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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

Gravidade do olho seco em pacientes internados em unidade de terapia intensiva: an?lise de conceito e constru??o de defini??es / Dry eye severity in patients admitted to the Intensive care unit: concept analysis and build settings

Fernandes, Ana Paula Nunes de Lima 15 October 2015 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-06T20:36:54Z No. of bitstreams: 1 AnaPaulaNunesDeLimaFernandes_DISSERT.pdf: 1379064 bytes, checksum: a03ad37f1ddd78ddc22531d83f0a3c8c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-08T19:52:06Z (GMT) No. of bitstreams: 1 AnaPaulaNunesDeLimaFernandes_DISSERT.pdf: 1379064 bytes, checksum: a03ad37f1ddd78ddc22531d83f0a3c8c (MD5) / Made available in DSpace on 2016-06-08T19:52:06Z (GMT). No. of bitstreams: 1 AnaPaulaNunesDeLimaFernandes_DISSERT.pdf: 1379064 bytes, checksum: a03ad37f1ddd78ddc22531d83f0a3c8c (MD5) Previous issue date: 2015-10-15 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A S?ndrome do Olho Seco ? uma doen?a multifatorial do filme lacrimal, resultado da instabilidade da unidade funcional lacrimal que produz altera??o de volume, composi??o ou distribui??o da l?grima. Em pacientes internados em terapia intensiva a causa ? potencializada devido aos diversos fatores de risco, como ventila??o mec?nica, seda??o, lagoftalmia, baixas temperaturas, entre outros. O estudo tem por objeto a constru??o de um instrumento de avalia??o da Gravidade do Olho Seco em pacientes internados em unidades de terapia intensiva com base na Sistematiza??o da Assist?ncia de Enfermagem e seus sistemas de classifica??o. O objetivo geral deste estudo ? construir um instrumento de avalia??o da Gravidade do Olho Seco em pacientes internados em Unidade de Terapia Intensiva. Trata-se de um estudo metodol?gico realizado em tr?s etapas, a saber: an?lise de contexto, an?lise de conceito, constru??o das defini??es e magnitudes operacionais do resultado de enfermagem. Para a primeira etapa utilizou-se o referencial metodol?gico de Hinds, Chaves e Cypress (1992). Para a segunda etapa foram empregados o modelo de Walker e Avant e uma revis?o integrativa segundo Whitemore, Knalf (2005). Esta etapa possibilitou a identifica??o dos atributos do conceito, os antecedentes e os consequentes e fundamentou a constru??o das defini??es para o resultado de enfermagem gravidade do olho seco. Para a constru??o das defini??es e magnitudes operacionais, foi utilizada a Psicometria proposta por Pasquali (1999). Como resultado da an?lise de contexto, visualizou-se a partir da reflex?o que o assunto deve ser discutido e que a enfermagem necessita atentar para a problem?tica das les?es oculares, para que sejam criadas estrat?gias de minimiza??o deste evento com elevada preval?ncia. Com a revis?o integrativa foram localizados a partir dos cruzamentos 19.853 t?tulos, e selecionados 215, e a partir dos resumos 96 artigos foram lidos na ?ntegra Com a leitura 10 foram exclu?dos, o que culminou na amostra de 86 artigos utilizados para analisar o conceito e constru??o das defini??es. Os artigos selecionados foram encontrados em maior n?mero na base de dados Scopus (55,82%), realizados nos Estados Unidos da Am?rica (39,53%), e publicados principalmente nos ?ltimos 5 anos (48,82%). Em rela??o ? an?lise de conceito identificaram-se como antecedentes: idade, lagoftalmia, fatores ambientais, uso de medicamentos, doen?as sist?micas, ventila??o mec?nica e cirurgias oft?lmicas. Como atributos: TBUT< 10s, teste de Schimer I < 5mm, teste de Schimer II < 10mm, osmolaridade diminu?da. Como consequentes: dano ? superf?cie ocular, desconforto ocular, instabilidade visual. As defini??es foram constru?das e acrescidos indicadores como: mecanismo de piscar diminu?do e fadiga ocular. / Dry eye syndrome is a multifactorial disease of the tear film, resulting from the instability of the lacrimal functional unit that produces volume change, up or