Acurácia dos indicadores clínicos de enfrentamento familiar comprometido no contexto do câncer na adolescência

Abstract

Studies of accuracy diagnostic in family are intended to provide clinical indicators that can predict human responses, generating knowledge to improve the diagnostic inference process. Thus, this study aimed to analyze the accuracy of clinical indicators of nursing diagnosis of Compromited family coping in the context of cancer in adolescence. It is a study of diagnostic accuracy, cross-sectional. Study participants were 236 caregivers and adolescents between 10 and 19 full years, diagnosed with cancer, hospitalized or outpatient visit or hospital day of a tertiary institution of reference in infatojuvenil oncology, in the months from March to May 2015. The strategy sample was not probabilistic for convenience and the collection held by the author and academic nursing. The data collection instrument was made based on clinical indicators of diagnosis under study and was administered by interview with the teen and his caregiver. Data were gathered on Excel software (2007), analyzed with the support of statistical package SPSS version 19.0 for Windows and the R version 2.12.1 software and synthesized in 10 tables. The descriptive analysis included the calculation of absolute frequencies, percentages, measures of central tendency and dispersion. For categorical variables the proportions of 95% confidence intervals were calculated. They applied to the Lilliefors tests, chi-square and Mann-Whitney. To check the sensitivity and specificity of each clinical indicator, we used the method of analysis of Latent Classes. Most of the adolescents evaluated were male, accompanied on hospital day. Sample teen half had aged under 14 years, real income of R$ 780.00 and more than 5 members in the family. Hematological tumors were the most frequent. Teenagers consider the family as a whole important in your life, but who else helps to treat and more accompanies is the mother figure. Clinical indicators of higher prevalence were: significant person reports inadequate understanding, which interferes with the effectiveness of behavior support and significant person reports preoccupation with personal reaction (eg fear, grief, guilt, anxiety) to customer needs. Compromited family coping diagnosis showed low prevalence both in the general population, as the sample subgroups of gender, age and time of diagnosis. For teen with diagnostic time equal to or less than 24 months were found: three sensitive and specific indicators. For males, two indicators were sensitive and two specific. For females, were found four sensitive indicators. Among these, also shown two indicators are specific. For individuals younger than 14, two indicators were receptive and proved to be specific. For individuals older than or equal to 14 years, three clinical indicators obtained valid and high levels of sensitivity and specificity. Identifying predictors of clinical indicators of a nursing diagnosis is important. And this study contributed to the diagnostic inference compromised family coping in the context of adolescent care with cancer.