Seganfredo Deborah Hein, Beltrão Beatriz Amorim, Silva Viviane Martins da, Lopes Marcos Venícios de Oliveira, Castro Stela Maris de Jezus, Almeida Miriam de Abreu
PhD, RN, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, BR.
PhD, RN, Hospital Universitário Walter Cantídio, Fortaleza, CE, BR.
Rev Lat Am Enfermagem. 2017 Dec 4;25:e2954. doi: 10.1590/1518-8345.1950.2954.
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.
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.
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.
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.
分析国际护理诊断协会（NANDA）中无效呼吸模式和自主呼吸受损这两个护理诊断的定义特征表现，以及文献中针对在重症监护病房接受氧疗的成年患者“通气”概念所确定的定义特征。
采用临床诊断验证研究，对626例接受氧疗的重症监护患者进行三种不同方式的研究。使用多重对应分析来验证定义特征的判别能力，并使用潜在类别分析来确定基于所使用通气模式定义的严重程度水平下这些特征的诊断准确性。
在多重对应分析中，结果表明，大多数定义特征对于这两个维度（诊断）的判别能力较低且解释方差的百分比也较低。针对这两个诊断分别调整的潜在类别模型拟合度较差，存在一些定义特征的共享情况。按严重程度水平（通气模式）调整的模型拟合度和组成定义特征的结构更好。
本研究获得的临床证据似乎表明，所研究的两个护理诊断的定义特征集在单一结构中拟合得更好。