tear distribution. In patients in intensive care the cause is enhanced due to various risk factors, such as mechanical ventilation, sedation, lagophthalmos, low temperatures, among others. The study's purpose is to build an assessment tool of Dry Eye Severity in patients in intensive care units based on the systematization of nursing care and their classification systems. The aim of this study is to build an assessment tool of Dry Eye Severity in hospitalized patients in Care Unit Intensiva.Trata is a methodological study conducted in three stages, namely: context analysis, concept analysis, construction of operational definitions and magnitudes of nursing outcome. For the first step we used the methodological framework for Hinds, Chaves and Cypress (1992). For the second step we used the model of Walker and Avant and an integrative review Whitemore seconds, Knalf (2005). This step enabled the identification of the concept of attributes, background and consequent ground and the construction of the settings for the result of nursing severity of dry eye. For the construction of settings and operational magnitudes, it was used Psicometria proposed by Pasquali (1999). As a result of context analysis, visualized from the reflection that the matter should be discussed and that nursing needs to pay attention to the problem of eye injury, so minimizing strategies are created this event with a high prevalence. With the integrative review were located from the crosses 19 853 titles, selected 215, and from the abstracts 96 articles were read in full. From reading 10 were excluded culminating in the sample of 86 articles that were used to analyze the concept and construction of settings. Selected articles were found in greater numbers in the Scopus database (55.82%), performed in the United States (39.53%), and published mainly in the last five years (48.82). Regarding the concept of analysis were identified as antecedents: age, lagophthalmos, environmental factors, medication use, systemic diseases, mechanical ventilation and ophthalmic surgery. As attributes: TBUT <10s, Schimer I test <5 mm in Schimer II test <10mm, reduced osmolarity. As consequential: the ocular surface damage, ocular discomfort, visual instability. The settings were built and added indicators such as: decreased blink mechanism and eyestrain.
2

Diagn?stico de enfermagem risco de olho seco e ressecamento ocular em pacientes adultos em p?s-operat?rio imediato / Nursing diagnosis dry eye risk and ocular dryness in adult patients in the immediate postoperative period

Medeiros, Raianny Alves Costa 14 December 2017 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T18:10:16Z No. of bitstreams: 1 RaiannyAlvesCostaMedeiros_DISSERT.pdf: 1661680 bytes, checksum: 6e7db62be4ce7dc09607a85dd29d2f5d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-15T20:38:22Z (GMT) No. of bitstreams: 1 RaiannyAlvesCostaMedeiros_DISSERT.pdf: 1661680 bytes, checksum: 6e7db62be4ce7dc09607a85dd29d2f5d (MD5) / Made available in DSpace on 2018-03-15T20:38:22Z (GMT). No. of bitstreams: 1 RaiannyAlvesCostaMedeiros_DISSERT.pdf: 1661680 bytes, checksum: 6e7db62be4ce7dc09607a85dd29d2f5d (MD5) Previous issue date: 2017-12-14 / Objetivou-se avaliar o DE Risco de Olho Seco e o Ressecamento Ocular em pacientes adultos em per?odo p?s-operat?rio imediato. Trata de estudo transversal, realizado no Centro Cir?rgico e na Unidade de Recupera??o P?s-Anest?sica (URPA) em um Hospital do nordeste do Brasil no per?odo de maio a agosto de 2017. A popula??o constituiu-se de pacientes adultos submetidos a procedimento cir?rgicos, amostra de 157 pacientes. O instrumento de coleta de dados constituiu-se de dados epidemiol?gicos e cl?nicos, fatores de risco da NANDA-I e os resultado de enfermagem Gravidade do Olho Seco da Nursing Outcomes Classification (NOC). Dois enfermeiros diagnosticadores fizeram a infer?ncia dos desfechos. Na an?lise descritiva utilizaram-se frequ?ncias, medidas do centro da distribui??o e