Yücel Şebnem Çinar, Eşer Ismet, Güler Elem Kocaçal, Khorshid Leyla
Department of Fundamentals of Nursing, Ege University School of Nursing, İzmir, Turkey.
Int J Nurs Pract. 2011 Oct;17(5):502-8. doi: 10.1111/j.1440-172X.2011.01959.x.
This research was carried out to find out the nursing diagnoses in patients who have mechanical ventilation support in a respiratory intensive care unit. The study was conducted with 51 evaluations of critically ill adult patients who underwent invasive and non-invasive mechanical ventilation therapy in 2008. Data collection was based on Gordon's 11 Functional Health Patterns, and nursing diagnoses were determined according to North American Nursing Diagnosis Association-International (NANDA-I) Taxonomy II. The nursing diagnoses were determined by two researchers separately. The consistency between the nursing diagnoses defined by the two researchers was evaluated by using Cohen's kappa (κ). Forty men (78.4%) and 11 women (21.6%) whose mean ages were 70.19 (SD = 8.96) years were included in the study. Nineteen subgroups of nursing diagnoses about safety/protection domain, and 15 subgroups about activity/rest domain were seen at different rates in the patients. There was a statistically significant difference between mechanical ventilation via tracheostomy or endotracheal tube and decreased cardiac output (d.f. = 1, χ(2) = 4.760, P = 0.029). The relationship between the length of time under mechanical ventilation and impaired physical mobility was considerably significant (d.f. = 3, χ(2) = 24.459, P = 0.000). It was found out that there was a high degree of agreement (96.8%) between the nursing diagnoses defined by the two researchers separately (κ = 0.936, SE = 0.08).
本研究旨在找出呼吸重症监护病房中接受机械通气支持患者的护理诊断。该研究对2008年接受有创和无创机械通气治疗的51例成年危重症患者进行了评估。数据收集基于戈登的11种功能健康模式，并根据北美护理诊断协会国际版（NANDA - I）分类法II确定护理诊断。护理诊断由两名研究人员分别确定。使用科恩kappa（κ）系数评估两名研究人员所定义的护理诊断之间的一致性。研究纳入了40名男性（78.4%）和11名女性（21.6%），他们的平均年龄为70.19岁（标准差=8.96）。在患者中，安全/保护领域的19个护理诊断亚组和活动/休息领域的15个护理诊断亚组出现的频率各不相同。经气管切开术或气管插管进行机械通气与心输出量降低之间存在统计学显著差异（自由度=1，χ²=4.760，P = 0.029）。机械通气时间长短与身体活动能力受损之间的关系极为显著（自由度=3，χ²=24.459，P = 0.000）。结果发现，两名研究人员分别定义的护理诊断之间存在高度一致性（96.8%）（κ=0.936，标准误=0.08）。
