Autocontrole inefi caz da saúde em pacientes em hemodiálise: análise de conteúdo

Paiva, Maria das Graças Mariano Nunes de; Tinôco, Jéssica Dantas de Sá; Silva, Fernanda Beatriz Batista Lima e; Dantas, Juliane Rangel; Lopes, Marcos Venícios de Oliveira; Lira, Ana Luisa Brandão de Carvalho

doi:10.1590/0034-7167-2016-0682

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

RESEARCH • Rev. Bras. Enferm. 71 (4) • Jul-Aug 2018 • https://doi.org/10.1590/0034-7167-2016-0682 copiar

Autocontrole inefi caz da saúde em pacientes em hemodiálise: análise de conteúdo

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

Analisar o conteúdo do diagnóstico de enfermagem Autocontrole ineficaz da saúde em pacientes em hemodiálise.

Método:

O Modelo de Validação de Diagnóstico de Enfermagem por Lopes, Silva e Araújo foi usado nesta pesquisa. Um questionário semiestruturado foi respondido por 22 especialistas em diagnóstico de enfermagem e, avaliou a definição, localização, características definidoras e fatores relacionados do diagnóstico Autocontrole ineficaz da Saúde. A análise foi realizada de agosto de 2014 a janeiro de 2015.

Resultados:

Os especialistas consideraram como adequada ao diagnóstico, a definição proposta e a localização atual na taxonomia II da NANDA-I, promoção de saúde do domínio 1, controle de saúde na classe 2. O nível de adequação adotado foi superior a 85% ou p> 0,05 para 10 características definidoras e 24 fatores relacionados. Especialistas também sugeriram que uma característica definidora deveria se tornar um fator relacionado e que três fatores devem se transformar em características definidoras.

Conclusão:

Uma nova proposta foi desenvolvida para o diagnóstico em estudo após a análise de especialistas.

Descritores:
Estudos de validação; Diagnóstico de Enfermagem; Diálise Renal; Taxonomia; Enfermagem

Variables			n	%
Sex
Female			21	95.5
Male			1	4.5
Region
Northeastern Brazil			20	91.0
Southeastern Brazil			1	4.5
Another country			1	4.5
Academic title
MS			19	86.4
Ph.D.			11	50.0
Specialization			11	50.0
Working institution in the last year
Educational institution			20	91.0
Hospital			7	31.8
Studies addressing the theme NDs by the NANDA-I			21	95.5
Studies addressing the theme nephrology			12	54.5
Participation in research groups on NDs by the NANDA-I			18	81.8
Teaches subjects on the theme NDs by the NANDA-I			19	86.4
Teaches subjects on the theme nephrology/HD			4	18.2
Use of NDs by the NANDA-I in clinical practice			10	45.5
Use of NDs by the NANDA-I in teaching			19	86.4
Nursing care for a patient undergoing HD or with the ND Ineffective Health Management			14	63.3
Practical identification of the ND Ineffective Self-Health Management
Few times			10	45.5
Often			8	36.4
Does not remember			3	13.6
Never			1	4.5
	Average	SD	Median	*p ^ * Kolmogorov-Smirnov test.**
Age (years)	31.14	4.57	30.00	0.031
Length of professional education (years)	7.95	4.43	7.00	0.096

Defining characteristics	n	%	p ^* * Binomial test.
Expressed difficulty with prescribed regimens	22	100.0	1.000
Daily life choices ineffective to achieve health goals	21	95.5	0.972
Intensified complications of chronic kidney disease	21	95.5	0.972
Changes in laboratory tests	20	90.9	0.863
Increased effects of the symptoms	20	90.9	0.863
Seeking emergency services	20	90.9	0.863
High interdialytic weight gain (over 2 kg)	19	86.4	0.661
Infection	19	86.4	0.661
Expressed wish to control the disease	17	77.3	0.226
Quality of life	16	72.7	0.099
Treatment dropout	13	59.1	0.002
Failure to act to reduce risk	12	54.5	0.000
Non-attendance to treatment	12	54.5	0.000
Problem with the fistula	12	54.5	0.000
Low self-esteem	11	50.0	0.000
Prolonged hospitalizations	11	50.0	0.000
Difficult fluid removal during hemodialysis	11	50.0	0.000
Changes in treatment time	9	40.9	0.000
Excessive stress	9	40.9	0.000
Increased treatment costs	8	36.4	0.000
Fatigue	8	36.4	0.000

