portuguese spoken in Brazil and indicated according to the indication of face and content. The preliminary use of GARC, however, was not associated with an improvement in the diagnostic accuracy of nursing students.
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    Assistência de enfermagem a gestantes portadoras do vírus da imunodeficiência humana: levantamento de dados e diagnósticos de enfermagem
    (Universidade Federal de São Paulo (UNIFESP), 1998) Vaz, Maria José Rodrigues [UNIFESP]; Barros, Sonia Maria Oliveira de [UNIFESP]
    Este trabalho e uma pesquisa descritiva com os objetivos de elaborar um protocolo de levantamento de dados clinicos e os diagnosticos de enfermagem em gestantes portadoras do HIV. Foram assistidas 25 gestantes em consultas de enfermagem no ano de 1997. A maioria delas, 72 por cento , encontrava-se na faixa etaria de 20 a 30 anos, 48 por cento apresentavam primeiro grau incompleto e 80 por cento desempenhavam atividades do lar. Foram encontrados 380 diagnosticos de Enfermagem, sendo os mais frequentes: Risco para infeccao, Risco para lesao letal, Risco para transmitir infeccao, Controle ineficaz do regime terapeutica, Medo, Nutricao alterada: inGestão menor que as necessidades corporais, Manutencao do lar prejudicada, Integridade tissular prejudicada, Deficit de conhecimento
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    Comportamento das características definidoras dos diagnósticos de enfermagem medo e ansiedade identificados no pré-operatório imediato de pacientes submetidos a cirurgia eletivas
    (Universidade Federal de São Paulo (UNIFESP), 2005) Suriano, Maria Lucia Fernandez [UNIFESP]; Barros, Alba Lucia Bottura Leite de [UNIFESP]
    Introdução: o medo e ansiedade estão presentes em muitos momentos da vida do indivíduo, principalmente durante o adoecer e na possibilidade de uma intervenção cirúrgica. A similaridade entre os sinais e sintomas de ambos os diagnósticos de enfermagem Medo e Ansiedade e a controvérsias quanto as suas definições, sugere estudos da presença dos sinais e sintomas desses diagnósticos em pacientes no pré- operatório imediato de cirurgia eletiva. Objetivos: identificar as características definidoras (CD) mais freqüentes para os diagnósticos de enfermagem de Medo e Ansiedade em pacientes no período pré-operatório imediato; elaborar e validar o conteúdo das definições conceituais e operacionais para estas CD; validar clinicamente estas CD em pacientes no pré-operatório imediato de cirurgias eletivas; Correlacionar as características demográficas dos pacientes e o tipo de cirurgia com a presença dos diagnósticos de enfermagem Medo e Ansiedade; analisar clinicamente o comportamento das características definidoras (CD) dos diagnósticos de medo e ansiedade identificados em pacientes no pré-operatório imediato de cirurgia eletiva. Método: estudo observacional com pacientes programados para cirurgia eletiva no período pré-operatório imediato, no Centro Cirúrgico de um Hospital Escola da rede pública de São Paulo, desenvolvido em três etapas metodológicas: na primeira foram selecionadas as CD mais freqüentes e encontradas na amostra de 100 em pré-operatório imediato programados para cirurgia cardíaca, e posteriormente, foram elaboradas as definições conceituais (DC) e operacionais (DO) para cada um das CD selecionadas. Na segunda etapa, essas DC e DO foram submetidas à validação consensual entre cinco especialistas clínicos. A terceira etapa foi à validação clínica do comportamento dessas CD identificados na amostra de 150 pacientes programados para cirurgia eletiva em pré-operatório imediato. A análise estatística descritiva utilizou os seguintes testes: Kappa, coeficiente de correlação de Pearson análise de Cluster, o teste de Qui-Quadrado de Pearson, teste exato de Fisher, análise de variância - ANOVA. Resultados: para a primeira fase a seleção de 14 CD para Medo e 19 CD Para Ansiedade; na segunda fase o consenso de 100 por cento dos especialistas para as definições