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Clinical validation of the nursing diagnosis of ineffective protection in haemodialysis patients.

Abstract：

AIMS AND OBJECTIVES:To evaluate the clinical validity of indicators of the nursing diagnosis of "ineffective protection" in haemodialysis patients. BACKGROUND:Haemodialysis patients have reduced protection. Studies on the nursing diagnosis of "ineffective protection" are scarce in the literature. The use of indicators to diagnose "ineffective protection" could improve the care of haemodialysis patients. The clinical usefulness of the indicators requires clinical validation. DESIGN:This was a diagnostic accuracy study. METHOD:This study assessed a sample of 200 patients undergoing haemodialysis in a reference clinic for nephrology during the first half of 2015. Operational definitions were created for each clinical indicator based on concept analysis and content validation by experts for these indicators. Diagnostic accuracy measurement was performed with latent class analysis with randomised effects. RESULTS:The clinical indicator of "fatigue" had high sensitivity (p = .999) and specificity (p = 1.000) for the identification of "ineffective protection." Additionally, "maladaptive response to stress" (p = .711) and "coagulation change" (p = .653) were sensitive indicators. The main indicators that showed high specificity were "fever" (p = .987), "increased number of hospitalisations" (p = .911), "weakness" (p = .937), "infected vascular access" (p = .962) and "vascular access dysfunction" (p = .722). CONCLUSION:A set of nine clinical indicators of "ineffective protection" were accurate and statistically significant for haemodialysis patients. Three clinical indicators showed sensitivity, and six indicators showed specificity. RELEVANCE TO CLINICAL PRACTICE:Accurate measures for nursing diagnoses can help nurses confirm or rule out the probability of the occurrence of "ineffective protection" in patients undergoing haemodialysis.

journal_name

J Clin Nurs

journal_title

Journal of clinical nursing

authors

de Sá Tinôco JD,de Paiva MDGMN,de Queiroz Frazão CMF,Lucio KDB,Fernandes MIDCD,de Oliveira Lopes MV,de Carvalho Lira ALB

doi

10.1111/jocn.13915

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

e195-e202

issue

1-2

eissn

0962-1067

issn

1365-2702

journal_volume

pub_type

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Clinical validation of the nursing diagnosis of ineffective protection in haemodialysis patients.