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- Validation of nursing diagnoses - The Differential Diagnostic Validation Model as a strategyPublication . Caldeira, Sílvia Maria Alves; Chaves, Érika de Cássia Lopes; Carvalho, Emília Campos de; Vieira, Margarida Maria da SilvaObjective: to analyze the contribution and limits of the use of Richard Fehring’s differential diagnostic validation model, as a methodological strategy in the validation of diagnoses. Method: theoretical review about the differential diagnostic validation model for the validation of NANDA-I nursing diagnoses. Results: the nursing diagnosis constitutes the step that precedes and promotes the appropriate nursing intervention. The correct identification of the diagnosis is fundamental for effective interventions.The presentation of a structured classification of diagnoses, such as for example the taxonomy II of NANDA-I, facilitates the clinical judgment of the nurse. It is necessary that the diagnoses are clear and that the defining characteristics are specific, and the validation studies contribute to this objective. Conclusions: the differential diagnostic validation model permits the validation of differences between diagnoses with very similar meanings; however, it is little known and applied in the validation studies. It is a methodology that can be useful for the accuracy of diagnoses and for contribution to the current discussion of taxonomy II and its new proposals. Descriptors: nursing; nursing diagnosis; validation studies. RESUMO Objetivo: analisar a contribuição e limites no uso do modelo diferencial de diagnósticos de Richard Fehring, como estratégia metodológica na validação de diagnósticos. Método: revisão teórica sobre o modelo diferencial para a validação de diagnósticos de enfermagem da NANDA-I. Resultados: o diagnóstico de enfermagem constitui a etapa que precede e favorece a intervenção adequada do enfermeiro. A identificação correta do diagnóstico é fundamental para que as intervenções sejam eficazes. A apresentação sistematizada dos diagnósticos em classificações, como por exemplo a taxonomia II da NANDA-I, facilita o julgamento clínico do enfermeiro. É necessário que os diagnósticos sejam claros e que suas características definidoras sejam específicas, e os estudos de validação contribuem para esse objetivo. Conclusão: o modelo de validação diferencial permite validar as diferenças entre diagnósticos com significados muito semelhantes; contudo, está pouco divulgado e aplicado nos estudos de validação. É uma metodologia que pode ser útil para a acurácia dos diagnósticos e para a contribuição na discussão atual da taxonomia II e suas novas propostas. Descritores: enfermagem; diagnóstico de enfermagem; estudos de validação. RESUMEN Objetivo: analizar la contribución y límites en el uso del modelo diferencial de diagnósticos de Richard Fehring, como estrategia metodológica en la validación de los diagnósticos. Metodología: revisión teórica sobre el modelo diferencial para validación de diagnósticos de enfermería de NANDA-I. Resultados: el diagnóstico enfermero es la etapa que precede y promueve la adecuada intervención de la enfermera. La identificación de un diagnóstico correcto es fundamental para que las intervenciones sean de clasificación efectiva. La presentación estructurada de diagnósticos, tales como la taxonomía II de NANDA-I, facilita el juicio clínico de las enfermeras. Se espera que los diagnósticos sean claros y que sus características definitorias sean especificas y son los estudios de validación que contribuyen a este objetivo. Conclusiones: el modelo diferencial de validación de diagnóstico se utiliza para validar el diagnóstico diferencial con las diferencias entre los significados muy similares, sin embargo, es poco conocido y aplicado en los estudios de validación. Se trata de una metodología que puede ser útil para la exactitud del diagnóstico y por su contribución actual a la discusión de la II taxonomía y sus nuevas propuestas.Parte superior do formulario. Descriptores: diagnósticos de enfermería; enfermería; estudios de validación.
- Clinical validation of the nursing diagnosis spiritual distress in cancer patients undergoing chemotherapyPublication . Caldeira, Sílvia; Timmins, Fiona; Carvalho, Emília Campos de; Vieira, MargaridaObjective: Validate the nursing diagnosis spiritual distress in cancer patients. Methods: Cross-sectional approach using Richard Fehring's Clinical Diagnostic Validity Model. Findings: The prevalence of diagnosis was 40.8% in a sample of 170 patients. A total of 16 defining characteristics were validated. Expresses suffering had the highest sensitivity value and lack of meaning in life had the highest specificity value. Conclusions: The diagnosis was validated. Cancer patients in spiritual distress are in a state of suffering related to lack of meaning in life. Implications for Practice: Sensitive diagnosis tools and language are required for nurses to make accurate judgments in situations of spiritual distress. Validation in different contexts would increase the clinical evidence of this diagnosis.
- Between spiritual wellbeing and spiritual distress: possible related factors in elderly patients with cancerPublication . Caldeira, Sílvia; Carvalho, Emília Campos de; Vieira, MargaridaObjective: this article describes the assessment of the spiritual wellbeing of elderly patients with cancer submitted to chemotherapy and possible predictive factors of the spiritual distress diagnosis. Methodology: this is a methodological study for clinical validation of a nursing diagnosis, using interviews to assist in completing the form. Results: 45 elderly patients participated in this study, Catholics, mostly female, diagnosed with breast cancer, average age of 70.3 years. The prevalence of spiritual distress was of 42%; 24.4% of the elderly patients were under anti-depressant medication. A significant association was noted between spiritual distress, anti- depressant medication and level of education; an increase (not significant) was acknowledged at the start of the treatment. Conclusion: these results emphasize the relevance of clarifying this diagnosis and the responsibility of nurses to provide spiritual care to patients. Interventions should be planned appropriately every time a nursing diagnosis is identified as a complex answer and for which pharmacological treatment is not sufficient.