Diagnosis Statement Research Articles

Subconjunto terminológico CIPE® para pacientes com tromboembolismo venoso associado a câncer

Resumo Objetivo Elaborar e validar um subconjunto terminológico da Classificação Internacional para Prática de Enfermagem (CIPE®) para pacientes com tromboembolismo venoso associado ao câncer. Métodos Estudo metodológico, desenvolvido em quatro etapas: revisão integrativa da literatura, que buscou evidências empíricas de diagnósticos e intervenções de enfermagem relacionadas ao tromboembolismo venoso associado ao câncer, nas bases de dados MEDLINE, PUBMED, CINAHL, LILACS, BDENF e COCHRANE, com recorte temporal de 2001 a 2016; na segunda etapa do estudo foi realizado o mapeamento cruzado entre os termos identificados na literatura e os termos constantes na CIPE® versão 2017; a terceira etapa consistiu na construção do subconjunto terminológico CIPE®, contendo os enunciados de diagnósticos/resultados e intervenções de enfermagem e distribuídos conforme as Necessidades Humanas Básicas postuladas no referencial conceitual de Wanda Horta; na quarta etapa foi realizada a validação de conteúdo das declarações por enfermeiros peritos. Resultados No total, 37 afirmativas de diagnósticos e intervenções de enfermagem foram elaboradas. Destas, 34 diagnósticos e 35 intervenções foram validadas. Foi proposta a inclusão de quatro diagnósticos de enfermagem como conceitos pré-coordenados na CIPE®: Edema periférico unilateral; Edema periférico crônico; Saturação de oxigênio no sangue, baixa; e Conhecimento sobre regime terapêutico. Conclusão O instrumento poderá constituir-se numa referência de fácil acesso para enfermeiros, propiciando um cuidado baseado em evidências e linguagem de enfermagem unificada.

Nursing diagnoses from ICNP® for people with metabolic syndrome.

To construct nursing diagnosis statements based on the International Classification for Nursing Practice (ICNP®) for people with metabolic syndrome, settled on the theoretical framework of Basic Human Needs. Descriptive study developed in four stages: 1) Identification and validation of terms relevant to care with health priority; 2) Cross-mapping of the terms identified with ICNP® terms; 3) Construction of the nursing diagnosis statements; and 4) Cross-mapping of constructed statements with the ones in ICNP®. Regarding terms extracted, 370 were validated based on the consensus (100%) among specialists, subsidizing the elaboration of 52 nursing diagnosis statements from ICNP® version 2015, distributed among the Basic Human Needs proposed by theoretical framework. It was possible to construct nursing diagnoses for people with metabolic syndrome based on the terms extracted from the literature, with a predominance of the need for "Health education and learning".

Data‐driven fault diagnosis and robust control: Application to PEM fuel cell systems

SummaryA data‐driven methodology that includes the unfalsified control concept in the framework of fault diagnosis and isolation (FDI) and fault‐tolerant control (FTC) is presented. The selection of the appropriate controller from a bank of controllers in a switching supervisory control setting is performed by using an adequate FDI outcome. By combining simultaneous online performance assessment of multiple controllers with the fault diagnosis decision from structured hypothesis tests, a diagnosis statement regarding what controller is most suitable to deal with the current (nominal or faulty) mode of the plant is obtained. Switching strategies that use the diagnosis statement are also proposed. This approach is applied to a nonlinear experimentally validated model of the breathing system of a polymer electrolyte membrane fuel cell. The results show the effectiveness of this FDI–fault‐tolerant control data‐driven methodology. Copyright © 2017 John Wiley & Sons, Ltd.

Simplified Mortality Score for the Intensive Care Unit (SMS-ICU): protocol for the development and validation of a bedside clinical prediction rule

IntroductionMortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex,...

