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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Acur?cia das caracter?sticas definidoras do diagn?stico de enfermagem baixa autoestima situacional em estomizados

Melo, Marjorie Dantas Medeiros 02 December 2016 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T22:18:32Z No. of bitstreams: 1 MarjorieDantasMedeirosMelo_DISSERT.pdf: 1107340 bytes, checksum: 834ffe4c8c6f2767bad0c75f77b373a6 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-23T21:46:38Z (GMT) No. of bitstreams: 1 MarjorieDantasMedeirosMelo_DISSERT.pdf: 1107340 bytes, checksum: 834ffe4c8c6f2767bad0c75f77b373a6 (MD5) / Made available in DSpace on 2017-03-23T21:46:38Z (GMT). No. of bitstreams: 1 MarjorieDantasMedeirosMelo_DISSERT.pdf: 1107340 bytes, checksum: 834ffe4c8c6f2767bad0c75f77b373a6 (MD5) Previous issue date: 2016-12-02 / Pacientes estomizados t?m sua perspectiva de vida alterada, principalmente pela imagem corporal negativa, devido ? presen?a do estoma associado ? bolsa coletora, aos padr?es de elimina??o alterados, as modifica??es nos h?bitos alimentares e de higiene, resultando muitas vezes, em autoestima diminu?da, sexualidade comprometida e at? em isolamento social. Tendo em vista, as dificuldades e complica??es apontadas, ainda que de forma sucinta, percebe-se que as pessoas com estomias necessitam prioritariamente serem estimuladas para o desenvolvimento da autoestima, e os profissionais de enfermagem por meio do processo de estabelecimento de diagn?sticos acurados s?o essenciais para uma assist?ncia integral. Estudo transversal e descritivo, com o objetivo de analisar a acur?cia das caracter?sticas definidoras do diagn?stico de enfermagem ?Baixa autoestima situacional? em pessoas estomizadas cadastradas no Centro de Reabilita??o de adultos do Rio Grande do Norte ? CERHRN. Realizou-se a coleta de dados entre os meses de janeiro a mar?o de 2015, mediante a utiliza??o de dois instrumentos: um deles composto por quest?es referentes a aspectos sociodemogr?ficos e cl?nicos dos pacientes, caracter?sticas do estoma e do efluente e suas complica??es, e um instrumento com base na NANDA-I e na Escala de autoestima de Rosenberg (RSES). O processo de amostragem foi determinado por conveni?ncia, resultando em um total de 90 estomizados. Para inferir sobre a presen?a ou a aus?ncia do diagn?stico de enfermagem em estudo, assim como de suas caracter?sticas definidoras, procedeu-se a etapa de infer?ncia diagn?stica, com a participa??o de ju?zes. A pesquisa obteve parecer favor?vel mediante o processo n? 421.342 CEP-HM Na caracteriza??o sociodemogr?fica, houve predomin?ncia do sexo masculino (62,2%), com faixa et?ria a partir de 50 anos (58,9%), de cor parda (50%), com companheiro (58,9%), aposentados (46,7%), com escolaridade at? o ensino fundamental (71,1%), cat?licos (65,6%) e com renda superior a um sal?rio m?nimo (66,7%). Com rela??o aos aspectos cl?nicos e do estoma houve predom?nio de estomizados sem comorbidades (54,4%), colostomizados (80%), com perman?ncia definitiva (63,3%) como principal causa da confec??o do estoma a neoplasia (60%), que fizeram tratamento quimioter?pico (50%), com 25 meses de estomia ou mais (53,3%). Com rela??o ?s vari?veis sociodemogr?ficas, observou-se associa??o da autoestima com a escolaridade (p=0,007). O diagn?stico de enfermagem Baixa autoestima situacional estava presente em (23,3%) da amostra. Dentre as caracter?sticas definidoras prevalentes destacaram-se: verbaliza??es autonegativas (33,3%), comportamento indeciso (28,8%) e comportamento n?o assertivo (26,1%). As caracter?sticas definidoras que apresentaram maiores raz?es de preval?ncia foram express?es de sentimento de inutilidade, relata verbalmente desafio situacional atual ao seu pr?prio valor e avalia??o de si mesmo como incapaz de lidar com situa??es ou eventos. As caracter?sticas com maior sensibilidade foram comportamento indeciso e express?es de sentimento de inutilidade e as mais espec?ficas foram relata verbalmente desafio situacional ao seu pr?prio valor, express?es de sentimento de inutilidade, avalia??o de si mesmo como incapaz de lidar com situa??es e eventos, express?es de desemparo. Conclui-se que a identifica??o das caracter?sticas definidoras mais sens?veis e especificas, permite predizer a real presen?a ou aus?ncia do diagn?stico Baixa Autoestima Situacional, auxiliando na assist?ncia de enfermagem a popula??o dos estomizados. / Stomatal patients have their life prospects altered, mainly by negative body image, due to the presence of the stoma associated with the collection bag, altered patterns of elimination, changes in eating and hygiene habits, often resulting in decreased self-esteem, compromised sexuality And even in social isolation. In view of the difficulties and complications pointed out, however succinctly, it is perceived that people with stomies need to be stimulated for the development of self-esteem, and nursing professionals through the process of establishing accurate diagnoses are essential For comprehensive assistance. A cross - sectional study and descriptive approach, aiming at analyzing the accuracy of the defining characteristics of the nursing diagnosis "Low situational self - esteem" in stomized persons enrolled in the Adult Rehabilitation Center of Rio Grande do Norte - CERHRN. Data collection was carried out between January and March 2015, using two instruments: one of them consisting of sociodemographic and clinical aspects of the patients, characteristics of the stoma and effluent, and their complications and characteristics. Self-care, and an instrument based on NANDA-I and the Rosenberg Self-Esteem Scale (RSES). The sampling process was determined by convenience, resulting in a total of 90 stomatal. In order to infer about the presence or absence of the nursing diagnosis under study, as well as its defining characteristics, a diagnostic inference step was performed, with the participation of judges. In the socio-demographic characterization, there was a predominance of males (62.2%), aged 50 years and over (58.9%), brown (50% ), With a partner (58.9%), retired (46.7%), with primary schooling (71.1%), Catholic (65.6%) and income higher than a minimum wage (66, 7%). With respect to the clinical and stomatal aspects, there was a predominance of stomates without comorbidities (54.4%), colostomized (80%), with definitive permanence (63.3%) as the main cause of the stoma to neoplasia (60%), Who underwent chemotherapy (50%), with 25 months of estomy or more (53.3%). Regarding sociodemographic variables, we observed an association between self-esteem and schooling (p = 0.007). The nursing diagnosis Low situational self-esteem was present in (23.3%) of the sample. Among the prevalent defining characteristics were: self-negative verbalizations (33.3%), undecided behavior (28.8%) and non-assertive behavior (26.1%). The defining characteristics that presented the highest prevalence reasons were expressions of feeling of worthlessness, verbally reporting current situational challenge to their own value, and evaluating themselves as unable to cope with situations or events. The most sensitive characteristics were undecided behavior and expressions of feeling of worthlessness and the most specific were verbally reports situational challenge to their own value, expressions of feeling of worthlessness, self-evaluation as unable to cope with situations and events, expressions of unpair . It is concluded that the identification of the most sensitive and specific defining characteristics, allows predicting the real presence or absence of the diagnosis Low Situational Self-esteem, assisting nursing care to the population of the stomates.
2

Proposi??o do diagn?stico de enfermagem atraso no desenvolvimento: an?lise de conte?do e valida??o cl?nica

