Search

This review aimed to analyze the use of differential validation of nursing diagnosis.Integrative literature review with search on international databases. The diagnoses, the type of the diagnosis differential validation, the sample, the method, main results, and the limitations were extracted. Ten studies were included.Differential diagnostic validation publication dates from 1994, and Brazil was the predominant country.This method seems helpful in improving diagnosis accuracy, particularly those related to subjective, behavioral, or complex human responses.Using this model may facilitate understanding the specificity of nursing diagnosis, which is critical for teaching clinical reasoning and for new opportunities to research.O objetivo desta revisão foi analisar a utilização da validação diferencial de diagnósticos de enfermagem. MÉTODOS: Revisão integrativa da literatura com pesquisa em bases de dados internacionais. Foram extraídos dados referentes ao tipo de diagnóstico, validação diferencial, amostra, metodologia, principais resultados e limitações. Foram incluídos 10 estudos.Foram identificadas publicações desde 1994, sendo o Brasil o país predominante. CONCLUSÕES: Este modelo parece ser útil para melhorar a precisão do diagnóstico, particularmente aqueles relacionados a respostas humanas subjetivas, comportamentais ou complexas. IMPLICAÇÕES PARA A PRÁTICA: O uso deste modelo pode facilitar a compreensão da especificidade do diagnóstico de enfermagem, que é fundamental para o ensino do raciocínio clínico, para novas oportunidades de pesquisa.

Purpose To analyze the short-term survival of the nursing diagnosis of neonatal hyperbilirubinemia in hospitalized neonates within the first 24 h of life and over a maximum of 7 days. Methods A prospective open cohort study with a longitudinal design was developed with 120 newborns during the first 24 h of life. The survival rate after a nursing diagnosis of neonatal hyperbilirubinemia was analyzed for 7 days. Findings The number of new cases of neonatal hyperbilirubinemia during the follow-up was 82 (RR: 90.1%, daily incidence rate: 34.17%). The greatest manifestation of the diagnosis occurred in the first three days (n = 97). The median diagnostic survival time was 2 days (95% CI: 2-2). Yellow-orange skin color (RR = 8.08), yellow mucous membranes (RR = 2.05), yellow sclera (RR = 1.99), and female gender (RR = 1.36) had the highest risk ratios. Conclusions A rapid impairment of neonatal hyperbilirubinemia in hospitalized neonates was observed. Some clinical indicators were associated with an increased risk for this diagnosis. Implications for nursing practice Studies on the prognostic capacity of the clinical indicators of nursing diagnoses like neonatal hyperbilirubinemia strengthen the clinical reasoning of nurses and subsidize diagnostic inferences and accurate clinical decisions.

Purpose To analyze the unidimensionality of the nursing diagnoses low situational self-esteem and low chronic self-esteem proposed by NANDA-I. Desing and methods Diagnostic accuracy study carried out with 180 patients with depressed mood in a psychiatric hospital in northeastern Brazil. Findings The analysis of the latent class considered the hypothesis of low self-esteem as a unique construct and included the indicators: Excessive seeking of reassurance, repeatedly unsuccessfulness in life events, rejection of positive feedback, insomnia, solitude, and nonassertive behavior. Practice implications The recognition of low self-esteem as a unique diagnostic construct allows nurses to be more assertive in the provision of care.

To compare factors associated with the sedentary lifestyle described in the literature with the factors listed in NANDA International.Systematic review with meta-analysis of factors associated with a sedentary lifestyle in adolescents, adults and older people.An electronic search of PubMed, Scopus, CINAHL and Latin America and the Caribbean Literature on Health and Science databases conducted in May 2016.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.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.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.Knowledge about these factors can contribute directly to public health policies.目的: 将文献中描述的与久坐不动的生活方式相关的因素与NANDA International中列出的因素进行比较。 设计: 对青少年、成年人和老年人久坐不动的生活方式相关因素进行系统评估和荟萃分析。 数据来源: 2016年5月对PubMed、Scopus、CINAHL以及拉丁美洲和加勒比地区的健康与科学文献数据库进行了电子检索。 评估方法: 根据标准化形式提取描述性数据。与久坐不动的生活方式相关的每种病因的比值比直接从文献中提取或从其中描述的数据中计算得出。对一项以上研究中调查的因素进行了荟萃分析。 结果: 纳入了35篇文章。具有统计学意义的因素包括: 缺乏社会支持、缺乏实际空间、时间、动力、运动技能以及对体育活动的兴趣、对活动的不耐受、退休、生活在低收入国家、懒惰、没有工作/学习、社会经济地位地下、缺乏体育活动知识、女性、生活在城市地区、对健康的负面自我认知、使用公共交通工具、在研究中属于年龄最大的群体以及感知的身体残疾。 结论: 与久坐不动的生活方式相关的新因素以及已经纳入NANDA International分类的那些因素将为护士提供更好的临床指导。 影响: 对这些因素的了解可直接促进公共卫生政策的制定。.

Background: Studies that establish the indicators of clinical status deterioration of Ineffective airway clearance remain scarce. Prognostic studies provide data for nurses identify clinical indica...

Aims and objectives To analyse, hierarchically, factors associated with hospital readmissions for acute coronary syndrome. Background Hospital readmissions have risen, especially in patients with multiple comorbidities, which are most often chronic. The leading causes of hospital readmission include acute coronary syndrome, which is costly and often preventable. Determining clinical and nonclinical variables that increase the chances of readmission is important to assess and evaluate patients hospitalised for coronary heart diseases. Design A case-control study whose dependent variable was hospital readmission for acute coronary syndrome. Methods The study included 277 inpatients, of whom 132 were in their first hospitalisation and 145 had already been hospitalised for acute coronary syndrome. The independent variables for this hierarchical model were sociodemographic conditions, life habits, access to health services and physical health measures. Data were obtained by interviews, anthropometric measurements and patient records. Logistic regression analysis was performed using the stepwise technique, with Microsoft Excel and R version 3.2.3. The research was reported via strengthening the reporting of observational studies in epidemiology (STROBE). Results In the final hierarchical logistic model, the following risk factors were associated with readmission for acute coronary syndrome: inadequate drug therapy adherence, stress, history of smoking for 30 years or more, and the lack of use of primary healthcare services. Conclusions Clinical and nonclinical variables are related to hospital readmission for acute coronary syndrome and can increase the chance of readmission by up to six times. Relevance to clinical practice The predictive model can be used to avoid readmission for acute coronary syndrome, and it represents an advance in the prediction of the occurrence of the outcome. This implies the need for a reorientation of the network for postdischarge care in the first hospitalisation for acute coronary syndrome.

PURPOSE To elucidate six diagnostic concepts related to urinary incontinence (UI). METHODS Eight out of nine steps of the simultaneous concept analysis (SCA) method were used to elucidate six diagnostic concepts related to UI proposed by NANDA International. FINDINGS Individual concepts of each diagnosis were elucidated, including antecedents, outcomes, associated conditions, and risk populations, and the interrelations among these concepts were identified, comparing them to those already present in the current NANDA-I taxonomy. The overflow UI was excluded, and were included mixed and transient UI diagnoses. CONCLUSIONS SCA enabled identifying similar characteristics and factors exclusive to the revised nursing diagnoses. IMPLICATIONS FOR NURSING PRACTICE To support for clinical reasoning to identify properly the types of UI. OBJETIVO Elucidar seis conceitos diagnosticos relacionados a incontinencia urinaria. METODOS: Oito das nove etapas do metodo de analise simultânea de conceitos foram utilizadas para elucidar seis conceitos diagnosticos relacionados a incontinencia urinaria propostos pela NANDA International. RESULTADOS Conceitos individuais de cada diagnostico foram elucidados, incluindo antecedentes, consequentes, condicoes associadas e populacoes em risco, e as inter-relacoes entre esses conceitos foram identificadas, comparando-as com aquelas ja presentes na atual taxonomia da NANDA-I. A incontinencia urinaria por transbordamento foi excluida e foram incluidos os diagnosticos de incontinencia urinaria mista e incontinencia urinaria transitoria. CONCLUSOES: A analise simultânea de conceitos permitiu identificar caracteristicas e fatores semelhantes exclusivos aos diagnosticos de enfermagem revisados. IMPLICACOES PARA A PRATICA DE ENFERMAGEM: Apoiar o raciocinio clinico para identificar adequadamente os tipos de incontinencia urinaria.

