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通过护理结果分类评估脑血管疾病患者的神经功能状态:一项方法学研究。

Assessment of Neurological Status in Patients with Cerebrovascular Diseases through the Nursing Outcome Classification: A Methodological Study.

作者信息

Lima Danielle Uehara de, Moreira Rafaella Pessoa, Cavalcante Tahissa Frota, Gasparino Renata Cristina, Emidio Suellen Cristina Dias, Oliveira-Kumakura Ana Railka de Souza

机构信息

Nursing Department, Clinical Hospital of University of Campinas, Campinas 13083-887, SP, Brazil.

Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony (UNILAB), Redencao 62790-000, CE, Brazil.

出版信息

Nurs Rep. 2022 Mar 2;12(1):152-163. doi: 10.3390/nursrep12010016.

Abstract

Nurses play an important role in healthcare, and the Nursing Outcomes Classification is a key tool for the standardization of care. This study aims to validate the nursing outcome "Neurological Status" for patients with cerebrovascular diseases. A methodological study was performed in four phases. In Phase 1, the relevance of the indicators was evaluated by seven specialists and the modified kappa coefficient and content validity index were calculated. In Phase 2, conceptual and operational definitions were formulated. In addition, their content was validated with a focus group in Phase 3. In Phase 4, the results were applied in clinical practice and convergence with the National Institute of Health Stroke Scale was verified. The reliability was measured by Cronbach's alpha. Of the 22 initial indicators, 6 were excluded. The focus group suggested changes in the definitions and the exclusion of two indicators. In Phase 4, only 13 indicators were validated due to the impossibility of measuring intracranial pressure. A strong correlation between the two scales and agreement among all the indicators were observed. Following the specialists' review, the nursing outcome was reliable and clinically validated with 13 indicators: consciousness, orientation, language, central motor control, cranial sensory and motor function, spinal sensory and motor function, body temperature, blood pressure, heart rate, eye movement pattern, pupil size, pupil reactivity, and breathing pattern.

摘要

护士在医疗保健中发挥着重要作用,而护理结果分类是护理标准化的关键工具。本研究旨在验证脑血管疾病患者的护理结果“神经状态”。进行了一项分四个阶段的方法学研究。在第一阶段,由七位专家评估指标的相关性,并计算修正的kappa系数和内容效度指数。在第二阶段,制定概念性和操作性定义。此外,在第三阶段通过焦点小组对其内容进行验证。在第四阶段,将结果应用于临床实践,并验证与美国国立卫生研究院卒中量表的一致性。可靠性通过Cronbach's alpha系数进行测量。在最初的22个指标中,排除了6个。焦点小组建议对定义进行修改并排除两个指标。在第四阶段,由于无法测量颅内压,仅13个指标得到验证。观察到两个量表之间有很强的相关性,并且所有指标之间具有一致性。经过专家审查,该护理结果可靠且通过13个指标在临床上得到验证:意识、定向力、语言、中枢运动控制、颅神经感觉和运动功能、脊髓感觉和运动功能、体温、血压、心率、眼动模式、瞳孔大小、瞳孔反应性和呼吸模式。

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