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Submitted by Fernando Souza (fernandoafsou@gmail.com) on 2017-09-05T12:33:23Z No. of bitstreams: 1 arquivototal.pdf: 3013442 bytes, checksum: 4d70fb0c1a311c9ae7173386d53c6ce3 (MD5) / Made available in DSpace on 2017-09-05T12:33:23Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 3013442 bytes, checksum: 4d70fb0c1a311c9ae7173386d53c6ce3 (MD5) Previous issue date: 2016-12-14 / Introduction: Common classification of nursing diagnoses, outcomes, and interventions were created in the Pediatric Clinic at the HULW/ UFPB. They are 126 nursing diagnoses and outcomes, and 576 nursing interventions. Objective: The aim of this study is to develop operational definitions for nursing diagnoses contained in the nomenclature of diagnoses, results, and nursing interventions for hospitalized children between zero and five years of age in the Pediatric Clinic at the HULW/ UFPB. Besides, clinical validation of nursing diagnoses, outcomes, and interventions for kids in this age range. Methodology: Methodological research was used in two phases: operational definitions of statements of nursing diagnoses and clinical validation of nursing diagnoses, outcomes, and interventions. The study was submitted to the Research Ethics Committee of HULW / UFPB and received the CAAE 43249415.0.0000.5183 before it begins data collection. Results: In the first phase, we have been prepared 126 nursing diagnoses, which were submitted to validation by consensus to confirm nursing diagnoses for children between zero and five years of age, and notice if the definition has empirical indicators for its identification. Seventy nursing diagnoses were validated, and 56 of them were considered not applicable. In the second phase, nursing diagnoses, outcomes, and interventions have been clinically validated through 6 clinical case studies. The study used the nursing process based on the Horta’s Basic Human Needs Theory. We identified that 24,3% of the validated nursing diagnoses and 54,5% of the nursing interventions were in the nomenclature. Conclusion: This study showed the effectiveness of the nomenclature in the Pediatric Clinic of HULW / UFPB through content and clinical validation of nursing diagnoses, improving and allowing a high quality of nursing care. / Introducción: En la Clínica Pediátrica de HULW / UFPB se construyó una nomenclatura común de diagnósticos, resultados e intervenciones de enfermería. Que consiste, 126 diagnósticos y resultados de enfermería y 576 intervenciones de enfermería. Objetivo: Elaborar definiciones operativas para los diagnósticos de enfermería contenidas en la nomenclatura de los diagnósticos, resultados e intervenciones de enfermería para los niños desde el nacimiento hasta los cinco años hospitalizados en la Clínica Pediátrica de HULW / UFPB y clínicamente validar los diagnósticos, resultados e intervenciones de enfermería para los niños este grupo de edad. Método: Metodológicos de investigación, desarrollada en dos etapas: definiciones operacionales de las declaraciones de los diagnósticos de enfermería y la validación clínica de los diagnósticos, resultados e intervenciones de enfermería. Antes de su ejecución, el proyecto fue presentado a la Comisión de Ética de Investigación de HULW / UFPB y recibió el CAAE 43249415.0.0000.5183. Resultados: En la primera etapa, las definiciones se han preparado para 126 diagnósticos de enfermería, los cuales fueron sometidos a validación por consenso para confirmar la presencia de los diagnósticos en niños de cero a cinco años y la definición presentada indicadores empíricos para su identificación. 70 diagnósticos fueron validados, y 56 fueron considerados no aplicable. En la segunda etapa, los diagnósticos, resultados e intervenciones de enfermería han sido clínicamente validados a través de seis estudios de casos clínicos, el uso de las fases del proceso de enfermería, con la base teórica de las necesidades humanas básicas de Horta. 