Anali Martegani Ferreira

Clinical Validation of Nursing Diagnoses of Acute Pain in Hospitalized Children

PURPOSE.  Clinically validate (Fehrings model) the characteristics of the nursing diagnosis acute pain in 65 hospitalized children. METHODS.  Cross-sectional study. FINDINGS.  This study resulted in 13 major characteristics (expressive behavior, change of mental state, verbal report of pain, observed evidence of pain, narrowed focus, position to avoid pain, guarding behavior, sleep disturbance, protective gestures, changes in heart rate, changes in muscle tone, changes in respiratory rate, and facial mask) and in 5 minor characteristics (changes in blood pressure, coded report, changes in breathing pattern, distraction behavior, and changes in appetite). CONCLUSIONS.  Characteristics with R > 0.50 and ≤ 1 were valid in the diagnosis acute pain. IMPLICATIONS FOR NURSING PRACTICE.  Clinical validation studies must be reproduced in different populations. OBJETIVO.  Validar clinicamente as caracteristicas definidoras do Diagnostico de Enfermagem (DE) Dor Aguda, em sessenta e cinco criancas hospitalizadas, seguindo o modelo proposto por Fehring. METODOS.  Estudo transversal. RESULTADOS.  Esse estudo resultou em 13 caracteristicas definidoras maiores (Comportamento expressivo, Mudanca do estado mental, Relato verbal, Evidencia observada de dor, Foco em si proprio, Gestos protetores, Posicao para evitar dor, Disturbio do sono, Comportamento de protecao, Mudanca na frequencia cardiaca, Alteracao no tonus muscular, Mudanca na frequencia respiratoria e Expressao facial e cinco menores (Alteracoes na pressao sanguinea, relato codificado, alteracoes no padrao respiratorio, Comportamento de Distracao e Alteracoes no apetite). CONCLUSOES.  As CD com R > 0.50 e ≤ 1 foram validadas para o DE Dor Aguda. IMPLICACOES PARA A PRATICA CLINICA.  Estudos de validacao clinica devem ser testados em outras populacoes.PURPOSE Clinically validate (Fehrings model) the characteristics of the nursing diagnosis acute pain in 65 hospitalized children. METHODS Cross-sectional study. FINDINGS This study resulted in 13 major characteristics (expressive behavior, change of mental state, verbal report of pain, observed evidence of pain, narrowed focus, position to avoid pain, guarding behavior, sleep disturbance, protective gestures, changes in heart rate, changes in muscle tone, changes in respiratory rate, and facial mask) and in 5 minor characteristics (changes in blood pressure, coded report, changes in breathing pattern, distraction behavior, and changes in appetite). CONCLUSIONS Characteristics with R > 0.50 and ≤ 1 were valid in the diagnosis acute pain. IMPLICATIONS FOR NURSING PRACTICE Clinical validation studies must be reproduced in different populations.

Clinical Validation of Nursing Diagnoses of Acute Pain in Hospitalized Children: Clinical Validation of Nursing Diagnoses of Acute Pain in Hospitalized Children

PURPOSE.  Clinically validate (Fehrings model) the characteristics of the nursing diagnosis acute pain in 65 hospitalized children. METHODS.  Cross-sectional study. FINDINGS.  This study resulted in 13 major characteristics (expressive behavior, change of mental state, verbal report of pain, observed evidence of pain, narrowed focus, position to avoid pain, guarding behavior, sleep disturbance, protective gestures, changes in heart rate, changes in muscle tone, changes in respiratory rate, and facial mask) and in 5 minor characteristics (changes in blood pressure, coded report, changes in breathing pattern, distraction behavior, and changes in appetite). CONCLUSIONS.  Characteristics with R > 0.50 and ≤ 1 were valid in the diagnosis acute pain. IMPLICATIONS FOR NURSING PRACTICE.  Clinical validation studies must be reproduced in different populations. OBJETIVO.  Validar clinicamente as caracteristicas definidoras do Diagnostico de Enfermagem (DE) Dor Aguda, em sessenta e cinco criancas hospitalizadas, seguindo o modelo proposto por Fehring. METODOS.  Estudo transversal. RESULTADOS.  Esse estudo resultou em 13 caracteristicas definidoras maiores (Comportamento expressivo, Mudanca do estado mental, Relato verbal, Evidencia observada de dor, Foco em si proprio, Gestos protetores, Posicao para evitar dor, Disturbio do sono, Comportamento de protecao, Mudanca na frequencia cardiaca, Alteracao no tonus muscular, Mudanca na frequencia respiratoria e Expressao facial e cinco menores (Alteracoes na pressao sanguinea, relato codificado, alteracoes no padrao respiratorio, Comportamento de Distracao e Alteracoes no apetite). CONCLUSOES.  As CD com R > 0.50 e ≤ 1 foram validadas para o DE Dor Aguda. IMPLICACOES PARA A PRATICA CLINICA.  Estudos de validacao clinica devem ser testados em outras populacoes.PURPOSE Clinically validate (Fehrings model) the characteristics of the nursing diagnosis acute pain in 65 hospitalized children. METHODS Cross-sectional study. FINDINGS This study resulted in 13 major characteristics (expressive behavior, change of mental state, verbal report of pain, observed evidence of pain, narrowed focus, position to avoid pain, guarding behavior, sleep disturbance, protective gestures, changes in heart rate, changes in muscle tone, changes in respiratory rate, and facial mask) and in 5 minor characteristics (changes in blood pressure, coded report, changes in breathing pattern, distraction behavior, and changes in appetite). CONCLUSIONS Characteristics with R > 0.50 and ≤ 1 were valid in the diagnosis acute pain. IMPLICATIONS FOR NURSING PRACTICE Clinical validation studies must be reproduced in different populations.