Nogueira, Isadora Lorenna Alves 18 December 2017 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T11:46:48Z No. of bitstreams: 1 IsadoraLorennaAlvesNogueira_DISSERT.pdf: 18928182 bytes, checksum: c08f30bcc26ce20b954f6132dbfabc74 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-16T15:02:33Z (GMT) No. of bitstreams: 1 IsadoraLorennaAlvesNogueira_DISSERT.pdf: 18928182 bytes, checksum: c08f30bcc26ce20b954f6132dbfabc74 (MD5) / Made available in DSpace on 2018-02-16T15:02:33Z (GMT). No. of bitstreams: 1 IsadoraLorennaAlvesNogueira_DISSERT.pdf: 18928182 bytes, checksum: c08f30bcc26ce20b954f6132dbfabc74 (MD5) Previous issue date: 2017-12-18 / O objetivo do estudo ? analisar o conte?do e as medidas de acur?cia da proposi??o diagn?stica de enfermagem Atraso no desenvolvimento em adolescentes no ?mbito escolar. O cuidado ? sa?de do adolescente ? um grande desafio, devido ?s in?meras mudan?as ocorridas na adolesc?ncia. Faz-se necess?rio uma assist?ncia direcionada ?s peculiaridades dessa idade mediante avalia??o do desenvolvimento. Para os enfermeiros, pode ser operacionalizada pelo processo de enfermagem, por meio do racioc?nio cl?nico adequado a essa condi??o. Nessa perspectiva, trata-se de um estudo metodol?gico direcionado por duas etapas: an?lise de conte?do e valida??o cl?nica. A primeira etapa foi desenvolvida com nove especialistas, entre janeiro e fevereiro de 2017, os quais avaliaram, por meio do grupo focal, os componentes do referido diagn?stico. Na segunda etapa, foram identificados os indicadores cl?nicos com melhor acur?cia para o Atraso no desenvolvimento. A amostra foi composta por estudantes adolescentes das escolas estaduais do munic?pio de Natal/RN, distribu?das nas quatro zonas - norte, sul, leste e oeste, incluindo 385 alunos de oito institui??es estaduais (duas escolas de cada zona). Realizou-se a coleta de dados nos meses de julho a setembro de 2017, incluindo o pr?-teste do instrumento de coleta de dados, realizado em duas institui??es, com 10% da amostra prevista (39 alunos). A estat?stica dos dados foi realizada no IBM SPSS Statistic vers?o 20.0 for Windows resultando em porcentagens absolutas e relativas para vari?veis categ?ricas, e em medidas central e dispers?o para vari?veis num?ricas, com normalidade constatada pelo teste de Kolmogorov-Smirnov (p<0,05). A associa??o estat?stica dos fatores relacionados baseou-se nos testes de Fisher e Qui-quadrado. A acur?cia dos indicadores cl?nicos foi verificada por medidas de sensibilidade e especificidade com constru??o do modelo de classe latente. O estudo foi aprovado pelo Comit? de ?tica em pesquisa da institui??o respons?vel, sob parecer 1.662.528 e Certificado de Apresenta??o para Aprecia??o ?tica 57945016.4.0000.5537. Os resultados da an?lise de conte?do evidenciaram que o quantitativo de fatores relacionados do Atraso no desenvolvimento passou de 16 termos para 18, devido ? realoca??o do ?Transtorno do d?ficit de aten??o e hiperatividade? e inser??o de ?Trauma psicol?gico? para compor os antecedentes. Os indicadores cl?nicos passaram de 14 termos para 12, por exclus?o do ?Transtorno de d?ficit de aten??o e hiperatividade? e ?Dificuldade de expressar emo??es?. Relativo aos resultados da valida??o cl?nica encontrouse uma preval?ncia do Atraso no desenvolvimento de 18,26%. Identificou-se que todos os indicadores cl?nicos analisados no estudo eram espec?ficos ? proposi??o diagn?stica estudada, entretanto, nenhuma se mostrou sens?vel. Conclui-se que o diagn?stico proposto foi validado pelos especialistas, bem como esteve presente em adolescentes no ?mbito escolar. Espera-se, assim, contribuir para o fortalecimento da pol?tica p?blica voltada ? sa?de do adolescente, o racioc?nio cl?nico dos enfermeiros e a inser??o do diagn?stico de enfermagem ?Atraso no desenvolvimento? na taxonomia da NANDA Internacional. / The objective of the study is to analyze the content and accuracy measures of the diagnostic proposal of nursing Delay in the development in adolescents in the school environment. Adolescent health care is a major challenge due to the many changes that occurred in adolescence. It is necessary to focus on the peculiarities of this age through evaluation of development. For nurses, it can be operationalized by the nursing process, through the appropriate clinical reasoning for this condition. In this perspective, it is a methodological study directed by two stages: content analysis and clinical validation. The first stage was developed with nine specialists, between January and February of 2017, who evaluated, through the focus group, the components of this diagnosis. In the second stage, the clinical indicators with the best accuracy for Developmental Delay were identified. The sample consisted of teenagers from the state schools of Natal / RN, distributed in the four zones - north, south, east and west, including 385 students from eight state institutions (two schools from each area). Data were collected from July to September 2017, including the pre-test of the data collection instrument, performed in two institutions, with 10% of the expected sample (39 students). The statistical data was performed in IBM SPSS Statistic version 20.0 for Windows resulting in absolute and relative percentages for categorical variables, and in central measures and dispersion for numerical variables, with normality verified by the Kolmogorov-Smirnov test (p <0.05) . The statistical association of the related factors was based on Fisher's and Chi-square tests. The accuracy of the clinical indicators was verified by measures of sensitivity and specificity with latent class model construction. The study was approved by the Research Ethics Committee of the responsible institution, under opinion 1,662,528 and Certificate of Presentation for Ethical Appraisal 57945016.4.0000.5537. The results of the content analysis showed that the number of factors related to developmental delay increased from 16 terms to 18 due to the reallocation of attention deficit hyperactivity disorder and insertion of psychological trauma to compose the antecedents. Clinical indicators went from 14 terms to 12, by exclusion of "Attention Deficit Hyperactivity Disorder" and "Difficulty of Expressing Emotions". Regarding the results of clinical validation, a prevalence of Delay in the development of 18.26% was found. It was identified that all the clinical indicators analyzed in the study were specific to the diagnostic proposal studied, however, none were sensitive. It is concluded that the proposed diagnosis was validated by the specialists, as well as was present in adolescents in the school environment. It is hoped, therefore, to contribute to the strengthening of the public policy focused on adolescent health, the clinical reasoning of nurses and the insertion of the nursing diagnosis "Delay in development" in NANDA International taxonomy.
3

Proposi??o diagn?stica para o atraso no crescimento em adolescentes escolares: an?lise de conte?do e valida??o cl?nica

