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PURPOSE To assess the validity of a Written Clinical Reasoning Prompt (WCRP) to help nursing students' clinical reasoning (CR). METHOD This is a methodological study of translation and cross-cultural adaptation into Brazilian Portuguese of instruments that aim to promote CR improvement, composed of (1) WCRP; (2) two case studies; (3) a questionnaire about students' perceptions during decision-making in case studies; (4) a scoring rubric for correcting case studies. For translation and cross-cultural adaptation, stages 1-8 of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network were adopted. Agreement values among experts >80% and content validity coefficient (CVC) > 0.8 were considered satisfactory. For the pretest, a randomized clinical trial was carried out with 24 nursing students (intervention group, n = 14, using the WCRP to solve case studies; control group, n = 10, without using the WCRP). FINDINGS The WCRP was translated and adapted into Brazilian Portuguese, requiring minimal adjustments to obtain agreement among the judges above 80% and CVC above 0.80. Regarding face validation, an adequate agreement was obtained in the assessment by students. There was no difference in the accuracy of nursing diagnoses between the intervention and control groups in the pretest. CONCLUSION The WCRP was translated and adapted into Brazilian Portuguese and had adequate face and content validity estimates; however, there was no association with improving nursing students' diagnostic accuracy. IMPLICATIONS FOR NURSING PRACTICE The translated and adapted versions of all instruments into Brazilian Portuguese had adequate evidence of content and face validity. The use of WCRP was not associated with a significant improvement in nursing students' diagnostic accuracy. New studies with larger samples, a sample power of at least 80%, and a level of significance of 5% are needed.

Objectives To summarize evidence in the literature on the predictors of insomnia in adults and to determine correspondences with diagnostic indicators of the NANDA-I diagnosis Insomnia. Methods An integrative review performed in Pubmed, Virtual Health Library and CINAHL. Forty-eight articles published in Portuguese, English or Spanish from 2011 to 2018 were included. An analysis of correspondence between the predictors and the NANDA-I related factors and associated conditions for Insomnia was performed. Results There was a correspondence of the predictors found in this review with NANDA-I related factors and associated conditions, except for grieving and frequent naps during the day. Smoking, caffeine intake, dysfunctional sleep beliefs, obesity and caregiver role strain are possible new related factors; chronic illness is a possible new associated condition and individuals going through changes in marital status, economically disadvantaged, female gender, increasing age and night shift worker are possible new at-risk populations. Conclusion The predictors of insomnia that had a correspondence with the NANDA-I elements can support the evidence base of the nursing diagnosis. The predictors found without a correspondence with the diagnosis can be considered for inclusion in the NANDA-I classification, thereby supporting the clinical reasoning of nurses and students.

Made available in DSpace on 2022-04-28T19:29:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 OBJECTIVE: to describe the theoretical construction process of nursing process support documents in COVID-19 care scenarios. METHODS: an experience report of the joint activity of the Brazilian Nursing Process Research Network (Rede de Pesquisa em Processo de Enfermagem) composed of Higher Education and Health Institution researchers in Brazil. RESULTS: five instruments were organized collectively, involving the elements of nursing practice (nursing diagnoses, outcomes and interventions) in assistance for community; for patients (with suspected or mild, moderate, and critical COVID-19 and residents in Nursing Homes); for nursing workers' health support, also subsidizing registration and documentation during the COVID-19 pandemic. FINAL CONSIDERATIONS: valuing the phenomena manifested by families/communities, patients and health professionals is essential for early detection, intervention, and prevention of diseases. Universidade Federal de São Paulo. São Paulo Universidade Federal do Ceará. Fortaleza Universidade Federal Fluminense. Niterói Universidade Federal de Goiás. Goiânia Universidade Federal do Rio Grande do Norte. Natal Universidade Federal do Rio Grande do Sul. Porto Alegre Universidade Federal de São Carlos. São Carlos Universidade Estadual de Campinas. Campinas Christine E. Lynn College of Nursing Florida Atlantic University. Boca Raton Universidad Industrial de Santander. Bucaramanga Pontifícia Universidade Católica do Paraná. Curitiba Universidade Federal da Paraíba. João Pessoa Universidade de São Paulo. São Paulo Universidade de Estadual Paulista. Botucatu Universidade Federal de Pernambuco. Recife Universidade Federal de Minas Gerais. Belo Horizonte Universidade de Estadual Paulista. Botucatu

Objectives: To evaluate the effectiveness of NIC interventions “Teaching: Disease Process”, “Health Education” and “Cardiac Care” in the improvement of NOC results in individuals with Heart Failure (HF), and the Nursing Diagnosis (ND) “Ineffective Health Control”. Methods: Retrospective cohort, conducted at a Health Education in Nursing outpatient clinic. Fourteen patients with HF had follow-up for one year in six bimonthly consultations. The effectiveness of interventions was verified through the change of the result scores through the Friedman’s Non-Parametric Test and Analysis of Non-Parametric Variance for repeated measures. The level of significance was 5%. Results: The interventions were implemented in consultations in a variety of activities. There was a significant improvement in the result scores until the fourth visit (p

Purpose To identify the prevalence of Sedentary Lifestyle (SL) and associations between its defining characteristics (DC) and related factors (RF) in patients with acute coronary syndrome (ACS). Data sources 123 patients with ACS were assessed for SL through the International Physical Activity Questionnaire. Associations between DC and RF was investigated by Pearson's Chi square and Fisher's exact test. Data synthesis 56.1% had SL. Insufficient motivation and Insufficient resources for physical activity were associated with two DC. Conclusion SL was frequent and there were associations between RF and DC. Implications for nursing practice Multi-professional interventions should aim at motivating patients to adopt physical activities.

Objective: to characterize the development of research on nursing diagnoses in nursing graduate programs and verify the application of the results of these studies according to the perception of academic advisors. Methods: documental research on dissertations and theses available from the databases of Brazilian universities with graduate programs in nursing, and exploratory survey on the practical application of their results. Results: 216 dissertations and theses were analyzed. Most of them were descriptive studies, and the most widely used diagnostic taxonomy was NANDA International. Little practical use of the knowledge produced by the dissertations and theses was identified. Conclusion: Although there has been a considerable increase in research on nursing diagnoses, the survey stage revealed scarce practical application of their results, prompting the need for further studies in order to identify the barriers in the way of transposing theory to practice. RESUMEN Objetivo: caracterizar el desarrollo de las investigaciones sobre diagnósticos de enfermería en los programas de postgrado en enfermería brasileños y verificar la aplicación de los resultados de esos estudios de acuerdo con la percepción de los orientadores. Métodos: investigación documental en los bancos electrónicos de disertaciones y tesis de universidades brasileñas con programas de postgrado en enfermería y survey exploratorio sobre la aplicación práctica de los resultados. Resultados: se analizaron 216 disertaciones y tesis. La mayoría se trataba de estudios descriptivos y la taxonomía diagnóstica más utilizada fue NANDA International. Se identificó poca utilización práctica del conocimiento producido por las disertaciones y tesis sobre la temática en cuestión. Conclusión: Aunque se ha revelado un aumento considerable en las investigaciones sobre diagnósticos de enfermería, la fase de survey reveló poca aplicación práctica de los resultados obtenidos, lo que sugiere la realización de nuevos estudios con el fin de identificar las barreras para que ocurra la transposición de la teoría para la práctica. RESUMO Objetivo: Caracterizar o desenvolvimento das pesquisas sobre diagnósticos de enfermagem nos programas de pós-graduação em enfermagem brasileiros e verificar a aplicação dos resultados desses estudos de acordo com a percepção dos orientadores. Métodos: Pesquisa documental nos bancos eletrônicos de dissertações e teses de universidades brasileiras com programas de pós-graduação em enfermagem e survey exploratório sobre a aplicação prática dos resultados. Resultados: Foram analisadas 216 dissertações e teses. A maioria tratava-se de estudos descritivos, sendo a taxonomia diagnóstica mais utilizada a NANDA International. Identificou-se pouca utilização prática do conhecimento produzido pelas dissertações e teses sobre a temática em questão. Conclusão: Embora tenha revelado aumento considerável nas pesquisas sobre diagnósticos de enfermagem, a fase de survey revelou pouca aplicação prática dos resultados obtidos, o que sugere a realização de novos estudos no intuito de identificar as barreiras para que ocorra a transposição da teoria para a prática.

