Content Analysis of the Diagnostic Proposition Risk of Excessive Fluid Volume in Hemodialysis Patients

Fernandes, Maria Isabel da Conceição Dias; Carino, Ana Carolina Costa; Gomes, Camila Sayonara Tavares; Dantas, Juliane Rangel; Lopes, Marcos Venicios de Oliveira; Lira, Ana Luisa Brandão de Carvalho

doi:10.1590/1980-220X-REEUSP-2021-0158

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REVIEW • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0158 copy

Content Analysis of the Diagnostic Proposition Risk of Excessive Fluid Volume in Hemodialysis Patients

Análisis de Contenido de la Proposición Diagnóstica Riesgo de Volumen de Líquidos Excesivo en Pacientes sometidos a Hemodiálisis

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze the content of the diagnostic proposition risk of excessive fluid volume in patients undergoing hemodialysis.

Method:

Content validity study, with 48 judges who assessed the content of the diagnostic proposition risk of excessive fluid volume, using an electronic data collection instrument. The judges’ answers were analyzed through the calculation of the Content Validity Index and the T test.

Results:

The risk of excessive fluid volume was considered adequate, containing 23 risk factors: increased sodium concentration in the dialysate; missing hemodialysis sessions; insufficient water; low self-efficacy for fluid restriction; deficient knowledge; altered body mass index; excessive intake of fluids, proteins and sodium; lower kt/v index; inadequate removal of fluids in hemodialysis; thirst; xerostomia; older people; comorbidities; renal function decline; decreased urinary volume; inflammatory status; hospitalization; low serum level of albumin and lymphocytes, and high level of phosphorus; and use of antihypertensive drugs.

Conclusion:

The content of the diagnostic proposition risk of excessive fluid volume was considered adequate by the judges.

DESCRIPTORES
Nursing; Validation Study; Renal Dialysis

Variables	CVI	95% CI		t test	gl	p-value*
Insertion of the proposition in domain 02 and class 05 of NANDA-I	0.961	0.929	0.993	10.169	47	1.000
Definition: Vulnerability to excessive isotonic fluid retention that occurs when interdialytic weight gain is above 3.5% of dry weight, due to excessive hydration, with consequent chronic overload of intravascular and extravascular fluid, capable of uncontrolled body volume and health impairment	0.853	0.781	0.925	1.493	47	0.929

Risk factor	CVI	95% CI		t test	gl	p value*
Diet abuse	0.873	0.811	0.935	2.373	47	0.989
Young adults	0.749	0.672	0.826	−1.342	47	0.093
Increase in dialysate sodium concentration	0.951	0.914	0.988	8.152	47	1.000
Missing the hemodialysis session	0.996	0.986	1.000	41.782	47	1.000
Insufficient water intake frequency	0.908	0.863	0.953	4.804	47	1.000
Low self-efficacy for fluid intake	0.853	0.791	0.915	1.732	47	0.955
Comorbidities	0.904	0.856	0.951	4.403	47	1.000
Deficient knowledge	0.980	0.961	1.000	18.408	47	1.000
Decline in renal function	0.969	0.941	0.998	11.874	47	1.000
Decrease in body fat	0.775	0.695	0.855	−0.623	47	0.268
Decrease in ultrafiltration volume	0.969	0.941	0.998	11.874	47	1.000
Inflammatory status	0.915	0.852	0.977	3.687	47	1.000
Daily stress	0.708	0.617	0.799	−2.024	47	0.024
Diuresis failure	0.892	0.831	0.954	3.020	47	0.998
Vascular access failure	0.919	0.877	0.961	5.667	47	1.000
Intermittent conventional hemodialysis	0.786	0.699	0.874	−0.315	47	0.377
Hospitalization	0.845	0.769	0.921	1.195	47	0.881
Older people	0.828	0.741	0.915	0.651	47	0.741
Altered body mass index	0.813	0.726	0.900	0.298	47	0.616
Excessive fluid intake	0.873	0.950	1.000	13.357	47	1.000
Excessive sodium intake	0.987	0.971	1.000	23.494	47	1.000
Greater experience in dialysis treatment	0.665	0.568	0.761	−2.813	47	0.004
Lower Kt/V index	0.926	0.860	0.992	3.830	47	1.000
Low serum albumin level	0.958	0.931	0.986	11.594	47	1.000
High serum level of phosphorus	0.853	0.767	0.940	1.243	47	0.890
Decreased serum level of lymphocytes	0.803	0.714	0.892	0.069	47	0.527
African American or white race	0.613	0.500	0.726	−3.317	47	0.001
Inadequate fluid removal during hemodialysis	0.993	0.981	1.000	32.085	47	1.000
Thirst	0.932	0.891	0.972	6.586	47	1.000
Use of antihypertensive drugs	0.881	0.816	0.947	2.494	47	0.992
Xerostomia	0.933	0.895	0.971	7.098	47	1.000

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Maria Isabel da Conceição Dias Fernandes Campus Universitário, Br-101, Lagoa Nova 59072-970 – Natal, RN, Brazil, bebel_6@hotmail.com