Cardiocutaneous syndrome (Naxos disease) in a Bangladeshi boy

Naxos disease is a rare autosomal recessive form of arrhythmogenic right ventricular cardiomyopathy (ARVC) with woolly hair and palmoplantar keratoderma. The cardiomyopathy presents by adolescence with syncope, ventricular tachycardia (VT) of left bundle branch block (LBBB) morphology, and/or ventricular fibrillation. The diagnosis and management of ARVC are at present in evolution; the recently published modified Task Force Criteria for diagnosis and International Task Force consensus statement for treatment of ARVC will hopefully bring about uniformity in recognition and management of Naxos disease as well. Here, typical phenotype and diagnostic work up have been presented in a Bangladeshi boy with the Cardiocutaneous syndrome.

THE ALGORITHM OF THE CASE FORMATION DURING THE DEVELOPMENT OF CLINICAL DISCIPLINES IN MEDICAL SCHOOL

The aim of the study is to develop the algorithm of formation of the case on discipline «Clinical Medicine». Methods . The methods involve the effectiveness analysis of the self-diagnosed levels of professional and personal abilities of students in the process of self-study. Results . The article deals with the organization of independent work of students of case-method, which is one of the most important and complex active learning methods. When implementing the method of case analysis in the educational process the main job of the teacher focused on the development of individual cases. While developing the case study of medical character the teacher needs to pay special attention to questions of pathogenesis and pathological anatomy for students’ formation of the fundamental clinical thinking allowing to estimate the patient’s condition as a complete organism, taking into account all its features, to understand the relationships of cause and effect arising at development of a concrete disease, to master new and to improve the available techniques of statement of the differential diagnosis. Scientific novelty and practical significance . The structure of a medical case study to be followed in the development of the case on discipline «Clinical Medicine» is proposed. Unification algorithm formation cases is necessary for the full implementation of the introduction in the educational process in the higher medical school as one of the most effective active ways of learning – method of case analysis, in accordance with the requirements that apply to higher professional education modern reforms and, in particular, the introduction of new Federal State Educational Standards.

Development and internal validation of a multivariable prediction model for biochemical failure after whole-gland salvage iodine-125 prostate brachytherapy for recurrent prostate cancer

BackgroundLocalized recurrent prostate cancer after primary radiotherapy can be curatively treated using salvage iodine-125 (125I) brachytherapy. Selection is hampered by a lack of predictive factors for cancer control. This study aims to develop and internally validate a prognostic model for biochemical failure (BF) after salvage 125I brachytherapy. Methods and MaterialsWhole-gland salvage 125I brachytherapy patients were treated between 1993 and 2010 in two radiotherapy centers in the Netherlands. Multivariable Cox regression was performed to assess the predictive value of clinical parameters related to BF (Phoenix-definition [prostate-specific antigen [PSA]-nadir + 2.0 ng/mL]). Missing data were handled by multiple imputation. The model's discriminatory ability was assessed with Harrell's C-statistic. Internal validation was performed using bootstrap resampling (2000 data sets). Goodness-of-fit was evaluated with calibration plots. All analyses were performed using the recently published TRIPOD (Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) statement. ResultsAfter median followup of 74 months (range 5–138), 43 of a total 62 patients developed BF. In multivariable analysis, disease-free survival interval (DFSI) after primary therapy and pre-salvage prostate-specific antigen doubling time (PSADT) were predictors of BF: corrected hazard ratio (HR) 0.99 (95% confidence interval 0.97–0.999; p = 0.04) and 0.94 (95% confidence interval 0.89–0.99; p = 0.03), both for a 1-month increase (optimism-adjusted C-statistic 0.70). Calibration was accurate up to 36 months. Of patients with PSADT >30 months and DFSI >60 months, 36-month biochemical disease-free survival was >75%. Every 12-month increase in DFSI will allow 3-month decrease in PSADT while maintaining the same biochemical recurrence-free rates. ConclusionsWe have presented results from a cohort of patients undergoing salvage 125I-brachytherapy. Our data show that better selection of patients is possible with the DFSI and PSADT.