OBJETIVO Investigar a aplicabilidade clinica das definicos conceituais e operacionais das caracteristicas definidoras (CD) e fatores relacionados (FR) de Controle ineficaz da saude em pessoas com insuficiencia cardiaca. METHODS Estudo piloto transversal. A presenca das CD e FRfoi investigada com base nas definicoses conceituais e operacionais. As frequenciasforam utilizadas para analise. RESULTADOS Dos 33 participantes, 32 (97%) tinham Controle ineficaz da saude.A principal CD foi Escolhas na vida diaria ineficazes para atingir as meta de saude, e oprincipal FR foi Impotencia CONCLUSÂO As definicoes conceituais e operacionais foram aplicaveis a pratica clinica, com excecâo de Beneficio percebido, Suscetibilidade percebida e Gravidade da condicâo percebida, as quais devem ser modificadas.

RESUMO Objetivo: identificar diagnósticos de enfermagem em pacientes hospitalizados em UTI por meio do mapeamento cruzado de termos contidos nas anotações de enfermagem, com a Taxonomia da NANDA-I. Método: estudo exploratório descritivo, mediante análise retrospectiva dos registros de enfermagem em 256 prontuários de pacientes que estiveram hospitalizados na UTI geral de um hospital da fronteira oeste do Rio Grande do Sul. Extraíram-se, dos registros, termos que indicavam condições que demandavam intervenções de enfermagem, realizou-se mapeamento cruzado dos mesmos com os diagnósticos da Taxonomia da NANDA-I e confirmação em grupo focal de enfermeiros. Analisaram-se os dados utilizando-se estatística descritiva. Resultados: identificaram-se 832 termos e expressões que se referiam a 52 diferentes diagnósticos em nove dos 13 domínios da Taxonomia da NANDA-I. Conclusão: este estudo permitiu identificar diagnósticos de enfermagem presentes em pacientes hospitalizados na UTI, trazendo implicações para gestão do cuidado, processo de formação de especialistas na área e sistemas de informação. RESUMEN Objetivo: identificar diagnósticos de enfermería en pacientes hospitalizados en UTI mediante mapeo cruzado de términos incluidos en notas de enfermería con Taxonomía de la NANDA-I. Método: estudio exploratorio, descriptivo, mediante análisis retrospectivo de registros de enfermería en 256 historias clínicas de pacientes hospitalizados en UTI general de hospital fronterizo del oeste de Rio Grande do Sul. Se extrajeron términos que indicaban condiciones demandando intervenciones de enfermería, se realizó mapeo cruzado de ellos con diagnósticos de Taxonomía de la NANDA-I y confirmación en grupo focal de enfermeros. Datos analizados aplicando estadística descriptiva. Resultados: se identificaron 832 términos y expresiones relativos a 52 diagnósticos diferentes en 9 de los 13 dominios de Taxonomía de la NANDA-I. Conclusión: fue posible identificar diagnósticos de enfermería presentes en pacientes internados en UTI, con implicancias en la gestión de cuidado, en el proceso de formación de especialistas en el área y en sistemas de información. ABSTRACT Objective: to identify nursing diagnoses in intensive care unit (ICU) patients by means of a cross-mapping of terms contained in nursing records with the NANDA-I taxonomy. Method: an exploratory, descriptive study with a retrospective analysis of nursing records in 256 medical records of patients that were hospitalized in the general ICU of a hospital in the western border of the state of Rio Grande do Sul. Terms indicating conditions demanding nursing interventions were collected from the records; cross-mapping of these terms with the NANDA-I taxonomy diagnoses was performed and confirmed in a nursing focus group. Data were analyzed through descriptive statistics. Results: a total of 832 terms and expressions referring to 52 different diagnoses in 9 of the 13 domains of the NANDA-I taxonomy were identified. Conclusion: the present study enabled the identification of nursing diagnoses in patients hospitalized in ICUs, affecting care management, the training process of experts in the area, and information systems.

Objective To construct conceptual and operational definitions for the defining characteristics (DCs) and related factors (RFs) of the nursing diagnosis (ND) ineffective health management for people with chronic heart failure. Method Conceptual and operational definitions for the DC and RF were based on studies found in an integrative literature review in the databases Latin American Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature, and MEDLINE by using the key words Nursing diagnosis, Heart Failure, and Patient Cooperation in different combinations. Results Conceptual and operational definitions for all the DCs and RFs were constructed. Conclusions and Implications for Practice The definitions will facilitate in the identification of ND in clinical practice in patients with heart failure, future research on ND validation, and education in undergraduate courses.

PURPOSE: To identify the possible defining characteristics (DCs) and related factors of the nursing diagnosis (ND) decreased cardiac tissue perfusion. METHODS: Cross-sectional study using medical charts of adults admitted to an emergency department with the chief complaint of chest pain in a hospital in Sao Paulo, Brazil. FINDINGS: DCs identified: crushing chest pain, elevated markers of myocardial necrosis, ischemic electrocardiogram changes, sweating, nausea, and vomiting. Related factors identified: interruption of arterial blood flow and coronary spasm. CONCLUSION: This ND was clinically identified due to significant differences in the DCs of patients with and without the diagnosis. PRACTICE IMPLICATIONS: The clinical indicators identified in this study can be the starting point for the DCs for this ND.

Purpose To construct and validate a data collection instrument (DCI), and a corresponding instructional guide, for assessment of the nursing diagnosis, risk for infection, in patients following cardiac surgery. Methods Construction of conceptual and operational definitions for risk factors based on literature, content validation by experts, and clinical validation by clinical nurses. Findings There were significant internal consistency and reproducibility in the content validation. In the clinical validation, agreement among nurses was higher than 70% for all risk factors. Conclusions The DCI was constructed and validated. Implications for Nursing Practice This DCI could be used for assessment of adult patients after cardiac surgeries worldwide because of its detailed cues for risk factors, which facilitate clinical reasoning and diagnostic judgment. Objetivo Construir e validar um instrumento de coleta de dados (ICD) e seu roteiro instrucional (RI) para avaliacao do diagnostico de enfermagem Risco de infeccao em pacientes pos-cirurgia cardiaca. Metodos Construcao de definicoes conceituais e operacionais dos fatores de risco baseada na literatura, validacao de conteudo por experts e validacao clinica por enfermeiras assistenciais. Resultados Consistencia interna e reprodutibilidade significativas na validacao de conteudo. Na validacao clinica, a concordância foi maior que 70% para todos os fatores de risco. Conclusoes O ICD foi construido e validado. Implicacoes Para Pratica De Enfermagem O ICD poderia ser utilizado para avaliacao de adultos pos-cirurgia cardiaca internacionalmente devido as suas pistas detalhadas sobre os fatores de risco, que facilitam o raciocinio clinico julgamento diagnostico.

Objectives To consensually validate the operational definitions of the nursing diagnoses activity intolerance, excessive fluid volume, and decreased cardiac output in patients with decompensated heart failure. Method Consensual validation was performed in two stages: analogy by similarity of defining characteristics, and development of operational definitions and validation with experts. Results A total of 38 defining characteristics were found. Operational definitions were developed and content-validated. One hundred percent of agreement was achieved among the seven experts after five rounds. “Ascites” was added in the nursing diagnosis excessive fluid volume. Conclusion The consensual validation improves interpretation of human response, grounding the selection of nursing interventions and contributing to improved nursing outcomes. Implications for Practice Support the assessment of patients with decompensated heart failure. Objetivos Realizar a validacao consensual das definicoes operacionais dos diagnosticos de enfermagem Intolerância a atividade, Volume de liquidos excessivo e Debito cardiaco diminuido em pacientes com insuficiencia cardiaca descompensada. Metodo Validacao consensual em duas etapas: Analogia de semelhanca das caracteristicas definidoras e desenvolvimento de definicoes operacionais e validacao com expertst. Resultados Foram encontradas 38 caracteristicas definidoras para os diagnosticos de enfermagem. Suas definicoes operacionais foram desenvolvidas e seu conteudo validado. Os resultados mostram que houve 100% de concordância entre os sete experts apos cinco rodada. As definicoes operacionais foram classificadas com base no nivel de concordânica. “Ascite” foi acrescentada ao diagnostico Volume de liquidos excessivo. Conclusao A validacao consensual melhora a interpretacao das respostas humanas, embasando a selecao de intervencoes de enfermagem e contribuindo para melhorar os resultados. Implicacoes Para A Pratica Apoio a avaliacao dos pacientes com insuficiencia cardiaca descompensada.