Purpose The study's objective was the clinical validation of the nursing diagnosis Risk for delayed surgical recovery (00246). Method Case control study was conducted in a university hospital; the charts of 239 patient, 71 cases and 168 controls. Odds ratio was calculated for the association between each risk factor and the outcome of delayed surgical recovery. Results Risk factors with higher odds of association were malnutrition, pain, and postoperative emotional response. The associated conditions were perioperative surgical site infection, psychological disorder in the postoperative period, and surgical site contamination. Conclusion Risk factors have different impact on the postoperative recovery. Implications for nursing practice Knowing the magnitude of the risk factors allows a decision making best interventions for a fast surgical recovery.

To investigate the clinical indicators of the nursing diagnosis impaired swallowing in children with neurological disorders.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.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.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.

Objetivo: Mapear os diagnósticos de enfermagem da taxonomia NorthAmerican Nursing Diagnosis Association International (NANDA-I) em pacientes no período transoperatório. Método: Estudo do tipo transversal, documental, dos registros de enfermagem no período transoperatório de um hospital da rede suplementar de saúde do município de Niterói, Rio de Janeiro, desenvolvido por meio da ferramenta metodológica mapeamento cruzado. Resultados: Foram avaliados 65 prontuários. A maior parte da amostra foi composta de mulheres com média de idade de 50,1 anos e submetidas a cirurgias eletivas. Quanto à especialidade cirúrgica, os procedimentos mais realizados foram gerais e urológicos. Os termos mais encontrados foram bisturi elétrico, placa de bisturi, anestesia geral e entubação. Pelo painel de especialistas, obtiveram-se como diagnósticos prevalentes: risco de infecção de sítio cirúrgico (84,6%), risco de integridade da pele prejudicada (78,5%), integridade tissular prejudicada (63,1%) e risco de aspiração (58,5%). Conclusão: Os diagnósticos de enfermagem encontrados são prioritariamente de risco. Logo, carecem de identificação precoce e de intervenções para evitar danos e prevenir complicações, como o retardamento na recuperação cirúrgica.

Purpose To analyze the accuracy of the defining characteristics of the nursing diagnosis of sexual dysfunction in women undergoing pharmacological treatment for breast cancer. Methods A cross-sectional accuracy study with statistical analysis. Findings Alteration in sexual satisfaction was the defining characteristic with the highest sensitivity value, while perceived sexual limitation was the defining characteristic with the highest value for both sensitivity and specificity. Conclusions Perceived sexual limitation is a good clinical indicator to infer initial stages of sexual dysfunction and to confirm its presence. Implications for nursing practice Accurate diagnostics allow devising an action plan directed to the patients' real needs, helping prescribe and deliver the appropriate nursing interventions.

Objective: To analyze the content of the diagnostic proposition risk of excessive fluid volume in patients undergoing hemodialysis. Method: Content validity study, with 48 judges who assessed the content of the diagnostic proposition risk of excessive fluid volume, using an electronic data collection instrument. The judges’ answers were analyzed through the calculation of the Content Validity Index and the T test. Results: The risk of excessive fluid volume was considered adequate, containing 23 risk factors: increased sodium concentration in the dialysate; missing hemodialysis sessions; insufficient water; low self-efficacy for fluid restriction; deficient knowledge; altered body mass index; excessive intake of fluids, proteins and sodium; lower kt/v index; inadequate removal of fluids in hemodialysis; thirst; xerostomia; older people; comorbidities; renal function decline; decreased urinary volume; inflammatory status; hospitalization; low serum level of albumin and lymphocytes, and high level of phosphorus; and use of antihypertensive drugs. Conclusion: The content of the diagnostic proposition risk of excessive fluid volume was considered adequate by the judges. RESUMEN Objetivo: Analizar el contenido de la proposición diagnóstica riesgo de volumen de líquidos excesivo en pacientes sometidos a hemodiálisis. Método: Estudio de validación de contenido, con 48 jueces que evaluaron el contenido de la proposición diagnóstica riesgo de volumen de líquidos excesivo, por medio de un instrumento electrónico de recolección de datos. Las respuestas de los jueces fueron analizadas por el cálculo del Índice de Validez de Contenido y la prueba T. Resultados: El riesgo de volumen de líquidos excesivo fue considerado adecuado, se identificó 23 factores de riesgo: aumento en la concentración de sodio del dializado; ausencia en la sesión de hemodiálisis; evaluación hídrica insuficiente; baja autoeficacia para restricción de líquidos; conocimiento insuficiente; índice de masa corporal alterada; ingestión excesiva de líquidos, de proteínas y sodio; menor índice del kt/V; remoción inadecuada de líquidos en la hemodiálisis; sed; xerostomía; ancianos; comorbilidades; disminución de la función renal; disminución del volumen urinario; estado inflamatorio; hospitalización; nivel sérico de albumina y linfocitos bajos, y de fósforo elevado; y uso de antihipertensivos. Conclusión: El contenido de la proposición diagnostica riesgo de volumen de líquidos excesivo fue considerado adecuado por los jueces. RESUMO Objetivo: Analisar o conteúdo da proposição diagnóstica risco de volume de líquidos excessivo em pacientes submetidos à hemodiálise. Método: Estudo de validação de conteúdo, com 48 juízes que avaliaram o conteúdo da proposição diagnóstica risco de volume de líquidos excessivo, a partir de um instrumento eletrônico de coleta de dados. As respostas dos juízes foram analisadas pelo cálculo do Índice de Validade de Conteúdo e o teste T. Resultados: O risco de volume de líquidos excessivo foi considerado adequado, contendo 23 fatores de risco: aumento na concentração de sódio do dialisado; ausência na sessão de hemodiálise; avaliação hídrica insuficiente; baixa autoeficácia para restrição de líquidos; conhecimento deficiente; índice de massa corporal alterada; ingesta excessiva de líquidos, de proteínas e sódio; menor índice do kt/v; remoção inadequada de líquidos na hemodiálise; sede; xerostomia; idosos; comorbidades; declínio da função renal; diminuição do volume urinário; estado inflamatório; hospitalização; níveis séricos de albumina e linfócitos baixos, e de fósforo elevado; e uso de anti-hipertensivos. Conclusão: O conteúdo da proposição diagnóstica risco de volume de líquidos excessivo foi considerado adequado pelos juízes.

To clinically validate the defining characteristics of nursing diagnoses related to self-care deficits in feeding, bathing, toileting, and dressing in patients with stroke. A diagnostic accuracy study was conducted with a sample of 135 patients with stroke. Sensitivity and specificity were calculated based on the latent class analysis method using the random effects model. The prevalence of diagnoses was 23.5% for Bathing self-care deficit, 18.5% for Dressing self-care deficit, 13.3% for Toileting self-care deficit, and 7.5% for Feeding self-care deficit. Fourteen defining characteristics were sensitive, and 17 were specific. Hemorrhagic stroke and note 4 on the Rankin scale was associated with self-care deficits. Of the 37 defining characteristics of the four diagnoses studied, 19 were clinically validated according to the latent class analysis model. These most accurate clinical indicators contribute to the development of the care plan for patients with stroke.