BEHCET'S DISEASE IN CHILDREN: RUSSIAN EXPERIENCE

The paper presents the clinical characteristics of Behcet's disease (BD) in Russian children, generally accepted criteria for BD, and diagnosis statement. The investigation is based on an observation of 17 children who met the international criteria for BD and were treated at the V.A. Nasonova Research Institute of Rheumatology in 2004 to 2013. One-third of children had a compromised family history; about 30% of the patients were ethnic Russian. The age at BD onset ranged from infancy to 16 years. The interval between disease onset and diagnosis was 1 to 10 years. The clinical symptoms at onset represented mostly frequently aphthous stomatitis and its accompanying fever and much less frequently aphthae of the genitalia. Furtherthe pathological process involved other organs and systems. In advanced stage of disease, there was already a clinical syndrome encompassing aphthous stomatitis, a genital ulcerative process, and lesions of the eye, skin, gastrointestinal tract, and less often central nervous system. The manifestations of the disease in different combinations can be concurrent with each other, showing a mosaic pattern. Treatment of children with BD included glucocorticoids, colchicine, azathioprine, and, if clinically indicated, tumor necrosis factor-α inhibitors. Their efficacy is discussed. The pediatric aspects of BD, which are presented in this paper, are first published in Russian medical press

Problems With the Development and Validation of a Prognostic Model

To the Editor: With high quality data and appropriate statistical methods, prognostic models can hold enormous potential for identifying individuals at increased risk developing a health condition. Unfortunately, the recent study described by He et al (1.He X Xu G Liang W Nomogram for predicting time to death after withdrawal of life-sustaining treatment in patients with devastating neurological injury.Am J Transplant. 2015; 15 (et al): 2136-2142Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar) not only fails to omit key important information as suggested the TRIPOD Initiative (2.Collins GS Reitsma JB Altman DG Moons KGM. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): The TRIPOD statement.Ann Intern Med. 2015; 162: 55-63Crossref PubMed Scopus (1217) Google Scholar) (www.tripod-statement.org), but has numerous methodological problems which deserve highlighting so that future investigators do not fall into the same trap. Sample size considerations for studies developing a prognostic model are frequently based on the rule-of-thumb of (a minimum of) 10 events per variable (EPV) (3.Steyerberg EW. Clinical prediction models: A practical approach to development, validation, and updating. Springer, New York2009Crossref Google Scholar). A small EPV will result in an overfit model, that is, a model that fits the data too well and ultimately describes noise or random error and is when too many predictors are examined in relation to the number of events. The performance of the model will then be overestimated (termed optimistic). The “event” is the smaller of the number of individuals experiencing the event or the number of individuals not experiencing the event. In the study by He et al, 123 died with 60 min and 52 did not; thus, the study had 52 “events.” The number of predictors examined was 46, leading to an EPV of 52/46 = 1.1, which is much lower than the recommended minimum of EPV = 10. The authors then proceed to evaluate the performance of the model on two separate datasets, of size 201 and 43 (the number of deaths within 60 min is disappointingly not reported) and reported rather spectacular performance. It is worth remarking that sample size considerations for studies validating a prediction model are that a minimum of 100 events and 100 nonevents are required (4.Vergouwe Y Steyerberg EW Eijkemans MJC Habbema JDF. Substantial effective sample sizes were required for external validation studies of predictive logistic regression models.J Clin Epidemiol. 2005; 58: 475-483Abstract Full Text Full Text PDF PubMed Scopus (398) Google Scholar); values most certainly not achieved in the study by He et al. The final, and arguably, the most important reporting issue affecting reproducibility and implementation relates to the presentation of the model; the authors produced a nomogram. A nomogram is not a prognostic model but merely a graphical presentation of the underlying regression model. For other independent investigators wishing to evaluate (i.e. validate) on other data, it is absolutely vital that the underlying model, namely all regression coefficients plus the baseline survival at 30, 60, 120, and 240 min (which the authors have not done) are clearly reported. In the absence of the full model, independent validation of the model by independent investigators is not possible. We recommend the authors and other investigators contemplating developing or validating a prediction model to consult to the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) Statement (2.Collins GS Reitsma JB Altman DG Moons KGM. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): The TRIPOD statement.Ann Intern Med. 2015; 162: 55-63Crossref PubMed Scopus (1217) Google Scholar). In addition to providing guidance on key information to report when describing a prognostic model study, the accompanying Explanation & Elaboration article also highlights many methodological considerations when developing or validation a clinical prediction model (5.Moons KGM Altman DG Reitsma JB Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): Explanation and elaboration.Ann Intern Med. 2015; 162 (et al): W1-W73Crossref PubMed Scopus (1167) Google Scholar). The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Increased familiarity, knowledge and confidence with Nutrition Care Process Terminology following implementation across a statewide health‐care system

