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

Deborah Hein Seganfredo,Viviane Martins Da Silva,Marcos Venícios De Oliveira Lopes,Miriam De Abreu Almeida,Stela Maris De Jezus Castro,Beatriz Amorim Beltrão

doi:10.1590/1518-8345.1950.2954

Abstract

ABSTRACTObjective: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.

Highlights

MethodThe NANDA International Taxonomy II (NANDA-I) is the globally accepted classification of Nursing Diagnoses (NDs), composed of 13 domains, 47 classes and 234 diagnoses
The aim of this study was to analyze how the Defining Characteristics (DCs) of the Ineffective Breathing Pattern (IBP) and Impaired Spontaneous Ventilation (ISV) NDs and the DCs found in the literature for the key concept “ventilation” are manifested in adult patients hospitalized in Intensive Care Unit (ICU) using oxygen therapy
Considering the aims of this study, namely, to analyze how the DCs of the IBP and ISV NDs are manifested, as well as those contained in the literature for the key concept “ventilation” in adult patients hospitalized in an ICU, using oxygen therapy, it was found that “decreased inspiratory pressure” and “decreased expiratory pressure” presented the highest frequency, in both (100%) the invasive mechanical ventilation (IMV) and Non-Invasive Mechanical Ventilation (NIMV) subsamples of patients

Summary

Introduction

MethodThe NANDA International Taxonomy II (NANDA-I) is the globally accepted classification of Nursing Diagnoses (NDs), composed of 13 domains, 47 classes and 234 diagnoses. The fourth domain, called “Activity/rest”, is defined as the “production, conservation, expenditure or balance of energy resources” and contains the class “Cardiovascular/pulmonary responses”, which is defined as “cardiopulmonary mechanisms that support activity/ rest”. This class includes the Ineffective Breathing Pattern (IBP) and Impaired Spontaneous Ventilation (ISV) NDs(1). The ISV ND, in turn, was introduced into the NANDA-I in 1992 and has never been revised It is defined as “decreased energy reserves resulting in an inability to maintain independent breathing that is adequate to support life” and has 11 DCs. The difficulties in accurately establishing each of these NDs come from both their closely related definitions and their similar or shared DCs

Objectives

Discussion

Conclusion