Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects

Abstract

Objective: To estimate the content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects. Method: Methodological study in two stages: 1) integrative literature review; 2) content validation, with 23 nurses. An instrument with 10 related factors and 21 defining characteristics for data collection was used. The analysis by the evaluators was carried out using the relevance criteria. The Content Validity Index was used. Valid results were those above 0.9 with a Wilcoxon test above 0.05. Results: The final proposal incorporates nine from the ten causal factors. From them, five do not belong in the NANDA-I list. Regarding the defining characteristics, they were all considered to be relevant, and five are not among the list of signs and symptoms of the NANDA-I taxonomy. Conclusion: The findings of this study include specific elements of the pediatric population with congenital heart defect which are not present in the structure of the diagnostic being studied.

Middle-Range Theory of Ineffective Breathing Pattern in children with Congenital Heart Disease

“…There are many clinical conditions in children with CHD that hinder passage of air, thus causing an increase in the resistance of air passages and compromising ventilation; some of these include abnormal anatomical structures (enlarged pulmonary artery, enlarged left atrium and massive cardiomegaly), pulmonary hypertension, increased pulmonary blood flow and respiratory infections. The clinical conditions that contribute to hampering lung expansion and thus to reducing pulmonary complacency are presence of intra-alveolar and interstitial fluid, congestive heart failure, pulmonary congestion, and increased pulmonary blood flow 8 - 9 .…”

“…The focal stimulus increases the carbon dioxide and hydrogen concentrations, acting as precipitation agents; that is, those that initially trigger the study phenomenon and cause an imbalance in the ventilation-perfusion process, triggering behaviors associated with the IBP Nursing diagnosis in order to compensate or correct the change in these values 8 , 10 - 11 .…”

“…Hypoxemia and cyanosis are acute behaviors of clinical deterioration that occur when there is no effective gas exchange at the alveolar level, causing a decrease in oxygenation in the arterial blood 8 , 17 - 18 . On the other hand, the acute behaviors of clinical deterioration hypoxia and fatigue of the respiratory muscles are the result of insufficient oxygen supply for a given metabolic rate, causing anaerobic metabolism, that is, an increase in the lactate rate and a decrease in serum bicarbonate for hypoxia and incoordination of respiratory movements for fatigue of the respiratory muscles 8 , 18 .…”

“…Initially, a list of concepts was submitted to the judges with 10 stimuli and 21 behaviors, and of these, nine stimuli and all behaviors were considered relevant. The stimulus that did not show statistical significance was age less than two years old; therefore, it was excluded 8 .…”

Teoría de Mediano Alcance del Patrón de Respiración Ineficiente en niños con cardiopatías congénitas

“…Inicialmente se presentó a los jueces una lista de conceptos con 10 estímulos y 21 comportamientos, de los cuales nueve estímulos y todos los comportamientos se consideraron relevantes. El único estímulo que no presentó significancia estadística fue tener menos de dos años de edad, por lo que fue excluido (8) .…”