Validação de intervenções de enfermagem para pacientes com lesão medular e mobilidade física prejudicada

Abstract

This is a descriptive study that aimed to validate the nursing interventions proposed in the Nursing Interventions Classification for the diagnosis of Impaired physical mobility in adults with sequels of spinal cord injury, based on opinions of experts in rehabilitation about each intervention proposed. The sample consisted of 54 nurses who were asked about how they consider the interventions for the nursing diagnosis. A questionnaire was administered to nurses who work at the Sarah Network of Rehabilitation Hospitals. Among the 46 interventions studied, 17 (37%) were considered essential and should be implemented; others 15 (32.6%) were considered complementary, and 14 (30.4%) should not be used and could be discarded. Nursing interventions not described in the classification and suggested by 22 nurses (40.7%) were: Care with Orthoses: Maintenance; and Care with Orthoses: Prevention.

Terms of international classification for Nursing Practice in motor and physical rehabilitation

“…Terms such as range of motion of joints, architectural barrier, bladder capacity, contraction, deformity, mobility, physical mobility, hollow foot, varus foot, rehabilitation, quality of life, bowel retraining, and bladder retraining are well used in rehabilitation nursing practices (2,(5)(6) . On the Location axis, the terms like shoulder joint, spine, elbow, iliac crest, knee, lateral malleolus, medial malleolus, leg, arm, shoulder, calf, patella, hip, shoulder region, inguinal region, intergluteal region, sciatic region, and trochanteric region are related to body structures, where joint pain and skin lesions such as pressure ulcers, may occur (14)(15) .…”

“…These patients require using adaptation resources to perform daily activities in order to minimize dependence or achieve independence (according to their motor and cognitive capabilities). As examples, the following can be mentioned: orthoses (used for limb placement, improving function or preventing deformities); bladder and bowel retraining techniques; control and prevention of complications such as autonomic dysreflexia, and pressure ulcer (2,6,(14)(15) . This work enabled us to identify correlations between the language used by nurses and terms of ICNP ® .…”

“…The Delphi technique accounts for the results depending on the level of experts; as there is no ideal number of judges, the group's composition varies according to the subject under study and criteria set by the researcher for the selection of these specialists. In the case of this study, the convenience sample was defined by 50 nurses, and the specificity of the rehabilitation area, the ICNP ® and studies that used experts for validation (6,10,(12)(13) were considered. The following criteria for the inclusion of experts were used: a) title of Master's of Nursing; b) title of Master's of Nursing with dissertation regarding content related to physical-motor rehabilitation, terminology, nursing process or nursing classifications; c) a research publication regarding physical-motor rehabilitation, terminology, nursing process or nursing classifications, with content relevant to the area; d) publication of an article on physical-motor rehabilitation, terminology, nursing process or nursing classifications in a reference journal; e) doctoral thesis regarding physical-motor rehabilitation, terminology, nursing process or nursing classifications; f ) clinical practice of at least two years in physical-motor rehabilitation; g) relevant clinical practice certificate in physical-motor rehabilitation (specialist in nursing rehabilitation).…”

“…This is due to the significant increase in the number of people with chronic diseases and those that survive neurological damage, such as stroke, spinal cord injury, and traumatic brain injury. However, there is a rating system specifically dedicated to the nursing care of physical-motor rehabilitation, although the number of individuals demanding this specialized care is increasing (5)(6) . Appreciating the fact that the ICN recognizes the necessity of the existence of diagnostic subsets, nursing interventions and outcomes for specific areas of practice (ICN, 2005), this study was designed with the purpose of contributing to the construction of a subset of ICNP ® concepts for physical-motor rehabilitation.…”

Validation of indicators of the nursing outcomes classification for hospitalized adults at risk of infection

“…[7][8][9][10] This justifies researchers' choice to adapt this method, constructed for the validation of NDx, 11 but which has been applied recently to validation nursing interventions and outcomes. 10,[12][13][14][15] As observed, further advances are needed in studies about the NOC with a view to deeper knowledge and use in practice, as described in a recent study that involved patients with heart failure in home care. 16 The NDx Risk for Infection, defined as being "at risk for being invaded by pathogenic organisms", was the most frequent at the three nursing services in a Brazilian study.…”