Compreensão do processo de enfermagem por enfermeiros de um hospital geral do sul do Brasil

Aim: to know the view of nurses that work in a general hospital in the western border of Rio Grande do Sul about the Nursing Process in their hospital care practice. Method: descriptive and exploratory study with a qualitative approach, performed in a general hospital. Semi-structured interviews with 13 nurses were used, then, the data were transcribed and analyzed using content analysis. Results: four categories emerged in this study: The meaning of the nursing process in the practice of nursing; Contributions of the Nursing Process for teamwork; Legal support for the work and nursing records; Valuation of Nursing work. Final Remarks: nurses recognized that the Nursing Process is a guiding tool for its practice and that it contributes to the professional’s autonomy. Furthermore, they state that, when the nursing process is not applied, care quality becomes weakened

PROCESSO DE ENFERMAGEM: DESAFIOS E ESTRATÉGIAS PARA SUA IMPLEMENTAÇÃO SOB A ÓTICA DE ENFERMEIROS

A utilizacao do Processo de Enfermagem (PE), na pratica assistencial, constitui-se em importante metodo de organizacao do trabalho de enfermagem, pois permite organizar e planejar as acoes de enfermagem a partir da tomada de decisao do enfermeiro. Objetivou-se conhecer os desafios enfrentados por enfermeiros para implementacao do PE e possiveis estrategias para sua implementacao. Trata-se de um estudo exploratorio descritivo, com abordagem qualitativa, realizado em um hospital geral da fronteira oeste do RS, Brasil, no segundo semestre de 2013. A populacao foi composta por enfermeiros assistenciais atuantes na instituicao em estudo. Os resultados deste estudo apontaram duas categorias denominadas Desafios enfrentados para a utilizacao do PE: no ensino e na pratica profissional; e Estrategias para implementacao do PE. Conclui-se que os enfermeiros compreendem o PE como um metodo cientifico e estrategico para qualificacao da pratica assistencial. Reconhecem que sua utilizacao na pratica contribui para a autonomia e valorizacao da profissao. Descritores: Processos de Enfermagem; Cuidados de Enfermagem; Enfermagem.

Evaluation of pain and accuracy diagnostic in hospitalized children.

PURPOSE:  Acute pain occurs in over 50% of hospitalized children. The accuracy of this diagnosis has been underexplored in the literature, as has the role of training to implement pain assessment. This study analyzed the accuracy of acute pain diagnoses after the implementation of a systematic evaluation of pain (study intervention). METHOD:  The sample was divided into: pre- and postintervention. The Nursing Diagnosis Accuracy Scale, which scores accuracy as null, low, moderate, or high, was used. RESULTS:  In the postimplementation, acute pain was diagnosed more often. However, accuracy only improved in the moderate category. CONCLUSION:  Diagnosis of acute pain increased in the postimplementation period, but accuracy did not. IMPLICATIONS:  The development of strategies for improvement of diagnostic accuracy is warranted.PURPOSE Acute pain occurs in over 50% of hospitalized children. The accuracy of this diagnosis has been underexplored in the literature, as has the role of training to implement pain assessment. This study analyzed the accuracy of acute pain diagnoses after the implementation of a systematic evaluation of pain (study intervention). METHOD The sample was divided into: pre- and postintervention. The Nursing Diagnosis Accuracy Scale, which scores accuracy as null, low, moderate, or high, was used. RESULTS In the postimplementation, acute pain was diagnosed more often. However, accuracy only improved in the moderate category. CONCLUSION Diagnosis of acute pain increased in the postimplementation period, but accuracy did not. IMPLICATIONS The development of strategies for improvement of diagnostic accuracy is warranted.