Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-04-02T14:01:59Z No. of bitstreams: 1 FernandoHiagoDaSilvaDuarte_DISSERT.pdf: 1579770 bytes, checksum: 4bdbf99e4d88319fa3b83e83ac96e609 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-04-05T11:53:40Z (GMT) No. of bitstreams: 1 FernandoHiagoDaSilvaDuarte_DISSERT.pdf: 1579770 bytes, checksum: 4bdbf99e4d88319fa3b83e83ac96e609 (MD5) / Made available in DSpace on 2018-04-05T11:53:40Z (GMT). No. of bitstreams: 1 FernandoHiagoDaSilvaDuarte_DISSERT.pdf: 1579770 bytes, checksum: 4bdbf99e4d88319fa3b83e83ac96e609 (MD5) Previous issue date: 2017-12-18 / A les?o por press?o ? o resultado da press?o prolongada sobre uma ?rea do corpo do paciente diminuindo a circula??o sangu?nea minimizando a distribui??o de sangue, nutrientes e oxig?nio nesta ?rea desencadeando destrui??o e morte tecidual, pois o tecido mole ? comprimido entre uma proemin?ncia ?ssea e uma superf?cie r?gida durante um per?odo de tempo prolongado. O banco de termos da linguagem especial de enfermagem identifica conceitos que contribuem com a constru??o de diagn?sticos, resultados e interven??es de enfermagem. A utiliza??o desse banco direcionada a pacientes com les?o por press?o permite desenvolver de forma piramidal a identifica??o de um vocabul?rio pr?prio direcionado ao cuidado de enfermagem. O estudo teve por objetivo construir um banco de termos da linguagem especial da enfermagem para pacientes com les?o por press?o utilizando a CIPE? vers?o 2017, com base na Teoria das Necessidades Humanas B?sicas. Trata-se de um estudo terminol?gico em um hospital privado na capital do nordeste do Brasil desenvolvida em seis etapas: 1) Identifica??o e coleta dos termos relevantes ? pr?tica da Enfermagem relacionada ? les?o por press?o; 2) Extra??o dos termos dos prontu?rios e elimina??o das repeti??es; 3) Normaliza??o dos termos; 4) Mapeamento cruzado entre termos extra?dos e os termos constantes na CIPE? vers?o 2017; 5) Refinamento dos termos; 6) Valida??o das afirmativas do banco de termos. Obteve-se aprova??o do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, sob parecer n? 2.356.736 e Certificado de Apresenta??o para Aprecia??o ?tica n? 76777017.20000.5537. Identificaram-se 391 termos que foram submetidos ao processo de mapeamento cruzado e valida??o de especialistas que resultou em 370 termos, sendo 225 termos constantes e 145 termos n?o constantes na Classifica??o Internacional para a Pr?tica de Enfermagem, vers?o 2017. O estudo permitiu explorar e conhecer os termos utilizados pelos enfermeiros na assist?ncia prestada ao paciente com les?o por press?o, possibilitando o desenvolvimento futuro dos enunciados de diagn?sticos / resultados e interven??es de enfermagem e tamb?m a unifica??o da linguagem profissional do enfermeiro. / Pressure injury is the result of prolonged pressure on an area of the patient's body by decreasing blood circulation, minimizing the distribution of blood, nutrients, and oxygen in this area, triggering destruction and tissue death, as the soft tissue is compressed between a bone prominence and a hard surface for an extended period of time. The terms bank of the special nursing language identifies concepts that contribute to the construction of nursing diagnoses, results and interventions. The use of this bank aimed at patients with pressure lesions allows the development of a pyramidal identification of an own vocabulary directed to nursing care. The aim of the study was to construct a bank of terms of the special nursing language for patients with pressure injury, using the International Classification for Nursing Practice version 2017. This is a terminological study in a private hospital in the northeast capital of the Brazil developed in six steps: 1) Identification and collection of terms relevant to the practice of Nursing related to pressure injury; 2) Extraction of the terms of the medical records and elimination of repetitions; 3) Standardization of terms; 4) Cross-mapping between extracted terms and the terms in CIPE? version 2017; 5) Refinement of terms; 