Acidente vascular encefálico : análise dos diagnósticos de enfermagem da classe atividade/exercício

Abstract

To determine nursing diagnoses is a very necessary task, for it contributes to the better planning of the interventions in clients who survived after the stroke and who, in most of the cases, presented incapabilities. Due to this, the study aimed to analyze the nursing diagnoses shown in the Activity/Exercise branch in clients with stroke during the period of rehabilitation. A transversal study was done amongst 121 clients who attended one of the eight units of Cearense Beneficent Association of Rehabilitation (ABCR) in Fortaleza City- Ceará, whose data collection occurred within the period of November, 2007 and March, 2008. The including criteria were: a) to be registered in the ABCR; b) to have suffered from stroke at least once, and presented the diagnosis confirmation by the doctor; c) to be over 18 years old. A form was used for the data collection, which had undergone content validation by two nurses expertise in the care of clients with stroke. The information was collected through interview and physical tests. To name the nursing diagnoses, the Taxonomy II proposed by the North American Nursing Diagnosis Association (NANDA), published in 2008, was followed as reference. With the data compiled in the Excel program, the statistic analysis was done within the EpiInfo and SPSS program. The level of significance adopted in the study was of 5%. All ethical recommendations were followed during the stages of the research. Taking the social and demographic data into account, it was verified that the majority of these participants was from masculine gender, elderly, without a partner, retired or pensioners and had low education and income per capita. Amongst the various risk indicators, the most frequent one was the arterial hypertension, followed by the sedentarism, dislipidemy, cardiopathies and diabetes mellitus. Half of the clients studied had at once suffered from stroke 12 months before, beginning rehabilitation in one of the units of the ABCR for at maximum seven months. The participants showed an average of 6.7 nursing diagnoses; 25.1 defining characteristics; 4.6 related factors and 10.1 risky factors. All the diagnoses of the branch studied were identified, but seven: Falling risk, Impaired physical mobility, Impaired deambulation, Sedentary lifestyle, Risk for disuse syndrome, Risk for intolerance to the activity and Impaired transference capability had the frequency of over 50% and were used for the statistic analysis. According to the tests, there was a statistically significant relation among the diagnoses, with the exception of the followings: Falling risk, Impaired physical mobility, Impaired deambulation and Impaired transference capability with the diagnosis Risk for intolerance to the activity. The defining characteristics, related factors and risky factors were statistically associated with the major part of the nursing diagnoses analyzed. Such fact can be justified by the fact that all of them are part of the same branch within the NANDA (2008). One may conclude that the majority of the nursing diagnoses showed statistically association amongst them. It is verified that the Impaired muscular force and Neuromuscular damage were the most frequent related factors found, causing thus, the main consequences for the stroke. The study permitted a deep knowledge upon the Activity/Exercise branch in clients with stroke