OBJETIVOS: Caracterizar os artrigos científicos relacionados ao diagnóstico de enfermagem débito cardíaco diminuído. Verificar os artigos que descrevem o comportamento das características definidoras deste diagnóstico, identificando aquelas que ocorrem com maior frequência. MÉTODOS: Trata-se de uma revisão sistemática realizada nas bases de dados: Lilacs, SciELO, Embase, Medline, Pubmed e Cochrane, no período de 1985 a 2008. RESULTADOS: Foram selecionados 13 artigos, identificando 50 características definidoras, sendo dez com maior frequência: alteração da frequência/ritmo cardíaco, dispneia, labilidade da pressão arterial, estertores, oligúria anúria, edema, pele fria, fadiga/fraqueza, diminuição dos pulsos periféricos e diminuição da perfusão periférica. CONCLUSÃO: A temática vem sendo pouco explorada. Constatou-se a importância do exame físico, a utilização de técnicas menos invasivas e a necessidade de rever as características definidoras propostas a fim de proporcionar clareza e objetividade na identificação desse diagnóstico de enfermagemOBJETIVOS: Caracterizar los artículos científicos relacionados al diagnóstico de enfermería débito cardíaco disminuído. Verificar los artículos que describen el comportamiento de las características definidoras de este diagnóstico, identificando aquellas que ocurren con mayor frecuencia. MÉTODOS: Se trata de una revisión sistemática realizada en las bases de datos: Lilacs, SciELO, Embase, Medline, Pubmed y Cochrane, en el período de 1985 al 2008. RESULTADOS: Fueron seleccionados 13 artículos, identificando 50 características definidoras, siendo diez con mayor frecuencia: alteración de la frecuencia/ritmo cardíaco, disnea, labilidad de la presión arterial, estertores, oliguria anuria, edema, piel fría, fatiga/debilidad, disminución de los pulsos periféricos y disminución de la perfusión periférica. CONCLUSIÓN: La temática viene siendo poco explorada. Se constató la importancia del examen físico, la utilización de técnicas menos invasivas y la necesidad de revisar las características definidoras propuestas a fin de proporcionar claridad y objetividad en la identificación de ese diagnóstico de enfermeríaOBJECTIVES: To characterize the scientific articles related to the NANDA-I nursing diagnosis, decreased cardiac output. Verify those articles that describe the behavior of the defining characteristics of this diagnosis, identifying those that occur with the highest frequency. METHODS: A systematic review of literature published between the years 1985 - 2008 was conducted, using the following databases: Lilacs, SciELO, EMBASE, Medline, Pubmed and Cochrane. RESULTS: The sample included 13 articles which identified 50 defining characteristics. Ten characteristics were noted to occur with high frequency: altered heart rate/rhythm, dyspnea, labile blood pressure, rales, oliguria / anuria, edema, cold skin, fatigue / weakness, decreased peripheral pulses and decreased peripheral perfusion. CONCLUSION: This subject has not been explored in depth in the literature. The importance of physical examination, the use of less invasive techniques, and the need to review the proposed defining characteristics to provide clarity and objectivity in the identification of this nursing diagnosis was identified

PURPOSE To validate the content of the priority Nursing Interventions Classification (NIC) interventions and Nursing Outcomes Classification (NOC)-suggested outcomes for cardiac patients with the nursing diagnosis excess fluid volume in the Brazilian context. METHODS The content of the interventions and outcomes was scored by seven expert nurses using a Likert scale, using the Fehring model. FINDINGS From the 83 activities of the priority NIC interventions, nine had scores lower than 0.5 (nonuseful) and 50 had scores higher than 0.8 (major); from the 53 indicators of the suggested NOC outcomes, eight scored lower than 0.5 and 26 had scores higher than 0.8. CONCLUSIONS The majority of the NIC interventions and NOC outcomes were considered useful by the Brazilian Cardiology expert nurses. IMPLICATIONS FOR PRACTICE Clinical studies are an important strategy for validation of the usefulness of North American Nursing Diagnosis Association, NIC, and NOC language in clinical protocols. Additional studies are necessary to confirm the findings of this pilot study.

OBJETIVOS: Identificar a presença das características definidoras Medo e Ansiedade no pré-operatório imediato de 50 pacientes submetidas à cirurgia ginecológica, e verificar a Síndrome da Ansiedade Perioperatória. MÉTODOS: Estudo de coorte de caráter transversal teve como objetivo Realizado na Unidade de Ginecologia do Hospital São Paulo em maio de 2007. RESULTADOS: Confirmou-se a presença dos diagnósticos de interesse em 48 pacientes (96,0%) do total de 50 mulheres (100,0%). A Síndrome da Ansiedade Perioperatória foi identificada em 48 (96,0%) das pacientes. CONCLUSÃO: A pesquisa comprovou a presença dos diagnósticos Medo e Ansiedade, devido às manifestações clínicas, também contribuintes para evidenciar a Síndrome da Ansiedade Perioperatória OBJECTIVES: To identify defining characteristics of fear and anxiety during the immediate preoperative period in patient scheduled for gynecological surgery, and to diagnose preoperative anxiety syndrome. METHODS: This was a cross-sectional study with 50 patients from the gynecological unit of the São Paulo hospital. Data was collected in May 2007. RESULTS: Preoperative anxiety syndrome was diagnosed in 48 of the participants (96.0%). CONCLUSION: Participants had clinical symptoms leading to the diagnosis of preoperative anxiety syndrome. OBJETIVOS: Identificar la presencia de las características definidoras de Miedo y Ansiedad en el pre-operatorio inmediato de 50 pacientes sometidas a cirugía ginecológica, y verificar el Síndrome de Ansiedad Perioperatoria. MÉTODOS: Este estudio de cohorte de carácter transversal tuvo como objetivo fue realizado en la Unidad de Ginecología del Hospital Sao Paulo en mayo del 2007. RESULTADOS: Se confirmó la presencia de los diagnósticos de interés en 48 pacientes (96,0%) de un total de 50 mujeres (100,0%). El Síndrome de Ansiedad Perioperatoria fue identificada en 48 (96,0%) de las pacientes. CONCLUSIÓN: Con la investigación se comprobó la presencia de los diagnósticos Miedo y Ansiedad, debido a las manifestaciones clínicas, también contribuyentes para evidenciar el Síndrome de Ansiedad Perioperatoria.

