Profile of nursing diagnoses in indigenous older adults in the community: a cross-sectional study

Silva, Carlos Jordão de Assis; Neves Júnior, Tarcísio Tércio das; Carvalho, Eloisa Araújo de; Silva, Valéria Gomes Fernandes da; Almeida, Sheyla Gomes Pereira de; Menezes, Rejane Maria Paiva de

doi:10.1590/0034-7167-2021-0128

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Brasil

Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (2) • 2022 • https://doi.org/10.1590/0034-7167-2021-0128 copy

Profile of nursing diagnoses in indigenous older adults in the community: a cross-sectional study

Perfil de los diagnósticos de enfermería en ancianos indígenas de la comunidad: un estudio transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to describe the profile of nursing diagnoses evidenced in indigenous elderly in the community.

Methods:

this is a cross-sectional study, carried out with 51 indigenous elderly people of Potiguara ethnicity, through a nursing consultation. The clinical data, obtained from the consultation, were analyzed following Risner’s diagnostic reasoning process and the NANDA-I Taxonomy (2018-2020). For greater accuracy, the diagnoses obtained underwent peer review by a specialist.

Results:

37 diagnoses were identified, such as Impaired dentition (98.0%), Risk for impaired skin integrity (66.7%), Chronic pain (64.7%), Risk for deficient fluid volume (54.9%), Impaired swallowing (45.1%), Impaired walking (45.1%), Disturbed sleep pattern (43.1%), Stress urinary incontinence (41.2%), Risk for falls (35.3%), and Sexual dysfunction (33.3%).

Conclusion:

the diagnoses identified were predominantly from Safety/protection domain and result from factors that negatively influence indigenous elderly’s functional capacity.

Descriptors:
Health of the Elderly; Indigenous Population; Nursing Diagnosis; Geriatric Nursing; Transcultural Nursing

NANDA-I domains (2018-2020)	Mean	Standard deviation	Minimum	Maximum
Total nursing diagnoses per elderly	8.41	2.58	3	14
Health promotion	0.82	0.77	0	3
Nutrition	1.39	0.80	0	3
Elimination and exchange	0.69	0.65	0	2
Activity/rest	1.43	0.94	0	3
Perception/cognition	0.24	0.47	0	2
Self-perception	0.00	0.00	0	0
Roles and relationships	0.10	0.30	0	1
Sexuality	0.33	0.48	0	1
Coping/stress tolerance	0.25	0.48	0	2
Life principles	0.00	0.00	0	0
Safety/protection	2.29	0.73	1	4
Comfort	0.78	0.50	0	2

Nursing diagnosis	(n=51)	%	^* * 95%CI - 95% confidence interval. 95%CI
Impaired dentition	50	98.0	89.7 - 99.7
Risk for impaired skin integrity	34	66.7	53.0 - 78.0
Chronic pain	33	64.7	51.0 - 76.4
Risk for deficient fluid volume	28	54.9	41.4 - 67.7
Impaired swallowing	23	45.1	32.3 - 58.6
Impaired walking	23	45.1	32.3 - 58.6
Disturbed sleep pattern	22	43.1	30.5 - 56.7
Stress urinary incontinence	21	41.2	28.8 - 54.8
Risk for falls	18	35.3	23.6 - 49.0
Sexual dysfunction	17	33.3	22.0 - 47.0
Frail elderly syndrome	15	29.4	18.7 - 43.0
Overweight	14	27.5	17.1 - 40.9
Activity intolerance	13	25.5	15.5 - 38.9
Impaired memory	12	23.5	14.0 - 37.8
Insomnia	9	17.6	9.57 - 30.3
Constipation	8	15.7	8.17 - 28.0
Impaired skin integrity	8	15.7	8.17 - 28.0
Anxiety	7	13.7	6.81 - 25.7
Dysfunctional family processes	4	7.8	3.1 - 18.5
Acute pain	4	7.8	3.1 - 18.5
Ineffective health maintenance	3	5.9	2.0 - 15.9
Readiness for enhanced health management	3	5.9	2.0 - 15.9
Obesity	3	5.9	2.0 - 15.9
Imbalanced nutrition: less than body requirements	3	5.9	2.0 - 15.9
Urinary retention	2	3.9	1.1 - 13.2
Impaired physical mobility	2	3.9	1.1 - 13.2
Caregiving role strain	2	3.9	1.1 - 13.2
Fear	2	3.9	1.1 - 13.2
Impaired oral mucous membrane integrity	2	3.9	1.1 - 13.2
Ineffective health control	2	3.9	1.1 - 13.2
Risk for unstable blood glucose level	1	2.0	0.3 - 10.3
Risk for constipation	1	2.0	0.3 - 10.3
Bowel incontinence	1	2.0	0.3 - 10.3
Decreased cardiac output	1	2.0	0.3 - 10.3
Unstable blood pressure risk	1	2.0	0.3 - 10.3
Impaired verbal communication	1	2.0	0.3 - 10.3
Risk for infection	1	2.0	0.3 - 10.3