L?cio, Kadyjina Daiane Batista 18 December 2017 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T11:46:48Z No. of bitstreams: 1 KadyjinaDaianeBatistaLucio_DISSERT.pdf: 3355186 bytes, checksum: b009255aa6f89969fd6a17f2a45217f4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-16T15:10:23Z (GMT) No. of bitstreams: 1 KadyjinaDaianeBatistaLucio_DISSERT.pdf: 3355186 bytes, checksum: b009255aa6f89969fd6a17f2a45217f4 (MD5) / Made available in DSpace on 2018-02-16T15:10:23Z (GMT). No. of bitstreams: 1 KadyjinaDaianeBatistaLucio_DISSERT.pdf: 3355186 bytes, checksum: b009255aa6f89969fd6a17f2a45217f4 (MD5) Previous issue date: 2017-12-18 / O termo crescimento ? muitas vezes compreendido, conceitualmente, como sin?nimo de desenvolvimento. Apesar de correlatos, esses s?o fen?menos distintos. O crescimento ? um acontecimento biol?gico complexo, determinado geneticamente e modulado por fatores extr?nsecos. No per?odo da adolesc?ncia, o ser humano viv?ncia uma s?rie de altera??es, dentre elas seu segundo surto de crescimento. Diante da necessidade de clarificar esse termo e analisar os fatores influenciadores e as caracter?sticas do atraso no crescimento durante a adolesc?ncia, o presente estudo tem como objetivo analisar o conte?do e as medidas de acur?cia da proposi??o diagn?stica de enfermagem Atraso no crescimento em adolescentes escolares. Trata-se de um estudo metodol?gico, desenvolvido em duas etapas, a saber: an?lise de conte?do e valida??o cl?nica. Na primeira etapa, foram analisados os componentes e defini??es da proposi??o diagn?stica, por meio do grupo focal, com nove enfermeiras. Ocorreram tr?s encontros, nos meses de janeiro a fevereiro de 2017. A segunda etapa avaliou, na pr?tica cl?nica, as caracter?sticas definidoras mais acuradas para a proposi??o diagn?stica. Participaram 385 adolescentes de oito escolas estaduais, localizadas no munic?pio de Natal-RN. Para an?lise dos dados, foi utilizada a estat?stica descritiva e inferencial. Na an?lise descritiva, utilizou-se as medidas de tend?ncia central e de dispers?o. Na inferencial, a mensura??o das medidas de acur?cia ocorreu por meio da an?lise de classe latente, sendo obtidos valores de especificidade e sensibilidade. O projeto de pesquisa foi aprovado pelo Comit? de ?tica em Pesquisa, sob o n?mero 1.713.820. Os achados referentes ? primeira etapa resultaram em oito fatores relacionados a proposi??o atraso no crescimento e sete caracter?sticas definidoras. Como defini??o para a proposi??o diagn?stica, adotou-se: Crescimento abaixo do esperado para indiv?duos, de mesmo sexo, na faixa et?ria de 10 aos 19 anos. A preval?ncia do diagn?stico proposto foi de 1,3% na clientela investigada. As caracter?sticas definidoras com maior sensibilidade foram Velocidade de crescimento abaixo do esperado e Baixa estatura por idade. Os espec?ficos foram: Baixo peso por idade, Velocidade de crescimento abaixo do esperado, Estatura final inferior ao alvo gen?tico e matura??o sexual retardada. Conclui-se que a proposi??o diagn?stica atraso no crescimento foi analisada pelos especialistas e validada na cl?nica. Acredita-se que essa valida??o contribuiu para o avan?o do conhecimento da enfermagem ao fornecer um conjunto de caracter?sticas que auxiliam o enfermeiro na detec??o do atraso no crescimento em adolescentes escolares. Outrossim, permite ao profissional a aproxima??o das terminologias espec?ficas da profiss?o, a partir de elementos acurados para a sua pr?tica cl?nica. / The term growth is often understood, conceptually, as synonymous with development. Although correlates, these are different phenomena. Growth is a complex biological event, genetically determined and modulated by extrinsic factors. In adolescence, the human being experiences a series of alterations, among them his second growth spurt. Given the need to clarify this term and to analyze the factors influencing and the characteristics of growth retardation during adolescence, the present study aims to analyze the content and accuracy measures of the nursing diagnosis Delay in growth in school adolescents. It is a methodological study, developed in two stages, namely: content analysis and clinical validation. In the first stage, the components and definitions of the diagnostic proposal were analyzed, through the focal group, with nine nurses. Three meetings took place from January to February 2017. The second stage evaluated, in clinical practice, the most accurate defining characteristics for the diagnostic proposition. A total of 385 adolescents from eight state schools, located in the city of Natal-RN, participated. To analyze the data, descriptive and inferential statistics were used. In the descriptive analysis, the measures of central tendency and dispersion were used. In the inferential, the measurement of the accuracy measurements occurred through the latent class analysis, obtaining values of specificity and sensitivity. The research project was approved by the Research Ethics Committee under number 1,713,820. The findings related to the first stage resulted in eight factors related to the delayed growth proposition and seven defining characteristics. As a definition for the diagnostic proposition, we adopted: Growth below that expected for individuals of the same sex, in the age group from 10 to 19 years. The prevalence of the proposed diagnosis was 1.3% in the clientele investigated. The defining characteristics with greater sensitivity were growth velocity below the expected and Low stature by age. The specifics were: Low weight for age, Lower than expected growth velocity, Final height below the genetic target and delayed sexual maturation. It is concluded that the diagnostic proposition delayed growth was analyzed by the specialists and validated in the clinic. It is believed that this validation contributed to the advancement of nursing knowledge by providing a set of characteristics that help the nurse in the detection of growth retardation in school adolescents. In addition, it allows the professional to approach the specific terminologies of the profession, from elements that are accurate to their clinical practice.
4

Mapeamento cruzado dos t?tulos de diagn?sticos de enfermagem formulados segundo a CIPE? versus diagn?sticos da NANDA Internacional para pessoas vivendo com AIDS / Cross mapping of titles of nursing diagnoses formulated by ICNP? versus NANDA International diagnostics for people living with AIDS