6) Validation of the terms bank statements. Approval was obtained from the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion no. 2.356.736 and Certificate of Presentation for Ethical Appreciation n? 76777017.20000.5537. It was identified 391 terms that were submitted to the process of cross-mapping and validation of specialists that resulted in 370 terms, being 225 constant terms and 145 terms not included in the International Classification for Nursing Practice, version 2017. The study allowed to explore and to know the terms used by nurses in the care provided to the patient with pressure injury, allowing the development of statements of diagnosis/results and nursing interventions and also the unification of nurses' professional language.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-27T13:30:49Z No. of bitstreams: 1 AnaBeatrizDeAlmeidaMedeiros_TESE.pdf: 2411384 bytes, checksum: 92c650f6680920b2f593c10ef84b8ed7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-31T13:24:12Z (GMT) No. of bitstreams: 1 AnaBeatrizDeAlmeidaMedeiros_TESE.pdf: 2411384 bytes, checksum: 92c650f6680920b2f593c10ef84b8ed7 (MD5) / Made available in DSpace on 2017-01-31T13:24:12Z (GMT). No. of bitstreams: 1 AnaBeatrizDeAlmeidaMedeiros_TESE.pdf: 2411384 bytes, checksum: 92c650f6680920b2f593c10ef84b8ed7 (MD5) Previous issue date: 2016-08-08 / Este estudo objetivou validar o diagn?stico de enfermagem Risco de ?lcera por press?o em pacientes internados na unidade de terapia intensiva. Diante da gravidade, complexidade e grau de depend?ncia dos pacientes cr?ticos, surge a necessidade da enfermagem avaliar a presen?a desse diagn?stico para atuar na preven??o dos fatores de risco e na manuten??o da qualidade nos servi?os ofertados. Tratou-se de um estudo metodol?gico, desenvolvido em tr?s etapas: an?lise de conceito, an?lise do conte?do por especialistas e valida??o cl?nica. A primeira etapa foi baseada no modelo de Walker e Avant e operacionalizada atrav?s de revis?o da literatura, que aconteceu nos meses de fevereiro e mar?o de 2015. Utilizaram-se as bases de dados: Scopus, Literatura Latino-Americana e do Caribe em Ci?ncias da Sa?de, Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine and Nattional Institutes of Health e Web of Science, e os descritores: ?lcera por press?o, fatores de risco e unidades de terapia intensiva e suas respectivas sinon?mias em ingl?s. Obteve-se uma amostra de 22 artigos. Ap?s a an?lise do conceito, identificaram-se 42 antecedentes e os seguintes atributos essenciais: Press?o; Press?o em combina??o com cisalhamento; e Isquemia tecidual. Na segunda etapa, foram solicitadas as opini?es dos especialistas com rela??o ? an?lise de conceito e de conte?do, por meio de grupo focal, composto por sete enfermeiras, em quatro encontros, durante os meses de maio a julho de 2015. Ap?s a discuss?o no grupo focal, resultou-se um total de 29 antecedentes e na seguinte defini??o conceitual para o diagn?stico estudado: Vulnerabilidade de rompimento da integridade da pele como resultado da isquemia tecidual ocasionada por press?o ou press?o em combina??o com cisalhamento. Na terceira etapa, foi realizado um estudo de caso-controle, com intuito de avaliar, na pr?tica cl?nica, a precis?o dos fatores de risco do diagn?stico de enfermagem identificados e validados nas etapas anteriores. Esta etapa ocorreu na unidade de terapia intensiva do Hospital Universit?rio Onofre Lopes, atrav?s de um formul?rio. A amostra consistiu de 180 participantes, sendo 90 no grupo caso e 90 no grupo controle. O projeto de pesquisa foi submetido e aprovado pelo Comit? de ?tica em Pesquisa do referido hospital, sob n?mero de protocolo 848.997 e Certificado de Apresenta??o para Aprecia??o ?tica 36883714.5.0000.5292. Os resultados mostram que, atrav?s da aplica??o do modelo de regress?o log?stica hier?rquica, um conjunto de cinco fatores de risco e um aspecto cl?nico deve ser visto como um forte indicativo do aumento do risco para ?lcera por press?o. Os fatores de risco foram: Hist?ria de ?lcera por press?o, Tempo prolongado de perman?ncia