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Purpose: To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension. Methods: This is a cross‐sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability. Results: Ineffective health management is probably present in 37.5% of people with hypertension. 'Failure to include treatment regimen in daily living' was the clinical indicator with the highest sensitivity value, and 'failure to take action to reduce risk factor' had the highest specificity value. Conclusions: Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario. Implications for Nursing Practice: This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: A standardized language system can support the elaboration of clinical guidelines by matching information from similar patterns of response to people. To identify the factors that are related to a higher likelihood of an ineffective health management nursing diagnosis. Methods: We conduct a systematic review and meta‐analysis. An electronic search was conducted in MEDLINE databases via PubMed, Web of Science, SciELO, CINAHL, SCOPUS, and Embase between October and November 2020. Descriptive data were extracted from each article. The odds ratios for each etiological factor related to ineffective health management were directly extracted from the articles or calculated from the data described in the articles. The analysis of the measurements of exposure and the magnitude of the effect was performed using the statistical software R, and a forest plot was constructed for each etiological factor. Findings: Ten studies were included, and 15 related factors were recovered from the primary studies. The factors that significantly increased the likelihood of an ineffective health management nursing diagnosis were insufficient knowledge of the therapeutic regimen, perceived barriers, powerlessness, economic disadvantage, and difficulty managing complex treatment regimens. No effect was verified with the following factors: decision conflict, family pattern of healthcare, and inadequate number of cues to action. Conclusion: Factors related to a higher likelihood of ineffective health management may be the focus of early and targeted nursing interventions, contributing to an improved quality of care. Clinical relevance: Understanding exposure to these factors can improve diagnostic reasoning at different population levels. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the accuracy of the defining characteristics of hypothermia in newborns and to verify associations between defining characteristics and clinical variables. METHODS: A cross‐sectional accuracy study with statistical analysis. FINDINGS: Slow capillary refill, decrease in ventilation, peripheral vasoconstriction, and insufficient weight gain were the defining characteristics with the highest specificity values, while slow gastric emptying, skin cool to touch, irritability, and bradycardia were the defining characteristics with the highest values for both sensitivity and specificity. CONCLUSION: Slow gastric emptying, skin cool to touch, irritability, and bradycardia are good clinical indicators to infer initial stages of hypothermia and to confirm its presence. IMPLICATIONS FOR NURSING PRACTICE: Accuracy measures may contribute to the improvement of the diagnostic inferential process. OBJETIVO: Analisar acurácia das características definidoras de Hipotermia em recém‐nascidos e identificar a associação delas com variáveis clínicas. MÉTODO: Estudo de acurácia transversal com análise estatística. RESULTADOS: Preenchimento capilar lento, diminuição da ventilação, vasoconstrição periférica e ganho de peso insuficiente apresentaram valores altos de especificidade enquanto esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia apresentaram valores elevados de sensibilidade e especificidade. CONCLUSÃO: Esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia são úteis para inferir estágios iniciais de hipotermia e para confirmação diagnóstica. IMPLICAÇÕES PARA PRÁTICA DE ENFERMAGEM: Medidas de acurácia podem contribuir para o processo de inferência do diagnóstico hipotermia. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify prognostic clinical indicators of short-term survival for ineffective breathing pattern in children with acute respiratory infection. Background Despite the studies of survival for nursing diagnosis, there is not enough evidence about the clinical indicators that are associated with a worse prognosis for ineffective breathing pattern. Design A prospective cohort study. Methods One hundred and thirty-six children were followed up for a minimum of six and a maximum of 10 consecutive days. The survival rate for ineffective breathing pattern was calculated using Nelson-Aalen's method. An extended Cox model was adjusted to identify the main prognostic clinical indicators for this nursing diagnosis. Results Over half of the sample had an ineffective breathing pattern at the first evaluation. The occurrence of new cases was observed until the ninth day of monitoring, and the survival rate after this day was low. According to the Cox model, the main clinical indicators of a poor prognosis were an abnormal breathing pattern, the use of accessory muscles, dyspnoea and increase in the anterior-posterior chest diameter. Conclusions Children with acute respiratory infection who present with an abnormal breathing pattern, the use of accessory muscles to breathe, dyspnoea and increased anterior-posterior diameter have a poor prognosis for an ineffective breathing pattern. Relevance to clinical practice Survival analyses of nursing diagnoses allow the identification of clinical indicators that can be used in clinical practice as prognostic markers. The identification of indicators associated with a poor clinical prognosis allows nurses to intervene early and to maximise the possibility of a good outcome. [ABSTRACT FROM AUTHOR]

Purpose To analyze the statistical characteristics of the weighted inter-rater reliability index for validating nursing diagnoses. Methods From a computational algorithm, the index values were compared with the sample size, frequency of the clinical indicator, number of agreements between raters, and three other agreement estimators. Findings The index moderately correlated with the frequency of the clinical indicator and strongly correlated with the number of agreements and disagreements between the raters. This index showed a poor correlation with sample size. Conclusion This index selects those clinical indicators with high frequency and/or absolute agreement and therefore has a high sensitivity. Implications for Nursing Practice The high sensitivity may result in incorporating false positive clinical indicators. [ABSTRACT FROM AUTHOR]

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

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

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Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The study aims to assess indicators of Nursing Outcomes Classification (NOC) related to the nursing diagnosis Ineffective Breathing Pattern (IBP) in children with congenital heart disease (CHD). The study used a cross-sectional study carried out in 63 children with CHD up to 2 years old. Seventeen operational indicators of NOC related to IBP were evaluated. Seven indicators presented statistically significant differences between children with and without IBP. Impaired expiration was the indicator assessed with greatest frequency in both groups. The study showed differences in the clinical indicators between children with and without IBP. The use of NOC indicators allowed an assessment of the differences and the level of respiratory impairment among children with and without IBP. Avaliar os indicadores da Classificação de Resultados de Enfermagem (NOC) relacionados ao diagnóstico Padrão Respiratório Ineficaz (PRI) em crianças com cardiopatias congênitas. Estudo transversal desenvolvido com 63 crianças menores de 2 anos, com diagnóstico médico de cardiopatia congênita. Foram avaliados 17 indicadores operacionais NOC relacionados ao diagnóstico de enfermagem PRI. Sete indicadores apresentaram diferenças estatisticamente significantes entre crianças com e sem PRI. O indicador Dificuldade respiratória foi avaliado com maior comprometimento entre os grupos. O estudo mostrou diferenças nos indicadores clínicos entre crianças com e sem PRI. O uso de indicadores NOC permitiu uma avaliação das diferenças e do nível de comprometimento respiratório entre crianças com e sem PRI. [ABSTRACT FROM AUTHOR]