Purpose This study aims to analyse the accuracy of clinical indicators of the proposed diagnosis of delayed growth in school-aged adolescents. Design and Methods This is a diagnostic accuracy study of 385 adolescents in public schools from July to September 2017 that aimed to assess the accuracy of clinical indicators of the proposed nursing diagnosis of delayed growth; the sensitivity and specificity values were calculated using latent class analysis. Results Growth velocity less than expected was associated with sensitivity and specificity. The clinical indicator short stature for age and sex showed sensitivity. Low weight for age and sex, stature below genetic target and delayed sexual maturation were specific indicators. Conclusion In a sample of adolescents in public schools in northeastern Brazil, a set of five clinical indicators best indicated delayed growth in adolescents. Two clinical indicators showed sensitivity, and four clinical indicators showed specificity. Practice implications This study contributes to refining the diagnostic proposition of delayed growth in adolescents. Accurate measures for nursing diagnoses can help paediatric nurse practitioners confirm or exclude this diagnosis in adolescents with a similar profile.

This study aimed to analyze the accuracy of the clinical indicators of the nursing diagnosis of dysfunctional gastrointestinal motility in infants from neonatal units and identify their association with clinical variables. This is a study of the diagnostic accuracy of clinical indicators of the diagnosis of dysfunctional gastrointestinal motility, with a cross-sectional design, performed on 228 hospitalized infants in neonatal units. A high prevalence of dysfunctional gastrointestinal motility was identified in the studied population. Regarding accuracy measures, clinical indicators such as increased gastric residual, changes in bowel sounds, bile-colored gastric residual, regurgitation, absence of flatus, and hard and formed stool were useful to discriminate between infants with and without dysfunctional gastrointestinal motility. The findings can help nurses during the diagnostic process, as they identify which defining characteristics can be used to confirm or rule out the probability of occurrence of the diagnosis.

Aims The aim of this study is to verify the clinical validity of clinical indicators and aetiological factors of sedentary lifestyle in individuals with arterial hypertension. Background Diagnostic validation is performed to expand nursing taxonomies and to revise or confirm the described concepts. New elements listed in the literature and those identified by the NANDA International definition for sedentary lifestyle need to be evaluated. Design This is a cross-sectional and diagnostic validation study. The STROBE guidelines were used in this study. Methods Two hundred and fifty subjects aged over 18 years were evaluated. The diagnostic status of the participants was obtained by latent class analysis. Logistic regression was used to identify aetiological factors with the manifestation of sedentary lifestyle, considering a significance level of 5%. Results A total of 57.8% of the study participants met the diagnostic criteria for sedentary lifestyle. The clinical indicators with high sensitivity were as follows: "Average daily physical activity is less than recommended for gender and age"; "Does not perform physical activity during leisure time"; "Preference for activity low in physical activity" and "Overweight." The significantly related factors associated with the diagnosis of sedentary lifestyle were as follows: "Insufficient knowledge on physical activity," "Lack of time," "Negative self-perception of health," "Lack of security," "Lack of appropriate place," "Lack of motivation," "Activity intolerance," "Lack of sports ability," "Having a partner," "Using public transportation," "Perception of physical disability," "Pain," "Having a job/studying," "Laziness," "Impaired mobility," "Living in an urban area," "Education in a public institution," "Female gender," "Lack of confidence to practice physical exercise," "Education level," "Age" and "Lack of social support for the practice of physical exercise." Conclusion Four out of eight clinical indicators had a good adjustment by the latent class analysis. Of the 27 aetiological factors, 22 were significantly associated with sedentary lifestyle. Relevance to practice The correct identification of sedentary lifestyle and its elements supports care planning, especially for health promotion and disease prevention.

Objective: To develop and evaluate an educational primer to promote healthy lifestyles in people with HIV. Methods: Study of technological development in three stages: Development of the booklet, with bibliographical review, illustrations, layout, diagramming, adopting as reference the trans-theoretical model of behavior change; Analysis of content and appearance by 22 judges; Semantic analysis by 22 people with HIV. The proportion of positive evaluations of the items was measured, considering a percentage equal to or greater than 85%. Results: My motivational booklet for change! Practices for promoting a healthy lifestyle" had six areas: Body weight control; Healthy eating; Exercise practice; Smoking, alcohol and other drugs; Stress control; and Drug treatment. Most of the items evaluated agreed with an overall average of 92.4% by the judges and 98.9% by the target audience. Conclusion: The booklet had evidence of adequate validity to be used by people with HIV.

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

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.

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.

Este estudo teve como objetivo geral analisar os fatores prognosticos, mortalidade e sobrevida em pessoas com aids admitidas em Unidade de Terapia Intensiva (UTI). Trata-se de um estudo de coorte retrospectivo, realizado com prontuarios de pacientes com aids admitidos na UTI do Hospital Sao Jose de Doencas Infecciosas (HSJDI). A amostra calculada foi de 202 pacientes admitidos no periodo de 2015 a 2017. Criterios de inclusao: prontuarios de pacientes de ambos os sexos, idade igual ou maior a 18 anos, com permanencia de ao menos 24 horas na UTI. Criterios de exclusao: pacientes sem prontuario disponivel no periodo do estudo e gravidez. A coleta de dados ocorreu de janeiro a outubro de 2018. Apos verificar os nomes dos pacientes e numeros dos prontuarios no livro de registro da UTI, estes foram solicitados no Servico de Arquivo Medico e Estatistica. Dados foram coletados por meio de formulario com variaveis de identificacao sociodemograficas, clinicas, epidemiologicas e de internacao. Apos coleta, os dados foram organizados e analisados no software R 3.2 (R Foundation for Statistical Computing, Viena, Austria). Primeiramente, realizou-se analise descritiva dos dados, considerando-se o nivel de significância de 95% (p < 0,05). A magnitude da associacao entre variaveis de exposicao e obito foi estimada pela odds ratio. Uma tabua de vida baseada no metodo de Kaplan-Meier foi construida para identificar taxas de sobrevida. Modelos univariados de riscos proporcionais de Cox foram ajustados para identificar fatores prognosticos de sobrevida. Um modelo multivariado de riscos proporcionais de Cox foi ajustado para identificar variaveis componentes do indice prognostico para sobrevida. O ajuste do modelo de Cox foi analisado considerando o poder explicativo das covariaveis no tempo de ocorrencia dos obitos dado pelo coeficiente R2, o teste de Wald para coeficientes da regressao (hipotese nula = 0), o Teste da razao de verossimilhanca para verificar o ajuste global do modelo, teste de Log-Rank para comparar distribuicao da ocorrencia dos obitos. Residuos de Schoenfeld foram analisados para verificar o efeito das covariaveis. O projeto foi aprovado pelo Comite de Etica em Pesquisa da Universidade Federal do Ceara e HSJDI sob pareceres, respectivamente, N° 1.832.921 e N° 1.684.646. Do total da amostra, 73,8% era do sexo masculino, com media de idade de 38,25 anos e 78,7% tinha escolaridade menor que oito anos de estudo. Dentre os participantes, 90,1% tiveram exposicao sexual, 54,9% apresentava sinais de vulnerabilidade, como uso de drogas licitas e ilicitas, 5,0% eram moderadores de rua, 61,4% nao tinham acompanhamento regular em servicos de saude, 40,6% nao aderiam a terapia antirretroviral (TARV), 94% possuia baixa contagem de linfocitos T CD4+ e 44,6% tinha alta carga viral. As doencas oportunistas mais comuns foram tuberculose pulmonar (30; 14,9%), neurotoxoplasmose (26; 12,9%), candidiase esofagica (41; 20,3%) e pneumonia por Pneumocistys jiroveci (23; 11,4%). As comorbidades mais informadas foram hipertensao arterial (28; 13,9%), dislipidemias (51; 25,2%) e nefropatia (79; 39,1%). As principais causas de internacao na UTI foram insuficiencia respiratoria (96,0%), sepse (59,9%), alteracoes neurologicas (54,5%) e insuficiencia renal (32,2%). Do total, 41,5% dos pacientes receberam alta para enfermaria e 58,5% foram a obito na UTI, sendo a taxa de sobrevida global de 41,6% e a mediana do risco de morte em torno do 15o ao 19o dia de internacao na UTI. O ultimo registro de mortalidade se deu no 45o dia de internacao. A media de dias de internacao foi de 11,97 dias (desvio padrao: 10,5; mediana: 8,5; intervalo interquartil: 14; valor de p = 0,0001). Os fatores associados ao obito e com maior impacto para mau prognostico foram terapia renal substitutiva (p = 0,001) e sepse (p = 0,0001). A presenca de disturbio neurologico (p = 0,043) e candidiase esofagica (p = 0,003) na admissao foram associadas a reducao do risco de obito na UTI. O tempo de internacao prolongado na UTI (p < 0,001), presenca de sepse na admissao (p < 0,001), disturbios neurologicos durante internacao na UTI (p = 0,013), presenca de lesao por pressao (p = 0,038), aumento da carga viral (p = 0,00001), uso de efavirenz (p = 0,030) e exposicao sexual ao HIV (p = 0,002) associaram-se ao aumento do risco de obito durante internacao na UTI. Concluiu-se que pacientes com aids admitidos na UTI possuem vulnerabilidades que influenciam na internacao e alta, sendo a taxa de sobrevida global de 41,6%. Os fatores associados ao obito foram terapia renal substitutiva e sepse. Disturbio neurologico e candidiase esofagica na admissao foram associados ao menor risco de mortalidade. Os fatores prognosticos para obito foram tempo de internacao prolongado, sepse na admissao, disturbios neurologicos durante internacao, lesao por pressao, aumento da carga viral, uso de efavirenz e exposicao sexual ao HIV.