AbstractAimInformation on attitudes and knowledge of practising dietitians regarding the Nutrition Care Process (NCP) and International Dietetics and Nutrition Terminology (IDNT) would be useful to inform effective implementation. The present study aimed to: (i) explore dietitians' expectations, perceptions and anticipated benefits of NCP/IDNT pre and post implementation; (ii) identify perceived implementation barriers and enablers; and (iii) develop and assess a train‐the‐trainer NCP/IDNT implementation approach.MethodsAll Queensland Government State hospitals from metropolitan, regional and remote areas were included in the study. Dietitian champions (n = 17) attended one face‐to‐face, train‐the‐trainer day, then led 14 one‐hour educational sessions to 279 district dietitians tailored to local situations, facilities and resources. NCP/IDNT were embedded into local processes and chart audits completed. Pre‐/post‐implementation surveys were completed by 86 dietitians.ResultsPre‐implementation results showed positive attitudes regarding the value of NCP/IDNT (mean 1.89, SD 0.67, 1 = strongly agree, 5 = strongly disagree). Dietitians identified management support; practice, tutorials and workshops; mentor support; and follow up audits as important for successful implementation. Most attendees (81%) completed ≥10/13 tutorials and 86% (415/480) of audited charts included Nutritional Diagnosis statements. Post‐implementation familiarity, confidence and knowledge of NCPT (Nutrition Care Process Terminology) significantly improved (P < 0.001).ConclusionsPrior to implementation, respondents viewed the NCP/IDNT as applicable to their practice areas. The train‐the‐trainer program with frequent teleconference and email support was effective in improving knowledge, confidence, preparedness for implementing NCPT and charting behaviour. Although training was positively received and has achieved good results, dietitians identified the need for ongoing training and support to further increase confidence following implementation.

Development and validation of a screening tool to predict the risk of chronic low back pain in patients presenting with acute low back pain: a study protocol

IntroductionAround 40% of people presenting to primary care with an episode of acute low back pain develop chronic low back pain. In order to reduce the risk of developing chronic...

Nursing diagnosis and results for the institutionalized elderly: a methodological study

Aims: To identify nursing practice focuses and create statements in terms of the diagnoses and results of the International Classification for Nursing Practice (ICNP®) for the institutionalized elderly. Method: This is a methodological study based on Horta’s theory, carried out in a long term care facility for the elderly (LTCF), using the cross-mapping technique and content validation. Eighty three (83) elderly individuals participated in the study. Results: We identified 192 focuses of nursing practice and the construction of 129 statements of diagnostics and results. According to the cross-mapping, we can highlight that 60 statements were constant and 69 were not listed in the ICNP®, version 2013. Conclusion: The 192 focuses of nursing practice that have been identified in the health assessment of the institutionalized elderly allowed the construction of 129 statements of diagnoses and results. These findings make it possible to implement the process in order to systematize nursing practice in these environments.

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study

IntroductionThe nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. PurposeTo describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. MethodsA nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. ResultsThere was a tendency to omit ‘nursing problem’ or ‘nursing diagnosis’ in the nursing process by changing these terms (used in the paper-based care plan) to ‘observation’ in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. ConclusionsThe overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses’ attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes.

Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): explanation and elaboration.

The TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis) Statement includes a 22-item checklist, which aims to improve the reporting of studies developing, validating, or updating a prediction model, whether for diagnostic or prognostic purposes. The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used. This explanation and elaboration document describes the rationale; clarifies the meaning of each item; and discusses why transparent reporting is important, with a view to assessing risk of bias and clinical usefulness of the prediction model. Each checklist item of the TRIPOD Statement is explained in detail and accompanied by published examples of good reporting. The document also provides a valuable reference of issues to consider when designing, conducting, and analyzing prediction model studies. To aid the editorial process and help peer reviewers and, ultimately, readers and systematic reviewers of prediction model studies, it is recommended that authors include a completed checklist in their submission. The TRIPOD checklist can also be downloaded from www.tripod-statement.org.

