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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.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/22709 |
| Date | 12 December 2016 |
| Creators | Botareli, Fabiane Rocha |
| Contributors | 91307570372, http://lattes.cnpq.br/1927801553508976, Kumakura, Ana Railka de Souza Oliveira, 65007522368, http://lattes.cnpq.br/7104233094436637, Ferreira J?nior, Marcos Antonio, 81717881149, http://lattes.cnpq.br/0912795990605736, Santana, Rosimere Ferreira, 85471763149, http://lattes.cnpq.br/7325445135879520, Santos, Viviane Euz?bia Pereira, 72339039053, http://lattes.cnpq.br/5808110442588994, Vitor, Allyne Fortes |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM ENFERMAGEM, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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