Objectives: to validate the nursing diagnosis “Terminality Syndrome” with experts. Methods: a quantitative research of content validation type based on collective wisdom approach. An online semi-structured questionnaire was used as an instrument for data collection, and Content Validity Index and Wilcoxon test were used for comparing possible differences. Results: the questionnaire was answered by 89 professionals after judges’ assessment in relation to the structural components of the diagnosis proposed. The mean Content Validity Index of items was above that recommended, except for title, which was ≥ 0.8. The suggestions were reviewed and accepted, being forwarded for a new analysis, reaching 83.7% of agreement among participants. Conclusions: the diagnosis’ content proved to be valid by judges. With that, it is expected to contribute with a useful nursing diagnosis for nursing practice documentation in palliative care. RESUMEN Objetivos: validar el diagnóstico “Síndrome de Terminalidad” con especialistas. Métodos: investigación cuantitativa, validación de contenido, basado en el enfoque de sabiduría colectiva. Se utilizó un cuestionario semiestructurado en línea como instrumento de recolección de datos, y para el análisis se utilizó el Índice de Validez de Contenido y la prueba de Wilcoxon, para comparar posibles diferencias. Resultados: el cuestionario fue respondido por 89 profesionales, luego del juicio de estos jueces en relación a los componentes estructurales de la propuesta diagnóstica, el Índice de Validez de Contenido de los ítems estuvo por encima de lo recomendado, excepto por el título, que fue ≥ 0.8. Las sugerencias fueron revisadas y aceptadas, siendo remitidas para un nuevo análisis, alcanzando un 83,7% de acuerdo entre los participantes. Conclusiones: los jueces consideraron válido el contenido de la propuesta de diagnóstico. Con esto, se espera contribuir con un diagnóstico de enfermería útil para la documentación de la práctica de enfermería en cuidados paliativos. RESUMO Objetivos: validar o diagnóstico “Síndrome de Terminalidade” com especialistas. Métodos: pesquisa quantitativa, do tipo validação de conteúdo, baseada na abordagem sabedoria coletiva. Utilizou-se como instrumento de coleta de dados um questionário semiestruturado online, e foi adotado para análise o Índice de Validade de Conteúdo e o teste de Wilcoxon, utilizado para comparar possíveis diferenças. Resultados: o questionário foi respondido por 89 profissionais, após o julgamento destes juízes em relação aos componentes estruturais da proposta diagnóstica, o Índice de Validade de Conteúdo dos itens foi acima do recomendado, com exceção do título, que foi ≥ 0,8. As sugestões foram revistas e aceitas, sendo reencaminhado para nova análise, alcançando 83,7% de concordância entre os participantes. Conclusões: o conteúdo da proposta de diagnóstico foi considerado válido pelos juízes. Com isso, espera-se contribuir com um diagnóstico de enfermagem útil para a documentação da prática de enfermagem em cuidados paliativos.

Objective To analyze the content of the diagnostic proposal, risk for impaired cardiovascular function, focusing on incarcerated women. Methods A methodological study of nursing diagnosis content validation carried out from December/2018 to June/2019. A sample of 24 judges evaluated the proposed definition and the relevance of the proposed etiological factors of risk for impaired cardiovascular function. To determine the content validity of the etiological factors, the Content Validity Index was calculated and a value of 0.9 was adopted, in addition to the Wilcoxon test. Results The diagnostic definition was considered consistent with the diagnostic label. All 18 etiological factors were validated with a Content Validity Index statistically >0.9 and categorized into risk factors, associated conditions, and at-risk populations. Conclusion The definition and 18 etiological factors of risk for impaired cardiovascular function were validated. Implications for the nursing practice The study allowed the new proposal for the risk for impaired cardiovascular function nursing diagnosis to be accepted to return to the taxonomy of NANDA International with an expanded and more consistent structure. The return of the referred nursing diagnosis to the taxonomy favors the nurse's diagnostic reasoning and the documentation of all nursing actions, linked to this diagnosis, which are aimed at minimizing cardiovascular risk.