respectivas variabilidades. Para as vari?veis associativas utilizou o Qui-quadrado de Pearson e em frequ?ncias menores que cinco, o teste de Fisher. A magnitude da associa??o pela Raz?o de Preval?ncia. Obteve-se parecer favor?vel do Comit? de ?tica em Pesquisa n? 2.004.545 e CAAE n? 64881717.5.0000.5537. Dos 157 pacientes do estudo 52,23% eram do sexo masculino, idade m?dia 48,90 (?15,98) anos, com companheiro (60,51%), nascido no interior do Rio Grande do Norte (RN) (56,05%), residem na capital do RN (49,8%), com tempo m?dio de estudo de 9,11 (?3,94) anos, trabalham com remunera??o (54,78%) e recebiam em m?dia 1,63 (?1,21) sal?rios m?nimos. A preval?ncia do DE Risco de Olho Seco foi de 14,65% e o Ressecamento Ocular de 85,35% nos pacientes em p?s-operat?rio imediato. Foi significantemente estat?stico a especialidade cir?rgica (p<0,017), a hipertens?o arterial (p<0,009) e diabetes (p<0,004) para o Ressecamento Ocular no Olho Esquerdo (OE) e a hipertens?o arterial (p<0,016) para o DE Risco de Olho Seco. Apresentou signific?ncia estat?stica a utiliza??o do anest?sico geral (p<0,004), o anest?sico raquidiano (p<0,046) e o inibidor/protetor de secre??o g?strica no Olho Direito (OD) para o Ressecamento Ocular e o anest?sico geral (p<0,017) para o DE Risco de Olho Seco. Quanto aos fatores de risco foram significante o hist?rico de alergia (p<0,048) para o DE Risco de Olho Seco e envelhecimento (p<0,046) e regime de tratamento (p<0,027) para o Ressecamento ocular. Em rela??o as caracter?sticas cl?nicas observou signific?ncia a hiperemia (p<0,010) e lacrimejamento excessivo (p<0,041) para o DE Risco de Olho Seco e hiperemia OD (p<0,032), hiperemia OE (p<0,002) e lacrimejamento excessivo OD (p<0,020) para o Ressecamento Ocular. Tamb?m foi significante o resultado do teste de Schirmer insuficiente (p<0,001) tanto para o DE Risco de Olho Seco quanto para o Ressecamento Ocular em ambos os olhos. Ao tratar da Gravidade do Olho Seco observou-se resultado significantemente estat?stico para o Ressecamento Ocular os indicadores diminui??o da produ??o lacrimal (P<0,001) e vermelhid?o da conjuntiva (p<0,028) para o OD e diminui??o de produ??o lacrimal (p<0,001) e vermelhid?o da conjuntiva (p<0,001) para o OE. O presente estudo foi relevante para incentivar iniciativas de preven??o do Ressecamento Ocular em pacientes em p?s-operat?rio imediato. / The objective of this study was to evaluate the risk of dry eye and eye dryness in adult patients in the immediate postoperative period. This is a cross-sectional study carried out at the Surgical Center and Post-Anesthetic Recovery Unit (URPA) at a Hospital in the northeast of Brazil from May to August 2017. The population consisted of adult patients submitted to surgical procedures, of 157 patients. The data collection instrument consisted of epidemiological and clinical data, NANDA-I risk factors and Nursing Outcomes Classification (NOC) Nursing Outcome results. Two diagnostic nurses made the inference of the outcomes. In the descriptive analysis we used frequencies, measures of the distribution center and respective variabilities. For the associative variables, Pearson's Chi-square was used and in frequencies smaller than five, Fisher's test. The magnitude of the association by the Prevalence Ratio. A favorable opinion was obtained from the Ethics Committee in Research n? 2,004,545 and CAAE n? 64881717.5.0000.5537. Of the 157 patients in the study, 52.23% were male, mean age 48.90 (? 15.98) years, with partner (60.51%), born in the interior of Rio Grande do Norte (Brazil) (49.8%), with a mean study time of 9.11 (? 3.94) years, paid (54.78%) and received an average of 1.63 ( ? 