Rocha, Cintia Capistrano Teixeira 06 December 2017 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T18:10:15Z No. of bitstreams: 1 CintiaCapistranoTeixeiraRocha_DISSERT.pdf: 2404367 bytes, checksum: 4d8cdfa4123750b944aee44c5980cfff (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-15T20:22:27Z (GMT) No. of bitstreams: 1 CintiaCapistranoTeixeiraRocha_DISSERT.pdf: 2404367 bytes, checksum: 4d8cdfa4123750b944aee44c5980cfff (MD5) / Made available in DSpace on 2018-03-15T20:22:27Z (GMT). No. of bitstreams: 1 CintiaCapistranoTeixeiraRocha_DISSERT.pdf: 2404367 bytes, checksum: 4d8cdfa4123750b944aee44c5980cfff (MD5) Previous issue date: 2017-12-06 / Tratar-se de um estudo transversal, com o objetivo de realizar o mapeamento cruzado dos t?tulos de diagn?sticos de enfermagem (DE) de pessoas vivendo com Aids formulados segundo a Classifica??o Internacional para a Pr?tica de Enfermagem (CIPE?) com os diagn?sticos da NANDA Internacional (NANDA-I), bem como classificar os t?tulos mapeados de acordo com a teoria das Necessidades Humanas B?sicas (NHB) de Horta com seguinte valida??o de conte?do do produto do mapeamento. Os t?tulos de diagn?sticos para pessoas vivendo com Aids da CIPE? e NANDA-I foram tabulados no programa Microsoft Excel (Office 2013) e elaboradas duas listas, em que os t?tulos de diagn?sticos de enfermagem foram comparados entre os sistemas de classifica??o, juntamente com suas, respectivas defini??es operacionais/conceito, em t?tulos constantes e n?o constantes. Em seguida, os t?tulos n?o constantes foram submetidos a an?lise utilizando os crit?rios advindos de Leal, sendo classificados como: similar, mais abrangente, mais restrito, n?o existe concord?ncia. Os produtos do mapeamento foram submetidos ? valida??o de conte?do. Para tanto, foi considerado o ?ndice de concord?ncia igual ou maior que 0,80 entre os especialistas. Selecionaram-se especialistas no sistema de classifica??o CIPE? no Centro CIPE, localizado em Jo?o Pessoa/PB; e no sistema de classifica??o NANDA-I utilizou-se a ferramenta de busca da Plataforma Lattes do portal do Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq). O projeto foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte mediante o Parecer n? 1.963.581 e certificado de apresenta??o para aprecia??o ?tica n?47380915.2.0000.5537. Foram encontrados 135 diagn?sticos de enfermagem, destes 84 do sistema de classifica??o CIPE? e 51 da NANDA-I. Ap?s realizar-se o mapeamento cruzado 81% dos DE CIPE? n?o contantantes na NANDA-I, enquanto 19% foram constantes. Dos 81% n?o constantes, foram classificados em: 27% similar, 12% mais restrito, 7% mais abrangente, 1% n?o existe concord?ncia e 58% n?o foi encontrado DE NANDA-I correspondente. Os DE foram classificados segundo as NHB, encontrou-se, respectivamente, para as classifica??es CIPE? e NANDA-I: 74% e 80% nas necessidades psicobiol?gicas; 23% e 16% nas necessidades psicossociais; 3% e 4% na necessidade psicoespiritual. Diante do quantitativo de DE para pessoas vivendo com Aids segundo a CIPE?, superior aos da NANDA-I, percebeu-se uma maior liberdade para sua elabora??o, j? que se baseia na utiliza??o de termos para elabora??o de seus DE, al?m de tais termos estarem, predominantemente, associados a sinais e sintomas cl?nicos, o que permite uma aproxima??o maior dos diagn?sticos da pr?tica cl?nica. Quanto as NHB, houve o predom?nio de diagn?sticos voltados para as NHB psicobiol?gicas tanto utilizando a CIPE? quanto a NANDA-I. Tal fato est? relacionado a hegemonia ainda do modelo de sa?de biom?dico, voltado para o corpo, al?m de ser justificada, em parte, pela especificidade da clientela, em que diversas altera??es fisiol?gicas ocorrem com a patologia instalada. Verificou-se que o processo de racioc?nio cl?nico para a elabora??o dos t?tulos diagn?sticos de enfermagem utilizando ambas as classifica??es, levou a formula??o de DE com padr?es semelhantes quando somamos os contantes 16 com os n?o contantes, mas similares 18, resultanto em 41% dos DE. Tal fato demostrou que utilizando-se um racioc?nio cl?nico com acur?cia o enfermeiro pode fazer uso de ambas as classifica??es. O estudo torna-se importante por comparar a utiliza??o pr?tica das duas classifica??es de enfermagem mais utilizadas no mundo, auxiliando a tomada de decis?o dos enfermeiros embasada no conhecimento cient?fico em uma clientela t?o complexa e espec?fica, al?m de contribuir para o desenvolvimento da CIPE? e NANDA-I e, consequente, fortalecer o estado da arte da Enfermagem / This is a cross-sectional study with the objective of cross-mapping the titles of nursing diagnoses (ED) of people living with AIDS formulated according to the International Classification of Nursing Practice (CIPE?) with NANDA International diagnoses (NANDA-I), as well as to classify the mapped titles according to Horta's Basic Human Needs theory (NHB) with the following validation of the product content of the mapping. The CIPE? and NANDA-I diagnostics certificates for people living with AIDS were tabulated in the Microsoft Excel (Office 2013) program and two lists were drawn up, in which the nursing diagnosis titles were compared between the classification systems, along with their, respective operational definitions / concept, in constant and non-constant securities. Then, the non-constant securities were submitted to analysis using the criteria derived from Leal, being classified as: similar, more comprehensive, more restricted, there is no agreement. The mapping products were submitted to content validation. For this, the agreement index was equal to or greater than 0.80 among the specialists. Specialists in the CIPE? classification system were selected at the CIPE? Center, located in Jo?o Pessoa / PB; and in the NANDA-I classification system was used the search tool of the Lattes Platform of the portal of the National Council of Scientific and Technological Development (CNPq). The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte through Opinion No. 1,963,581 and presentation certificate for ethical assessment n?47380915.2.0000.5537. We found 135 nursing diagnoses, of these 84 of the CIPE? classification system and 51 of NANDA-I. After cross-mapping, 81% of CIPE? DE were non-accommodating in NANDA-I, while 19% were constant. Of the 81% that were not constant, they were classified in: 27% similar, 12% more restricted, 7% more comprehensive, 1% no agreement and 58% not found NANDA-I correspondent. Were DE classified according to NHB, they were, respectively, for the CIPE? and NANDA-I classifications: 74% and 80% Psychobiological needs; 23% and 16% Psychosocial needs; 3% and 4% Psychospiral needs. Given the amount of ED for people living with AIDS according to CIPE?, superior to those of NANDA-I, it was perceived a greater freedom for its elaboration, since it is based on the use of terms for elaboration of its DE, in addition to such terms are predominantly associated with clinical signs and symptoms, which allows a greater approximation of clinical practice diagnoses. As for NHBs, there was a predominance of diagnoses for psychobiological NHBs using both ICNP and NANDA-I. This fact is related to the hegemony still of the biomedical health model, directed to the body, besides being justified, in part, by the specificity of the clientele, in which several physiological changes occur with the installed pathology. It was verified that the clinical reasoning process for the elaboration of the nursing diagnostic titles using both classifications led to the formulation of ED with similar patterns when we added the 16 counters to the non-constant, but similar 19, resulting in 41% of the DE. This fact showed that using a clinical reasoning with accuracy, the nurse can make use of both classifications. The study is important because it compares the practical use of the two most used nursing classifications in the world, helping the decision-making of nurses based on scientific knowledge in such a complex and specific clientele, besides contributing to the development of ICNP and NANDA-I and, consequently, strengthen the state of the art of nursing.
5

Valida??o cl?nica do diagn?stico de enfermagem prote??o ineficaz em pacientes submetidos ? hemodi?lise

Tin?co, J?ssica Dantas de S? 24 November 2015 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-06T20:36:54Z No. of bitstreams: 1 JessicaDantasDeSaTinoco_DISSERT.pdf: 1164249 bytes, checksum: 3ee3bbb39005b1d8b42779f8bccd39fa (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-08T20:08:46Z (GMT) No. of bitstreams: 1 JessicaDantasDeSaTinoco_DISSERT.pdf: 1164249 bytes, checksum: 3ee3bbb39005b1d8b42779f8bccd39fa (MD5) / Made available in DSpace on 2016-06-08T20:08:46Z (GMT). No. of bitstreams: 1 JessicaDantasDeSaTinoco_DISSERT.pdf: 1164249 bytes, checksum: 3ee3bbb39005b1d8b42779f8bccd39fa (MD5) Previous issue date: 2015-11-24 / Estudo transversal de acur?cia diagn?stica, cujo objetivo foi validar clinicamente o diagn?stico de enfermagem Prote??o Ineficaz em pacientes submetidos ? hemodi?lise. Duzentos pacientes submetidos ? hemodi?lise em uma cl?nica no nordeste do Brasil foram selecionados por conveni?ncia, de forma consecutiva, durante os meses de mar?o e abril de 2015. Na coleta de dados, utilizou-se o prontu?rio e um instrumento estruturado de entrevista e exame f?sico. A acur?cia dos indicadores cl?nicos do diagn?stico Prote??o Ineficaz se deu a partir da an?lise de classe latente. Foram identificadas a preval?ncia do diagn?stico, os valores de sensibilidade e especificidade de cada indicador cl?nico investigado e os respectivos intervalos de confian?a de 95%. O estudo foi aprovado pelo comit? de ?tica em pesquisa, com parecer n?mero 387.837 e Certificado de Apresenta??o para Aprecia??o ?tica: 18486413.0.0000.5537. Os resultados indicam uma preval?ncia de 60,5% do diagn?stico Prote??o Ineficaz na clientela investigada. Os indicadores cl?nicos com maior sensibilidade ao diagn?stico Prote??o Ineficaz foram: Fadiga, Resposta mal adaptada ao estresse e Altera??o na coagula??o. Os espec?ficos foram: Fadiga, Febre, Aumento do n?mero de hospitaliza??es, Fraqueza, Acesso vascular infeccionado e Disfun??o do acesso vascular. Conclui-se que o diagn?stico estudado ? v?lido clinicamente para a clientela em hemodi?lise, pois a identifica??o do conjunto de indicadores cl?nicos acurados, por meio das medidas de sensibilidade e especificidade, permitiu a predi??o fidedigna do mesmo. Destaca-se o indicador Fadiga com melhores medidas de acur?cia para a ocorr?ncia do diagn?stico investigado. Ademais, os achados contribuem para a pr?tica cl?nica do enfermeiro, auxiliando no processo de infer?ncia diagn?stica e no plano de interven??es preciso e direcionado ? realidade do paciente em hemodi?lise. / Cross-sectional study of diagnostic accuracy, with purpose the clinical validation of the nursing diagnosis Ineffective Protection in patients undergoing hemodialysis. Two hundred patients undergoing hemodialysis at a clinic in northeastern Brazil were selected by convenience, consecutively, during the months of March and April 2015. In the data collection, we used the medical records and a structured instrument of interview and physical examination. The accuracy of the clinical indicators of diagnosis Ineffective Protection took from the latent class analysis. It was identified the prevalence of diagnosis, the sensitivity and specificity of each clinical indicator investigated and their confidence intervals of 95%. The ethics committee in research approved the study, with sound number 387 837 and Certificate Presentation to Ethics Assessment: 18486413.0.0000.5537. The results indicate a prevalence of 60.5% in the diagnosis Ineffective Protection investigated clientele. Clinical indicators with greater sensitivity to the diagnosis Ineffective Protection were: fatigue, maladaptive response to stress and coagulation alterations. Specific were: fatigue, fever, increase in the number of hospitalizations, weakness, vascular access dysfunction and infected vascular access. It concludes that the studied diagnosis is clinically valid for the clientele in hemodialysis, since the identification of the accuracy of set clinical indicators, by the measures of sensitivity and specificity, allows for the consistent prediction of the same. Noteworthy is the fatigue indicator with better accuracy measures for the occurrence of the investigated diagnosis. In addition, the findings contribute to the clinical nursing practice, assisting in diagnostic inference process and intervention plan precise and directed to the patient's reality in hemodialysis.
6