Domain	Nursing diagnosis	Related factors/risk factors and Defining characteristics	n	%
Nutrition	Impaired swallowing	Related factors
		Disordered eating behaviors	23	100
		Defining characteristics
		Insufficient chewing	23	100
		Difficulty swallowing	22	95.7
		Food falls from mouth	5	21.7
	Risk for deficient fluid volume	Risk factors
	Risk for deficient fluid volume	Insufficient fluid intake	28	100
Elimination and exchange	Stress urinary incontinence	Related factors
		Weakened supporting pelvic	21	100
		Defining characteristics
		Involuntary leakage of small volume of urine in the absence of overdistended bladder	21	100
		Involuntary leakage of small volume of urine (e.g., with coughing, laughing, sneezing, on exertion)	21	100
		Involuntary leakage of small volume of urine in the absence of detrusor contraction	20	95.2
Activity/rest	Impaired walking	Related factors
		Pain	21	91.3
		Insufficient muscle strength	16	69.6
		Defining characteristics
		Impaired ability to walk on decline	19	82.6
		Impaired ability to walk on incline	19	82.6
		Impaired ability to walk on uneven surface	18	78.3
		Impaired ability to climb stairs	18	78.3
		Impaired ability to navigate curbs	17	73.9
		Impaired ability to walk required distance	6	26.1
	Disturbed sleep pattern	Related factors
		Nonrestorative sleep pattern (i.e., due to caregiver responsibilities, parenting practices, sleep partner)	22	100
		Defining characteristics
		Unintentional awakening	19	86.4
		Difficulty initiating sleep	17	77.3
		Alteration in sleep pattern	15	68.2
		Dissatisfaction with sleep	11	50.0
		Feeling unrested	4	18.2
		Difficulty in daily functioning	2	9.1
Sexuality	Sexual dysfunction	Related factors
		Insufficient knowledge about sexual function	17	100
		Misinformation about sexual function	1	5.9
		Defining characteristics
		Alteration in sexual activity	17	100
		Alteration in sexual excitation	12	70.6
		Alteration in sexual satisfaction	8	47.1
		Decrease in sexual desire	7	41.2
		Perceived sexual limitation	4	23.5
		Change in interest towards others	1	5.9
Safety/protection	Impaired dentition	Related factors
		Difficulty accessing dental care	50	100
		Insufficient knowledge of dental health	45	90.0
		Insufficient oral hygiene	44	88.0
		Defining characteristics
		Absence of teeth	48	96.0
		Abraded teeth	35	70.0
		Excessive oral calculus	20	40.0
		Excessive oral plaque	11	22.0
		Enamel discoloration	5	10.0
	Risk for impaired skin integrity	Risk factors
		Hydration	22	64.7
		Humidity	22	64.7
		Excretions	20	58.8
		Inadequate nutrition	2	5.9
		Extremes of age	1	2.9
		Chemical injury agent (e.g., burn, capsaicin, methylene chloride, mustard agent)	1	2.9
Safety/protection	Risk for falls	Risk factors
		Difficulty with gait	16	88.9
		Decrease in lower extremity strength	14	77.8
		Incontinence	9	50.0
		Impaired mobility	1	5.6
Comfort	Chronic pain	Related factors
		Injury agent	33	100
		Defining characteristics
		Alteration in ability to continue previous activities	33	100
		Self-report of intensity using standardized pain scale (e.g., Wong-Baker FACES scale, visual analogue scale, numeric rating scale)	33	100
		Proxy report of pain behavior/activity changes (e.g., family member, caregiver)	31	93.9
		Self-report of pain characteristics using standardized pain instrument (e.g., McGill Pain Questionnaire, Brief Pain Inventory)	29	87.9

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[1] Corresponding author: Carlos Jordão de Assis Silva. E-mail: carlosjrdao@gmail.com