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Valida??o do resultado de enfermagem mobilidade em idosos acometidos por febre de Chikungunya / Validation of the nursing outcome mobility in the elderly affected by Chikungunya fever

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Previous issue date: 2017-12-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O estudo teve como objetivo Validar o resultado de Enfermagem Mobilidade apresentado pela Nursing Outcomes Classification em idosos acometidos por Febre de Chikungunya. Estudo metodol?gico, segundo referencial de Pasquali (2010) realizado em tr?s etapas: revis?o integrativa da literatura, valida??o sem?ntica e valida??o cl?nica, a partir de um instrumento proposto por Moreira (2011), o qual apresentou para o Resultado de Enfermagem Mobilidade, oito indicadores bem como suas defini??es constitutivas, operacionais e magnitudes operacionais. Estes foram revistos e adaptados em nove indicadores direcionados ? popula??o idosa acometida por Febre de Chikungunya. A primeira etapa ocorreu mediante revis?o integrativa da literatura para adapta??o de instrumento validado em estudo anterior. A revis?o integrativa ocorreu entre os meses de fevereiro e abril de 2017, nas bases de dados: CINAHL, Cochrane, LILACS, PubMed, Scopus, Science Direct e Web of Science. Realizou-se uma busca n?o controlada das produ??es cient?ficas, sem recorte temporal, pelos descritores indexados e n?o indexados e os 12 indicadores da Nursing Outcomes Classification para o Resultado de Enfermagem Mobilidade. Em seguida, para a etapa de valida??o sem?ntica, o instrumento foi entregue no m?s de junho, a 12 enfermeiros que trabalhavam na aten??o prim?ria ? sa?de. Para avalia??o quanto a sua inteligibilidade. Ap?s atender as sugest?es propostas pelos enfermeiros nesta etapa, procedeu-se o estudo piloto e valida??o cl?nica. Esta etapa foi realizada nos meses de julho e agosto, por duas duplas de enfermeiros treinados, em Unidades de Sa?de do munic?pio de Natal/RN, com 90 idosos acometidos por Febre de Chikungunya. Uma dupla aplicou o instrumento proposto pela NOC para o Resultado de Enfermagem Mobilidade e outra com o instrumento adaptado e revisado. Para an?lise de conte?do textual da revis?o integrativa, utilizou-se o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) vers?o 0.7 Alpha 2. Os dados da valida??o sem?ntica e cl?nica foram organizados em planilha no programa Microsoft Office Excel 2012 e exportados para o programa estat?stico Statistical Package for Social Sciences vers?o 22.0 for Windows. Na valida??o sem?ntica foi aplicado teste binominal com concord?ncia igual ou superior a 85%. Na valida??o cl?nica, para an?lises descritivas foram calculadas as medidas do centro da distribui??o e suas variabilidades. Aplicou-se o teste de Friedman para verificar diverg?ncia entre avaliadores e calculado o Coeficiente de Correla??o Intraclasse para comparar a correla??o das avalia??es realizadas pelos enfermeiros avaliadores. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte sob CAAE n? 64880017.9.0000.5537. Na revis?o integrativa, a Classifica??o Hier?rquica Descendente apontou dois eixos principais relacionados ? Febre de Chikungunya relacionados a artigos que priorizam evid?ncias cl?nicas da fase aguda, fase subaguda e cr?nica. O indicador Dor articular foi adicionado por ser considerado importante na literatura, representado na nuvem de palavras e foi constru?do suas defini??es operacionais, defini??es constitutivas e magnitudes operacionais. Quanto ? etapa de valida??o sem?ntica, o instrumento foi considerado intelig?vel para avalia??o proposta, por parte dos enfermeiros. Oito indicadores alcan?aram ou excederam o ?ndice de concord?ncia de 0,85, com exce??o do indicador Desempenho na transfer?ncia, pois a concord?ncia foi de 0,83 e p<0,05. Na etapa de valida??o cl?nica, houve uma predomin?ncia de participantes homens (75,56%), com mediana de idade de 70,00, com maioria de casados, aposentados, com ensino fundamental incompleto e renda mensal de at? um sal?rio m?nimo. O teste de Friedman indicou diferen?as entre avalia??o das duplas em sete indicadores, a saber: Equil?brio, Andar, Movimento dos m?sculos, Movimento das articula??es, Desempenho no posicionamento do corpo, Desempenho na transfer?ncia e Dor articular. Para os indicadores Coordena??o e Marcha n?o foram identificadas diferen?as significativas pelo teste de Friedman. Todos os indicadores apresentaram-se estatisticamente significantes (p< 0,001) e satisfat?rios, segundo o Coeficiente de Correla??o Intraclasse. Ao analisar os resultados mediante os testes estat?sticos, tem-se que os resultados foram satisfat?rios para maioria dos indicadores presentes no instrumento com as defini??es. Assim, a utiliza??o de instrumentos para uma popula??o espec?fica como os idosos acometidos por Febre de Chikungunya, s?o eficazes e devem ser continuamente realizados no intuito de refin?