RESUMO Objetivo Analisar o conteúdo dos diagnósticos de enfermagem relacionados à incontinência urinária da NANDA International e outros identificados na literatura. Método Estudo metodológico realizado com juízes expertos em disfunções miccionais e diagnósticos de enfermagem. Analisaram-se os diagnósticos de Incontinência Urinária de Esforço, Incontinência Urinária de Urgência, Incontinência Urinária Funcional e Incontinência Urinária por Hiperatividade Detrusora Neurogênica (antes denominado Incontinência Urinária Reflexa, na taxonomia da NANDA International) e Incontinência Urinária Mista e Incontinência Urinária Transitória. Aplicou-se o teste de Wilcoxon e considerou-se adequado o Índice de Validade de Conteúdo ≥0,85. Resultados Participaram 51 juízes. Os juízes sugeriram modificações nos elementos de todos os diagnósticos (inclusão, exclusão ou alteração no tipo de elemento previamente classificado). Conclusão Sugerem-se a manutenção dos quatro diagnósticos analisados na taxonomia da NANDA International, com modificações, e a inclusão dos diagnósticos de enfermagem Incontinência Urinária Mista e Transitória. RESUMEN Objetivo Analizar el contenido de los diagnósticos de enfermería relacionados con la incontinencia urinaria en NANDA International y otros identificados en la literatura. Método Estudio metodológico realizado con jueces expertos en disfunciones urinarias y diagnósticos de enfermería. Se analizaron los diagnósticos de Incontinencia Urinaria de Esfuerzo, Incontinencia Urinaria de Urgencia, Incontinencia Urinaria Funcional e Incontinencia Urinaria de Hiperactividad Neurogénica del Detrusor (anteriormente llamada Incontinencia Urinaria Refleja en la taxonomía de NANDA International) e Incontinencia Urinaria Mixta e Incontinencia Urinaria Transitoria. Se aplicó la prueba de Wilcoxon y se consideró adecuado el Índice de Validez del Contenido ≥ 0,85. Resultados Cincuenta y uno jueces participaron. Los jueces sugirieron modificaciones en los elementos de todos los diagnósticos (inclusión, exclusión o cambio en el tipo de elemento previamente clasificado). Conclusión Se sugiere el mantenimiento de los cuatro diagnósticos de la taxonomía de NANDA International con modificaciones y la inclusión de los diagnósticos de enfermería Incontinencia Urinaria Mixta y Transitoria. ABSTRACT Objective To analyze the content of nursing diagnoses related to urinary incontinence according to NANDA International and others identified in the literature. Method Methodological study conducted with judges who were experts in urinary dysfunctions and nursing diagnosis. The analysis included diagnoses of Stress Urinary Incontinence, Urgency Urinary Incontinence, Functional Urinary Incontinence, Urinary Incontinence due to Neurogenic Detrusor Overactivity (previously denominated Reflex Urinary Incontinence in NANDA International’s taxonomy), Mixed Urinary Incontinence, and Transient Urinary Incontinence. Wilcoxon test was applied and Content Validity Index ≥ 0.85 was considered appropriate. Results Fifty-one judges participated in this study. The judges recommended modifications in elements of all diagnoses (inclusion, exclusion or change of previous element type). Conclusion The four diagnoses analyzed in NANDA International’s taxonomy are recommended to be maintained with modifications; inclusion of nursing diagnoses Mixed and Transient Urinary Incontinence is also recommended.

PURPOSE To construct a situation-specific theory (SST) to represent nutritional deficits for assessing children with cancer. DATA SOURCES Literature review. DATA SYNTHESIS The SST included the definition of key concepts, a pictorial scheme, propositions, causal relationships, and evidence for nursing practice. CONCLUSIONS It was possible to characterize the elements as antecedent and consequent clinical factors to allow for an understanding of the existing relationships between them and their temporality. These elements differed considerably from those included in NANDA International. IMPLICATIONS FOR NURSING PRACTICE This study provides additional information so that nurses in clinical practice can infer the presence of nutritional deficits in children with cancer early, given the risk already inherent in the diagnosis of cancer and treatment.

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).

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.

Objective To verify the accuracy of the nursing diagnosis, decreased cardiac tissue perfusion, in patients with coronary artery disease. Methods Clinical validation consisted of evaluation by 75 participants. Sensitivity and specificity measurements were performed by means of latent class analysis. Results The prevalence of the diagnosis was 64.5%. Nausea, dizziness, and vomiting were sensitive and specific; altered heart rate was specific. Conclusion Four indicators were accurate for the nursing diagnosis. Implications for nursing Accurate defining characteristics contribute to reliable and precise assessment and enable nurses to diagnose and intervene in the outcome of the patient's clinical condition.

Objective: to analyze the NANDA-I taxonomy “maternal-fetal dyad” concept in high-risk pregnancy. Method: an integrative literature review based on the Conceptual Analysis model proposed by Walker and Avant. It was conducted at PUBMED, CINAHL, SCOPUS, LILACS and SciELO, with the descriptors: Complications of pregnancy, Risk Factors, and Pregnancy, High-Risk (from 2008-2020). Result: the sample consisted of 44 articles, which identified two attributes and 21 antecedents of the concept. Conclusion: concept analysis allowed to identify the attributes and antecedents of the “maternal-fetal dyad” concept in high-risk pregnancy, in addition to raising and clarifying ideas. It was possible to identify 12 antecedents that are not included in NANDA-I as well as the need to review the definition of the diagnosis proposed by the taxonomy. RESUMEN Objetivo: analizar el concepto “binomio madre-feto”” de la taxonomía NANDA-I en mujeres embarazadas de alto riesgo. Método: una revisión bibliográfica integradora, basada en el modelo de Análisis Conceptual propuesto por Walker y Avant. Realizado en las bases de datos PubMed, CINAHL, Scopus, LILACS y en la biblioteca electrónica SciELO, con los descriptores: Pregnancy Complications, Risk Factors y Pregnancy, High-Risk, con un marco temporal de 2008-2020. Resultado: la muestra consistió en 44 artículos, que identificaron dos atributos y 21 antecedentes del concepto. Conclusión: el análisis conceptual permitió identificar los atributos y antecedentes del concepto “binomio madre-feto” en mujeres embarazadas de alto riesgo, planteando y aclarando ideas. Fue posible identificar 12 antecedentes que no están incluidos en NANDA-I, así como la necesidad de revisar la definición del diagnóstico propuesto por la taxonomía. RESUMO Objetivo: analisar o conceito “binômio mãe-feto” da taxonomia da NANDA-I em gestantes de alto risco. Método: revisão integrativa da literatura, fundamentada no modelo de Análise Conceitual proposto por Walker e Avant. Realizada nas bases de dados PubMed, CINAHL, Scopus, LILACS e na biblioteca eletrônica SciELO, com os descritores: Pregnancy Complications, Risk Factors e Pregnancy, High-Risk, com recorte temporal de 2008-2020. Resultado: a amostra constituiu-se de 44 artigos, que identificaram dois atributos e 21 antecedentes do conceito. Conclusão: a análise de conceito permitiu identificar os atributos e os antecedentes do conceito “binômio mãe-feto” em gestantes de alto risco, além de suscitar e esclarecer ideias. Foi possível identificar 12 antecedentes que não constam na NANDA-I, bem como a necessidade de revisar a definição do diagnóstico proposta pela taxonomia.

Objectives: theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct. Methods: construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles. Results: eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health. Conclusions: the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined. RESUMO Objetivo: validação teórica do conceito de baixa autoeficácia em saúde como um construto diagnóstico de enfermagem. Métodos: construção de uma teoria de médio alcance para validação de diagnósticos compreendendo cinco etapas: definição da abordagem para a construção de teoria, definição de conceitos-chaves, construção de um diagrama pictórico, formulação de proposições, estabelecimento de relações causais e evidências para a prática. Os principais conceitos foram descritos por meio de uma revisão de literatura. Os estudos foram retirados das bases de dados LILACS, SCOPUS, CINAHL e PubMed/MEDLINE obtendo uma amostra final de 92 artigos. Resultados: foram identificados dezoito fatores etiológicos e dezesseis indicadores clínicos, caracterizados em antecedentes e as manifestações para a inferência diagnóstica de baja autoeficácia em saúde. Conclusões: foram identificados e definidos os conceitos relacionados ao novo diagnóstico de enfermagem de baixa autoeficácia em saúde a ser aplicado na prática clínica de enfermagem. RESUMEN Objetivos: validación teórica del concepto de baja autoeficacia en salud como un constructo diagnóstico de enfermería Métodos: construcción de una teoría de rango medio para validación de diagnósticos que comprende cinco etapas: definición del abordaje de construcción de la teoría, definición de los conceptos principales, construcción de un pictograma, formulación de proposiciones, establecimiento de las relaciones de causalidad y la evidencia para la práctica. Los conceptos principales fueron descritos por medio de una revisión de literatura. Los estudios fueron tomados de las bases de datos LILACS, SCOPUS, CINAHL y PubMed/MEDLINE. Obteniendo la muestra final de 92 artículos. Resultados: se identificaron dieciocho factores etiológicos y dieciséis indicadores clínicos; caracterizados en antecedentes y las manifestaciones para la inferencia diagnóstica de baja autoeficacia en salud. Conclusiones: se identificaron y definieron los conceptos relacionados del nuevo diagnóstico de enfermería de baja autoeficacia en salud, para ser aplicados en la práctica clínica de enfermería.

