Construction and validation of conceptual and operational definitions of the defining characteristics of the nursing diagnosis "Ineffective health self-management" in people living with HIV/AIDS.

PURPOSE: Build and validate the content of conceptual and operational definitions of the defining characteristics of the nursing diagnosis of NANDA-I "Ineffective health self-management" in people living with HIV/AIDS. METHODS: Methodological study, with a quantitative approach. The validation was performed by 26 specialist nurses selected through the Lattes do Brazil platform. The process followed two steps: (a) proposal of new defining characteristics to the Nursing Diagnosis "Ineffective Health Self-Management" and elaboration of conceptual and operational definitions; (b) content validation of the new defining characteristics of the Nursing Diagnosis "Ineffective Health Self-Management" and the conceptual and operational definitions. Data were collected between October 2020 and May 2021. FINDINGS: The researchers included six defining characteristics as components of the diagnosis, adding to the 10 already existing in the NANDA-I version (2021-2023). Then, the experts judged these components and 13 defining characteristics were validated using the binominal test with adequacy ratio above 85% and p value <0.05. After this stage, the conceptual and operational definitions of these defining characteristics were constructed, validating them by the content validation index ≥0.80 by the expert nurses. CONCLUSIONS: Three new defining characteristics for Ineffective health self-management were proposed and validated by specialists. Conceptual and operational definitions of the new and current defining characteristics were elaborated and validated for people living with HIV/AIDS. IMPLICATIONS FOR NURSING PRACTICE: The knowledge and study of the conceptual and operational definitions of nursing diagnoses can contribute to good nursing practices, assisting in the care and evaluation of nurses in the provision of care to people living with HIV/AIDS, and can avoid misunderstandings and inappropriate interpretations and can guarantee assertive clinical judgment. SEARCH TERMS: Nursing diagnosis, validation studies, nursing processes, acquired immunodeficiency syndrome.

OBJETIVO: Construir e validar o conteúdo das definições conceituais e operacionais das características definidoras do diagnóstico de enfermagem da NANDA-I "Autogestão ineficaz da saúde" em pessoas vivendo com HIV/AIDS. MÉTODOS: Estudo metodológico, de abordagem quantitativa. A validação foi realizada por 26 experts enfermeiros selecionados por meio da plataforma Lattes do Brasil. O processo seguiu duas etapas: 1. proposta de novas características definidoras ao Diagnóstico de Enfermagem "Autogestão Ineficaz da Saúde" e elaboração de definições conceituais e operacionais; 2. validação de conteúdo das novas características definidoras ao Diagnóstico de Enfermagem "Autogestão Ineficaz da Saúde" e das definições conceituais e operacionais. A coleta de dados ocorreu entre outubro de 2020 a maio de 2021. RESULTADOS: Foram incluídas pelos pesquisadores 6 características definidoras como componentes do diagnóstico, somando-se às 10 já existentes na versão NANDA-I (2021-2023). Em seguida, os experts julgaram tais componentes e 13 características definidoras foram validadas utilizando-se o teste binominal com proporção de adequação acima de 85% e p valor <0, 05. Após esta etapa, construiu-se as definições conceituais e operacionais destas características definidoras, validando-as pelo índice de validação de conteúdo ≥0, 80 pelos experts enfermeiros. CONCLUSÃO: Três novas características definidoras para Autogestão ineficaz da saúde foram propostas e validadas por especialistas. Definições conceituais e operacionais das novas e atuais características definidoras foram elaboradas e validadas para pessoas vivendo com HIV/AIDS. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: O conhecimento e estudo das definições conceituais e operacionais de diagnósticos de enfermagem pode contribuir para as boas práticas de Enfermagem, auxiliando no cuidado e avaliação do enfermeiro na prestação da assistência à pessoa que vive com HIV/AIDS, podendo evitar equívocos e interpretações inadequadas, a fim de garantir julgamento clínico assertivo. DESCRITORES: diagnóstico de enfermagem, estudos de validação, processos de enfermagem, síndrome de imunodeficiência adquirida.

