Juliana de Melo Vellozo Pereira

Diagnósticos de enfermagem de pacientes hospitalizados com doenças cardiovasculares

Objetivo: Identificar a frequencia dos diagnosticos de enfermagem e caracteristicas definidoras de pacientes com doencas cardiovasculares e caracteriza-los quanto as variaveis sociodemograficas e clinicas. Metodo: Estudo descritivo transversal realizado com 30 pacientes hospitalizados em um hospital de grande porte. Utilizou-se instrumento proprio validado para coleta de dados, que foram analisados por 5 peritos;, havendo concordância de 50%, sofreram analise estatistica descritiva e inferencial. Resultados: Foram encontradas associacoes significativas com fatores Presenca da Insuficiencia Cardiaca, do Infarto Agudo do Miocardio, da Dor, Sexo e Idade. Os diagnosticos mais frequentes foram: Ansiedade (76,7%), Dor Aguda (70,7%), Debito Cardiaco Diminuido (56,7%), Percepcao Sensorial Perturbada - Visual (53,3%), Insonia (46,7%), Intolerância a Atividade (36,7%), Disfuncao Sexual (36,7%) e Eliminacao Urinaria Prejudicada (36,7%). Conclusao: a descricao dos diagnosticos de enfermagem contribui para a analise das respostas a doenca cardiovascular, com foco no objeto de trabalho do enfermeiro, apresentando respostas a doenca cardiovascular por meio de investigacao holistica.

Nursing diagnoses of patients with heart failure: an integrative review

Aim: To identify the knowledge produced and published in national and international literature on nursing diagnoses in hospitalized patients with heart failure . Method : Integrative review without time cut in CINAHL , MEDLINE , SCOPUS , LILACS , Web of science , Bank theses CAPES , Theses Database USP and BIREME data. Results: We selected and analyzed 24 productions . Decreased cardiac output, excessive fluid volume , activity intolerance , impaired skin integrity , impaired gas exchange , deficient knowledge , risk of falls and impaired physical mobility were the most frequent diagnoses in the studies cited . Discussion : The results are in accordance with the progression of heart failure , which limits the exercise causes water retention and tolerance of the individual. Conclusion : These observations contribute to the direction of nursing care and preparation of medical protocols.

Nursing diagnoses for inpatients with cardiovascular diseases

Objetivo: Identificar a frequencia dos diagnosticos de enfermagem e caracteristicas definidoras de pacientes com doencas cardiovasculares e caracteriza-los quanto as variaveis sociodemograficas e clinicas. Metodo: Estudo descritivo transversal realizado com 30 pacientes hospitalizados em um hospital de grande porte. Utilizou-se instrumento proprio validado para coleta de dados, que foram analisados por 5 peritos;, havendo concordância de 50%, sofreram analise estatistica descritiva e inferencial. Resultados: Foram encontradas associacoes significativas com fatores Presenca da Insuficiencia Cardiaca, do Infarto Agudo do Miocardio, da Dor, Sexo e Idade. Os diagnosticos mais frequentes foram: Ansiedade (76,7%), Dor Aguda (70,7%), Debito Cardiaco Diminuido (56,7%), Percepcao Sensorial Perturbada - Visual (53,3%), Insonia (46,7%), Intolerância a Atividade (36,7%), Disfuncao Sexual (36,7%) e Eliminacao Urinaria Prejudicada (36,7%). Conclusao: a descricao dos diagnosticos de enfermagem contribui para a analise das respostas a doenca cardiovascular, com foco no objeto de trabalho do enfermeiro, apresentando respostas a doenca cardiovascular por meio de investigacao holistica.

Accuracy in inference of nursing diagnoses in heart failure patients

UNLABELLED Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. OBJECTIVE to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. METHOD descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. RESULTS the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. DISCUSSION the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. CONCLUSION the training allowed the exercise of clinical judgment and better accuracy of nurses.

Acurácia na inferência de diagnósticos de enfermagem de pacientes com insuficiência cardíaca

UNLABELLED Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. OBJECTIVE to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. METHOD descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. RESULTS the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. DISCUSSION the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. CONCLUSION the training allowed the exercise of clinical judgment and better accuracy of nurses.