conceituais e operacionais de ambos diagnósticos de enfermagem e a inclusão de uma nova característica para Medo, “motilidade intestinal alterada”, ficando este diagnóstico com 15 CD. Na terceira etapa os resultados descritivos foram: 73,10 por cento das mulheres apresentaram alto índice para alto medo e ansiedade, já o sexo masculino, observamos índices maiores para pouco medo e ansiedade. Com relação a CD “motilidade intestinal alterada”, observamos um índice elevado de 73,3 por cento. As características definidoras para o diagnóstico de enfermagem de Medo obtiveram índices de freqüência superiores a 80 por cento foram: medo da morte, boca seca, respiração aumentada, excitação, verbalização, nervosismo, tensão aumentada e apreensão. Para Ansiedade algumas CD apresentaram altos índices de freqüências como: apreensão (100 por cento), nervosismo (99,3 por cento), tensão (99,3 por cento), inquietação (98,7 por cento), ansioso (99,3 por cento), angústia (82,7 por cento), verbalização (96,7 por cento), boca seca (89,3 por cento), perspiração aumentada (87,3 por cento), tremor de voz (84 por cento), insônia (76 por cento) e urgência urinária (74,7 por cento). Algumas questões de Ansiedade, apresentaram índices de freqüência superiores a 80 por cento, como: insônia, angústia, tremor de voz, respiração aumentada, boca seca, verbalização, inquietação, ansioso, tensão, nervosismo e apreensão. Conclusão: as características consideradas maiores para os diagnósticos de enfermagem Medo e Ansiedade e que apresentaram forte correlação entre ambos os diagnósticos. Sugerimos a inclusão de uma nova característica, “motilidade intestinal alterada” para Medo, que confirmou alta freqüência nos pacientes estudados. Sugerimos, também, a denominação de uma síndrome da ansiedade perioperatória, para uma possível inclusão na classificação da taxonomia da NANDA, om seguintes CDs que poderiam ser consideradas preditivas: medo da morte, boca seca, respiração aumentada, excitação, verbalização, nervosismo, tensão aumentada, apreensão, insônia, angústia, tremor de voz, inquietação, relato verbal de ansiedade, que obtiveram índices superiores a 80 por cento de freqüência..
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    Diagnósticos de enfermagem de alta acurácia em pessoas com insuficiência cardíaca
    (Universidade Federal de São Paulo (UNIFESP), 2020-08-27) Souza, Larissa Maiara Da Silva Alves [UNIFESP]; Barros, Alba Lucia Bottura Leite De [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Heart failure (HF) is a complex clinical syndrome secondary to cardiac structural and functional abnormalities. The existence of comorbidities such as hypertension, diabetes, physical inactivity and dyslipidemia and non-adherence to drug and non-drug treatment, as well as a lack of knowledge of the exacerbation symptoms of the disease are associated with hospitalizations. It is estimated that around 2 million new cases appear worldwide each year. In 2018, there were 200,814 hospital admissions registered in the Unified Health System (UHS) associated with HF, with 9,156 admissions registered in the state of São Paulo. Today, approximately 5.1 million Americans have HF. It is believed that this number tends to increase 46% by 2030, reaching eight million individuals diagnosed with HF. In this scenario, the performance of nursing can be circumstantial. When identifying the nursing diagnoses (ND) associating them to clinical signs and symptoms, the nurse unifies the individual's needs so that the elaborated interventions are aimed at solving these identified NDs. These diagnoses, when elaborated in an accurate way, make possible a more assertive care, with higher rates of resolution, reduction of complications and improvement of health status. The Nursing Diagnosis Accuracy Scale version-2 (NDAS-2) assesses the degree to which the statement of the ND is confirmed through a set of clinical information of the patient being used to measure the degree of accuracy of the listed