School of Nursing-Postgraduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
J Adv Nurs. 2013 Jun;69(6):1338-45. doi: 10.1111/j.1365-2648.2012.06125.x. Epub 2012 Aug 22.
To validate, clinically, the defining characteristics for the nursing diagnoses of Impaired Tissue Integrity and Impaired Skin Integrity in patients subjected to heart catheterization and to validate acute pain, haematoma, bleeding, redness, and heat as additional characteristics.
In clinical practice, an applicable nursing diagnosis for patients subjected to diagnostic heart catheterization has not been well-defined.
Cross-sectional.
This clinical validation study using Fehring's model was performed at a Brazilian general hospital between November 2009-November 2010. This study included 250 patients who received elective femoral artery catheterization. Each patient was identified as having two characteristics of Impaired Tissue Integrity and three characteristics of Impaired Skin Integrity, according to NANDA-I nursing diagnoses. Due to certain postprocedure events, five additional characteristics were added to be validated in this setting. In addition to Fehring's reliability rating, the kappa coefficient was used to evaluate inter-rater agreement during the clinical evaluation.
The defining characteristic of damaged tissue was validated for Impaired Tissue Integrity and the defining characteristics of the invasion of body structures and the disruption of the skin surface were validated for Impaired Skin Integrity. Although the five characteristics that were added to the investigated diagnoses were not validated because of their low rate of occurrence in this setting, the measurements of acute pain, haematoma, bleeding, redness, and heat each had excellent inter-rater agreement.
The validation of characteristics from both of these diagnoses suggested that these criteria could be utilized for clinical practice in a diagnostic setting. Moreover, additional characteristics should also be observed to better guide nursing intervention.
从临床角度验证接受心脏导管检查患者的护理诊断“组织完整性受损”和“皮肤完整性受损”的定义特征，并验证急性疼痛、血肿、出血、发红和发热作为附加特征。
在临床实践中，尚未明确针对接受诊断性心脏导管检查的患者的适用护理诊断。
横断面研究。
该使用 Fehring 模型的临床验证研究于 2009 年 11 月至 2010 年 11 月在巴西一家综合医院进行。该研究纳入了 250 名接受选择性股动脉导管检查的患者。根据 NANDA-I 护理诊断，每位患者被确定具有组织完整性受损的两个特征和皮肤完整性受损的三个特征。由于某些术后事件，增加了五个附加特征以在此环境下进行验证。除了 Fehring 的可靠性评分外，kappa 系数还用于评估临床评估过程中的评估者间一致性。
受损组织的定义特征得到了验证，用于组织完整性受损的护理诊断，身体结构的侵犯和皮肤表面的破坏的定义特征得到了验证，用于皮肤完整性受损的护理诊断。尽管由于在这种情况下发生频率较低，因此未对添加到研究诊断中的五个特征进行验证，但急性疼痛、血肿、出血、发红和发热的测量值具有很好的评估者间一致性。
对这两个诊断的特征的验证表明，这些标准可用于诊断环境下的临床实践。此外，还应观察其他附加特征，以更好地指导护理干预。
