Diagnósticos de enfermagem respiratórios em crianças com infecção respiratória aguda : um estudo longitudinal

Abstract

Through nursing subject, studies of accuracy contribute to improve the quality of care by allowing the identification of defining characteristics (DC) with good predictive power and directly influence the choice of nursing diagnosis appropriate to each clinical situation. Because the importance of research related to this subject, this study was made with the goal to analyze the predictive ability of the DC of nursing diagnoses Ineffective Breathing Pattern (IBP), Ineffective airway clearance (IAC) and Impaired gas exchange (IGE) in children with acute respiratory infection (ARI). It was developed an open cohort study in the months January to June 2011, two children hospitals in the public network in Fortaleza-CE. The sample was consisted of 136 children, who were followed for a minimum period of six and maximum of ten days. To collect the data, it was used an instrument based on the characteristics of the diagnostics studied and some relevant literature about the lung evaluation. The data were collected through examination of the child and interview with their responsibles. The information obtained was analyzed by the researcher to determine the presence or ausence of the characteristics of IBP, IAC and IGE and lately were sent to nurses diagnosticians that performed the diagnostic inference process. It was used Excel and PASW software for organizing and analyzing statistical data. The level of significance was 5%. The temporal evolution of the diagnostics IAC, IBP and IGE showed a curvilinear trend, with reduction over the monitoring period. For IAC and IBP, there was a similar distribution although they occurred in different proportions, but IAC maintained high values in ten days of follow-up. The measures of accuracy, the characteristics more accurated for predicting the occurrence of IAC, IGE and IBP were respiratory rales, hypoxemia and use of accessory muscles to breathe, respectively. All children evaluated IAC developed by the end of follow-up time and no statistically significant relationship was found between survival time and the variables analyzed. Of the total number of children followed, 86.76% developed IGE during the follow-up period. The time of hospital staying was the only variable that showed a correlation statistically significant with survival time. The median survival time for IBP was a day of total and accompanied children, 86.76% developed this diagnosis during the study period. Based on the analysis of multiple matches, the best characteristics that assist in differentiating between the diagnoses studied are: expectoration, cough absent, Speech and difficult to IAC adventitious breath sounds, agitation and irritability for IGE and Change in the depth of breathing, use of accessory muscles breathing and anormal breathing for IBP. Studies of this nature are important for providing information about the predictive ability of the defining characteristics and the temporal evolution and characteristics of the respiratory nursing diagnoses in children with acute respiratory infection.