An?lise de conte?do e valida??o cl?nica do diagn?stico de enfermagem autocontrole ineficaz da sa?de

Paiva, Maria das Gra?as Mariano Nunes de 24 November 2015 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:23Z No. of bitstreams: 1 MariaDasGracasMarianoNunesDePaiva_DISSERT.pdf: 1617534 bytes, checksum: bdf20a4c5dfbaa77ee6485f3f947ad4d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T20:12:19Z (GMT) No. of bitstreams: 1 MariaDasGracasMarianoNunesDePaiva_DISSERT.pdf: 1617534 bytes, checksum: bdf20a4c5dfbaa77ee6485f3f947ad4d (MD5) / Made available in DSpace on 2016-06-28T20:12:19Z (GMT). No. of bitstreams: 1 MariaDasGracasMarianoNunesDePaiva_DISSERT.pdf: 1617534 bytes, checksum: bdf20a4c5dfbaa77ee6485f3f947ad4d (MD5) Previous issue date: 2015-11-24 / O objetivo do estudo ? analisar o conte?do e as medidas de acur?cia do diagn?stico de enfermagem Autocontrole Ineficaz da Sa?de em pacientes submetidos ? hemodi?lise. Estudo do tipo metodol?gico, desenvolvido em duas etapas, a saber: an?lise de conte?do por ju?zes e acur?cia dos indicadores cl?nicos. Na primeira etapa, 22 ju?zes avaliaram a defini??o e localiza??o do diagn?stico, indicadores cl?nicos e fatores etiol?gicos e suas defini??es conceituais e emp?ricas. Utilizou-se o teste binomial para avaliar a concord?ncia entre os ju?zes. Na segunda etapa, utilizou-se o modelo de classe latente para a infer?ncia diagn?stica. Pesquisa aprovada pelo Comit? de ?tica, sob o Parecer no 387.837 e CAAE 18486413.0.0000.5537. Os resultados mostram que os ju?zes avaliaram como pertinentes 12 indicadores cl?nicos e 22 fatores etiol?gicos. Propuseram altera??o da nomenclatura de cinco indicadores cl?nicos e seis fatores etiol?gicos e a transposi??o de um indicador cl?nico para fator etiol?gico e tr?s fatores etiol?gicos para indicadores cl?nicos. Nas defini??es conceituais e emp?ricas, os ju?zes julgaram como n?o pertinentes as defini??es conceitual e emp?rica de um indicador cl?nico e defini??es conceituais de dois fatores etiol?gicos e defini??es emp?ricas de quatro fatores etiol?gicos. Ainda, foram sugeridas altera??es nas defini??es conceitual e emp?rica de dois indicadores cl?nicos, nas defini??es conceituais de 12 fatores etiol?gicos e em defini??es emp?ricas de 11 fatores etiol?gicos. Os indicadores cl?nicos analisados na primeira etapa foram validados clinicamente em pacientes submetidos ? hemodi?lise. Os indicadores cl?nicos mais frequentes foram Altera??es de exames laboratoriais (100%) e Escolhas de vida di?ria ineficazes para atingir metas de sa?de (81%) e, tr?s fatores etiol?gicos apresentaram maior frequ?ncia, s?o eles: Fatores sociodemogr?ficos desfavor?veis (94,5%), Cren?as (79%) e Comorbidades (77,5%). A partir do Modelo de Classe Latente, foi estimada a preval?ncia do diagn?stico em 66,28%. Os indicadores cl?nicos que apresentaram as melhores medidas de acur?cia para a sensibilidade do diagn?stico de enfermagem Autocontrole Ineficaz da Sa?de foram: Escolhas de vida di?ria ineficazes para atingir metas de sa?de e Express?o de dificuldade com os regimes prescritos. Por sua vez, os indicadores cl?nicos Uso inadequado de medicamentos, N?o Express?o de desejo de controlar a doen?a, Comparecimento irregular ?s sess?es de di?lise e Infec??o foram mais espec?ficos quanto ao referido diagn?stico. N?o ades?o ao tratamento foi o ?nico indicador que apresentou intervalos de confian?a com signific?ncia para sensibilidade e especificidade. Deste modo, o indicador cl?nico N?o ades?o ao tratamento ? mais preciso e fidedigno quanto ? infer?ncia do diagn?stico de enfermagem Autocontrole Ineficaz da Sa?de na clientela hemodial?tica. Assim, acredita-se que o aprimoramento dos componentes do diagn?stico de enfermagem em quest?o, ir? contribuir para a elabora??o de interven??es de enfermagem mais fidedignas ao estado de sa?de do indiv?duo em hemodi?lise, proporcionando um cuidado mais qualificado cientificamente. / The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.
7

Constru??o do diagn?stico de enfermagem atraso do crescimento no contexto do adolescente