Effect of an orientation group for patients with chronic heart failure: randomized controlled trial

ABSTRACT Objective: To evaluate the effect of the orientation group on therapeutic adherence and self-care among patients with chronic heart failure. Method: Randomized controlled trial with 27 patients with chronic heart failure. The intervention group received nursing consultations and participated in group meetings with the multi-professional team. The control group only received nursing consultations in a period of four months. Questionnaires validated for use in Brazil were applied in the beginning and in the end of the study to assess self-care outcomes and adherence to treatment. Categorical variables were expressed through frequency and percentage distributions and the continuous variables through mean and standard deviation. The comparison between the initial and final scores of the intervention and control groups was done through the Student’s t-test. Results: The mean adherence in the intervention group was 13.9 ± 3.6 before the study and 4.8 ± 2.3 after the study. In the control group it was 14.2 ± 3.4 before the study and 14.7 ± 3.5 after the study. The self-care confidence score was lower after the intervention (p=0.01). Conclusion: The orientation group does not improve adherence to treatment and self-care management and maintenance and it may reduce confidence in self-care. Registry REBEC RBR-7r9f2m.

INSTRUMENTO PARA O PROCESSO DE ENFERMAGEM EM UNIDADES CARDIOLÓGICAS: ESTUDO QUASE-EXPERIMENTAL

pela Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminense e-mail: allanaraphaelaenf@gmail.com ** Professora Associada do Departamento de Fundamentos de Enfermagem e Administração da Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminens *** Enfermeira do Hospital Universitário Clementino Fraga Filho/HUCFF-UFRJ e Doutoranda do Programa de Pós Graduação em Ciências Cardiovasculares, Universidade Federal Fluminense **** Mestranda do Programa de Pós Graduação em Ciências Cardiovasculares, Universidade Federal Fluminense INSTRUMENTO PARA O PROCESSO DE ENFERMAGEM EM UNIDADES CARDIOLÓGICAS: ESTUDO QUASE-EXPERIMENTAL

La precisión en inferencia de diagnóstico de enfermería en pacientes con insuficiencia cardíaca

UNLABELLED Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. OBJECTIVE to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. METHOD descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. RESULTS the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. DISCUSSION the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. CONCLUSION the training allowed the exercise of clinical judgment and better accuracy of nurses.

Diagnósticos de Enfermagem em crianças com cardiopatias congênitas: mapeamento cruzado

Objective To identify the NANDA International nursing diagnoses from the terms found in the nursing records of hospitalized children with congenital heart defects, and verify the association between these terms and the mapped nursing diagnoses. Methods Observational and cross sectional study, developed by mapping of the terms in the nursing records of hospitalized children up to two years of age with congenital heart disease. The association between the terms and the most frequent nursing diagnoses were evaluated using the Student’s t-test or chi-square. Results The most frequent nursing diagnoses in the 82 records analyzed were: risk for infection (81.7%), impaired gas exchange (46.3%) and activity intolerance (36.6%). The terms “cyanotic” and “pallor” had significant associations with the diagnosis, impaired gas exchange. Conclusion The terms recorded in the records of children with congenital heart disease allowed for the identification of NANDA International nursing diagnoses, in addition to verification of associations.

Terms of nursing: human responses of children hospitalized with heart disease – a cross-sectional study

Objetivos: Descrever as caracteristicas demograficas e clinicas a partir dos termos encontrados nos registros de enfermagem dos prontuarios de criancas com cardiopatias congenitas hospitalizadas. Metodo: Trata-se de um estudo transversal, realizado em um hospital da rede publica. Foi realizado por duas especialistas, atraves da analise documental de 01 registro de enfermagem de cada prontuario para identificacao das principais caracteristicas clinicas dessas criancas. Resultados: Foram estudados 82 prontuarios, as criancas do estudo apresentaram um perfil majoritariamente do sexo masculino (54,9%), sao lactentes (91,5%) e maioria possui cardiopatia acianotica (58,5%). Os termos mais encontrados nos prontuarios das criancas com cardiopatias congenitas foram: “cianotico” (80,5%), seguido de “esforco respiratorio” (79,3%), “taquipneico” (72,3%) e “hipocorado” (65,9%). Conclusao: O reconhecimento precoce da cardiopatia congenita pelo enfermeiro, possibilita que os cuidados de enfermagem sejam estabelecidos e executados com prioridade. Evitando a rapida deterioracao clinica e mantendo a crianca em bom estado para realizacao dos procedimentos terapeuticos.