Ineffective breathing pattern in children and adolescents with congenital heart disease: accuracy of defining characteristics.

Abstract

The purpose of this study was to assess the prevalence of ineffective breathing pattern and the accuracy of its defining characteristics, among children and adolescents with congenital heart disease. The NANDA International nursing diagnosis, ineffective breathing pattern, has been noted to have high prevalence in different clinical contexts and age groups. Despite that, nurses continue to report difficulties in confirming this diagnosis. The lack of data regarding the sensitivity, specificity and predictive values of the defining characteristics contribute to decreased certainty in diagnosing ineffective breathing pattern. A diagnostic accuracy study. This study of diagnostic accuracy was conducted with 61 children and adolescents with congenital heart disease. Two nurses were trained by the primary investigator on use of defining characteristics in the diagnostic process for ineffective breathing pattern. Ineffective breathing pattern was present in 26·2% of the children and adolescents sampled. When analysing the defining characteristics, alterations in depth of breathing, showed high values of sensitivity and specificity. In addition, orthopnoea, tachypnoea and use of accessory muscles to breathe, showed high values of specificity; dyspnoea showed high values of sensitivity. Finally, assumption of three-point position, bradypnoea and increased anterior-posterior diameter were not found to be statistically significant for this sample population. Five defining characteristics of ineffective breathing pattern presented measures of accuracy with statistically significant values in children with congenital heart disease. The findings can help nurses during the diagnostic process, as they identify which defining characteristics can be used to confirm or rule out the probability of occurrence of the diagnosis.