Andriola, Isadora Costa 08 August 2016 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-13T11:25:05Z No. of bitstreams: 1 IsadoraCostaAndriola_DISSERT.pdf: 1399307 bytes, checksum: 6e91128c1d756488d91078317b12f089 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-20T15:50:28Z (GMT) No. of bitstreams: 1 IsadoraCostaAndriola_DISSERT.pdf: 1399307 bytes, checksum: 6e91128c1d756488d91078317b12f089 (MD5) / Made available in DSpace on 2017-01-20T15:50:28Z (GMT). No. of bitstreams: 1 IsadoraCostaAndriola_DISSERT.pdf: 1399307 bytes, checksum: 6e91128c1d756488d91078317b12f089 (MD5) Previous issue date: 2016-08-08 / Estudo do tipo an?lise de conceito, cujo objetivo foi construir o diagn?stico de enfermagem Atraso do crescimento em adolescentes, a partir da literatura. A an?lise de conceito ocorreu segundo o modelo proposto por Walker e Avant, o qual se comp?e de oito etapas, a saber: sele??o do conceito; determina??o dos objetivos da an?lise conceitual; identifica??o dos poss?veis usos do conceito; determina??o dos atributos definidores; constru??o de um caso modelo; constru??o de casos adicionais; identifica??o dos antecedentes e consequentes; al?m dos referenciais emp?ricos. O conceito selecionado foi o atraso do crescimento em adolescentes e o objetivo da an?lise foi analisar o fen?meno atraso do crescimento em adolescentes, a fim de subsidiar a sua identifica??o na pr?tica cl?nica por parte do profissional enfermeiro. A fim de operacionalizar a an?lise, foi realizada uma revis?o integrativa da literatura, segundo Whittermore e Knafl. A revis?o ocorreu nas bases de dados: LILACS, PUBMED, CINAHL, SCOPUS, Web of Science, Science Direct, e no peri?dico Journal of Human Growth and Development. A partir da revis?o, obteve-se uma amostra final de 29 estudos para an?lise. Esses estudos foram analisados atrav?s de leitura minuciosa, com vistas ? identifica??o dos termos ou express?es que representassem a ess?ncia do conceito, seus atributos, antecedentes e consequentes. A proposta diagn?stica, a qual resultou da an?lise conceitual, apresentou a seguinte defini??o para o atraso do crescimento em adolescentes: crescimento abaixo do esperado para indiv?duos dos 10 aos 19 anos de mesmo sexo: estatura inferior ao 3? percentil ou d?ficit em estatura acima de 2 desvios-padr?o, que, associado ? velocidade de crescimento diminu?da, resulta na altura final inferior ao alvo gen?tico. Fatores relacionados: altera??es hormonais; desnutri??o cr?nica; doen?as cr?nicas; imunodefici?ncia/imunossupress?o; estresse f?sico prolongado; desordens do sistema nervoso central; e dist?rbios gen?ticos. Caracter?sticas definidoras: baixa estatura por idade; baixo peso por idade; matura??o sexual retardada; atraso no surto de crescimento puberal; velocidade de crescimento abaixo do esperado; estatura final inferior ao alvo gen?tico; e diminui??o da massa ?ssea. Constatou-se que, a partir da identifica??o dos atributos, antecedentes e consequentes, foi poss?vel uma melhor compreens?o do conceito atraso do crescimento em adolescentes. O entendimento desse fen?meno contribui para o avan?o no estado da arte da enfermagem, aperfei?oando a identifica??o do atraso do crescimento nessa clientela e contribuindo para o estabelecimento de planos terap?utico mais eficazes, com interven??es voltadas ?s necessidades prementes dessa clientela. / This study is typified as concept analysis, whose objective was to build the nursing diagnosis ?Growth delay? in adolescent context, based on literature. The concept analysis was performed in line with the model proposed by Walker and Avant, which is composed of eight steps, namely: concept analysis; determination of the objectives of the conceptual analysis; identification of possible uses of the concept; determination of the defining attributes; construction of a model case; construction of supplementary cases; identification of the backgrounds and consequences; besides the empirical benchmarks. The selected concept was the ?Growth delay? and the objective of the analysis was to analyze the phenomenon of growth delay in adolescent context, with the purpose of subsidizing its identification in clinical practice on the part of the nursing professional. In order to operationalize the analysis, we held an integrative literature review, according to Whittermore and Knafl. The review took place in the databases: LILACS, PUBMED, CINAHL, SCOPUS, Web of Science, Science Direct, as well as in the Journal of Human Growth and Development journal. From the review, we obtained a final sample of 29 studies to be analyzed. These studies were analyzed by means of thorough reading, with a view to identifying the terms or expressions that could represent the essence of the concept, its attributes, backgrounds and consequences. The diagnostic proposal, which resulted from the conceptual analysis, showed the following definition for the growth delay: below expected growth for individuals from 10 to 19 years of the same sex: height below the 3rd percentile or deficit in height above 2 standard deviations, which, associated with decreased growth velocity, results in the final height lower than the genetic target. The related factors were: hormonal changes; unfavorable environmental conditions; chronic malnutrition; chronic diseases; immunodeficiency/ immunosuppression; prolonged physical stress; central nervous system diseases; and genetic disorders. The defining characteristics were: low height for age; low weight for age; delayed pubertal growth spurt; below expected growth velocity; final height lower than the genetic target; and decreased bone mass. We found that, from the identification of attributes, backgrounds and consequences, it was possible to achieve a better understanding of the concept ?Growth delay? in adolescent context. The understanding of this phenomenon contributes to the advancement in the state of the art of nursing, thereby improving the identification of the delayed growth in these customers and contributing to the establishment of more effective therapeutic plans, with interventions aimed at their urgent needs.
8

An?lise dos fatores de risco do diagn?stico de enfermagem risco de infec??o em pacientes com c?ncer hospitalizados

Ara?jo, Aryele Rayana Antunes de 25 November 2016 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T22:18:31Z No. of bitstreams: 1 AryeleRayanaAntunesDeAraujo_DISSERT.pdf: 1394872 bytes, checksum: c3c3c35a81f56d9245ca54c8db612ecf (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-23T20:05:29Z (GMT) No. of bitstreams: 1 AryeleRayanaAntunesDeAraujo_DISSERT.pdf: 1394872 bytes, checksum: c3c3c35a81f56d9245ca54c8db612ecf (MD5) / Made available in DSpace on 2017-03-23T20:05:29Z (GMT). No. of bitstreams: 1 AryeleRayanaAntunesDeAraujo_DISSERT.pdf: 1394872 bytes, checksum: c3c3c35a81f56d9245ca54c8db612ecf (MD5) Previous issue date: 2016-11-25 / As Infec??es Relacionadas ? Assist?ncia ? Sa?de representam uma grave problem?tica de sa?de mundial. Relativo especificamente aos pacientes com c?ncer hospitalizados, estes possuem fatores relacionados ? doen?a, ao tratamento e ? interna??o que favorecem o desenvolvimento desses eventos. Assim, objetivou-se identificar os fatores de risco do Diagn?stico de Enfermagem Risco de Infec??o em pacientes com c?ncer hospitalizados notificados com Infec??o Relacionada ? Assist?ncia de Sa?de e acordo com a NANDA-I. Trata-se de um estudo documental quantitativo desenvolvido em um hospital refer?ncia em oncologia para pacientes do Sistema ?nico de Sa?de no estado do Rio Grande do Norte. Foram analisados os prontu?rios de pacientes com idade igual ou superior a 18 anos, de ambos os sexos, entre os anos de 2013 e 2014, os quais apresentaram infec??o associada ? assist?ncia de sa?de durante o per?odo de interna??o. A amostra totalizou 105 prontu?rios. A coleta de dados se deu entre os meses de novembro de 2015 a abril de 2016 por meio de um instrumento composto por vari?veis sociodemogr?ficas e de sa?de e os fatores de risco para infec??o. Foram realizadas an?lises explorat?rias amostrais por meio de distribui??es de frequ?ncias e medidas descritivas. As diferen?as entre as propor??es foram verificadas mediante aplica??o dos Testes Qui-quadrado de Pearson e o Teste Exato de Fisher e a Regress?o M?ltipla foi avaliada por meio do teste T de Student, todos com n?vel de signific?ncia de 5% (p valor ? 0,05). O estudo foi aprovado nos Comit?s de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte e da Liga Norte-rio-grandense contra o C?ncer, n? do CAAE 48374815.3.3001.5293. Quanto ? caracteriza??o da amostra, verificou-se maioria de adultos (54,3%), com m?dia de idade de 58,9 (?14,7), do sexo feminino (57,1%), com companheiro (51,4%), trabalhavam (34,3%), provenientes do interior do estado do Rio Grande do Norte (59,0%). Em rela??o ?s caracter?sticas cl?nicas, 64,8% dos pacientes estavam internados por uma cl?nica cir?rgica. As manifesta??es cl?nicas mais relatadas nos prontu?rios foram febre (43,8%), dor (33,3%) e constipa??o (26,7%). Os s?tios de infec??o mais presentes foram infec??o do s?tio cir?rgico (50,5%), infec??o do trato urin?rio (21,0%), e infec??o de corrente sangu?nea (19,0%). Referente aos fatores de risco do diagn?stico de enfermagem risco de infec??o, os mais prevalentes foram, respectivamente, procedimento invasivo (100,0%), pele rompida (93,3%) e peristaltismo inadequado (63,8%). Observou-se uma associa??o estatisticamente significante entre os fatores de risco pele rompida caracter?stica cir?rgica do paciente; e hemoglobinemia aos pacientes de condi??o n?o-cir?rgica com p-valor ? 0,05. Al?m disso, foi significativa a rela??o entre o tempo de interna??o e pertencentes a uma cl?nica n?o-cir?rgica e que realizaram cirurgia pr?via. / The infections regarding health care represents a serious problematic of global health. Especially when it involves patients with cancer that are hospitalized, they have factors pertaining the disease, treatment and hospitalization that boosts the development of these events. Therefore, the purpose was to analyze the risk factors of the Nursing?s infection risk diagnostic on patients with cancer that are hospitalized and with an infection related to health care and according to the North American Nursing Diagnosis-International. It is about a documentary and quantitative study developed inside a hospital that is reference on the field of oncology for patients of the Single Health System (SUS) in the state of Rio Grande do Norte. The handbooks of patients with age equal or above 18 years, of both gender, between the years of 2013 and 2014, which had showed infection associated with the health care during their hospitalization period were analyzed. Sample was composed with 105 handbooks. The data gathering happened between November of 2015, to April of 2016, using an instrument composed by sociodemographic and health variables and the risk factors for infection. Sample exploratory analysis were made using frequency distributions and descriptive measures. The differences between the proportions were verified upon the applications of the Chi ? Square test and Fisher?s Exact test and the Multiple regression was evaluated using Student?s T test, all of them with significance level of 5% (p value ? 0,05). The study was approved on the committees of Ethics in Research of Universidade Federal do Rio Grande do Norte and the Norte Riograndense League against cancer, n? of CAAE 48374815.3.3001.5293. Regarding the sample?s characterization, it was verified a majority of adults (54.3%), with average age of 58.9 (?14.7), female (57.1%), with a companion (51.4%), that used to work (34.3%), coming from the state?s countryside (59.0%). Regarding clinical characterization, 64.8% of the patients were hospitalized by a surgical clinic. The most reported clinical manifestations on the handbooks were fever (43.8%), pain (33.3%) and constipation (26.7%). Referring the risk factors of the Nursing?s infection risk diagnostic, the most prevailing were, respectively, invasive procedure (100.0%), disrupted skin (93.3%) and inadequate peristalsis (63.8%). One observes a statistically significant association between risk factors, disrupted skin, a patient?s surgical characteristic, and the presence of free hemoglobin on the blood on patients with a non ? surgical condition, with p-value ? 0.05. Furthermore, the hospitalization?s time evaluation and the patient being a woman was significant, belonging to a non ? surgical clinic and that made a previous surgery.
9

