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重症监护病房中护理诊断为无效呼吸模式的相关因素。

Related factors of the nursing diagnosis ineffective breathing pattern in an intensive care unit.

作者信息

Prado Patricia Rezende do, Bettencourt Ana Rita de Cássia, Lopes Juliana de Lima

机构信息

Universidade Federal do Acre, Rio Branco, AC, Brasil.

Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil.

出版信息

Rev Lat Am Enfermagem. 2019 Oct 7;27:e3153. doi: 10.1590/1518-8345.2902.3153. eCollection 2019.

Abstract

OBJECTIVE

to identify the predicting factors and sensitivity, specificity, positive and negative related value of nursing diagnosis Ineffective Breathing Pattern among patients of an intensive care unit.

METHOD

cross-sectional study. A logistic regression was fitted to assess the simultaneous effects of related factors.

RESULTS

among the 120 patients, 67.5% presented Ineffective Breathing Pattern. In the univariate analysis, the related factors were: group of diseases, fatigue, obesity and presence of bronchial secretion, and the defining characteristics were: changes in respiratory depth, auscultation with adventitious sounds, dyspnea, reduced vesicular murmurs, tachypnea, cough and use of the accessory musculature to breathe. The mean age of patients with was higher than those without this diagnosis. The defining characteristics reduced murmurs had high sensitivity (92.6%), specificity (97.4%), negative related value (86.4%) and positive related value (98.7%). The related factors of Ineffective Breathing Pattern were the related factors fatigue, age and group of diseases.

CONCLUSION

fatigue, age and patients with a group of diseases were related factors of Ineffective Breathing Pattern in this study. Reduced vesicular murmurs, auscultation with adventitious sounds and cough may be defining characteristics to be added in the international classification, as well as the related factors bronchial secretion and group of diseases.

摘要

目的

确定重症监护病房患者护理诊断“呼吸模式无效”的预测因素以及敏感性、特异性、阳性和阴性关联值。

方法

横断面研究。采用逻辑回归评估相关因素的同时作用。

结果

120例患者中,67.5%存在呼吸模式无效。单因素分析中,相关因素为:疾病组、疲劳、肥胖和支气管分泌物的存在,决定性特征为:呼吸深度改变、闻及附加音、呼吸困难、肺泡呼吸音减弱、呼吸急促、咳嗽以及使用辅助呼吸肌。有此诊断的患者平均年龄高于无此诊断的患者。决定性特征肺泡呼吸音减弱具有高敏感性(92.6%)、特异性(97.4%)、阴性关联值(86.4%)和阳性关联值(98.7%)。呼吸模式无效的相关因素为疲劳、年龄和疾病组。

结论

本研究中,疲劳、年龄和患有疾病组是呼吸模式无效的相关因素。肺泡呼吸音减弱、闻及附加音和咳嗽可能是国际分类中需增加的决定性特征,以及支气管分泌物和疾病组等相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1436/6781423/5f218aa28810/0104-1169-rlae-27-e3153-gf01.jpg

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