1.21) minimum wages. The prevalence of dry eye risk was 14.65% and ocular dryness of 85.35% in patients in the immediate postoperative period. Statistically significant was the surgical specialty (p<0.017), arterial hypertension (p<0.009) and diabetes (p<0.004) for left eye ocular resection (OE) and arterial hypertension (p<0.016) of Dry Eye. Statistical significance was found for the use of general anesthetics (p<0.004), spinal anesthetic (p<0.046) and the Right Eye (OD) inhibitor / protector for Ocular Dryness and general anesthetic (p<0.017) for the dry eye risk. Regarding the risk factors, the history of allergy (p<0.048) for dry eye risk and aging (p<0.046), treatment regimen (p<0.027) for ocular resection were significant. In relation to clinical characteristics, hyperemia (p<0.010) and excessive tearing (p<0.041) were observed for OD and OD hyperemia (p<0.032), OE hyperemia (p <0.002) and excessive tearing OD (p<0.020) for Ocular Dryness. The results of the insufficient Schirmer test (p<0.001) were also significant for both dry eye risk and ocular dryness in both eyes. In the treatment of dry eye severity, a statistically significant result for ocular dryness was observed for the indicators of decreased lacrimal production (P<0.001) and conjunctival redness (p<0.028) for DO and decreased lacrimal production (p<0.001) and conjunctival redness (p<0.001) for OE. The present study was relevant to encourage initiatives to prevent eye dryness in patients in the immediate postoperative period.
3

Diagn?stico de enfermagem risco de olho seco e ressecamento ocular em pacientes adultos internados em unidade de terapia intensiva / Nursing diagnosis risk of dry eye and ocular dryness in hospitalized adult patients in Intensive care unit

Ara?jo, J?ssica Naiara de Medeiros 04 October 2016 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-20T23:42:57Z No. of bitstreams: 1 JessicaNaiaraDeMedeirosAraujo_DISSERT.pdf: 1314685 bytes, checksum: 5277073c7a6b748dee41a1e611c029c5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-02T21:24:47Z (GMT) No. of bitstreams: 1 JessicaNaiaraDeMedeirosAraujo_DISSERT.pdf: 1314685 bytes, checksum: 5277073c7a6b748dee41a1e611c029c5 (MD5) / Made available in DSpace on 2017-03-02T21:24:47Z (GMT). No. of bitstreams: 1 JessicaNaiaraDeMedeirosAraujo_DISSERT.pdf: 1314685 bytes, checksum: 5277073c7a6b748dee41a1e611c029c5 (MD5) Previous issue date: 2016-10-04 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Objetivou-se avaliar o Diagn?stico de Enfermagem (DE) Risco de olho seco da NANDA-Internacional em pacientes internados em Unidade de Terapia Intensiva (UTI). Trata-se de um estudo transversal realizado na UTI de adultos do Hospital Universit?rio Onofre Lopes. A amostra final foi constitu?da de 206 pacientes. Para coleta de dados utilizou-se um instrumento composto por vari?veis pertinentes aos dados sociodemogr?ficos, cl?nicos e fatores de risco do DE em estudo. A infer?ncia quanto ? presen?a do diagn?stico nos pacientes avaliados foi realizada por um par de enfermeiros diagnosticadores com experi?ncia em julgamento diagn?stico e em assist?ncia de enfermagem em UTI. Todos os dados coletados foram organizados e armazenados em um banco de dados constru?do no programa Statistical Package for Social Science (SPSS) vers?o 22.0 para teste. Para a an?lise descritiva, foram consideradas as frequ?ncias, medidas do centro da distribui??o e suas variabilidades. Para comparar m?dias, aplicou-se o teste t de Student para amostras independentes. Em caso de assimetria, o teste de Mann-Whitney foi utilizado. Para medidas associativas, utilizou-se o teste Qui-quadrado de Pearson e quando as frequ?ncias esperadas foram menores que cinco, foi aplicado o teste de Fisher. A magnitude da associa??o foi verificada por meio da raz?o de preval?ncia. Este estudo obteve parecer favor?vel do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte e ? financiado pelo Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico - CNPq, processo n? 444290/2014-1. Dos 206 pacientes, 52,4% eram do sexo masculino, idade m?dia de 58,41 anos e 57,6% residiam no interior do Rio Grande do Norte. Em rela??o ? escolaridade, a maioria (40,3%) tinha ensino fundamental incompleto e 43,3% eram aposentados. De acordo com o tipo de interna??o, 49% foram cl?nicas, 29,1% cirurgias de urg?ncia/emerg?ncia e 21,8% cirurgias eletivas. Das comorbidades, 59,7% apresentavam hipertens?o arterial sist?mica e 31,6% diabetes mellitus. 