Diagn?sticos, resultados e interven??es da CIPE para pessoas vivendo com Aids / Diagnostics, results and ICNP? nursing intervention for people living with Aids

Souza Neto, Vinicius Lino de 30 November 2016 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T22:18:32Z No. of bitstreams: 1 ViniciusLinoDeSouzaNeto_DISSERT.pdf: 2625253 bytes, checksum: 51f4dae3b5763e1c40034327d9cec4d2 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-23T22:25:00Z (GMT) No. of bitstreams: 1 ViniciusLinoDeSouzaNeto_DISSERT.pdf: 2625253 bytes, checksum: 51f4dae3b5763e1c40034327d9cec4d2 (MD5) / Made available in DSpace on 2017-03-23T22:25:00Z (GMT). No. of bitstreams: 1 ViniciusLinoDeSouzaNeto_DISSERT.pdf: 2625253 bytes, checksum: 51f4dae3b5763e1c40034327d9cec4d2 (MD5) Previous issue date: 2016-11-30 / A S?ndrome da Imunodefici?ncia Adquirida perfaz um dos grandes desafios ? pesquisa, tratamento e interven??o cl?nica e social. Diante disto, o enfermeiro, enquanto membro da equipe de sa?de pode fazer uso de novas tecnologias e realinhar sua pr?tica, para que possa implementar a??es e interven??es seguras e de qualidade ?s pessoas vivendo com essa doen?a. Desse modo, a Sistematiza??o da Assist?ncia de Enfermagem, por meio de uma linguagem profissional unificada, contribui para a organiza??o do cuidado, direcionando as necessidades priorit?rias das pessoas vivendo com Aids, e respeitando o sistema de valores e cren?as morais do conhecimento t?cnico cientifico. Nesse sentido, o estudo teve como objetivos: identificar os fen?menos da Pr?tica de Enfermagem na avalia??o ? sa?de de pessoas vivendo com Aids; elaborar os Diagn?sticos, Resultados e Interven??es de Enfermagem com base na CIPE? vers?o 2013, direcionado pelos fen?menos da pr?tica; e validar diagn?sticos, resultados e interven??es de Enfermagem da CIPE?, por enfermeiros especialistas. Trata-se de um estudo transversal com abordagem quantitativa, desenvolvido em tr?s etapas: 1?: identifica??o dos fen?menos da pr?tica de enfermagem para pessoas vivendo com Aids; 2?: elabora??o dos diagn?sticos, resultados e interven??es de enfermagem; 3?: valida??o e an?lise estat?stica das afirmativas. O projeto foi submetido ao Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, obtendo-se aprova??o com o Certificado de Apresenta??o para Aprecia??o ?tica (CAAE) 47380915.2.0000.5537. Os dados foram analisados por meio da estat?stica descritiva e inferencial Para analisar o grau de concord?ncia dos enfermeiros especialistas adotou-se o ?ndice de Concord?ncia (IC> 0.80), ?ndice de Valida??o de Concord?ncia (IVC> 0.80) e o Teste Binominal (p<0,005). Como resultados, foram identificados 146 fen?menos da pr?tica de enfermagem para pessoas vivendo com Aids, elaborando-se 96 diagn?sticos e resultados, sem sinon?mia e 210 com grau de repeti??o. As afirmativas foram categorizadas conforme as necessidades humanas b?sicas, sendo 73 estavam ao eixo das necessidades psicobiol?gicas, por?m 35 foram validados IC> 0.80 (68,75%), IVC > 0.80 (55,42%), p<0,005(51,66%). No ?mbito das necessidades psicossociais elaborou-se 20 afirmativas e espirituais apenas tr?s, por?m 11 foram validadas IC> 0.80 (61,33%), IVC > 0.80 (59,37%), p<0,005(64,17%). Em rela??o ?s interven??es de enfermagem foram elaboradas 230 interven??es dos quais 191 obtiveram a valida??o pelos especialistas IC> 0.80 (50,17%), IVC > 0.80 (60,38%), p<0,005(49,35%). Conclui-se que a partir dos fen?menos da pr?tica foi poss?vel elaborar os diagn?sticos, resultados e interven??es de enfermagem da CIPE?. Assim, acredita-se que tais enunciados de diagn?sticos poder? contribuir para o cuidado as pessoas vivendo com Aids, possibilitando a utiliza??o de uma linguagem especial de enfermagem para essa clientela. / The Acquired Immunodeficiency Syndrome represents one of the great challenges to research, treatment and clinical and social intervention. In view of this, the nurse, as a member of the health team can make use of new technologies and realign their practice, so that it can implement actions and interventions safe and of quality to the people living with this disease. Thus, the Systematization of Nursing Care, through a unified professional language, contributes to the organization of care, directing the priority needs of people living with AIDS, and respecting the system of values and moral beliefs of scientific technical knowledge. In this sense, the study had as objectives: to identify the phenomena of Nursing Practice in the evaluation of the health of people living with AIDS; To elaborate the Nursing Diagnoses, Results and Interventions based on the CIPE? version 2013, guided by the phenomena of the practice; And to validate CIPE? Nursing diagnoses, results and interventions, by specialist nurses. This is a cross-sectional study with a quantitative approach, developed in three stages: 1?: identification of the phenomena of nursing practice for people living with AIDS; 2nd: elaboration of nursing diagnoses, results and interventions; 3?: validation and statistical analysis of the statements. The project was submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the Certificate of Presentation for Ethical Appraisal (CAAE) 47380915.2.0000.5537. Data were analyzed through descriptive and inferential statistics. The concordance index (CI> 0.80), the concordance validation index (IVC> 0.80) and the binomial test were used to analyze the degree of agreement among the specialist nurses (p < 0.005). As a result, 146 phenomena of nursing practice for people living with AIDS were identified, drawing 96 diagnoses and results, with no synonymy and 210 with repetition degree. The assumptions were categorized according to basic human needs, with 73 being at the heart of the psychobiological needs, but 35 were validated CI> 0.80 (68.75%), IVC> 0.80 (55.42%), p <0.005 (51.66 %). In terms of psychosocial needs, 20 affirmations and only three spiritual statements were elaborated, but 11 were validated CI> 0.80 (61.33%), IVC> 0.80 (59.37%), p <0.005 (64.17%). In relation to nursing interventions, 230 interventions were elaborated, of which 191 obtained validation by specialists IC> 0.80 (50.17%), IVC> 0.80 (60.38%), p <0.005 (49.35%). It is concluded that from the practical phenomena it was possible to elaborate the nursing diagnoses, results and interventions of CIPE?. Thus, it is believed that such statements of diagnosis may contribute to the care of people living with AIDS, making possible the use of a special nursing language for this clientele.
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Simula??o real?stica no processo de ensino-aprendizagem do racioc?nio diagn?stico de enfermagem

