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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.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/24742 |
| Date | 18 December 2017 |
| Creators | Nogueira, Isadora Lorenna Alves |
| Contributors | 64194892372, Vieira, Caroline Evelin Nascimento Kluczynik, 07654109407, Santos, Paula Fernanda Brand?o Batista dos, 80211054372, Guedes, Nirla Gomes, 91803268387, Lira, Ana Luisa Brand?o de Carvalho |
| 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/masterThesis |
| 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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