24.3% fueron identificados de diagnóstico validado y utilizado el 54,5% de las intervenciones de enfermería constante Nomenclatura. Conclusión: El estudio demostró la eficacia de la nomenclatura en la Clínica Pediátrica de HULW / UFPB a través de la validación de contenido y la validación clínica de los diagnósticos de enfermería constantes, mejorar la atención, lo que permite la realización de una atención de calidad. / Introdução: Na Clínica Pediátrica do HULW/UFPB foi construída uma Nomenclatura de diagnósticos, resultados e intervenções de enfermagem. Constando, 126 diagnósticos e resultados de enfermagem e 576 intervenções de enfermagem. Objetivo: Desenvolver definições operacionais para os diagnósticos de enfermagem contidos na Nomenclatura de diagnósticos, resultados e intervenções de enfermagem para crianças de zero a cinco anos hospitalizadas na Clínica Pediátrica do HULW/UFPB e validar clinicamente os diagnósticos, os resultados e as intervenções de enfermagem para as crianças dessa faixa etária. Método: Pesquisa metodológica, desenvolvida em duas etapas:Definições operacionais dos enunciados de diagnósticos de enfermagem e Validação clínica dos diagnósticos, resultados e intervenções de enfermagem. Antes de sua execução, o projeto foi submetido à apreciação do Comitê de Ética em Pesquisa do HULW/UFPB e recebeu o CAAE 43249415.0.0000.5183. Resultados: Na primeira etapa, foram elaboradas definições para os 126 diagnósticos de enfermagem, que foram submetidos à validação por consenso para confirmar a presença dos diagnósticos nas crianças de zero a cinco anos e se a definição apresentava os indicadores empíricos para sua identificação. Foram validados 70 diagnósticos, e 56 foram considerados não aplicáveis. Na segunda etapa, os diagnósticos, resultados e as intervenções de enfermagem foram validados clinicamente, por meio de seis de estudos de casos clínicos, utilizando as fases do processo de enfermagem, tendo como fundamentação teórica as Necessidades Humanas Básicas de Horta. Foram identificados 24,3% dos diagnósticos validados, e utilizadas 54,5% das intervenções de enfermagem constantes na Nomenclatura. Conclusão: O estudo mostrou a eficácia da Nomenclatura na Clínica Pediátrica do HULW/UFPB, por meio da validação de conteúdo e da validação clínica dos diagnósticos de enfermagem constantes, aprimorando o cuidar, permitindo a realização de uma assistência de qualidade.

Il est généralement reconnu, par la communauté́ scientifique, que le risque de morbidité́ augmente lors des vagues de chaleur. On retrouve néanmoins des différences importantes en ce qui a trait à la vulnérabilité́ des populations au stress thermique. L'effet de la température sur la morbidité́ diffère selon plusieurs facteurs, dont l’âge. Pour des raisons physiologiques et comportementales, les enfants sont l’un des groupes les plus vulnérables aux vagues de chaleur (Hutter et al., 2007; Thompson et al., 2012). La présente étude vise à analyser l’influence de la vulnérabilité́ différentielle face aux problèmes de santé chez les enfants lors des vagues de chaleur à Ouagadougou. L’analyse de la vulnérabilité́ aux risques environnementaux rend compte des conditions de fragilité́ des individus pouvant mener à des expériences de souffrance et de dépendance à autrui. Ceci influence conséquemment la capacité à faire face aux catastrophes et à se rétablir (Becerra, 2012; Muttarak et al., 2015). Les données utilisées ont été́ recueillies par l’Observatoire de Population de Ouagadougou (OPO) de mars à mai 2017 lors d’une enquête sur la vulnérabilité́ et la capacité d'adaptation de la population de l'OPO aux vagues de chaleur. Ces données transversales regroupent un sous-échantillon aléatoire de 332 enfants de cinq ans et moins, habitant dans cinq quartiers de la périphérie nord de Ouagadougou. Nous les analysons tout d’abord à l’aide de tableaux croisés, de tests de chi-2 et d’une analyse factorielle. Des régressions logistiques ordinales permettent ensuite d’étudier la force et la significativité des associations entre la prévalence des symptômes lors des vagues de chaleur et les variables associées à la vulnérabilité climatique. L’analyse permet de relever des associations inattendues entre la prévalence de certains symptômes chez l’enfant lors des vagues de chaleur et plusieurs variables indépendantes. Par exemple, lorsque nous étudions les effets bruts des variables indépendantes sur la variable dépendante, nous constatons que les enfants dont la mère n’a pas tendance à apporter de l’aide supplémentaire aux très jeunes enfants lors des périodes de très forte chaleur sont plus susceptibles de ne pas présenter de symptôme(s) que de présenter des symptômes (OR = 0,60* (0,36 ; 1,01), à la limite du significatif de 10%), comparativement aux enfants ayant une mère apportant de l’aide supplémentaire. Nous notons également que les enfants dont le toit de chambre est isolé ou construit avec du ciment / béton (dalle) sont plus susceptibles