Rodrigues, Iellen Dantas Campos Verdes 24 March 2017 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-05-31T20:40:57Z No. of bitstreams: 1 IellenDantasCamposVerdesRodrigues_TESE.pdf: 1827378 bytes, checksum: 25fae1f5d938088d0c3ea5a5316c2c6f (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-06-01T19:58:51Z (GMT) No. of bitstreams: 1 IellenDantasCamposVerdesRodrigues_TESE.pdf: 1827378 bytes, checksum: 25fae1f5d938088d0c3ea5a5316c2c6f (MD5) / Made available in DSpace on 2017-06-01T19:58:51Z (GMT). No. of bitstreams: 1 IellenDantasCamposVerdesRodrigues_TESE.pdf: 1827378 bytes, checksum: 25fae1f5d938088d0c3ea5a5316c2c6f (MD5) Previous issue date: 2017-03-24 / O estudo objetivou avaliar a efic?cia da simula??o real?stica no processo de ensino-aprendizagem do racioc?nio diagn?stico de enfermagem. ? um estudo experimental, do tipo ensaio cl?nico controlado e randomizado (ECCR). Foi realizado no Departamento de Enfermagem da Universidade Federal do Rio Grande do Norte (UFRN), Campus Natal. A popula??o do estudo foi composta por enfermeiros na condi??o de especialistas para valida??o dos casos cl?nicos e diagn?sticos de enfermagem (DE) e graduandos de enfermagem da UFRN, que cursam o 9? per?odo do curso. A sele??o dos ju?zes foi realizada por meio de processo de amostragem proposital, em bola de neve e sequencial, dentre os membros do grupo de estudos do Centro CIPE? e de outros grupos de estudos de Universidades Federais que trabalham com a CIPE, sendo inclu?dos todos os especialistas que aceitaram participar do estudo, totalizando uma amostra de 6 especialistas. A amostra de estudantes foi composta por 24 discentes, alocados em dois grupos (controle e interven??o) pareados de forma aleat?ria conforme as vari?veis de controle: idade, sexo, experi?ncia cl?nica, ocupa??o, perfil do aluno e IRA. Os dados foram coletados no per?odo de mar?o de 2017. Ap?s valida??o dos casos cl?nicos e DE houve a realiza??o do curso ?Julgamento Cl?nico e Pensamento Cr?tico-Reflexivo: compet?ncias para o aprendizado do racioc?nio diagn?stico?, que foi desenvolvido em 5 etapas: aula te?rica expositiva-dialogada, cen?rio de simula??o 1, 2 e 3 e avalia??o do curso. A efic?cia da estrat?gia de simula??o foi avaliada mediante os o ?ndice de acerto dos DE priorit?rios elaborados nos dois grupos ap?s o pr? e p?s-testes, comparando-os com os diagn?sticos validados pelos especialistas. Os dados foram organizados em tabelas e analisados com base em frequ?ncias absolutas, em medidas de tend?ncia central e dispers?o, e testes de concord?ncia por meio do ?ndice de Validade de Conte?do (IVC) e Kappa. Para avaliar a independ?ncia das vari?veis do estudo foi utilizado o teste exato de Fisher. A pesquisa obteve anu?ncia do Comit? de ?tica em Pesquisa (CEP) da UFRN com CAAE: 64881617.5.0000.5537 Foram validados cinco diagn?sticos priorit?rios para o caso cl?nico 4 utilizado no pr? e p?s-teste: Processo do sistema imunol?gico prejudicado; Risco de D?ficit Nutricional; Atitude em rela??o ? condi??o de sa?de Prejudicada; Atitude em rela??o ao manejo da medica??o conflituosa; Continuidade do cuidado prejudicada. Al?m dos diagn?sticos priorit?rios 33 outros diagn?sticos foram validados como diagn?sticos de enfermagem n?o priorit?rios para o caso cl?nico apresentado. Quanto ? avalia??o da estrat?gia de simula??o para o ensino dos DE observou-se que n?o houve diferen?a estat?stica significativa na elabora??o dos DE no pr? e p?s-teste do grupo controle, o mesmo n?o obteve ?xito na elabora??o dos DE priorit?rios. No entanto, o grupo interven??o apresentou um resultado significativo na elabora??o dos diagn?sticos priorit?rios ap?s o p?s-teste e sobressaiu-se na elabora??o de outros DE tido como v?lidos para a situa??o cl?nica apresentada. Na avalia??o quanto ao grau de aproveitamento e benef?cios da estrat?gia, o tempo de dura??o dos cen?rios de simula??o foi apontado como insuficiente, embora tenha seguido o preconizado pelo referencial adotado no estudo, os demais itens avaliados foram considerados adequados com elevado ?ndice de concord?ncia. Desse modo, tem-se a simula??o como uma estrat?gia eficaz para o ensino-aprendizagem do racioc?nio diagn?stico de enfermagem. / The study aimed to evaluate the efficacy of realistic simulation in the teaching-learning process of the nursing diagnosis rationale. It is an experimental, randomized controlled trial (RCT). It was carried out at the Nursing Department of the Federal University of Rio Grande do Norte (UFRN), Campus Natal. The study population consisted of nurses as specialists for the validation of clinical cases and nursing diagnoses (DE) and undergraduate nursing students from the UFRN, who attend the 9 th period of the course. The selection of the judges was carried out by means of a purposive, snowball and sequential sampling process among the members of the CIPE? Study Group and other study groups from Federal Universities working with the CIPE, all of which were included The specialists who accepted to participate in the study, totaling a sample of 6 specialists. The sample of students was composed of 24 students, randomly matched in two groups (control and intervention) according to control variables: age, sex, clinical experience, occupation, student profile and ARI. The data were collected in the period of March 2017. After validation of the clinical cases and ED, the course "Clinical Judgment and Critical-Reflexive Thinking: competences for the learning of the diagnostic reasoning" was carried out, which was developed in 5 stages: theoretical lecture Expository-dialog, simulation scenario 1, 2 and 3 and course evaluation. The efficacy of the simulation strategy was evaluated by the correctness index of the priority SDs elaborated in the two groups after the pre and post-tests, comparing them with the diagnoses validated by the specialists. Data were organized into tables and analyzed based on absolute frequencies, measures of central tendency and dispersion, and concordance tests using the Content Validity Index (IVC) and Kappa. Fisher's exact test was used to assess the independence of the study variables. The research was approved by the Research Ethics Committee (CEP) of UFRN with CAAE: 64881617.5.0000.5537 Five priority diagnoses were validated for the clinical case 4 used in the pre- and post-test: Immune system process impaired; Risk of Nutritional Deficit; Attitude towards health condition Impaired; Attitude regarding the management of conflicting medication; Continuity of impaired care. In addition to the priority diagnoses 33 other diagnoses were validated as non-priority nursing diagnoses for the clinical case presented. Regarding the evaluation of the simulation strategy for the teaching of ED, it was observed that there was no significant statistical difference in the preparation of the DE in the pre- and post-test of the control group, it was not successful in the elaboration of the priority SDs. However, the intervention group presented a significant result in the elaboration of the priority diagnoses after the post-test and excelled in the elaboration of other EDs considered as valid for the presented clinical situation. In the evaluation of the degree of utilization and benefits of the strategy, the duration of the simulation scenarios was indicated as insufficient, although it was followed by the reference adopted in the study, the other items evaluated were considered adequate with a high agreement rate. Thus, we have simulation as an effective strategy for the teaching-learning of nursing diagnostic reasoning.

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