NDs. Objectives: to identify highly accurate NDs present on admission and discharge of patients hospitalized for HF; identify the prevalence of NDs on admission and discharge from patients hospitalized for HF; test the reliability of the NDAS-2 within the between evaluators regarding the degree of accuracy of the diagnoses; Method: prospective cohort of diagnostic accuracy conducted in the Emergency Room of a large reference hospital in cardiology in a Brazilian metropolis, from August 2018 to July 2019, 155 patients hospitalized for HF participated in the research. Socio-demographic, clinical and drug treatment data were collected from an instrument developed by the researchers and previously tested. Subsequently, two researchers applied EADE-2 to NDs registered on admission and discharge of hospitalized HF patients. The variables were presented by means of descriptive statistics (absolute and relative frequencies) and by mean ± standard deviation. Fisher's exact test was used and associations with a descriptive level≤0.05 were considered significant. To assess the agreement between the evaluators, the Kappa coefficient was used, which varies from 0 to 1, and the closer to one, the greater the agreement. Results: The average age of hospitalized patients was 62.6 years, the majority being male (61.3%), white (54.19%) and incomplete elementary school (49.03%). The predominant hemodynamic profile was B (73.5%), the most frequent etiologies were cardiomyopathies (19.4%) and chagas disease (16.1%), with 25.16% not having a classification. Acute coronary syndrome was the most frequent pathology, observed in 43 patients (27.7%), the most prevalent comorbidities were hypertension (74.19%), diabetes (40.64%) and dyslipidemia (40.64%). Among the 18 NDs identified, four were prevalent both at admission and at discharge: Risk for Infection, Risk for Fall, Risk for decreased cardiac output and Fluid volume excess. These DEs had a good agreement between evaluators, with the Fluid volume excess being the one with the highest correlation at admission (0.7) and at discharge (0.9). Considering all NDs 85% were classified as highly accurate on admission and about 66% on hospital discharge. The NDs that stood out in this high accuracy classification were: Risk for Infection and Risk for decreased cardiac output on admission; and at discharge, he kept the Risk for infection together with the Risk for fall. Conclusion: The results of the study possibled to identify highly accurate nursing diagnoses. In addition, ND Risk for infection was the most prevalent and highly accurate, although it is not directly related to pathology such as the Risk for decreased cardiac output and the Fluid volume excess that are NDs related to the pathophysiological conditions of HF, demonstrating that there is the need to prioritize those NDs of greater clinical relevance in critical situations such as admission and discharge. Considering that nurses, through signs and symptoms, physical examination, laboratory and image exams, can identify other NDs, and thus make decisions in view of the current and real conditions of patients, the identification of highly accurate NDs will help them during systematic care, enabling appropriate nursing planning and care.
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    Diagnósticos e intervenções de enfermagem no período perioperatório dos pacientes submetidos a cirurgias cardiovasculares
    (Universidade Federal de São Paulo (UNIFESP), 1999) Suriano, Maria Lucia Fernandez [UNIFESP]; Barros, Alba Lucia Bottura Leite de [UNIFESP]