OBJECTIVE: To identify the difficult and easy aspects of performing the different stages of the nursing process, according to the reports of nurses working at Hospital São Paulo. METHODS: Eighty-three nurses from 20 different hospital units, where the nursing process was regularly implemented, answered structured research questionnaires. RESULTS: Nursing diagnosis and evolution were the phases where nurses reported more difficulties. Most of the difficult and easy points reported are related to the nurses' theoretical and practical knowledge to perform the phases of the process. CONCLUSION: Insufficient knowledge becomes an obstacle for the nurses' compliance to the nursing process. An evaluation of theoretical and practical teaching of the nursing process during undergraduate courses is recommended, as well as continuous education in hospital settings. OBJETIVO: Identificar as dificuldades e facilidades mencionadas por enfermeiras do Hospital São Paulo na execução das fases do processo de enfermagem. MÉTODOS: Foram entrevistadas 83 enfermeiras, atuantes em 20 unidades de internaçaõ que possuem o processo de enfermagem implantado no serviço, utilizando-se questionários estruturados. RESULTADOS: O diagnóstico e evolução de enfermagem foram as fases que as enfermeiras referiram ter maior dificuldade para operacionalizar. O núcleo das dificuldades e facilidades está relacionado com o nível de conhecimento teórico e prático das enfermeiras para a execução das fases do processo de enfermagem. CONCLUSÃO: A falta de conhecimento suficiente torna-se uma barreira para a adesão das enfermeiras ao método. Sugere-se a avaliação do ensino teórico e prático do processo de enfermagem na graduação e a educação permanente nos serviços hospitalares. OBJETIVO: Identificar las dificultades y facilidades mencionadas por enfermeras del Hospital Sao Paulo en la ejecución de las fases del proceso de enfermería. MÉTODOS: Fueron entrevistadas 83 enfermeras, que trabajaban en 20 unidades de internamiento que poseen el proceso de enfermería implantado en el servicio, utilizándose cuestionarios estructurados. RESULTADOS: El diagnóstico y evolución de enfermería fueron las fases que las enfermeras refirieron tener mayor dificultad para operacionalizar. El núcleo de las dificultades y facilidades está relacionado con el nivel de conocimiento teórico y práctico de las enfermeras para la ejecución de las fases del proceso de enfermería. CONCLUSIÓN: La falta de conocimiento suficiente se vuelve una barrera para la adhesión de las enfermeras al método. Se sugiere la evaluación de la enseñanza teórica y práctica del proceso de enfermería en el pregrado y la educación permanente en los servicios hospitalarios.

Aims. The aims of this study were to validate the signs and symptoms of the respiratory nursing diagnoses impaired gas exchange, ineffective airway clearance and ineffective breathing pattern in patients under mechanical ventilation; to verify whether intubation time and ventilatory modalities were related factors for respiratory nursing diagnoses; to verify the occurrence of shared signs and symptoms in the diagnoses and compare them with North American Nursing Diagnosis Association's proposition and to ascertain whether respiratory nursing diagnoses occur in isolated or associated patterns. Background. The need for mechanical ventilation is common in several patients admitted to intensive care units. Therefore, critical care nurses should identify the respiratory nursing diagnoses of high incidence. Design and methods. Descriptive observational study, with 177 evaluations of surgical and medical critically ill adult patients undergoing invasive mechanical ventilation. The study adopted Fehring's Modified Clinical Diagnostic Validity Model, with a suggested alteration. Results. The critical signs and symptoms were the same as proposed by North American Nursing Diagnosis Association, when the diagnoses were separately identified, although no particular sign and symptom was found for ineffective breathing pattern. Impaired gas exchange and ineffective airway clearance were identified as having 88 (49·7%) evaluations sharing the critical signs and symptoms. Intubation time and ventilation modality were related factors for the development of ineffective airway clearance and ineffective breathing pattern. Conclusion. The critical signs and symptoms of impaired gas exchange were abnormal blood gases and hypoxemia. For ineffective airway clearance, they were rhonchi and decreased breath sounds. No highlights were found for ineffective breathing pattern signs and symptoms. Validation by experts has confirmed these findings. The interface between ineffective airway clearance and impaired gas exchange was confirmed by the presence of the shared critical signs and symptoms. Relevance to clinical practice. Studies like this are relevant to clinical practice because they evaluate the adequacy of Taxonomy II for patients under mechanical ventilation in clinical practice, thus allowing for the intensive care nurses to go from one mechanical and routine practice to a critical, reflexive practice, committed to professional progress.

To construct conceptual and operational definitions for the defining characteristics (DCs) and related factors (RFs) of the nursing diagnosis (ND) ineffective health management for people with chronic heart failure.Conceptual and operational definitions for the DC and RF were based on studies found in an integrative literature review in the databases Latin American Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature, and MEDLINE by using the key words Nursing diagnosis, Heart Failure, and Patient Cooperation in different combinations.Conceptual and operational definitions for all the DCs and RFs were constructed.The definitions will facilitate in the identification of ND in clinical practice in patients with heart failure, future research on ND validation, and education in undergraduate courses.

PURPOSE. To identify the nursing diagnoses and their most frequent related factors or risk factors in patients admitted to an intensive care unit (ICU). METHOD. Descriptive cross-sectional study with information from 991 admissions to an ICU during a 6-month period. FINDINGS. Sixteen nursing diagnoses resulting from hospitalization were most frequently identified; six had percentages greater than 40% with 29 related/risk factors. The resulting averages were 6.9 diagnoses per hospitalization and 1.2 related/risk factors per nursing diagnoses. CONCLUSIONS. The nursing diagnoses identified seemed to be common to the clinical practice of nursing and their fundamental related/risk factors to precise clinical judgment, thus providing a basis for interventions for a desired outcome. PRACTICE IMPLICATIONS. The findings have contributed to the development of the standardized nursing language usage in Brazilian nursing practices. Diagnosticos de Enfermagem em uma Unidade de Terapia Intensiva Brasileira OBJETIVO. Identificar os diagnosticos de enfermagem e os seus fatores relacionados/risco mais frequentemente estabelecidos aos pacientes internados numa unidade de terapia intensiva (UTI). METODO. Estudo descritivo, transversal, com informacoes de 991 admissoes numa UTI, durante seis meses. RESULTADOS. Dezesseis diagnosticos de enfermagem foram mais frequentes, seis deles com percentuais acima de 40% por internacao e com 29 fatores relacionados ou de risco. As medias foram de 6,9 diagnosticos de enfermagem por internacao e 1,2 fatores relacionados ou de risco por diagnostico de enfermagem. CONCLUSOES. Os diagnosticos de enfermagem identificados parecem ser comuns a pratica clinica de enfermagem e os seus fatores relacionados ou de risco fundamentais ao julgamento clinico preciso, que subsidia a escolha da intervencao para um resultado esperado. IMPLICACOES PARA A PRATICA. Os resultados tem colaborado para o desenvolvimento do uso da linguagem padronizada de enfermagem no Brasil.

INTRODUÇÃO: As lesões medulares constituem evento grave que acomete principalmente jovens, requerendo um planejamento cuidadoso da assistência de enfermagem Este estudo tem a finalidade de contribuir nesse planejamento, oferecendo subsídios para melhorar a qualidade do cuidado desses pacientes. OBJETIVOS: Identificar os diagnósticos de enfermagem, segundo a NANDA, em portadores de lesão medular internados numa Unidade de Ortopedia e Traumatologia; e propor as intervenções de enfermagem, conforme a NIC. MÉTODOS: Estudo descritivo prospectivo, com 10 casos analisados no período de janeiro/2000 a julho/2002. Os dados foram coletados por meio de um instrumento criado para uso na unidade de estudo, identificando-se os diagnósticos de enfermagem. As intervenções foram propostas pelas autoras e submetidas à avaliação de duas especialistas. RESULTADOS: Foram identificados 15 diagnósticos de enfermagem prevalentes, para os quais foram propostas 26 intervenções de enfermagem. CONCLUSÃO: Os resultados poderão subsidiar as enfermeiras ao cuidado do paciente com lesão medular, auxiliando-o e contribuindo à sua autonomia, através das intervenções propostas.INTRODUCCIÓN: Las lesiones medulares constituyen un evento grave que afecta, en su mayoría, a los jóvenes, las cuales requirien una planificación cuidadosa para la atencion de enfermeria. Este estudio tiene la finalidad de contribuir con subsidios para mejorar la calidad de los cuidados prestados a esos pacientes. OBJETIVOS: Identificar los diagnósticos de enfermería, según la taxonomía de la NANDA, en pacientes con lesión medular, internados en una Unidad de Ortopedia y Traumatología; y proponer las intervenciones de enfermería, conforme el referencial de la NIC. MÉTODOS: Estudio descriptivo prospectivo en el cual fue analizado un total de 10 casos, en el período de enero/2000 a julio/2002. Los datos fueron recolectados por medio de un instrumento creado para uso en la unidad de estudio, con la finalidad de identificar los diagnósticos de enfermería. Las intervenciones fueron propuestas por las autoras y sometidas a la evaluación de dos especialistas. RESULTADOS: Fueron identificados 15 diagnósticos de enfermería prevalentes, para los cuales se propusieron 26 intervenciones de enfermería. CONCLUSIÓN: Los resultados del estudio servirán de subsidio a las enfermeras para el cuidado de pacientes con lesión medular, auxiliándolos y contribuyendo en su autonomía, a través de las intervenciones propuestas.INTRODUCTION: Spinal cord lesions constitute very serious events that occur mostly among young people. Providing care to these patients is a complex task because they are greatly dependent on nursing staff and require a very carefully designed plan of care. The purpose of this study was to contribute ways to design a quality plan of care to attend these patients. OBJECTIVES: To identify nursing diagnoses according to the NANDA for patients with spinal cord lesions from an Orthopedic and Trauma Unit, and to propose appropriate nursing interventions according to the NIC. METHODS: This study used a descriptive and prospective research design. The sample consisted of 10 patients with spinal cord lesions. Data were colleted from January, 2000 to July, 2002 using a specific assessment tool. Data analysis led the researchers to propose nursing diagnoses which were validated by two clinical nursing specialists. RESULTS: Fifteen prevalent nursing diagnoses were identified and 26 nursing interventions were proposed. CONCLUSION: The results can be used to assist nurse to provide quality care for patients with spinal cord lesions, so as to improve the patients independence.