47,6% dos pacientes apresentaram o DE em estudo. Desta forma, 52,4% j? apresentaram o diagn?stico cl?nico de ressecamento ocular. Na an?lise por olho, 56,8% apresentaram o DE, j? o ressecamento ocular esteve presente em 43,2% dos olhos. Os fatores de risco mais prevalentes foram: fatores ambientais e regime de tratamento (100%), terapia com ventila??o mec?nica (52,4%), envelhecimento (51%), les?es neurol?gicas com perda sensorial reflexo motora (50%), sexo feminino (47,6%) e estilo de vida (36,4%). Apresentaram associa??o estatisticamente significante com a presen?a do DE estudado no olho direito (OD) a aus?ncia das seguintes caracter?sticas cl?nicas: motivo de interna??o por dist?rbio gastrointestinal, lagoftalmia no OD, lagoftalmia no olho esquerdo (OE), hiperemia do OE, secre??o mucosa OD, edema palpebral OD, proptose OD e uso de anti-inflamat?rio. A presen?a da hiperemia no OD foi significativa para aus?ncia do DE no OD. A diferen?a de m?dias do schirmer no OD e OE entre a presen?a e aus?ncia do DE no OD tamb?m apresentaram signific?ncia. Em rela??o ao OE, existiu associa??o estatisticamente significante entre o reflexo c?rneo-palpebral do OD e DE risco de olho seco do OD com a presen?a do DE no OE. Al?m disso, as aus?ncias de outras caracter?sticas cl?nicas apresentaram-se significativas com a presen?a do DE no OE: hiperemia OD e OE, edema palpebral OD e OE, secre??o mucosa OE, uso de bloqueadores neuromusculares e ressecamento ocular no OD e OE. Ainda, o schirmer do OD e OE apresentaram diferen?as de m?dias significativas entre a presen?a e aus?ncia do DE no OE. Em rela??o ? an?lise do ressecamento ocular no OD,a aus?ncia de determinadas caracter?sticas cl?nicas foram estatisticamente significantes para a aus?ncia do ressecamento no OD, a saber: motivo de interna??o por dist?rbio gastrointestinal, lagoftalmia no OD e OE e ressecamento ocular no OE. A presen?a de hiperemia no OD apresentou signific?ncia com a presen?a no ressecamento no OD. Contudo, a aus?ncia da hiperemia no OE mostrou associa??o com a aus?ncia do ressecamento ocular no OD, assim como a secre??o mucosa no OD, edema palpebral OD, proptose OD e uso de anti-inflamat?rio. A presen?a do DE no OD e OE demonstraram associa??o com a aus?ncia do ressecamento ocular no OD. A diferen?a de m?dias do schirmer do OD apresentou rela??o significativa entre a presen?a e aus?ncia do ressecamento ocular no OD, assim como a diferen?a de m?dias dos postos do schirmer do OE. No que concerne ao ressecamento ocular no OE, a presen?a do reflexo c?rneo-palpebral no OD e DE no OD e OE apresentaram rela??o estatisticamente significativa com a aus?ncia do ressecamento ocular no OE. A hiperemia ocular presente no OD e o ressecamento do OE tamb?m demonstraram associa??o. No entanto, a aus?ncia de hiperemia ocular no OE, secre??o mucosa no OE, edema palpebral no OD e OE e o n?o uso de bloqueadores neuromusculares associaram-se significativamente com a aus?ncia do ressecamento ocular no OE. Al?m do mais, como nos demais desfechos existiram diferen?as de m?dias significativas do schirmer OD e OE entre quem apresenta ou n?o ressecamento ocular no OE. Destarte, o conhecimento obtido apresenta estimada relev?ncia no sentido de garantir uma a??o direcionada para a preven??o do ressecamento ocular em pacientes internados em UTI. / This study aimed to identify the Nursing Diagnosis (ND) Dry Eye Risk NANDA-International and ocular dryness in adult patients admitted into the Intensive Care Unit (ICU). This is a cross-sectional study done into the adult ICU of the University Hospital Onofre Lopes. The final sample consisted of 206 patients. An instrument composed of related variables to the sociodemographic data, clinical and risk factors in the study was used for data collection. Inference for the presence of the diagnosis in