    O Centro Cirurgico possui uma dominancia diferente das demais unidades de um hospital, realizando cirurgias de urgencia, emergencia e eletivas, onde a enfermeira convive com situacoes de risco e de cuidados intensivos, visando minimizar o alto risco de morbi-mortalidade do paciente cirurgico no periodo' perioperatorio. Sua principal funcao e gerenciar a programacao cirurgica, providenciando recursos humanos e materiais, conforme o volume e o porte das cirurgias, alem de planejar a assistencia com base no processo de enfermagem, utilizando o SAEP (Sistema de Assistencia de Enfermagem Perioperatoria). A finalidade deste trabalho foi melhorar a qualidade da assistencia de enfermagem para os pacientes submetidos a cirurgias de grande porte, atraves da implantacao do SAEP, num hospital geral de ensino. Os objetivos foram: construir um instrumento de coleta de dados apropriado para atender pacientes no perioperatorio de cirurgias de grande porte, apoiado nos referenciais de Horta, Epidemiologico de Risco e Biomedico; identificar o perfil dos diagnosticos de enfermagem dos pacientes submetidos a cirurgia cardiovascular utilizando a Taxonomia da NANDA; estabelecer um planejamento da assistencia a partir dos diagnosticos de enfermagem identificados. Para a analise dos resultados dos diagnosticos de enfermagem utilizou-se a proporcao simples; para os demais dados aplicou-se os testes de Mann-Whitney, G de Cochran e McNemar. Como resultado, identificaram-se 13 titulos diagnosticos no periodo pre operatorio, 15 no transoperatorio e 15 no pos operatorio imediato. Para cada um dos diagnosticos de enfermagem foi realizado um planejamento das intervencoes de enfermagem apropriado. Estudos de validacao destes diagnosticos devem ser realizados no sentido de aprofundar os conhecimentos a respeito dos diagnosticos de enfermagem identificados, bem como da avaliacao dos resultados da assistencia prestada
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    Elaboração e validação de um estudo de caso para o desenvolvimento do raciocínio diagnóstico de estudantes e enfermeiros
    (Universidade Federal de São Paulo (UNIFESP), 2020-09-24) Leandro, Daniela Luana Fernandes [UNIFESP]; Lopes, Juliana De Lima [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Case studies are teaching tools that can be used for the development and improvement of diagnostic reasoning, contributing to an evidence-based nursing practice and with better health indicators for the patient. Therefore, they must be prepared based on the literature and their content must be validated. In the literature, there are few validated case studies and, to the best of our knowledge, none addressing peripheral arterial disease (PAD). Due to the high prevalence of this disease in the world population, it is relevant that nurses are able to identify the human responses common to patients with PAD. Objective: Develop and validate a case study to assist in the development of the diagnostic reasoning of students and nurses. Method: Methodological study, carried out in three stages: 1) preparation of the case study; 2) content validation of the case study and identification of the nursing diagnoses present; 3) assessment of diagnostic accuracy and establishment of priority diagnosis. This study was approved by the Unifesp Research Ethics Committee, Protocol 1550/2017. Participants: Twelve nurses specialized in Nursing Process selected according to pre-defined criteria. Results: The case study was based on a narrative review of the literature, which allowed the identification of clues related to the most frequent nursing diagnoses (ND) in patients with PAD, selected as the central health problem of the case. For the construction of the case, Lunney's eight assumptions were followed for the elaboration of case studies. The content of the case study was validated in the second evaluation round and the experts identified 18 ND with different degrees of accuracy. The most frequent diagnoses were: ineffective peripheral tissue perfusion (100%), impaired ambulation (83%), impaired comfort (50%) and chronic pain (50%). The diagnosis considered a priority by all specialists was "Ineffective peripheral tissue perfusion". Conclusion: The validated case study can be used by students and nurses to facilitate the development of diagnostic reasoning and critical thinking in the context of care practice, teaching and research.