As definições operacionais são requisitos importantes no ensino da Semiologia e Semiotécnica nos Cursos de Graduação e Pós-Graduação em Enfermagem. Este estudo descritivo, acerca das definições operacionais elaboradas para as características definidoras do diagnóstico de enfermagem Volume de Líquidos Excessivo em portadores de cardiopatias foi realizado a partir de revisão da literatura, no período de 1985 a 2001. As definições operacionais foram analisadas criticamente por quatro enfermeiros especialistas em diferentes campos clínicos de atuação. Após os ajustes sugeridos por esses especialistas, os dados foram enviados a uma consultora técnica, para avaliação conclusiva.

Aims and objectives To assess the clinical usefulness of the operational definitions for the defining characteristics of the NANDA International nursing diagnoses, activity intolerance, decreased cardiac output and excess fluid volume, and the concomitant presence of those diagnoses in patients with decompensated heart failure. Background Content validity of the operational definitions for the defining characteristics of activity intolerance, excess fluid volume and decreased cardiac output have been previously validated by experts. Their clinical usefulness requires clinical validation. Design This was a descriptive exploratory study. Methods Two expert nurses independently assessed 25 patients with decompensated heart failure for the presence or absence of 29 defining characteristics. Interrater reliability was analysed using the Kappa coefficient as a measure of clinical usefulness. The Fisher's exact test was used to test the association of the defining characteristics of activity intolerance and excess fluid volume in the presence of decreased cardiac output, and the correlation between the three diagnoses. Results Assessments regarding the presence of all defining characteristics reached 100% agreement, except with anxiety. Five defining characteristics of excess fluid volume were significantly associated with the presence of decreased cardiac output. Concomitant presence of the three diagnoses occurred in 80% of the patients. However, there was no significant correlation between the three diagnoses. Conclusions The operational definitions for the diagnoses had strong interrater reliability, therefore they were considered clinically useful. Only five defining characteristics were representative of the association between excess fluid volume and decreased cardiac output. Therefore, excess fluid volume is related to decreased cardiac output, although these diagnoses are not necessarily associated with activity intolerance. Relevance to clinical practice The operational definitions may favour early recognition of the sequence of responses to decompensation, guiding the choice of common interventions to improve or resolve excess fluid volume and decreased cardiac output.

The identification of nursing diagnoses most commonly reported in the literature in the perioperative period of cardiac surgery can assist nurses in this context of clinical practice to plan the nursing care towards the individual needs of each patient, contributing to the implementation of rapid and effective actions to solve identified problems. An integrative literature review aimed at identifying nursing diagnoses in the perioperative period of cardiac surgery was developed. The search was performed in the LILACS and SCIELO databases with the descriptors “nursing diagnosis”, “nursing care”, and “cardiac surgery” or “thoracic surgery”. Thirteen studies were included, which identified 17 main preoperative diagnoses, 10 main intraoperative diagnoses, and 28 main post-operative diagnoses. Different studies often found the same diagnosis in each period, which reinforces a profile with which nurses can expect to deal with, and on which they must intervene to obtain the best results. Additional studies on diagnostic accuracy and validity of such diagnoses are expected.

This was a descriptive, retrospective study, with a quantitative method, with the aim of analyzing the nursing diagnoses contained in the records of children of 0 to 36 months of age who attended infant health nursing consults. A documentary analysis and the cross-mapping technique were used. One hundred eighty-eight different nursing diagnoses were encountered, of which 33 (58.9%) corresponded to diagnoses contained in the Nomenclature of Nursing Diagnoses and Interventions and 23 (41.1%) were derived from ICNP® Version 1.0. Of the 56 nursing diagnoses, 43 (76.8%) were considered to be deviations from normalcy. It was concluded that the infant health nursing consults enabled the identification of situations of normalcy and abnormality, with an emphasis on the diagnoses of deviations from normalcy. Standardized language favors nursing documentation, contributing to the care of the patient and facilitating communication between nurses and other health professionals. Estudio descriptivo y retrospectivo de abordaje cuantitativo, cuyo objetivo fue analizar los diagnósticos de enfermería (DE) formulados en los registros de niños de 0 a 36 meses de edad atendidos en la consulta de enfermería en Puericultura. Se utilizó el análisis documental y la técnica de mapeo cruzado, encontrándose 188 diferentes diagnósticos de enfermería, de los cuales 33 (58,6%) correspondían a diagnósticos contenidos en la Nomenclatura de Diagnósticos e Intervenciones en Enfermería adoptada en la red básica de Curitiba, y 23 (41,1%) eran provenientes de la CIPE® Versión 1.0. De los 56 DE, se encontraron 43 (76,8%) diagnósticos de desviación de la normalidad. Se concluyó que las consultas de enfermería infantil permiten identificar situaciones de normalidad y anormalidad, destacándose los diagnósticos de desviación de la normalidad y que la estandarización del lenguaje de enfermería favorece la documentación de enfermería, contribuyendo con el cuidado del paciente y facilitando la comunicación entre los enfermeros y otros profesionales de la salud. Estudo descritivo e retrospectivo, com abordagem quantitativa, que objetivou analisar os diagnósticos de enfermagem constantes de prontuários de crianças de 0 a 36 meses de idade atendidas em consulta de enfermagem em puericultura. Utilizou-se a análise documental e a técnica de mapeamento cruzado. Foram encontrados 188 diferentes diagnósticos de enfermagem, dos quais 33 (58,9%) correspondiam a diagnósticos contidos na Nomenclatura de Diagnósticos e Intervenções de Enfermagem e 23 (41,1%) eram provenientes da CIPE® Versão 1.0. Dos 56 diagnósticos de enfermagem, 43 (76,8%) foram considerados de desvio de normalidade. Conclui-se que as consultas de enfermagem à criança permitem identificar situações de normalidade e anormalidade, com destaque para os diagnósticos de desvio de normalidade. A padronização da linguagem favorece a documentação de enfermagem, contribuindo para o cuidado ao paciente e facilitando a comunicação entre os enfermeiros e outros profissionais de saúde.

This is a randomized clinical trial, aimed to compare the frequency and intensity of symptoms of anxiety in patients of preoperative cardiac surgery who received empathic behavior from nurse or family or those who received no specific type of empathic behavior. The sample consisted of 66 patients in preoperative of cardiac surgery, which were divided in three groups: empathic behavior by nurses, without specific empathic behavior and by family. Anxiety was assessed at two points in time: before and after the intervention. The instrument used was developed and validated by Suriano, comprising 19 defining characteristics of the nursing diagnosis anxiety. It was observed that the reduction of anxiety symptoms was higher in the group receiving empathic behavior of relatives when compared to the other two groups. The results suggested that encouraging the participation of family members can contribute to the reduction of anxiety symptoms in patients in preoperative cardiac surgery.

