Comportamentos ineficazes de manutenção da saúde em pacientes transplantados renais: revisões sistemáticas

Abstract

Ineffective health maintenance behaviors impair the quality of life of kidney transplant patients. The objective of this study was to analyze evidence from the literature on clinical indicators, etiological factors, and populations at risk for the nursing diagnosis of ineffective health maintenance behaviors in kidney transplant patients. To this end, two systematic reviews were conducted. The first consisted of a diagnostic accuracy review, which evaluated the performance of clinical indicators related to the nursing diagnosis of Ineffective Health Maintenance Behaviors. The second was an etiology and risk review, focused on identifying etiological factors and populations at risk associated with the development of these behaviors. The protocols were registered on the PROSPERO platform. The searches for both reviews were conducted in ten databases (Scopus, Web of Science, PubMed/MEDLINE, CINAHL, Embase, Ovid, PsycINFO, BVS, ProQuest, and Google Scholar). The selection of studies was performed independently and blindly by peers, using the Rayyan software. Methodological quality was assessed using QUADAS-2 in the accuracy review and JBI instruments in the etiology and risk review. Data extraction was performed using a standardized remote spreadsheet, and the data were analyzed using descriptive and inferential statistics. In the accuracy review, 15 clinical indicators for the diagnosis of ineffective health maintenance behaviors in kidney transplant patients were identified; of these, 9 are present in NANDA-International 2024-2026, and 6 were developed during the analysis of the studies. In the etiology review, 19 etiological factors and three at-risk populations were found. The synthesis of the studies revealed a consistent set of clinical indicators capable of indicating the presence of the diagnosis in this population, as well as related etiological factors, mainly psychosocial aspects that favor its occurrence. Furthermore, groups more vulnerable to the development of these behaviors were identified, allowing for the recognition of higher-risk profiles. Taken together, this evidence broadens the understanding of the phenomenon, offers theoretical support for future validations of the diagnosis, and provides insights for planning more precise, safe, and effective nursing interventions in the context of kidney transplantation.