the patients was performed by nurse diagnosticians. All data collected were organized and stored in a database built by the Statistical Package for Social Sciences (SPSS) version 22.0 for testing. For the discriptive analysis, frequency, measures of the destribution center and it?s variabilities were considered. To compare means, the Student t test was applied for independent samples. In the case of asymmetry, the Mann-Whitney test was used. For associative measurements, Pearson's chi-squared test was used, and when the expected frequencies were lower than five, Fisher's test was applied. The magnitude of the association was verified by the prevalence ratio. This study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte and is funded by the National Scientific and Technological Development Council - CNPq, process n ? 444290 / 2014-1. Of the 206 patients, 52.4% were male, the mean age was 58.41 years and 57.6% lived in the countryside of Rio Grande do Norte. According to the type of hospitalization, 50.5% were surgical (27.7% emergency surgery / emergency and elective surgery 22.8%) and 49.5% were clinics. About comorbidities, 59.7% had hypertension and 31.6% diabetes mellitus. Of the total sample, 47.6% of patients showed the ND in the study. Thus, 52.4% have had a clinical diagnosis of ocular dryness. In the analysis by eye, 56.8% had the ND, while ocular dryness was present in 43.2% of the eyes. The most prevalent risk factors were: environmental factors and treatment regimen (100%), mechanical ventilation therapy (52.4%), aging (51.0%), neurological lesions with sensory motor reflex loss (50.0%), female gender (47.6%) and lifestyle (36.4%). The absence of the following clinical features showed statistically significant association with the presence of ND studied in the right eye (RE): gastrointestinal disorder as the main reason for the hospitalization, lagophthalmos in the RE, lagophthalmos in the left eye (LE), LE hyperemia, RE mucous secretion, RE eyelid edema, RE proptosis and use of anti-inflammatory. The presence of hyperemia in the RE was significant for the absence of ND in the RE. Regarding the LE, there was a statistically significant association between corneal-palpebral reflex RE with the ND's presence in the LE. Moreover, the absence of other clinical characteristics was significant to the ND's presence in the LE: LE hyperemia, RE and LE eyelid edema, LE mucous secretion and use of neuromuscular blockers. Still, there was a significant relationship between the presence of hyperemia in the RE, and the absence of ND in the LE. Regarding the analysis of ocular dryness in the RE, the absence of certain clinical characteristics was statistically significant for the absence of dryness in the RE like gastrointestinal disorder as the reason for the hospitalization, lagophthalmos in the RE and LE, hyperemia in LE, mucous secretion in RE, RE eyelid edema, RE proptosis and use of anti-inflammatory. However, the presence of hyperemia in the RE showed meaning to the presence in the dryness of the RE. Concerning ocular dryness in the LE, the presence of corneal-palpebral reflex in RE showed a statistically significant relationship with the absence of ocular dryness in LE. Ocular hyperemia present in RE and dryness in the LE also showed association. Nevertheless, the absence of ocular hyperemia in LE, mucous secretion in the LE, eyelid edema in RE and LE and the non use of neuromuscular blockers were significantly associated with the absence of ocular dryness in LE. The difference among Schirmers posts? means in the RE and LE showed significant relation between the presence and the ausence of the ND and ocular dryness in the RE and LE. The magnitude of the association demonstrates that the presence of ND in the RE is almost four times greater for the presence of ND in the LE. Thus, the knowledge gained has valued relevance when it comes to ensure an action directed to the prevention of ocular dryness in ICU patients.