na UTI; Fric??o, Desidrata??o e Temperatura elevada da pele em torno de 1 a 2 ?C. E o aspecto cl?nico foi: Tratamento das comorbidades. Conclui-se que o diagn?stico de enfermagem Risco de ?lcera por press?o p?de ser validado em seus aspectos de conceito, de conte?do e cl?nicos e que existe um conjunto de vari?veis que aumentam a chance da ocorr?ncia do diagn?stico de enfermagem Risco de ?lcera por press?o em pacientes internados em unidade de terapia intensiva. Assim, acredita-se que o estudo contribuiu para o aperfei?oamento da linguagem diagn?stica, com vistas a ado??o de medidas preventivas, aplica??o de interven??es mais eficazes, alcance de resultados positivos e melhoria da qualidade do cuidado prestado pelo enfermeiro. / The objective of this study was to validate the nursing diagnosis ?Pressure ulcer risk? in patients admitted to the intensive care unit. Faced with the severity, complexity and degree of dependence of the critical patients, nursing needs to assess the presence of this diagnosis to act in the prevention of risk factors and maintenance of quality in the services offered. This was a methodological study, conducted in three steps: concept analysis, content analysis by experts and clinical validation. The first step was based on the model of Walker and Avant and performed through literature review, which occurred in the months of February and March 2015. We used the databases: Scopus, Latin American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine and National Institutes of Health, and Web of Science, and the descriptors: pressure ulcer, risk factors and intensive care units, and their respective synonyms in the English language. We obtained a sample of 22 papers. After completing the concept and content analysis, we identified 42 backgrounds and the following essential attributes: Pressure; Pressure combined with shearing; and Tissue ischemia. In the second step, we asked the experts to give opinions about the concept analysis, by means of a focus group, composed of seven nurses, in four meetings, which were held from May to July 2015. After finishing the discussion in the focus group, we had a total of 29 backgrounds, besides the following conceptual definition for the diagnosis under study: Vulnerability of rupture of the skin integrity as a result of the tissue ischemia provoked by pressure or pressure combined with shearing. In the third step, we conducted a case-control study with the aim of assessing, in clinical practice, the accuracy of the risk factors of the nursing diagnosis identified and validated in the preceding steps. This step took place in the intensive care unit of the Onofre Lopes University Hospital, through a form. The sample was composed of 180 participants, with 90 in the case group and 90 in the control group. The research project was submitted and approved by the Research Ethics Committee of the aforementioned hospital, under Protocol number 848.997 and Presentation Certificate for Ethics Assessment number 36883714.5.0000.5292. The results show that, through the application of the hierarchical logistic regression model, a set of five risk factors and one clinical aspect must be regarded as a strong indicator of the increased risk for pressure ulcer. The risk factors were: History of pressure ulcer; Extended period of stay in the ICU; Friction, Dehydration and High skin temperature around 1 to 2 ? C. As for the clinical aspect, it was: Treatment of comorbidities. We conclude that the nursing diagnosis of pressure ulcer risk could be validated in aspects of concept, content and clinical and that there is a set of variables that increase the chance of occurrence of the nursing diagnosis ?Pressure ulcer risk? in patients admitted to the intensive care unit. Accordingly, we believe that this study has contributed to the improvement of the diagnostic parlance, with regard to adopting preventive measures, applying more effective interventions, achieving positive results and improving the quality of the health care provided by the nursing professional.