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Introdução: As respostas humanas perante a condição de infertilidade fazem destacar a angústia espiritual e acometer a capacidade de ser resiliente dos indivíduos. A este respeito, a NANDA-I integra, na sua maioria, diagnósticos com baixo nível de evidência e requer validação clínica, em particular, em populações específicas, como a de pessoas com esta condição de saúde. Esta tese de doutoramento, surge de um aprimoramento diagnóstico necessário a uma intervenção de enfermagem efetivamente integrativa, holística e centrada na singularidade dos portugueses que enfrentam esta condição e seu tratamento. Objetivo: Realizar a validação clínica dos diagnósticos de enfermagem da NANDA-I, de “Angústia Espiritual (00066)” e “Resiliência Comprometida (00210)” em pessoas em tratamento de fertilidade. Metodologia: Estudo exploratório, quantitativo, observacional, transversal, e de validação clínica dos diagnósticos de enfermagem mencionados, com base no Modelo Rasch. A recolha de dados teve lugar entre setembro de 2019 e junho de 2020 numa amostra de 104 adultos portugueses em tratamento de fertilidade ou na iminência do tratamento, por meio de um questionário online disponibilizado em sítios afetos à fertilidade. Tratou-se de uma amostragem não probabilística e de conveniência. Foram garantidos e salvaguardados os princípios éticos e apresentado um formulário de consentimento informado. Resultados: Foram validadas 22 características definidoras do diagnóstico de enfermagem “Angústia Espiritual (00066)”, apresentando uma prevalência de 23.6% nesta amostra. O “Sofrimento percebido” foi a característica definidora mais sensível (94.1%). A “Raiva relativa a Poder maior do que o próprio” (87.3%) e “Sensação de não ser amado” (87.3%) foram as mais específicas. A “Resiliência Comprometida (00210)” apresentou uma prevalência de 15.4% na amostra, tendo sido validadas sete características definidoras. O “Aumento renovado da angústia” (93.8%) e “Baixa autoestima” (93.8%) foram as características mais sensíveis e o “Isolamento social” foi a mais específica (71.6%). Conclusões: Este estudo contribui para o aumento do nível de evidência dos diagnósticos NANDA-I estudados. Propõem-se procedimentos metodológicos semelhantes noutros estudos que ajudariam a comprovar a robustez científica destes resultados, em amostras maiores e heterogéneas que permitam a generalização, e/ou estudos longitudinais capazes de observar as alterações ocorridas em diferentes fases do tratamento de fertilidade.
Introduction: Human responses to infertility highlight spiritual distress and the ability of individuals to be resilient. In this regard, most diagnoses listed in NANDA-I have a low level of evidence and requires clinical validation in specific populations, such as people with infertility. This doctoral thesis arises from a diagnostic improvement necessary for an effectively integrative, holistic nursing intervention focused on the uniqueness of the Portuguese persons who face this condition and its treatment. Objectives: To conduct a clinical validation of NANDA-I nursing diagnoses of “Spiritual Distress (00066)” and “Impaired Resilience (00210)” in people undergoing fertility treatment. Method: It was an exploratory, quantitative, observational, cross-sectional study, and clinical validation of the mentioned nursing diagnoses, based on the Rasch model. Data collection took place between September 2019 and June 2020 in a sample of 104 Portuguese adults undergoing fertility treatment or on the verge of treatment, through an online questionnaire made available on fertility websites. It was a non-probabilistic and convenience sampling. Ethical principles were guaranteed and safeguarded, and an informed consent form was presented. Results: Twenty-two defining characteristics of the nursing diagnosis “Spiritual Distress (00066)” were validated and the diagnosis had a prevalence of 23.6% in this sample; “Perceived suffering” was the most sensitive defining characteristic (94.1%); “Anger over Power greater than self” (87.3%) and “Feeling unloved” (87.3%) were the most specific. “Impaired Resilience (00210)” had a prevalence of 15.4% in the sample, with seven defining characteristics having been validated. “Renewed elevation of distress” (93.8%) and “Low self-esteem” (93.8%) were the most sensitive characteristics, and “Social isolation” was the most specific (71.6%). Conclusions: This study contributes to increase the level of evidence of the NANDA-I diagnoses studied. Similar methodological procedures are proposed in other studies that would help to prove the scientific robustness of these results, in larger and heterogeneous samples to allow generalization, and/or longitudinal studies capable of observing the changes that occur in different phases of fertility treatment.
Introduction: Human responses to infertility highlight spiritual distress and the ability of individuals to be resilient. In this regard, most diagnoses listed in NANDA-I have a low level of evidence and requires clinical validation in specific populations, such as people with infertility. This doctoral thesis arises from a diagnostic improvement necessary for an effectively integrative, holistic nursing intervention focused on the uniqueness of the Portuguese persons who face this condition and its treatment. Objectives: To conduct a clinical validation of NANDA-I nursing diagnoses of “Spiritual Distress (00066)” and “Impaired Resilience (00210)” in people undergoing fertility treatment. Method: It was an exploratory, quantitative, observational, cross-sectional study, and clinical validation of the mentioned nursing diagnoses, based on the Rasch model. Data collection took place between September 2019 and June 2020 in a sample of 104 Portuguese adults undergoing fertility treatment or on the verge of treatment, through an online questionnaire made available on fertility websites. It was a non-probabilistic and convenience sampling. Ethical principles were guaranteed and safeguarded, and an informed consent form was presented. Results: Twenty-two defining characteristics of the nursing diagnosis “Spiritual Distress (00066)” were validated and the diagnosis had a prevalence of 23.6% in this sample; “Perceived suffering” was the most sensitive defining characteristic (94.1%); “Anger over Power greater than self” (87.3%) and “Feeling unloved” (87.3%) were the most specific. “Impaired Resilience (00210)” had a prevalence of 15.4% in the sample, with seven defining characteristics having been validated. “Renewed elevation of distress” (93.8%) and “Low self-esteem” (93.8%) were the most sensitive characteristics, and “Social isolation” was the most specific (71.6%). Conclusions: This study contributes to increase the level of evidence of the NANDA-I diagnoses studied. Similar methodological procedures are proposed in other studies that would help to prove the scientific robustness of these results, in larger and heterogeneous samples to allow generalization, and/or longitudinal studies capable of observing the changes that occur in different phases of fertility treatment.
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Keywords
Diagnóstico de enfermagem Espiritualidade Infertilidade NANDA-I Resiliência Nursing diagnosis Spirituality Infertility NANDA-I Resilience