To construct and validate a data collection instrument (DCI), and a corresponding instructional guide, for assessment of the nursing diagnosis, risk for infection, in patients following cardiac surgery.Construction of conceptual and operational definitions for risk factors based on literature, content validation by experts, and clinical validation by clinical nurses.There were significant internal consistency and reproducibility in the content validation. In the clinical validation, agreement among nurses was higher than 70% for all risk factors.The DCI was constructed and validated.This DCI could be used for assessment of adult patients after cardiac surgeries worldwide because of its detailed cues for risk factors, which facilitate clinical reasoning and diagnostic judgment.

Purpose This case study illustrates the use of the nursing process based upon the standardized nursing diagnoses approved by NANDA International (NANDA-I), and using the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC) in the care of a patient with pemphigus vulgaris (PV). Data Sources The published literature on PV and the experience and expertise of the authors in working with people with impaired skin integrity and PV were used to develop this case study. Data Synthesis The accuracy of nursing diagnoses and appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. Conclusion Impaired skin integrity is a human response diagnosed by nurses, and early treatment is important due to the vulnerability of these patients. Implications for Nursing Practice The case study contributes to nursing knowledge for professionals who care for patients with PV. Objetivo Este estudo de caso ilustra o uso do processo de enfermagem baseado na padronizacao dos diagnosticos de enfermagem aprovados pela NANDA International (NANDA-I), e da classificacao de resultados de enfermagem (NOC) e da classificacao de intervencoes de enfermagem (NIC) na assistencia ao paciente com penfigo vulgar. Revisao de literatura As publicacoes na literatura sobre penfigo vulgar e a experiencia e expertise dos autores na assistencia a pessoas com integridade da pele prejudicada e penfigo vulgar foram utilizadas para o desenvolvimento deste estudo de caso. Analise de dados A acuracia dos diagnosticos de enfermagem e as intervencoes apropriadas foram suportes positivos nos resultados na saude do paciente. Conclusao Integridade da pele prejudicada e uma resposta humana diagnosticada por enfermeiros, e o tratamento precoce e importante devido a vulnerabilidade destes pacientes. Implicacoes para a pratica de enfermagem O estudo de caso contribui para o conhecimento dos profissionais de enfermagem que cuidam de pacientes com penfigo vulgar.

OBJECTIVES: to validate the concept "risk for decreased cardiac output". METHOD: Six of the eight steps suggested in the technique developed by Walker & Avant were adopted to analyze the concept of the phenomenon under study and the proposal made by Hoskins was used for content validation, taking into account agreement achieved among five experts. RESULTS: the concept "decreased cardiac output" was found in the nursing and medical fields and refers to the heart's pumping capacity while the concept "risk" is found in a large number of disciplines. In regard to the defining attributes, "impaired pumping capacity" was the main attribute of decreased cardiac output and "probability" was the main attribute of risk. The uses and defining attributes of the concepts "decreased cardiac output" and "risk" were analyzed as well as their antecedent and consequent events in order to establish the definition of "risk for decreased cardiac output", which was validated by 100% of the experts. CONCLUSION: The obtained data indicate that the risk for decreased cardiac output phenomenon can be a nursing diagnosis and refining it can contribute to the advancement of nursing classifications in this context. OBJETIVO: validar o conceito de risco de débito cardíaco diminuído. MÉTODO: foi adotada a técnica de Walker & Avant para a análise do conceito do fenômeno em foco, com utilização de seis das oito etapas sugeridas, e da proposta de Hoskins para validação de conteúdo, considerando-se a concordância entre cinco especialistas. RESULTADOS: o conceito de débito cardíaco diminuído foi encontrado nas áreas de enfermagem e médica e está centrado na capacidade de bombeamento do coração, embora também esteja presente em um grande número de disciplinas. Em relação aos atributos definidores, o débito cardíaco diminuído teve como atributo principal a deficiência de bombeamento cardíaco e o risco, o atributo de probabilidade. Analisados os usos e os atributos definidores dos conceitos de "débito cardíaco diminuído" e "risco", seus eventos antecedentes e consequentes, construiu-se a definição de risco de débito cardíaco diminuído, que foi validada por 100% dos especialistas. CONCLUSÃO: os dados obtidos permitiram inferir que o fenômeno risco de débito cardíaco diminuído pode se constituir num diagnóstico de enfermagem e, por meio do seu refinamento, contribuir para o avanço das classificações de enfermagem nesse contexto. OBJETIVO: Validar el concepto riesgo del débito cardíaco disminuido. MÉTODO: Fue adoptada la técnica de Walker & Avant para analizar la definición del fenómeno enfocado, utilizando seis de las ocho etapas sugeridas y la propuesta de Hoskins para validar el contenido, considerándose la conformidad entre cinco expertos. RESULTADOS: el concepto de debito cardíaco disminuido se encuentra en las áreas enfermería y médica y su atención se centra en la capacidad de bombeo del corazón. Sin embargo, el concepto de riesgo es presente en un gran número de áreas. Las características definitorias de la disminución del gasto cardíaco mostraron como principal atributo deficiencia de la bomba cardiaca y, para el riesgo, el atributo de probabilidad. Analizados los usos y características definidoras de los conceptos "débito cardíaco disminuido" y "riesgo" con los hechos anteriores y subsiguientes, fue posible elaborar la definición de "riesgo de débito cardíaco disminuido", la cual fue validada por 100% de los expertos. CONCLUSIÓN: Los resultados encontrados permitieron concluir que el fenómeno de riesgo de débito cardíaco disminuido puede constituir un diagnóstico de enfermería y su refinamiento puede contribuir al avance de las clasificaciones de enfermería.

OBJETIVO: Identificar diagnósticos de enfermagem (DEs) que constam atualmente na taxonomia NANDA, validados na área de Cardiologia no Brasil. MÉTODOS: Revisão integrativa de literatura, norteada pela seguinte questão: quais diagnósticos de enfermagem foram validados no Brasil. Foram analisados 11 trabalhos: três validações de conteúdo e oito validações clínicas. RESULTADOS: Os DEs validados foram Intolerância à Atividade, Débito Cardíaco Diminuído, Angústia Espiritual, Conhecimento deficiente, Volume Excessivo de Líquidos, Desobstrução Ineficaz de Vias Aéreas, Perfusão Tissular Periférica Ineficaz, Medo, Ansiedade e Dor. Destacaram-se a produção da Pós-Graduação de instituições públicas, a validação das características definidoras, modelos de validação e critérios de seleção de experts de Fehring modificados. O modelo de validação clínica foi usado para DEs da esfera psicobiológica; o modelo de validação de conteúdo foi utilizado sobretudo para DEs das esferas psicossocial e psicoespiritual. O conhecimento produzido pode embasar futuros estudos sobre a pertinência do conteúdo dos resultados de enfermagem na avaliação de eficácia das intervenções de enfermagem no País. OBJECTIVE: To identify nursing diagnoses (ND) currently appearing in the NANDA-I taxonomy, validated in the area of cardiology in Brazil. METHODS: An integrative literature review, guided by the following question: what nursing diagnoses were validated in Brazil? Eleven works were analyzed: three content validations and eight clinical validations. RESULTS: The NDs validated were: activity intolerance, decreased cardiac output, spiritual distress, deficient knowledge, excessive fluid volume, ineffective airway clearance, ineffective peripheral tissue perfusion, fear, anxiety, and pain. The highlights were the production of the graduate programs in public institutions, the validation of defining characteristics, models of validation and the modified Fehring criteria for selection of experts . The clinical validation model was used for NDs of the psychobiological sphere; the content validation model was used mainly for NDs in the psychosocial and psychospiritual spheres. CONCLUSION: The knowledge produced can provide a basis for future studies on the relevance of the content of nursing outcomes in the evaluation of the effectiveness of nursing interventions in the country. OBJETIVO: Identificar diagnósticos de enfermería (DEs) que se encuentran actualmente en la taxonomía de la NANDA, validados en el área de Cardiología en el Brasil. MÉTODOS: Revisión integrativa de literatura, orientada por la siguiente pregunta:qué diagnósticos de enfermería fueron validados en el Brasil. Fueron analizados 11 trabajos: tres validaciones de contenido y ocho validaciones clínicas. RESULTADOS: Los DEs validados fueron Intolerancia a la Actividad, Débito Cardiaco Disminuído, Angustia Espiritual, Conocimiento deficiente, Volumen Excesivo de Líquidos, Desobstrucción Ineficaz de Vías Aéreas, Perfusión Tisular Periférica Ineficaz, Miedo, Ansieda y dolor. Se destacaron la producción del Postgrado de instituciones públicas, la validación de las características definitorias, modelos de validación y criterios de selección de experts de Fehring modificados. El modelo de validación clínica fue usado para DEs de la esfera psicobiológica; el modelo de validación de contenido fue utilizado, sobre todo para DEs de las esferas psicosocial y psicoespiritual. El conocimiento producido puede ser fundamentación de futuros estudios sobre la pertinencia del contenido de los resultados de enfermería en la evaluación de la eficacia de las intervenciones de enfermería en el País. Federal University of São Paulo Paulista School of Nursing UNIFESP, EPE SciELO