Evaluation of the INTERGROWTH-21st project newborn standard for neonatal phenotypes and neonatal morbidity and mortality.

INTRODUCTION: The use of local references or standard for neonatal studies still requires their validation through indicators of morbidity and mortality. OBJECTIVE: evaluate the performance of the INTERGROWTH-21st Project (IG-21) standard and a commonly used Argentinian reference (Urquia) by examining the differences in the frequency of growth phenotypes, and the associated neonatal morbidity and mortality. METHODS: Retrospective cohort study of all singleton live-births from Sarda Maternity Hospital (Buenos Aires, Argentina) between 33 and 42 gestational age, using information obtained from a Perinatal Surveillance System (Agustina) dataset between 1996-2001 (n = 25948). Phenotypes small- and large-for-gestational age, stunting and waisting and a composite of neonatal morbidity/mortality (CNMM) were contrasted between the IG-21 standard and Urquia reference. RESULTS: the Urquia 3rd centile value was lower than IG-21 before 37 weeks, but then it surpassed IG-21 until term. Among Sarda , 2.3%, 5.9% and 8.9 were <3rd, <10th and >97th centile, respectively, under the IG-21 standard, while 3.7%, 10.1% and 8.4% were <3rd, <10th and >97th centile, respectively, under the Urquia reference. Stunting and waisting were 16.1% and 0.9%, respectively under IG-21. The IG-21 detection rates of CNMM showed that 28.5%, 19.6% and 8.5% occurred among weight<3rd,<10th and >97th centile, respectively, while 21.8%, 14.2% and 8.0%  occurred among <3rd, <10th and >97th centile under the Urquia criteria. Newborn weight <3rd,<10th and >97th  centile under IG-21 showed higher neonatal CNMM risk compared with Urquia reference. CONCLUSIONS: The IG-21 standard identified a higher risk of neonatal morbidity and mortality than the Urquia reference.

Introducción: El uso de referencias locales o estándares para estudios neonatales aún requiere su validación a través de indicadores de morbilidad y mortalidad. Objetivo: Comparar la capacidad predictiva del estándar INTERGROWTH-21st (IG-21st) y una referencia argentina (Urquia) mediante los fenotipos de crecimiento fetal y morbi-mortalidad neonatales. Métodos: Estudio de cohorte retrospectivo de recién nacidos vivos entre 33 y 42 semanas del Hospital Materno-Infantil Ramón Sarda (Buenos Aires, Argentina), entre 1996-2001 (n = 25948). Los fenotipos pequeños (PEG) y grandes para la edad gestacional, acortado y emaciado y un índice compuesto de morbilidad / mortalidad neonatal (CNMM) se contrastaron entre IG-21st y la referencia Urquia. Resultados: El 3er percentil del peso al nacer de Urquia fue menor que el de IG-21st antes de las 37 semanas; 2.3%, 5.9% y 8.9 de los RN fueron <3o, <10° y > 97° percentil, respectivamente, bajo el estándar IG-21st, mientras que 3,7%, 10,1% y 8,4% fueron <3 °, <10 ° y> 97 ° percentil, respectivamente, bajo la referencia Urquia. Acortados fueron 16.1% y emaciados 0.9%, bajo IG-21st. CNMM bajo IG-21st fueron 28.5%, 19.6% y 8.5% en peso<3o, <10º y >97º percentil, respectivamente, mientras que 21.8%, 14.2% y 8.0% ocurrieron en peso< 3°, <10° y > 97° percentil bajo Urquia. Acortados fueron 17.3% y emaciados 18.3%. Los RN <3er°, <10° y > 97° percentil bajo IG-21st mostraron mayor riesgo de CNMM en comparación con la referencia Urquia. Conclusiones: El estándar IG-21st identificó mayor riesgo de morbilidad y mortalidad que la referencia Urquia.