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    Fatores Preditores Do Diagnóstico De Enfermagem Padrão Respiratório Ineficaz Em Pacientes De Uma Unidade De Terapia Intensiva
    (Universidade Federal de São Paulo (UNIFESP), 2017-11-30) Prado, Patricia Rezende Do [UNIFESP]; Lopes, Juliana De Lima [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To identify the prevalence, the related factors (RF), the defining characteristics (DC), the accuracy measures and the predictive factors of the nursing diagnosis of ineffective breathing pattern (IBP) in adults and elderly patients of an intensive care unit). Method: this thesis consists of two articles, an integrative review of the literature and a cross sectional paper. The integrative review aimed to identify the DC and RF of the IBP diagnosis. Articles were used between the years 1980 and 2016, which presented these indicators in newborns, children, adults and the elderly. The research question was formulated using the PICOT (Patient, Intervention, Comparation, Outcomes and Time) strategy. The quality of the articles was evaluated by the New Castle Ottawa scale. The cross-sectional study aimed to identify the prevalence, RF, DC, accuracy measures and predictive factors of IBP. For this, the sample consisted of adults and elderly patients hospitalized in an ICU in the city of Rio Branco, Acre. To be considered as having IBP, patients should present three or more defining characteristics (DC), as well as having a low inspiratory pressure obtained by the manovacuometer test. The patients were divided into two groups, with and without the IBP diagnosis. The independent variables were identified in the NANDA International classification (NANDA-I), literature (bronchial secretion, cough, decreased vesicular murmurs, altered respiratory depth and auscultation with adventitious sounds) and included some variables of interest identified in the clinical practice of researchers (age, medical diagnosis and smoking). Data were analyzed descriptively by means of absolute and relative frequencies. For all defining characteristics and related factors of dichotomous nature, accuracy measurements were presented through sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). In order to evaluate the simultaneous effects of the defining characteristics and related factors (predictor variables), on the presence of IBP (dependent variable), logistic regressions were adjusted. For the final model, having as predictors the related factors, the fitting adequacy of the final model was evaluated by Hosmer and Lemeshow test. Sensitivity and specificity were calculated from the ROC curve. Results: In the integrative literature review, the main RF identified in children was bronchial secretion (81.8%), followed by hyperventilation (22.4%). The main DC were: dyspnea (97,9%), tachypnea (82,9%), cough (74,3%), use of accessory breathing muscles (70,3 %), orthopnea (69,9%) and adventitious noise (67,5%). In adults, the main RF were fatigue (28.8%), pain (17.5%) and obesity (16.7%). The main DC were dyspnea (40.3%), tachypnea (16.7%) and orthopnea (15.6%). In the cross-sectional study, of the 120 patients, 67.5% presented IBP. In the univariate analysis, the variables that were associated with this nursing diagnosis were: group of disease (p = 0.008), RFs fatigue (p <0.001), obesity (p = 0.01) and secretion in the bronchi (p = 0.01), and the DC were changes in respiratory depth, auscultation with adventitious sounds, dyspnea, decreased vesicular murmurs, tachypnea, cough and use of accessory musculature to breathe, all with p-value <0.001. The DC decreased vesicular murmurs had high sensitivity (92.6%), specificity (97.4%), negative predictive value (86.4%) and positive (98.7%) and mean age of patients with positive IBP was higher than those with negative PRI (p = 0.003). The predictive factors of IBP in this ICU were: fatigue (OR = 61.96, p <0.001), age (OR = 1.06, p = 0.001) and group of diseases as the cardiocirculatory system (OR=0,07; p=0,02), trauma (OR=1; p=0,013) and other diagnoses (OR=0,15; p=0,009). Conclusion: Fatigue, age and group of diseases were predictors of IBP nursing diagnosis in this intensive care unit. Decreased vesicular murmurs, auscultation with adventitious sounds, and cough may be defining characteristics to be added in the NANDA-I classification, as well as secretion in the bronchi and group of disease as a related factor. It is emphasized the importance of investigating and identifying early these predictive factors with the intention of planning and implementing a care to improve the prognosis of patients with this nursing diagnosis.
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    Identificação das características definidoras de medo e ansiedade em pacientes programadas para cirurgia ginecológica
    (Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2009-01-01) Suriano, Maria Lucia Fernandez [UNIFESP]; Lopes, Daniela Cristina Da Fonte; Macedo, Giselle Pinto De Oliveira Sá [UNIFESP]; Michel, Jeanne Liliane Marlene [UNIFESP]; Barros, Alba Lucia Bottura Leite de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To identify defining characteristics of fear and anxiety during the immediate preoperative period in patient scheduled for gynecological surgery, and to diagnose preoperative anxiety syndrome. METHODS: This was a cross-sectional study with 50 patients from the gynecological unit of the São Paulo hospital. Data was collected in May 2007. RESULTS: Preoperative anxiety syndrome was diagnosed in 48 of the participants (96.0%). CONCLUSION: Participants had clinical symptoms leading to the diagnosis of preoperative anxiety syndrome.