Purpose To validate the clinical indicators of the nursing diagnosis of Ineffective protection in adolescents with cancer based on diagnostic accuracy measurements. Design and Methods Measurements of sensitivity and specificity for the indicators were calculated using latent class analysis with random effects in a sample of 127 adolescents between 10 and 19 years of age. Results The prevalence of diagnosis was estimated at 93.7%. The indicators deficient immunity and weakness showed higher sensitivity values, whereas opportunistic infections, recurrent infections, insomnia, mucosal lesions, and coughing showed high specificity. Conclusions Seven indicators were clinically validated. Practice Implications The validation of clinical indicators provides nurses with the knowledge of useful signs and symptoms to identify early spectra of a nursing diagnosis or confirm their presence in a specific population. In clinical practice, this knowledge contributes to an accurate diagnostic inference and the planning of nursing interventions directed to the idiosyncrasies of individuals.

Purpose This study aimed to identify the defining characteristics of, and examine their association with, the nursing diagnosis (ND) of Neonatal Jaundice (00194) in sample of hospitalized newborns. Design and Methods A cross-sectional study developed with 100 newborns aged between 24 h and ten days. Data collection was performed in a public hospital of tertiary health care between March and June of 2016. Results The ND of Neonatal jaundice was present in 31% of the sample. The most frequent defining characteristics were yellow-orange skin color (65%) and abnormal blood profile (75%). Yellow mucous membranes, yellow-orange skin color and bruised skin showed statistically significant sensitivity and specificity. Yellow mucous membranes, yellow sclera and yellow-orange skin color were statistically associated with Neonatal jaundice. Yellow mucous membranes showed the best diagnostic accuracy measurements. Conclusions The clinical indicators that best predicted and increased the probability of developing jaundice were identified. Practice Implications These clinical indicators increase the ability of nurses to clinically infer nursing diagnoses. This allows nurses to identify signs and symptoms of health conditions in a sensible and definitive manner, decreasing the possibility of errors.

This study analyzed the accuracy of clinical indicators of ineffective health management in hemodialysis patients. A diagnostic accuracy study was performed in 200 chronic kidney disease patients undergoing hemodialysis during the first half of 2015. Measures of sensitivity and specificity were calculated using latent class analysis. Ineffective health management was present in 66.28% of patients. Accurate clinical indicators included expressed nonadherence to treatment, daily life choices ineffective to achieve health goals, expression of difficulty with prescribed regimens, inappropriate use of medicines, lack of expression of willingness to control the disease, irregular attendance of dialysis sessions, and infection. Hemodialysis may trigger a set of clinical indicators that predict the presence of ineffective health management. This knowledge provides evidence to clinical practices for hemodialysis patients and contributes to the best clinical performance of nurse practitioners.

Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis for “fatigue in women with breast cancer under radiotherapy”. Method: Study of diagnostic accuracy, with cross-sectional design, performed in 130 women with breast cancer under radiation treatment. A data collection instrument was used to evaluate clinical socio-demographics and to investigate the presence or absence of defining characteristics for fatigue. The latent class analysis model was applied to assess accuracy measurements of the characteristics identified. Results: Fatigue diagnosis was present in 21.9% of the women. The characteristic which showed the highest sensitivity was “Impaired capacity in maintaining the usual level of physical activity”, while “Impaired capacity in maintaining usual routines” and “Lack of interest about the surrounding environment” presented greater specificity. Conclusion: Accurate diagnostics allow devising an action plan directed to the patients' real needs. RESUMEN Objetivo: Evaluar la precisión de las características definidoras del diagnóstico de enfermería “fatiga en mujeres con cáncer de mama en radioterapia”. Método: Estudio de precisión diagnóstica con delineamiento transversal realizado en 130 mujeres con cáncer de mama en tratamiento radioterápico. Se ha utilizado un instrumento de recogida de datos para la evaluación sociodemográfica clínica y para la investigación de la presencia o de la ausencia de las características definidoras de la fatiga. Se ha aplicado el modelo de análisis de clase latente para la evaluación de las medidas de precisión de las características identificadas. Resultados: El diagnóstico de fatiga ha estado presente en el 21,9% de las mujeres. La característica que ha presentado la mayor sensibilidad ha sido “la capacidad perjudicada para mantener el nivel habitual de actividad física”, mientras “la capacidad perjudicada para mantener las rutinas habituales” y “el desinterés cuanto al ambiente que lo rodea” presentaron especificidad más grande. Conclusión: Diagnósticos precisos permiten la construcción de un plan de acciones direccionado para las reales necesidades de los pacientes. RESUMO Objetivo: Avaliar a acurácia das características definidoras do diagnóstico de enfermagem “fadiga em mulheres com câncer de mama em radioterapia”. Método: Estudo de acurácia diagnóstica com delineamento transversal realizado em 130 mulheres com câncer de mama em tratamento radioterápico. Utilizou-se um instrumento de coleta de dados para avaliação sociodemográfica clínica e para investigação da presença ou ausência das características definidoras da fadiga. Aplicou-se o modelo de análise de classe latente para avaliação das medidas de acurácia das características identificadas. Resultados: O diagnóstico de fadiga esteve presente em 21,9% das mulheres. A característica que apresentou maior sensibilidade foi “capacidade prejudicada para manter o nível habitual de atividade física”, enquanto “capacidade prejudicada para manter as rotinas habituais” e “desinteresse quanto ao ambiente que o cerca” apresentaram maior especificidade. Conclusão: Diagnósticos acurados permitem a construção de um plano de ações direcionado para as reais necessidades dos pacientes.

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 acuracia das caracteristicas definidoras de Hipotermia em recem-nascidos e identificar a associacao delas com variaveis clinicas. METODO Estudo de acuracia transversal com analise estatistica. RESULTADOS Preenchimento capilar lento, diminuicao da ventilacao, vasoconstricao periferica e ganho de peso insuficiente apresentaram valores altos de especificidade enquanto esvaziamento gastrico lento, pele fria, irritabilidade e bradicardia apresentaram valores elevados de sensibilidade e especificidade. CONCLUSAO Esvaziamento gastrico lento, pele fria, irritabilidade e bradicardia sao uteis para inferir estagios iniciais de hipotermia e para confirmacao diagnostica. IMPLICACOES PARA PRATICA DE ENFERMAGEM Medidas de acuracia podem contribuir para o processo de inferencia do diagnostico hipotermia.

Aims and objectives The aim of this study was to evaluate the clinical validity of indicators of the nursing diagnosis of “ineffective protection” in hemodialysis patients. Background Hemodialysis patients have reduced protection. Studies on the nursing diagnosis of “ineffective protection” are scarce in the literature. The use of indicators to diagnose “ineffective protection” could improve the care of hemodialysis patients. The clinical usefulness of the indicators requires clinical validation. Design This was a diagnostic accuracy study. Method This study assessed a sample of 200 patients undergoing hemodialysis in a reference clinic for nephrology during the first half of 2015. Operational definitions were created for each clinical indicator based on concept analysis and content validation by experts for these indicators. Diagnostic accuracy measurement was performed with latent class analysis with randomized effects. Results The clinical indicator of “fatigue” had high sensitivity (p = 0.999) and specificity (p = 1.000) for the identification of “ineffective protection”. Additionally, “maladaptive response to stress” (p = 0.711) and “coagulation change” (p = 0.653) were sensitive indicators. The main indicators that showed high specificity were “fever” (p = 0.987), “increased number of hospitalizations” (p = 0.911), “weakness” (p = 0.937), “infected vascular access” (p = 0.962) and “vascular access dysfunction” (p = 0.722). Conclusion A set of nine clinical indicators of “ineffective protection” were accurate and statistically significant for hemodialysis patients. Three clinical indicators showed sensitivity, and six indicators showed specificity. Relevance to clinical practice Accurate measures for nursing diagnoses can help nurses confirm or rule out the probability of the occurrence of “ineffective protection” in patients undergoing hemodialysis. This article is protected by copyright. All rights reserved.