Usage Patterns of Nursing Diagnoses among Student Nurses in Psychiatric Unit: Relation with NANDA and SNOMED CT

Purpose: The aim of this study was to explore how nursing diagnoses are made by undergraduate students of psychiatric unit in Korea. Methods: Data were collected from case reports and analyzed based on NANDA (North American Nursing Diagnosis Association) nursing diagnoses and Systematized Nomenclature of Medicine- Clinical Terms (SNOMED CT) as reference terminology. Results: The 30 different nursing diagnoses from 135 distinct nursing diagnosis statements were assessed after removing repetition of case studies from a of total of 1,140 statements of nursing diagnoses. The most frequently used NANDA diagnosis was ineffective coping The thirty nursing diagnoses were grouped under 10 out of the 13 NANDA domains. In addition, 98 related factors were classified into SNOMED CT hierarchies of Clinical Finding, Procedure, and Observable Entity. The content validity index for the mapping of nursing diagnoses was 0.97, indicating a relatively strong agreement. Conclusion: These results can help students to improve their knowledge and better formulate appropriate diagnoses. Using standardized terminology would improve competency of education and help to ratify the steps of the nursing process, especially nursing planning. Educational strategies that enhance diagnostic accuracy are recommended.

Sistematização da assistência de enfermagem fundamentada na CIPE® e na teoria da adaptação em hipertensos

Study aimed to identify diagnoses and plan outcomes and interventions based on the CIPE® nomenclature and on the theory of adaptation to hypertensive patients with associated diseases. It is a multiple case study conducted with 45 users of the Family Health Strategy and registered in HIPERDIA. The most frequent diagnoses identified were partial self-care (93.3%), decreased exercise pattern (84.4%), impaired dentition (82.2%), and low learning process (60%). Outcomes and interventions aimed at improving adherence to treatment and quality of life were planned for these diagnoses. The results of this study highlight the need for care of hypertensives with complications, supporting a theoretical foundation and practice of nursing care through the development of statements of diagnoses, outcomes, and interventions. doi: 10.5216/ree.v16i4.22945.

Posttraumatic stress in breast cancer patients

Background. Breast cancer diagnosis is a potential life-threatening event associated with significant distress. The present study aimed to identify the prevalence of posttraumatic stress and its association with clinical and social factors in early breast cancer patients and one year after surgery. Materials and methods. Four hundred twenty one newly diagnosed breast cancer patients completed three questionnaires: Impact of Event Scale – revised (IES-R), Beck Depression Inventory II (BDI-II), Vrana &amp; Lauterbach Traumatic Events Scale-Civilian (TEQ). Women were questioned before surgery and one year later. Patients were 18–80 years old resident Lithuanian women with histologically confirmed breast cancer and no history of other cancers. Additional requirements were as follows: ability to read Lithuanian and being capable of completing a questionnaire. Results. 51.5% of newly diagnosed breast cancer patients had from moderate to severe symptoms of PTSD (score average of IES-R ≥ 1.5). After one year it decreased and there were 33.5% of patients who had symptoms of PTSD. The scores of all subscales were decreased a bit as well. Immediately after statement of diagnosis, PTSD correlated with sadness, often cry and earlier traumatic experience. One year later, PTSD correlated with poor self perception, sadness and traumatic experience during this year. Pessimistic mood, lack of energy, difficulties to concentrate were significant to breast cancer patients. Conclusions. A significant number of breast cancer patients suffers from PTSD symptoms. After one year, the amount of patients suffering from PTSD decreased almost twice. Depression and traumatic experience are the predictors of PTSD. The findings show that early evaluation of psychoemotional needs of breast cancer patients is necessary and early interventions are meaningful.