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    Nursing diagnoses in patients with immune-bullous dermatosis
    (Hindawi Ltd, 2016) Brandao, Euzeli da Silva; dos Santos, Iraci; Lanzillotti, Regina Serrao; Ferreira, Adriano Menis; Gamba, Monica Antar [UNIFESP]; Azulay-Abulafia, Luna
    Objective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11). 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology.
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    Nursing Interventions in the Clinical Practice of an Intensive Care Unit
    (Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2010-10-01) Lucena, Amália de Fátima [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Echer, Isabel Cristina; Barros, Alba Lucia Bottura Leite de [UNIFESP]; Universidade Federal do Rio Grande do Sul Escola de Enfermagem; Universidade Federal de São Paulo (UNIFESP)
    This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping. A total of 57 different NIC interventions frequently used in the unit were identified; most of them in the complex (42%) and basic physiological (37%) domains, in the classes respiratory management and self-care facilitation . Similarity between the nursing care prescribed and nursing interventions/NIC was found in 97.2% of the cases. The conclusion is that the interventions/NIC used in the clinical practice of this intensive care unit reflects the level of complexity of nursing care, which is mainly directed at the regulation of the body s physical and homeostatic functioning.
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    Parental role conflict: the nursing diagnosis in mothers of hospitalized newborns
    (Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2013-04-01) Carmona, Elenice Valentim [UNIFESP]; Vale, Ianê Nogueira do; Ohara, Conceicao Vieira da Silva [UNIFESP]; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To verify if mothers of newborns hospitalized recognize the defining characteristics of parental role conflict as representative of that experience. METHODS: A cross-sectional and descriptive study, developed in a neonatal unit of a public teaching hospital in the state of São Paulo. The sample consisted of 100 women who assigned scores of 1 to 5 to the defining characteristics of the diagnosis, where 1 meant not at all characteristic and 5 meant completely characteristic of what I am experiencing. RESULT: Of the total sample, 96 women self-identified with the diagnosis. The most prevalent defining characteristics were: anxiety, mother expresses concern(s) in relation to changes in maternal role; verbalizes feelings of frustration, reports concern about family and fear. Women who were with their children less often during hospitalization had a higher number of defining characteristics. CONCLUSION: There was a high prevalence of the defining characteristics of the studied diagnosis, suggesting the relevance of the topic and the need for further studies to be developed in the neonatal unit.
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    Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis
    (Univ Sao Paulo, Escola De Enfermagem De Ribeirao Preto, 2017) Teixeira, Andressa Magalhaes; Tsukamoto, Rosangela; Lopes, Camila Takáo [UNIFESP]; Gengo e Silva, Rita de Cassia
    Objective: to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International. Method: an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015. Results: altered levels of glycated hemoglobin, body mass index>31 kg/m(2), previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia. Conclusions: risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.
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    Validation of the concept Risk for Decreased Cardiac Output
    (Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2013-02-01) Santos, Eduarda Ribeiro dos [UNIFESP]; Souza, Mariana Fernandes de [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Maria, Vera Lucia Regina; Barros, Alba Lucia Bottura Leite de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: to validate the concept risk for decreased cardiac output. METHOD: Six of the eight steps suggested in the technique developed by Walker & Avant were adopted to analyze the concept of the phenomenon under study and the proposal made by Hoskins was used for content validation, taking into account agreement achieved among five experts. RESULTS: the concept decreased cardiac output was found in the nursing and medical fields and refers to the heart's pumping capacity while the concept risk is found in a large number of disciplines. In regard to the defining attributes, impaired pumping capacity was the main attribute of decreased cardiac output and probability was the main attribute of risk. The uses and defining attributes of the concepts decreased cardiac output and risk were analyzed as well as their antecedent and consequent events in order to establish the definition of risk for decreased cardiac output, which was validated by 100% of the experts. CONCLUSION: The obtained data indicate that the risk for decreased cardiac output phenomenon can be a nursing diagnosis and refining it can contribute to the advancement of nursing classifications in this context.