Purpose To review the nursing outcome, Fall Prevention Behavior , and clinically validate its indicators in people with stroke. Methods A methodological study performed with 106 patients in two outpatient clinics, from July to September of 2013. Two pairs of trained nurses applied the NOC scale, one with and one without the use of operational definitions. The internal consistency, stability and difference between the medians obtained by nurses were compared within and between pairs. Results Most participants were men, elderly, with low education and income. Statistically significant differences were noted in twelve indicators. Five indicators had different means that were greater than the least significant difference. Conclusions The indicators were statistically significant; the internal consistency was similar between the pairs and the intraclass correlation coefficient was more satisfactory in the pair that used the definitions. Thus, the construction of empirical referents and the clinical validation process makes the nursing indicators and outcomes more adequate for specific populations and provides an effective means to better evaluate the nursing actions.

Purpose The aim of this study was to analyze the accuracy of the defining characteristics of ineffective breathing pattern (IBP) in postoperative cardiac patients. Methods A diagnostic accuracy study was performed with 98 patients. Measures of sensitivity, specificity, predictive values, likelihood ratios, diagnostic odds ratio, and area under the ROC curve were calculated. Results IBP was present in 23.5% of the patients. Alterations in depth of breathing (sensitivity 96%, negative likelihood ratio 0.11%) and pursed-lip breathing (sensitivity 99%, negative likelihood ratio 0.07%) were the most sensitive defining characteristics for IBP, while altered chest excursion (specificity 97%, positive likelihood ratio 11.41%) and prolonged expiration phase (specificity 99%, positive likelihood ratio 42.39%) were the most specific. Conclusion Some clinical indicators were more related to the presence or absence of IBP than others. Knowledge of such measures can help nurses to assess patients more accurately.

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.

Objective: to validate clinically the factors associated with nursing diagnosis sedentary lifestyle in adolescents. Methods: a cross-sectional study, developed with 158 adolescent students. The chi-square test was used to identify the association between the presence of sedentary lifestyle and associated factors. The level of significance was set at p

Objective: to evaluate the accuracy and to determine the prevalence of the defining characteristics of the nursing diagnosis Impaired gas exchange in children with respiratory diseases. Methods: cross-sectional study carried out with 236 children who were in the initial 48 hours of hospital admission. A questionnaire was used with sociodemographic data and physical examination of the respiratory system to identify the defining characteristics of the studied diagnosis. For the analysis of the accuracy,the sensitivity and specificity measures were calculated. Results: the diagnosis Impaired gas exchange was present in 21.6% of the sample and the most prevalent defining characteristics were dyspnea and tachycardia. Regarding the accuracy measures, the characteristics that presented high sensitivity values were dyspnea and abnormal respiratory pattern, while cyanosis, hypoxemia, and restlessness obtained high values of specificity. Conclusion: the characteristics that stood out both for the accuracy measures and for the prevalence were dyspnea and abnormal respiratory pattern. Objetivo: avaliar a acurácia e determinar a prevalência das características definidoras do diagnóstico de enfermagem Troca de gases prejudicada em crianças com doenças respiratórias. Métodos: estudo transversal realizado com 236 crianças que estavam nas 48 horas iniciais de internação hospitalar. Utilizou-se questionário com dados sociodemográficos e exame físico do sistema respiratório para identificação das características definidoras do diagnóstico estudado. Para análise da acurácia foram calculadas as medidas de sensibilidade e especificidade. Resultados: o diagnóstico Troca de gases prejudicada esteve presente em 21,6% da amostra e as características definidoras mais prevalentes foram Dispneia e Taquicardia. No que se refere às medidas de acurácia, as características que apresentaram altos valores de sensibilidade foram Dispneia e Padrão Respiratório anormal, enquanto Cianose, Hipoxemia e Inquietação obtiveram elevados valores de especificidade. Conclusão: as características que se destacaram tanto pelas medidas de acurácia quanto pela prevalência foram Dispneia e Padrão respiratório anormal.

RESUMO Objetivo: Avaliar a eficácia de uma intervenção educativa de enfermagem no autocuidado de idosos com Diabetes Mellitus. Método: Estudo quase-experimental com dois grupos, controle e intervenção, realizado com idosos que vivem com Diabetes Mellitus, atendidos em Unidades de Atenção Primária à Saúde do município de Fortaleza/Ceará. A intervenção foi uma abordagem educativa grupal com orientações sobre o tratamento de diabetes e cuidado com os pés. Para a avaliação antes e depois do autocuidado utilizou-se do Questionário de Autocuidado em Diabetes. Foi considerado um nível de significância de 0,05. Resultados: Participaram 103 idosos. Depois da intervenção educativa houve aumento do autocuidado em diabetes relacionado aos aspectos: dieta saudável (p=0,027), orientação alimentar (p=0,013) e exame dos pés (p=0,012). Conclusão: A intervenção realizada promoveu de forma positiva mudanças comportamentais, favorecendo a adoção de hábitos saudáveis e a promoção do autocuidado em pacientes idosos com Diabetes Mellitus. RESUMEN Objetivo: Evaluar la efectividad de una intervención educativa de enfermería en el autocuidado de ancianos con Diabetes Mellitus. Método: Estudio cuasi-experimental con dos grupos, control e intervención, realizado con ancianos que viven con Diabetes Mellitus, atendidos en Unidades de Atención Primaria de Salud del municipio de Fortaleza/Ceará. La intervención fue un abordaje educativo de grupo con orientaciones acerca del tratamiento de diabetes y cuidados con los pies. Para la evaluación antes y después del autocuidado se utilizó el Cuestionario de Autocuidado en Diabetes. Fue considerado un nivel de significación de 0,05. Resultados: Participaron 103 personas mayores. Después de la intervención educativa hubo aumento del autocuidado en diabetes relacionado con los aspectos: dieta sana (p=0,027), orientación alimentaria (p=0,013) y examen de los pies (p=0,012). Conclusión: La intervención llevada a cabo promocionó de modo positivo cambios de comportamiento, favoreciendo la adopción de hábitos sanos y la promoción del autocuidado en pacientes mayores con Diabetes Mellitus. ABSTRACT Objective: To evaluate the efficacy of an educational nursing intervention in self-care for older adults who have Diabetes Mellitus. Method: A quasi-experimental study with control and intervention two groups conducted with older adults living with Diabetes Mellitus, attended at Primary Health Care Units of Fortaleza/Ceará. The intervention was a group educational approach with guidelines on diabetes treatment and foot care. The Brazilian adapted version of the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) was used for evaluating before-and-after self-care. A significance level of 0.05 was considered. Results: 103 older adults participated in the study. There was an increase in self-care for diabetes after the educational intervention related to the aspects: healthy diet (p = 0.027), dietary instruction (p = 0.013) and foot examination (p = 0.012). Conclusion: The performed intervention promoted positive behavioral changes, favoring the adoption of healthy habits and the promotion of self-care in older adult patients with Diabetes Mellitus.