de manifester des symptômes lors des vagues de chaleur que de ne pas en manifester (OR = 1,68* (0,97 ; 2,91), à la limite du significatif de 10%), en comparaison aux enfants dont le toit de chambre est fait de tôle galvanisée / métal / fer-blanc / zinc. Néanmoins, ces résultats sont très faiblement significatifs (seuil de 10%) à partir d’un échantillon de petite taille. Ainsi, le fait que les résultats sont à la limite du significatif à 10% nous amène à interpréter de manière prudente l’existence des liens entre ces variables. Dans l’explication de ces résultats, nous soupçonnons la présence de biais dans l’auto-déclaration des symptômes. Les limites des données incluent l’auto-déclaration des symptômes, la petite taille de l’échantillon, la nature transversale des données ainsi que la présence de biais de rappel liée aux problèmes de mémoire. Compte tenu de ces limites méthodologiques, il serait nécessaire de confirmer les résultats obtenus dans de futures recherches. Néanmoins, ces résultats pourront contribuer à orienter de futures recherches sur l’effet des vagues de chaleur chez les enfants au Sahel. / It is generally recognized by the scientific community that the risk of morbidity increases during heatwaves. However, there are important differences in regard to the vulnerability of populations to increased temperatures. The effect of temperature on morbidity differs depending on several factors, including age. Children are one of the most vulnerable groups when it comes to heatwaves due to physiological and behavioral reasons (Hutter et al., 2007; Thompson et al., 2012). This study aims to analyze the influence of differential vulnerability on children’s health during heatwaves in Ouagadougou. The analysis of vulnerability on environmental risks takes into account the fragile conditions of individuals that can lead to experiences of suffering and dependence on others. Consequently, it influences the capacity to cope with and recover from disasters (Becerra, 2012; Muttarak et al., 2015). The data used were collected by the Ouagadougou Population Observatory (OPO) from March to May 2017 during a survey on the vulnerability and adaptability of the OPO population to heatwaves. The cross-sectional data brings together a random subsample of 332 children aged five and under, living in five neighborhoods in the northern outskirts of Ouagadougou. We first analyze them using crosstabs, chi-2 tests and factor analysis. Ordinal logistic regressions are then performed to study the strength and significance of the associations between the prevalence of symptoms during heatwaves and the variables associated with climatic vulnerability. Descriptive analysis reveals unexpected associations between the prevalence of certain symptoms in children during heatwaves and several independent variables. An in-depth analysis carried out with the use of ordinal logistic regressions shows that the results do not support our initial hypotheses. For example, when we study the gross effects of the independent variables on the dependent variable, we found that children with mothers who do not tend to provide extra help to very young children during intense periods of heat are more likely to be symptom-free than to have symptoms (OR = 0.60 * (0,36 ; 1,01), at the significant limit of 10%), compared to children with mothers who provide extra help. We also note that children whose room roof is insulated or built with cement / concrete (slab) are more likely to show symptoms during heat waves than to not show symptoms (OR = 1.68 * (0,97 ; 2,91), at the significant limit of 10%), compared to children whose room roof is made of galvanized sheet metal / metal / tinplate / zinc. Nevertheless, these results are very weakly significant (10% threshold) from a small sample size. Thus, the fact that the results are at the limit of significance at 10% leads us to interpret the existence of links between these variables cautiously. In an attempt to explain these results, we suspect that there is a bias in the self-reported symptoms. Data limitations include self-reporting of symptoms, small sample size, the cross-sectional nature of the data, and the presence of recall bias related to memory problems. Given these methodological limitations, it would be necessary to confirm our results with those obtained in future research. However, the results obtained may help guide future research about the effect of heatwaves on children’s health in Sahel.