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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.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/23359 |
| Date | 24 March 2017 |
| Creators | Rodrigues, Iellen Dantas Campos Verdes |
| Contributors | 02508410454, http://lattes.cnpq.br/2184669241700299, Silva J?nior, Fernando Jos? Guedes da, 01624688306, http://lattes.cnpq.br/0174608319919866, Sena, Filadelfia Carvalho de, 38854988391, http://lattes.cnpq.br/3548299705586001, Lima, Maria Alzete de, 91943540306, http://lattes.cnpq.br/8917202234995917, Souza, Nilba Lima de, 42997186404, http://lattes.cnpq.br/3552543432083948, Silva, Richardson Augusto Rosendo da |
| 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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