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急性冠状动脉综合征患者护理诊断“活动耐力下降”定义特征的临床验证

Clinical Validation of the Defining Characteristics of the Nursing Diagnosis 'Activity Intolerance' in Patients With Acute Coronary Syndrome.

作者信息

Cáceres Rivera Diana Isabel, Jaimes Rojas Luz Mileyde, Cristancho Zambrano Luisa Yaneth, Acosta Barón Jennifer Vanesa, Cañon Gómez Diana Ivonne, Rojas Lyda Z

机构信息

Research Group for the Strengthening of Health and Wellness (GIFOSABI), Universidad Cooperativa de Colombia, Bucaramanga, Colombia.

Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Center, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

出版信息

Nurs Open. 2024 Dec;11(12):e70050. doi: 10.1002/nop2.70050.

Abstract

AIM

To validate the defining characteristics (CDs) of the nursing diagnosis 'Activity intolerance [00092]' in patients with acute coronary syndrome (ACS).

DESIGN

Cross-sectional study. Patients over 18 years of age with a confirmed medical diagnosis of hospitalised ACS were included and those who were haemodynamically unstable, with alterations in the mental sphere or with communication limitations were excluded. The CDs were previously operationalised for standardised measurement and independently assessed by nurses.

RESULTS

A total of 111 patients with ACS were studied. The CDs with prevalence > 50% were: generalised weakness (80.56 vs. 78.70%), discomfort on exertion (72.07% vs. 75.68%) and ECG changes (71.17% vs. 68.47%). Inter-rater agreement for determining the CDs ranged from 0.69 to 1.00.

CONCLUSIONS

This study established the clinical validation of the CDs of the nursing diagnosis 'Activity Intolerance [00092]' in patients with ACS identifying three major CDs: EKG changes, generalised weakness and exertional discomfort.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution the research was developed in its entirety by the authors.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The clinical validation of the defining characteristics of the activity intolerance diagnosis was conducted. This validation was based on operationalising each characteristic using commonly employed nursing scales and instruments. This process contributes significantly to the establishment of evidence-based nursing practices. The customisation of nursing diagnoses gains further ground through the validation studies of NANDA-I diagnoses. This process solidifies standardised nursing language as a valuable strategy in nursing care, providing substantial support for practical decision-making. Among the evaluators, EKG changes, generalised weakness and discomfort on exertion emerged as the most frequently encountered defining characteristics with substantial agreement. This discovery offers crucial insights for devising individualised and collective care plans within coronary units.

摘要

目的

验证急性冠状动脉综合征(ACS)患者护理诊断“活动耐力下降[00092]”的定义特征(CDs)。

设计

横断面研究。纳入年龄在18岁以上、经医学确诊为住院ACS的患者,排除血流动力学不稳定、精神状态改变或有沟通障碍的患者。这些CDs先前已进行操作化以便标准化测量,并由护士独立评估。

结果

共研究了111例ACS患者。患病率>50%的CDs为:全身无力(80.56%对78.70%)、运动时不适(72.07%对75.68%)和心电图改变(71.17%对68.47%)。评定者间确定CDs的一致性范围为0.69至1.00。

结论

本研究确立了ACS患者护理诊断“活动耐力下降[00092]”的CDs的临床验证,确定了三个主要CDs:心电图改变、全身无力和运动时不适。

患者或公众贡献

患者或公众未参与贡献,该研究完全由作者开展。

对专业和/或患者护理的启示:对活动耐力下降诊断的定义特征进行了临床验证。该验证基于使用常用的护理量表和工具对每个特征进行操作化。这一过程对确立循证护理实践有显著贡献。通过对北美护理诊断协会(NANDA - I)诊断的验证研究,护理诊断的定制得到了进一步发展。这一过程巩固了标准化护理语言作为护理实践中一项有价值策略的地位,为实际决策提供了有力支持。在评估者中,心电图改变、全身无力和运动时不适是最常出现的定义特征,且一致性较高。这一发现为制定冠心病病房的个体化和集体护理计划提供了关键见解。

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