4

Valida??o do diagn?stico de enfermagem risco de olho seco em pacientes adultos internados em unidade de terapia intensiva / Validation of diagnostic nursing Risk of dry eye in adult patients hospitalizes in the Intensive Care Unit

Botareli, Fabiane Rocha 12 December 2016 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:08:15Z No. of bitstreams: 1 FabianeRochaBotareli_TESE.pdf: 2442381 bytes, checksum: 41d6068d7d112e405810a025b8ac5066 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T21:10:14Z (GMT) No. of bitstreams: 1 FabianeRochaBotareli_TESE.pdf: 2442381 bytes, checksum: 41d6068d7d112e405810a025b8ac5066 (MD5) / Made available in DSpace on 2017-04-20T21:10:14Z (GMT). No. of bitstreams: 1 FabianeRochaBotareli_TESE.pdf: 2442381 bytes, checksum: 41d6068d7d112e405810a025b8ac5066 (MD5) Previous issue date: 2016-12-12 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Objetivou-se validar o diagn?stico de enfermagem Risco de olho seco em pacientes internados em Unidade de Terapia Intensiva. Trata de um e 1) Constru??o das defini??es conceituais e operacionais dos fatores de risco do olho seco; 2) Valida??o cl?nica do diagn?stico de enfermagem Risco de olho seco. A primeira etapa foi operacionalizada por meio de revis?o integrativa para constru??o das defini??es conceituais e operacionais dos fatores de risco para o olho seco e subsidiou a etapa de valida??o cl?nica. Esta foi operacionalizada por meio de um estudo de coorte prospectivo Definiu-se a amostra de 69 pacientes com tempo de coleta de 7 meses. Crit?rios de inclus?o: pacientes sem olho seco na admiss?o, idade maior ou igual de 18 anos e tempo de interna??o maior que 24 horas. Crit?rios de exclus?o: diagn?stico pr?vio de doen?as da superf?cie ocular, cirurgias faciais e uso de qualquer tipo de medicamento ocular t?pico. A avalia??o aconteceu diariamente e com tempo de seguimento de at? cinco dias. O desfecho de olho seco foi estabelecido por crit?rios cl?nicos e teste de Schirmer. Os dados descritivos foram analisados por meio de frequ?ncias simples, m?dia, mediana, desvio padr?o e coeficiente de varia??o. As medidas de associa??o entre as vari?veis de desfecho e preditoras foram calculadas pelo teste qui-quadrado e teste exato de Fisher. O n?vel de signific?ncia adotado foi de 5%. A medida de associa??o entre exposi??o e desfecho utilizada foi o Risco Relativo. Esta pesquisa foi submetida e aprovada pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte. 75,36% dos pacientes tiveram olho seco e 24,64% o diagn?stico de enfermagem Risco de olho seco. A etapa 1 do estudo permitiu o refinamento dos fatores de risco para os pacientes internados em UTI e construiu as defini??es constitutivas e operacionais para padroniza??o da valida??o cl?nica. Os fatores de risco validados na etapa 2 foram: lagoftalmia (p <0,041; RR=3,51); ventila??o mec?nica invasiva (p<0,002; RR=2,18), quemose (<0,06; RR=4,94), aus?ncia ou redu??o do reflexo espont?neo de piscar (p<0,037; RR=0,60); analg?sicos opi?ides (p< 0,001; RR=17,50); sedativos (p<0,001; RR=10,83); antibi?ticos (p< 0,029; RR=7,69); vasodilatadores (p< 0,019; RR=0,19). Os resultados possibilitaram a revis?o do diagn?stico de enfermagem e sugeriu a mudan?a do termo olho seco para ressecamento ocular. Al?m disso, baseados nas evid?ncias apresentadas dos crit?rios definidos para o desfecho de ressecamento ocular (hiperemia conjuntival: RR=18,37; secre??o mucosa: RR=12; teste de Schirmer: RR=0,35; todos com p <0,001) foi proposto