-los e aperfei?o?-los. / The study aimed to validate the result of Nursing Mobility presented by Nursing Outcomes Classification in elderly people affected by Chikungunya Fever. Methodological study, according to Pasquali's (2010) referential in three stages: integrative literature review, semantic validation and clinical validation, based on an instrument proposed by Moreira (2011), which presented for the Nursing Nursing Outcome, eight indicators as well as their constitutive, operational definitions and operational magnitudes. These were reviewed and adapted in nine indicators aimed at the elderly population affected by Chikungunya Fever. The first stage occurred through an integrative review of the literature for instrument adaptation validated in a previous study. The integrative review occurred between February and April 2017, in the databases: CINAHL, Cochrane, LILACS, PubMed, Scopus, Science Direct and Web of Science. There was an uncontrolled search of the scientific productions, without temporal cut, by the indexed and non-indexed descriptors and the 12 indicators of the Nursing Outcomes Classification for the Nursing Outcome Mobility. Then, for the semantic validation stage, the instrument was delivered in the month of June to 12 nurses who worked in primary health care. For evaluation as to its intelligibility. After following the suggestions proposed by the nurses at this stage, the pilot study and clinical validation were carried out. This stage was carried out in July and August, by two pairs of trained nurses, in Health Units of the city of Natal / RN, with 90 elderly people affected by Chikungunya Fever. One pair applied the instrument proposed by the NOC for the Mobility Nursing Outcome and another with the instrument adapted and revised. In order to analyze the textual content of the integrative review, we used the software Interface for Multidimensionnelles of Textes et de Questionnaires (IRAMUTEQ) version 0.7 Alpha 2. The data of the semantic and clinical validation were organized in a spreadsheet in the program Microsoft Office Excel 2012 and exported to the statistical program Statistical Package for Social Sciences version 22.0 for Windows. In the semantic validation, a binomial test with agreement equal or superior to 85% was applied. In the clinical validation, for the descriptive analyzes the measures of the distribution center and its variabilities were calculated. The Friedman test was used to verify divergence among raters and the Intraclass Correlation Coefficient was calculated to compare the correlation of the evaluations performed by the rater nurses. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under CAAE n? 64880017.9.0000.5537. In the integrative review, the Descending Hierarchical Classification pointed out two main axes related to Chikungunya Fever related to articles that prioritize clinical evidences of the acute phase, subacute and chronic phase. The articular pain indicator was added because it was considered important in the literature, represented in the word cloud and its operational definitions, constitutive definitions and operational magnitudes were constructed. As for the semantic validation stage, the instrument was considered intelligible for the proposed evaluation, by the nurses. Eight indicators reached or exceeded the agreement index of 0.85, except for the transfer performance indicator, since the agreement was 0.83 and p <0.05. In the clinical validation stage, there was a predominance of male participants (75.56%), with a median age of 70.00, most married, retired, with incomplete primary education and monthly income up to a minimum wage. The Friedman test indicated differences between the pairs' evaluation in seven indicators, namely: Balance, Walking, Muscle movement, Movement of joints, Performance in body positioning, Performance in transference and Joint pain. For the Coordination and March indicators, no significant differences were identified by the Friedman test. All indicators were statistically significant (p <0.001) and satisfactory, according to the Intraclass Correlation Coefficient. When analyzing the results through the statistical tests, it has been that the results were satisfactory for most of the indicators present in the instrument with the definitions. Thus, the use of instruments for a specific population such as the elderly affected by Chikungunya Fever are effective and must be continuously carried out in order to refine and improve them.

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/24739
Date05 December 2017
CreatorsSilva, Amanda Barbosa da
Contributors91307570372, Botareli, Fabiane Rocha, 01053269412, Ferreira J?nior, Marcos Antonio, 81717881149, Moreira, Rafaella Pessoa, 96708859300, Vitor, Allyne Fortes
PublisherPROGRAMA DE P?S-GRADUA??O EM ENFERMAGEM, UFRN, Brasil
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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