O estudo teve como objetivo verificar as características definidoras com melhor poder de predição para auxiliar na classificação de Padrão respiratório ineficaz, utilizando árvores de classificação, em crianças com infecção respiratória aguda. Estudo transversal, realizado em dois hospitais pediátricos juntamente a 249 crianças com infecção respiratória aguda. Para a coleta, foi utilizado um instrumento específico desenvolvido para o estudo. Empregaram-se três algoritmos de indução para a geração das árvores, CHi-square Automatic Interaction Detection, Classification and Regression Treese Quick, Unbiased, Efficient Statistical Tree. Construíram-se três árvores para auxiliar na identificação de Padrão Respiratório ineficaz. As árvores de classificação geradas apresentam probabilidades condicionais à ocorrência do diagnóstico associada a dispneia e alterações na profundidade respiratória. Padrão respiratório ineficaz esteve presente 65,5% da amostra. Assim, a probabilidade da ocorrência do referido diagnóstico nas crianças com infecção respiratória aguda foi de 100% com a presença de dispneia e de alterações na profundidade respiratória.

Identificar a prevalência dos diagnósticos de enfermagem: Padrão respiratório ineficaz (PRI), Troca de gases prejudicada (TGP) e Ventilação espontânea prejudicada (VEP) e de seus indicadores clínicos em recém-nascidos internados em Unidades de Terapia Intensiva Neonatal. Estudo de abordagem quantitativa, transversal, com 154 recém-nascidos. Os dados foram coletados pela inspeção e avaliação da gasometria. Para análise, foram utilizados: Teste Qui-quadrado de Pearson e teste exato de Fisher. Os diagnósticos apresentaram prevalência elevada: VEP 94,2%; TGP 88,3% e PRI 87,7%. Dispneia e Uso aumentado de musculatura acessória foram os indicadores clínicos mais prevalentes de VEP e PRI. Para TGP, Dispneia e Cor da pele anormal. A associação evidenciou correlação significante para alguns indicadores prevalentes: dispneia, pressão parcial de oxigênio diminuída/hipoxemia, uso aumentado de musculatura acessória, padrão respiratório anormal, taquipneia, bradpneia, dióxido de carbono diminuído e gases sanguíneos arteriais.VEP, TGP e PRI apresentaram alta prevalência em recém-nascidos das Unidades de Terapia Intensiva.

Objective: To review the contents of the nursing diagnosis of Impaired Verbal Communication in patients with Amyotrophic Lateral Sclerosis. Method: For the review of this diagnosis we used the integrative review. The 21 selected articles were submitted to a careful concept analysis for the definition of the diagnostic concept and review of its elements. Results: It is recommended, in addition to a new definition for the diagnosis of Impaired Verbal Communication, the incorporation of twelve Risk Factors, the maintenance of three others and the relocation of a Defining Characteristic for Risk Factor. It is also recommended the incorporation of nine Defining Characteristics and the modification of the nomenclature of the other three that already make up the NANDA-I. Conclusion: The content review process subsidized a clarification of the chosen concept, contributing to a future refinement and improvement of the study diagnosis and its components present in NANDA-I. RESUMEN Objetivo: Revisar el contenido del diagnóstico de enfermería de Comunicación Verbal Prejudicada en pacientes con Esclerosis Lateral Amiotrófica. Método: Para la revisión de dicho diagnóstico, se utilizó la revisión integrativa. Los 21 artículos seleccionados fueron sometidos a un análisis de concepto criterio para la definición del concepto diagnóstico y revisión de sus elementos. Resultados: Se recomienda, además de una nueva definición para el diagnóstico de Comunicación Verbal Prejudicada, la incorporación de doce Factores Relacionados, el mantenimiento de otros tres y la reubicación de una Característica Definidora para Factor Relacionado. Se recomienda también la incorporación de nueve Características Definidoras y la modificación de la nomenclatura de otras tres que ya componen la NANDA-I. Conclusión: El proceso de revisión de contenido subsidió una clarificación del concepto escogido, contribuyendo para un futuro refinamiento y perfeccionamiento del diagnóstico en estudio y de sus componentes presentes en la NANDA-I. RESUMO Objetivo: Revisar o conteúdo do diagnóstico de enfermagem de Comunicação Verbal Prejudicada em pacientes com Esclerose Lateral Amiotrófica. Método: Para a revisão do referido diagnóstico, utilizou-se a revisão integrativa. Os 21 artigos selecionados foram submetidos a uma análise de conceito criteriosa para a definição do conceito diagnóstico e revisão de seus elementos. Resultados: Recomenda-se, além de uma nova definição para o diagnóstico de Comunicação Verbal Prejudicada, a incorporação de doze Fatores Relacionados, a manutenção de outros três e a realocação de uma Característica Definidora para Fator Relacionado. Recomenda-se também a incorporação de nove Características Definidoras e a modificação da nomenclatura de outras três que já compõem a NANDA-I. Conclusão: O processo de revisão de conteúdo subsidiou uma clarificação do conceito escolhido, contribuindo para um futuro refinamento e aprimoramento do diagnóstico em estudo e de seus componentes presentes na NANDA-I.

The objective of this study was to validate the proposal ofthe nursing diagnosis Risk for delayed surgical recovery. Methodologicalresearch for content validation by specialists, with a sample of 34 specialists. A data collection instrument was used containing a Likert-type scale of 1 to 5. The data analysis was the estimate proportion by the binomial test. Ten items were obtained from the assessed diagnosis proposal with a proportion superior or equal to 75%. Other seven items: Definition; Expressed feelings; History of healing delay; Prolonged surgical procedure; Advanced Age; Edema and trauma in the surgical site; High ASA Classification (American Society of Anesthesiologists), were assessed with a proportion lower than 75%, revised until reaching consensus among specialists. In conclusion, the nursing diagnosis was content validated. Its identification may allow predicting the vulnerability of patients with Risk for delayed surgical recovery (00246), and the planning of individualized perioperative interventions. O objetivo desse estudo foi validar o conteúdo da proposta do diagnóstico de enfermagem Risco de recuperação cirúrgica retardada. Pesquisa metodológica, de validação de conteúdo por especialistas, com amostra de 34 especialistas. Utilizou-se um instrumento de coleta de dados contendo escala do tipo Likert de 1 a 5. A análise de dados foi a proporção estimada pelo teste binomial. Obteve-se10 itens da proposta diagnóstica avaliada com proporção superior ou igual a 75%. Outros sete itens: Definição; Sentimentos expressos; Histórico de retardo da cicatrização; Procedimento cirúrgico prolongado; Idade avançada; Edema e trauma no local da cirurgia; Classificação ASA elevada (American Society of Anesthesiologists); foram avaliados com proporção inferior a 75%, revisados até consenso dos especialistas. Conclui-se que o diagnóstico de enfermagem foi validado em conteúdo. Sua identificação pode possibilitar predizer a vulnerabilidade dos pacientes com Risco de recuperação cirúrgica retardada (00246), e o planejamento das intervenções perioperatórias de forma individualizada.

The identification of clinical indicators with good predictive ability allows the nurse to minimize the existing variability in clinical situations presented by the patient and to accurately identify the nursing diagnosis, which represents the true clinical condition. The purpose of this study was to analyze the accuracy of NANDA-I clinical indicators of the nursing diagnosis ineffective airway clearance (IAC) in children with acute respiratory infection. This was a prospective cohort study conducted with a group of 136 children and followed for a period of time ranging from 6 to 10 consecutive days. For data analysis, the measures of accuracy were calculated for clinical indicators, which presented statistical significance in a generalized estimated equation model. IAC was present in 91.9% of children in the first assessment. Adventitious breath sounds presented the best measure of accuracy. Ineffective cough presented a high value of sensitivity. Changes in respiratory rate, wide-eyed, diminished breath sounds, and difficulty vocalizing presented high positive predictive values. In conclusion, adventitious breath sounds showed the best predictive ability to diagnose IAC in children with respiratory acute infection.