OBJETIVOS: Caracterizar os artrigos científicos relacionados ao diagnóstico de enfermagem débito cardíaco diminuído. Verificar os artigos que descrevem o comportamento das características definidoras deste diagnóstico, identificando aquelas que ocorrem com maior frequência. MÉTODOS: Trata-se de uma revisão sistemática realizada nas bases de dados: Lilacs, SciELO, Embase, Medline, Pubmed e Cochrane, no período de 1985 a 2008. RESULTADOS: Foram selecionados 13 artigos, identificando 50 características definidoras, sendo dez com maior frequência: alteração da frequência/ritmo cardíaco, dispneia, labilidade da pressão arterial, estertores, oligúria\ anúria, edema, pele fria, fadiga/fraqueza, diminuição dos pulsos periféricos e diminuição da perfusão periférica. CONCLUSÃO: A temática vem sendo pouco explorada. Constatou-se a importância do exame físico, a utilização de técnicas menos invasivas e a necessidade de rever as características definidoras propostas a fim de proporcionar clareza e objetividade na identificação desse diagnóstico de enfermagem OBJECTIVES: To characterize the scientific articles related to the NANDA-I nursing diagnosis, decreased cardiac output. Verify those articles that describe the behavior of the defining characteristics of this diagnosis, identifying those that occur with the highest frequency. METHODS: A systematic review of literature published between the years 1985 - 2008 was conducted, using the following databases: Lilacs, SciELO, EMBASE, Medline, Pubmed and Cochrane. RESULTS: The sample included 13 articles which identified 50 defining characteristics. Ten characteristics were noted to occur with high frequency: altered heart rate/rhythm, dyspnea, labile blood pressure, rales, oliguria / anuria, edema, cold skin, fatigue / weakness, decreased peripheral pulses and decreased peripheral perfusion. CONCLUSION: This subject has not been explored in depth in the literature. The importance of physical examination, the use of less invasive techniques, and the need to review the proposed defining characteristics to provide clarity and objectivity in the identification of this nursing diagnosis was identified OBJETIVOS: Caracterizar los artículos científicos relacionados al diagnóstico de enfermería débito cardíaco disminuído. Verificar los artículos que describen el comportamiento de las características definidoras de este diagnóstico, identificando aquellas que ocurren con mayor frecuencia. MÉTODOS: Se trata de una revisión sistemática realizada en las bases de datos: Lilacs, SciELO, Embase, Medline, Pubmed y Cochrane, en el período de 1985 al 2008. RESULTADOS: Fueron seleccionados 13 artículos, identificando 50 características definidoras, siendo diez con mayor frecuencia: alteración de la frecuencia/ritmo cardíaco, disnea, labilidad de la presión arterial, estertores, oliguria\ anuria, edema, piel fría, fatiga/debilidad, disminución de los pulsos periféricos y disminución de la perfusión periférica. CONCLUSIÓN: La temática viene siendo poco explorada. Se constató la importancia del examen físico, la utilización de técnicas menos invasivas y la necesidad de revisar las características definidoras propuestas a fin de proporcionar claridad y objetividad en la identificación de ese diagnóstico de enfermería Irmandade da Santa Casa de Misericórdia de São Paulo Santa Casa de São Paulo Faculdade de Ciências Médicas Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem UNIFESP, EPE SciELO

PURPOSE. The purpose of this study was to conduct a content validation for the elements of the nursing diagnosis Impaired Memory and include aging as a related factor. METHOD. Fehring's (1987) model of diagnosis content validation was used, with the participation of 18 experts. FINDING. The definition, defining characteristics, and related factors of NANDA-I were evaluated by experts, as was the proposed related factor “aging.” CONCLUSIONS. Elements of the NANDA-I diagnosis Impaired Memory and the proposed related factor of aging were validated in the Brazilian context. A clinical validation of this related factor will be necessary to build evidence for this relationship. IMPLICATIONS FOR NURSING PRACTICE. NANDA-I diagnoses should be tested and validated in the elderly, in order to take their specific needs into account, thus contributing to quality nursing care for these patients. OBJETIVO. Realizar a validacao de conteudo dos elementos do diagnostico de enfermagem Memoria Prejudicada e incluir o envelhecimento como fator relacionado. METODO. Utilizou-se o modelo de validacao de conteudo de diagnostico de Fehring (1987) com a participacao de 18 experts. RESULTADOS. A definicao, as caracteristicas definidoras, os fatores relacionados da NANDA-I foram validados pelos experts, assim como o proposto fator relacionado “envelhecimento”. CONCLUSOES. Os elementos do diagnostico memoria prejudicada da NANDA-I e o proposto fator relacionado envelhecimento foram validados no contexto brasileiro. Faz-se necessaria a realizacao de validacao clinica de fator relacionado para aumentar as evidencias dessa relacao. IMPLICACOES PARA A PRATICA DE ENFERMAGEM. Os diagnosticos da NANDA I devem ser testados e validados em idosos, para contemplar suas especificidades, e assim contribuir na qualidade da assistencia de enfermagem a esses pacientes.

This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping. A total of 57 different NIC interventions frequently used in the unit were identified; most of them in the complex (42%) and basic physiological (37%) domains, in the classes ‘respiratory management’ and ‘self-care facilitation’. Similarity between the nursing care prescribed and nursing interventions/NIC was found in 97.2% of the cases. The conclusion is that the interventions/NIC used in the clinical practice of this intensive care unit reflects the level of complexity of nursing care, which is mainly directed at the regulation of the body’s physical and homeostatic functioning. Se trata de un estudio descriptivo, transversal realizado en un hospital universitario con los objetivos de describir las intervenciones de enfermería más utilizadas en la práctica clínica de una unidad de terapia intensiva, con base en las prescripciones de enfermería y, analizar si son similares a las Nursing Interventions Clasification (NIC). La muestra constó de 991 internaciones de pacientes. Los datos fueron recolectados retrospectivamente, en base informatizada, y analizados por la estadística descriptiva y diseño cruzado. Se identificó 57 diferentes intervenciones/NIC frecuentemente utilizadas en la unidad; siendo la mayoría en el dominio fisiológico complejo (42%) y fisiológico básico (37%), en las clases de control respiratorio y facilitación del autocuidado. En 97,2% de los casos se encontraron similares entre las prescripciones de enfermería de la unidad y las intervenciones/NIC. Se concluye que las intervenciones/NIC utilizadas en la práctica clínica de la unidad de terapia intensiva reflejan el nivel de complejidad del cuidado de enfermería en esta unidad, destinándose, principalmente, a regular el funcionamiento físico y homeostático del organismo. Este é estudo descritivo, transversal, realizado em um hospital universitário com os objetivos de descrever as intervenções de enfermagem mais utilizadas na prática clínica de uma unidade de terapia intensiva, com base nas prescrições de enfermagem, e analisar a sua similaridade com a Nursing Interventions Classification (NIC). A amostra constou de 991 internações de pacientes. Os dados foram coletados, retrospectivamente, em base informatizada, e analisados pela estatística descritiva e mapeamento cruzado. Identificaram-se 57 diferentes intervenções/NIC, frequentemente utilizadas na unidade, sendo a maioria no domínio fisiológico complexo (42%) e fisiológico básico (37%), nas classes de controle respiratório e facilitação do autocuidado. Em 97,2% dos casos houve similaridade entre as prescrições de enfermagem da unidade e as intervenções/NIC. Conclui-se que as intervenções/NIC, utilizadas na prática clínica da unidade de terapia intensiva, refletem o nível de complexidade do cuidado de enfermagem nessa unidade, destinando-se, principalmente, à regulação do funcionamento físico e homeostático do organismo.