um novo diagn?stico de enfermagem Ressecamento ocular. Portanto, acredita-se que este estudo ? inovador para o avan?o do conhecimento sobre a tem?tica e para o aperfei?oamento e valida??o do uso da taxonomia da NANDA-I por enfermeiros que atuam neste cen?rio, com vistas a proporcionar subs?dio para avalia??o ocular precisa, acur?cia na infer?ncia do diagn?stico em quest?o, predi??o de risco como ado??o de medidas de preven??o e monitoramento de complica??es. / The objective of this study was to validate the nursing diagnosis of dry eye risk in patients admitted to the Intensive Care Unit. It is a methodological study developed in two stages of validation of nursing diagnoses: 1) Construction of the conceptual and operational definitions of dry eye risk factors; 2) Clinical validation of the nursing diagnosis Dry eye risk. The first step was operationalized through an integrative review to construct the conceptual and operational definitions of risk factors for dry eye and subsidized the clinical validation stage. This was performed using a prospective cohort study. A sample of 69 patients with a collection time of 7 months was defined. Inclusion criteria: patients without dry eye at admission, age greater than or equal to 18 years and length of hospital stay longer than 24 hours. Exclusion criteria: prior diagnosis of ocular surface diseases, facial surgeries and use of any topical ocular medication. The evaluation took place daily and with a follow-up time of up to five days. The dry eye outcome was established by clinical criteria and Schirmer's test. Descriptive data were analyzed using simple frequencies, mean, median, standard deviation and coefficient of variation. The measures of association between the outcome variables and predictors were calculated using the chi-square test and Fisher's exact test. The level of significance was 5%. The measure of association between exposure and outcome used was Relative Risk. This research was submitted and approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. 75.36% of the patients had dry eye and 24.64% the nursing diagnosis Dry eye risk. Stage 1 of the study allowed the refinement of risk factors for ICU patients and constructed the constitutive and operational definitions for the standardization of clinical validation. The risk factors validated in stage 2 were: lagoftalmia (p <0.041; RR = 3.51); (P <0.001, RR = 0.60), absence or reduction of the spontaneous flashing reflex (p <0.037, RR = 0.60); Opioid analgesics (p <0.001, RR = 17.50); Sedatives (p <0.001, RR = 10.83); Antibiotics (p <0.029, RR = 7.69); Vasodilators (p <0.019, RR = 0.19). The results allowed the revision of the nursing diagnosis and suggested the change of dry eye term for ocular dryness. In addition, based on the evidence presented from the criteria defined for the outcome with p <0.001 for ocular dryness (conjunctival hyperemia: RR = 18.37; mucus secretion: RR = 12; Schirmer test: RR = 0.35) was possible propose a new nursing diagnosis Eye dryness. Therefore, it is believed that this study is innovative for the advancement of knowledge on the subject and for the improvement and validation of the use of NANDA-I taxonomy by nurses working in this scenario, in order to provide support for precise ocular evaluation, accuracy In the inference of the diagnosis in question, prediction of risk as adoption of measures of prevention and monitoring of complications.

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