Analysis of ineffective breathing pattern and impaired spontaneous ventilation of adults with oxygen therapy

Abstract

Objective:to analyze the manifestation of the defining characteristics of the nursing diagnoses of ineffective breathing pattern and impaired spontaneous ventilation, of the NANDA International and the defining characteristics identified in the literature for the concept of “ventilation” in adult patients hospitalized in an intensive care unit with use of oxygen therapy. Method:clinical diagnostic validation study, conducted with 626 patients in intensive care using oxygen therapy, in three different modalities. Multiple correspondence analysis was used to verify the discriminative capacity of the defining characteristics and latent class analysis to determine the diagnostic accuracy of them, based on the severity level defined by the ventilatory mode used. Results:in the multiple correspondence analysis, it was demonstrated that the majority of the defining characteristics presented low discriminative capacity and low percentage of explained variance for the two dimensions (diagnoses). Latent class models, separately adjusted for the two diagnoses, presented a worse fit, with sharing of some defining characteristics. Models adjusted by level of severity (ventilation mode) presented better fit and structure of the component defining characteristics. Conclusion:clinical evidence obtained in the present study seems to demonstrate that the set of defining characteristics of the two nursing diagnoses studied fit better in a single construct.

Fatores preditores do diagnóstico de enfermagem padrão respiratório ineficaz em pacientes de uma unidade de terapia intensiva

“…A recent study, also performed in an ICU in the city of Ribeirão Preto, SP, Brazil, with 626 adult patients, showed that the RF fatigue presented greater sensitivity for the IBP diagnosis 23 . The authors emphasize that IBP patients present DC related to ventilatory dysfunction and, if not treated adequately, this diagnosis may evolve to the diagnosis of impaired spontaneous ventilation (ISV), characterizing a worse prognosis of the patient 23 .…”

“…The DC decreased inspiratory pressure evaluated by the manovacuometer was chosen to confirm the presence of IBP because a study conducted in 2015 and 2016 with 626 adult ICU patients showed that this DC and the RF fatigue were the ones that had the greatest sensitivity for the IBP diagnosis in these patients 23 .…”

Accuracy of Defining Characteristics for Nursing Diagnoses Related to Patients with Respiratory Deterioration

“…Clusters of DC are also recommended by NANDA‐I taxonomy II, suggesting that to achieve accuracy in certain diagnoses it is necessary to analyze a group of signs and symptoms (Herdman & Kamitsuru, ). Furthermore, grouping of DC for respiratory ND has been recently proposed in a study that aimed to analyze through a latent class model DC for ISV and IBP (Seganfredo et al., ).…”

“…Although the identification of respiratory deterioration is a priority in nurses' assessment (Borgert et al, 2015;Mc-Coll & Pesata, 2016), assessment of these needs is not always reflected in accurate ND because there are factors that make this process difficult, such as the similarity among the respiratory diagnoses. Accuracy studies examining the association between DC and the respective respiratory ND have been performed with diverse patient populations, such as adult postoperative period of cardiac surgery patients (Sousa et al, 2015(Sousa et al, , 2016, intensive care unit (ICU) patients (Seganfredo et al, 2017), and in newborns (Avena, Pedreira, Alves, Herdman, & Gutierrez, 2019). Overall, previous studies have explored which DC better predicts the presence/absence of their respective ND.…”

Fatores Preditores Do Diagnóstico De Enfermagem Padrão Respiratório Ineficaz Em Pacientes De Uma Unidade De Terapia Intensiva

“…A CD pressão inspiratória diminuída avaliada pelo manovacuômetro foi escolhida para confirmar a presença de PRI, pois um estudo realizado em 2015 e 2016, com 626 pacientes adultos em UTI mostrou que essa CD e o FR fadiga foram os fatores que apresentaram maior sensibilidade para o diagnóstico PRI nesses pacientes (23) . A enfermeira responsável por esta pesquisa coletou os dados com a ajuda de um instrumento padronizado elaborado para esse fim.…”