Using an Educational Electronic Documentation System to Help Nursing Students Accurately Identify Patient Data

This quantitative research study used a pretest/posttest design and reviewed how an educational electronic documentation system helped nursing students to identify the accurate "related to" statement of the nursing diagnosis for the patient in the case study. Students in the sample population were senior nursing students in a bachelor of science nursing program in the northeastern United States. Two distinct groups were used for a control and intervention group. The intervention group used the educational electronic documentation system for three class assignments. Both groups were given a pretest and posttest case study. The Accuracy Tool was used to score the students' responses to the related to statement of a nursing diagnosis given at the end of the case study. The scores of the Accuracy Tool were analyzed, and then the numeric scores were placed in SPSS, and the paired t test scores were analyzed for statistical significance. The intervention group's scores were statistically different from the pretest scores to posttest scores, while the control group's scores remained the same from pretest to posttest. The recommendation to nursing education is to use the educational electronic documentation system as a teaching pedagogy to help nursing students prepare for nursing practice.

The own method and program of isotopic quantitative assessment of perfusion in muscles of upper limbs

The issue of blood flow in muscles has been dealt with for many years. However, most often it was assessed qualitatively with standard vascular examinations. The quantitatively perfusion assessment is indispensable in the normal and pathological conditions. Some diseases impair the perfusion mainly in the area of upper limbs. It can be observed in Raynaud's disease, vascular occlusive diseases, neurological disturbances, and thermal injuries. Hyperhidrosis of upper limbs after sympathectomy of thoracic part of sympathetic trunk may bring closer the diagnosis statement. Nuclear medicine has the markers and methods that allow for the assessment of the volume of perfusion in muscles. The aim for creating this method and program was the development of radioisotope method allowing for quantitative assessment of perfusion in muscles of upper limbs. This should lead to calculating the perfusion index and its range of normal values in a greater group of patients and to using this method both in the healthy and pathological conditions. 20 patients, age 30.4 ± 7.1 years, who underwent following examinations: qualification to the group, medical history, subject examinations, USG of upper limb vessels, anthropometric examinations, biochemical and hormonal blood tests, the assessment of upper limbs with USG Doppler and FMD (flow mediated dilatation), radioisotope examinations with gamma camera BrightView XCT by own program RAPUL (Radioisotope Assessment Perfusion of Upper Limb). Acquisitions were started five minutes after intravenous injection of 99mTc-MIBI (metoxyisobutylnitrite). The whole body scintigram and scintigrams of arm and forearm muscles in A-P projections were taken. In the examined patients, the results of anthropometric, biochemical and hormonal test were within the range of normal values. In radioisotope quantitative assessment of perfusion, perfusion indexes of left arm were 20 < PI(_left) < 11.90 and of the right arm 7.00 < PI(_right) <12.30. The dependency correlation PI(_left) vs. PI(_right) was strong r = 0.92036.The values of perfusion symmetry index (IPS) had a normal distribution and were within the following range: 0.9231 < IPS < 1.1019. The RAPUL method and program allow for quantitative assessment of perfusion in muscles of upper limbs. Developed program has a high repeatability of results. The results in the bigger group will allow for defining the range of normal values of perfusion index in muscles of upper limbs at rest. These will be diagnostically used both in healthy (sports medicine, military services) and pathological conditions.

Diagnósticos e intervenções de enfermagem para pacientes portadores de insuficiência cardíaca congestiva utilizando a CIPE®

The aim of this descriptive exploratory study was to construct nursing diagnosis and intervention statements for patients with Congestive Heart Failure. To accomplish this aim, 53 terms were identified in the focus axis of the International Classification for Nursing Practice (ICNP®), which guided the construction of these statements using the guidelines of the International Council of Nurses and ISO 18. 104. A total of 92 nursing diagnosis statements were constructed, which resulted in 66 statements after standardization. The standardized statements were separated according to the following pathophysiological models: 13 related to tachycardia, 20 related to dyspnea, 19 related to edema, and 14 related to congestion. A total of 234 interventions were constructed for these statements using the terms from the 7-Axis Model of the ICNP®, the literature in the area and the clinical experience of the authors. The nursing diagnosis and intervention statements designed are expected to facilitate the evaluation of CHF patients and assist in the construction of a terminological subset for the ICNP®.