Related factors	n	%	p ^* * Binomial test.
Complexity of the therapeutic regimen	21	95.5	0.972
Poor knowledge	21	95.5	0.972
Failure to communicate	21	95.5	0.972
Lack of motivation	21	95.5	0.972
Failure to adapt to new conditions	21	95.5	0.972
Irregular attendance to hemodialysis sessions	20	90.9	0.863
Lack of planning	20	90.9	0.863
Lack of emotional support	20	90.9	0.863
Non-adherence to treatment	20	90.9	0.863
Asymptomaticnature of disease	20	90.9	0.863
Time spent on hemodialysis sessions	20	90.9	0.863
ExInappropriate use of medications	20	90.9	0.863
Comorbidities	19	86.4	0.661
Withdrawal from goals	19	86.4	0.661
Neurocognitive dysfunction	19	86.4	0.661
Perceived severity	19	86.4	0.661
Negative self-image	18	81.8	0.424
Beliefs	18	81.8	0.424
Previous experiences	18	81.8	0.424
Socioeconomic factor	18	81.8	0.424
Chronic sadness	17	77.3	0.226
Anxiety	16	72.7	0.099
Perceived benefits	16	72.7	0.099
Residual renal function	16	72.7	0.099
Obesity	15	68.2	0.036
Pain to puncture in arteriovenous fistula	13	59.1	0.002
Poor social support network	13	59.1	0.002
Identification of barriers to changes	12	54.5	0.000
Family conflict	11	50.0	0.000
Excessive demands	11	50.0	0.000
Sexual dysfunction	11	50.0	0.000
Poor transport to hemodialysis	11	50.0	0.000
Poorly defined treatment plans	11	50.0	0.000
Financial problems	11	50.0	0.000
Negative psychological status	10	45.5	0.000
Lack of fistulacare	10	45.5	0.000
Dialysis inadequacy	10	45.5	0.000
Non-adherence to food restrictions	10	45.5	0.000
Break with basic human needs	10	45.5	0.000
Non-adherence to water restriction	9	40.9	0.000
Poor negotiation	9	40.9	0.000
Family patterns of health care	9	40.9	0.000
Self-efficacy	8	36.4	0.000
Perceived susceptibility	8	36.4	0.000
Inadequate number of clues to action	7	31.8	0.000
Health policies	7	31.8	0.000

Defining characteristics	Related factors
Changes in laboratory tests	Anxiety
Irregular attendance to dialysis sessions	Unperceived benefits
High interdialytic weight gain (over 2 kg)	Seeking hospital services
Daily life choices ineffective to achieve health goals	Comorbidities
Expression of difficulty with the treatment prescribed	Treatment complexity
Infection	Poor knowledge
Intensified disease complications	Beliefs
Intensified disease symptoms	Treatment dropout
Non-adherence to treatment	Neurocognitive dysfunction
Non-expressed wish to control the disease	Negative previous experiences
Impaired quality of life	Failure to communicate
Inappropriate use of medications	Lack of motivation
	Lack of planning
	Lack of emotional support
	Unfavorable sociodemographic factor
	Residual kidney function
	Negative body image
	Maladjustment to new conditions
	No perception of disease severity
	Asymptomatic nature of disease
	Time spent on hemodialysis
	Chronic sadness

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDING AUTHOR: Maria das Graças Mariano Nunes de Paiva. E-mail: gracinhamariano@hotmail.com