PURPOSE. This case study illustrates nursing diagnoses and interventions for a man with leprosy. DATA SOURCES. Data sources were published literature on the disease of leprosy, and the experience and expertise of the authors in working with people with leprosy. DATA SYNTHESIS. Data were synthesized using the standardized nursing languages of North American Nursing Diagnosis Association International and the Nursing Interventions Classification. The accuracy of the diagnoses and the appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. CONCLUSIONS. Although leprosy has been eradicated in some countries, the risk of new cases is present anywhere that Mycobacterium leprae still exists. The recommended treatment of multibacilar polychemotherapy has lowered the rate of new cases in Brazil. IMPLICATIONS FOR NURSING PRACTICE. Nurses need to incorporate evidence-based practice interventions for leprosy-based wound care, and nurses should encourage persons with leprosy to maintain regular medical care with multibacilar polychemotherapy.

OBJETIVO: Avaliar os resultados alcançados após intervenções de enfermagem para o diagnóstico de enfermagem Fadiga. MÉTODOS: Estudo, quase-experimental, tempo série e transversal, realizado em Hospital Universitário por meio da implementação de intervenções e avaliação diária dos resultados em 30 pacientes com diagnóstico de insuficiência cardíaca e de enfermagem fadiga, internados na Unidade de Cardiologia e UTI Coronária. Foi elaborado um instrumento de coleta de dados composto por intervenções e resultados de enfermagem. RESULTADOS: Foi observada boa evolução de todos os indicadores avaliados. As intervenções de enfermagem atingiram satisfatoriamente os resultados esperados. CONCLUSÃO: Ao sistematizar a assistência de enfermagem, alcançamos resultados favoráveis em suas evidências clínicas. OBJECTIVE: To evaluate expected outcomes of nursing interventions to address the nursing diagnosis of fatigue. METHODS: A cross-sectional quasi-experimental design was used. The sample consisted of 30 coronary care unit in-patient with congestive heart failure and fatigue. A specific tool designed for this study was used to collect specific data on outcomes of nursing interventions to manage the nursing diagnosis of fatigue. RESULTS: Nursing interventions to manage patients' fatigue had positive outcomes. CONCLUSION: The use of the nursing process to identify the nursing diagnosis of fatigue, design and implement specific nursing interventions, and evaluate patient outcomes leads to quality nursing care. OBJETIVO: Evaluar los resultados alcanzados después de las intervenciones de enfermería para el diagnóstico de enfermería Fatiga. MÉTODOS Se trata de un estudio, cuasi-experimental, tiempo serie y transversal, realizado en un Hospital Universitario por medio de la implementación de intervenciones y evaluación diaria de los resultados en 30 pacientes con diagnóstico de insuficiencia cardiaca y de enfermería fatiga, internados en la Unidad de Cardiología y UCI Coronaria. Fue elaborado un instrumento de recolección de datos compuesto por intervenciones y resultados de enfermería. RESULTADOS: Fue observada buena evolución de todos los indicadores evaluados. Las intervenciones de enfermería alcanzaron de manera satisfactoria los resultados esperados. CONCLUSIÓN: Al sistematizar la asistencia de enfermería, alcanzamos resultados favorables en sus evidencias clínicas. Federal University of São Paulo Federal University of São Paulo Nursing Department UNIFESP, Nursing Department SciELO

INTRODUÇÃO: As lesões medulares constituem evento grave que acomete principalmente jovens, requerendo um planejamento cuidadoso da assistência de enfermagem Este estudo tem a finalidade de contribuir nesse planejamento, oferecendo subsídios para melhorar a qualidade do cuidado desses pacientes. OBJETIVOS: Identificar os diagnósticos de enfermagem, segundo a NANDA, em portadores de lesão medular internados numa Unidade de Ortopedia e Traumatologia; e propor as intervenções de enfermagem, conforme a NIC. MÉTODOS: Estudo descritivo prospectivo, com 10 casos analisados no período de janeiro/2000 a julho/2002. Os dados foram coletados por meio de um instrumento criado para uso na unidade de estudo, identificando-se os diagnósticos de enfermagem. As intervenções foram propostas pelas autoras e submetidas à avaliação de duas especialistas. RESULTADOS: Foram identificados 15 diagnósticos de enfermagem prevalentes, para os quais foram propostas 26 intervenções de enfermagem. CONCLUSÃO: Os resultados poderão subsidiar as enfermeiras ao cuidado do paciente com lesão medular, auxiliando-o e contribuindo à sua autonomia, através das intervenções propostas. INTRODUCTION: Spinal cord lesions constitute very serious events that occur mostly among young people. Providing care to these patients is a complex task because they are greatly dependent on nursing staff and require a very carefully designed plan of care. The purpose of this study was to contribute ways to design a quality plan of care to attend these patients. OBJECTIVES: To identify nursing diagnoses according to the NANDA for patients with spinal cord lesions from an Orthopedic and Trauma Unit, and to propose appropriate nursing interventions according to the NIC. METHODS: This study used a descriptive and prospective research design. The sample consisted of 10 patients with spinal cord lesions. Data were colleted from January, 2000 to July, 2002 using a specific assessment tool. Data analysis led the researchers to propose nursing diagnoses which were validated by two clinical nursing specialists. RESULTS: Fifteen prevalent nursing diagnoses were identified and 26 nursing interventions were proposed. CONCLUSION: The results can be used to assist nurse to provide quality care for patients with spinal cord lesions, so as to improve the patients independence. INTRODUCCIÓN: Las lesiones medulares constituyen un evento grave que afecta, en su mayoría, a los jóvenes, las cuales requirien una planificación cuidadosa para la atencion de enfermeria. Este estudio tiene la finalidad de contribuir con subsidios para mejorar la calidad de los cuidados prestados a esos pacientes. OBJETIVOS: Identificar los diagnósticos de enfermería, según la taxonomía de la NANDA, en pacientes con lesión medular, internados en una Unidad de Ortopedia y Traumatología; y proponer las intervenciones de enfermería, conforme el referencial de la NIC. MÉTODOS: Estudio descriptivo prospectivo en el cual fue analizado un total de 10 casos, en el período de enero/2000 a julio/2002. Los datos fueron recolectados por medio de un instrumento creado para uso en la unidad de estudio, con la finalidad de identificar los diagnósticos de enfermería. Las intervenciones fueron propuestas por las autoras y sometidas a la evaluación de dos especialistas. RESULTADOS: Fueron identificados 15 diagnósticos de enfermería prevalentes, para los cuales se propusieron 26 intervenciones de enfermería. CONCLUSIÓN: Los resultados del estudio servirán de subsidio a las enfermeras para el cuidado de pacientes con lesión medular, auxiliándolos y contribuyendo en su autonomía, a través de las intervenciones propuestas. Universidade Federal de São Paulo (UNIFESP) Departamento de Enfermagem Universidade Federal do Rio Grande do Sul Escola de Enfermagem Faculdade de Ciências Médicas da Santa Casa de São Paulo Departamento de Medicina Social UNIFESP, Depto. de Enfermagem SciELO