Nursing interventions for people in palliative care, based on the Dignity Model.

BACKGROUND: The use of the standardised nursing language aims to accurately represent clinical practice, contributing to proper documentation and the creation of evidence-based practice. AIMS: To validate nursing interventions (NI) for patients in palliative care, structuring these using the Dignity-Conserving Care Model. METHODS: A methodological study was conducted, developed according to the recommendations of the International Council of Nurses (ICN) and anchored in the Dignity-Conserving Care Model. The NI were developed in four stages: 1) construction of NI, based in the International Standards Organisation's standard (18.104:2014); 2) content validation by 26 expert nurses; 3) cross-mapping with the NIs contained in the International Classification for Nursing Practice (ICNP®) catalogue, Palliative Care for Dignified Dying, to identify those already existing in the catalogue; and 4) structuring the NI based on the concepts of the Dignity-Conserving Care Model. FINDINGS: 209 NI were validated and grouped into categories, namely: illness-related concerns; dignity-conservation repertoire; social dignity inventory. Of these, 183 were new and 26 already existed in the ICNP® Catalogue. CONCLUSION: The study presents new insights into palliative care in Brazil and presents 183 new NI in addition to those already published by the ICN.

Meleis' Nursing Theories Evaluation: integrative review.

OBJECTIVE: to analyze the application of the theory evaluation model proposed by Meleis in Brazilian studies. METHOD: integrative review of online articles published from 2002 to 2012 in the databases LILACS and BDENF. RESULTS: the 16 selected studies confirmed the use of only three of the five stages proposed for Meleis' theories analysis: Description of the Theory, Criticism of the Theory and Analysis of the Theory, with a predominance of a single unit of analysis in each. CONCLUSION: the analysis of nursing theories provides support to nurses in the practice, research, education and administration of the different dimensions of care. Meleis' model figures as very important by contributing to the development of knowledge of nursing discipline, considering that its use as a method allows several reflections on theories in order that they be revalidated to support a more theoretical and practical applicability.

Convergence, divergence and diagnostic accuracy in the light of two nursing terminologies.

OBJECTIVE: compare divergences and convergences between the nursing diagnoses established for a case study, in the light of two nursing terminologies. METHOD: a descriptive research was undertaken. The participants were 24 nurses from public teaching hospitals (N=12) and hospital care institutions (N=12) in the Northeast of Brazil. RESULTS: in group A (6 faculty members and 6 clinical professionals), 51 diagnoses were established according to NANDA-I: 54.9% of high accuracy, 23.5% zero, 15.7% low and 5.9% moderate accuracy. In group B (6 faculty members and 6 clinical professionals), 43 declarations were established using the ICNP®: 44.2% of zero accuracy, 39.5% high, 16.3% low. Four out of fi ve diagnostic titles of high accuracy in group A and the seven titles in group B converged; divergences were attributed to the number of combinations among the focus, judgment and location axes of the ICNP®. CONCLUSION: a range of titles was observed with different diagnostic inferences and low diagnostic accuracy in both groups.

Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses.

OBJECTIVE: to know the beliefs of older adults about their vulnerability to HIV/Aids, and to identify nursing diagnoses. METHOD: a field research implemented in Family Health Units, in João Pessoa, Brazil. The sample included 250 older adults of both genders with data collected from April to July of 2011. A Test of Free Word Association was applied using the term HIV/Aids. A content analysis and cross-mapping of the most frequent terms with the International Classification for Nursing Practice, 2011 were performed. RESULTS: 202 terms were identified in terms, with an overall frequency of 1156. Of the 202 terms, 16 were more frequent and were used to construct the nursing diagnoses. The diagnoses identified were knowledge about appropriate sexual behavior, ability for partial protection, fear of death and hopelessness. CONCLUSION: understanding these beliefs drew from knowledge about factors related to, vulnerability to HIV/Aids aimed at planning health care actions for this population segment.

Anxiety in children following hospitalization: a proposal for a nursing diagnosis.

OBJECTIVE: to describe the process of developing a nursing diagnosis regarding child anxiety following hospitalization, which is to be submitted to the international classification for nursing practice, in accordance with the guidelines set out by the International Council of Nurses and the ISO standard 18104:2014. METHOD: this methodological study includes a conceptual analysis that bases itself on analyzing the phenomena of anxiety and hospitalization, while identifying the critical attributes of the concept and developing an operational definition. RESULTS: all the criteria for including a new nursing concept were followed and there was no violation of the framework of the International Classification for Nursing Practice with the proposed inclusion, since the concept of anxiety already exists in this classification system and the concept of anxiety from hospitalization would be considered a species or subclass of this concept. CONCLUSION: this analysis of the concept of hospitalization anxiety in children allowed its meaning to be clarified and, consequently, understanding to be constructed regarding its practical applicability. This achievement contributed in terms of providing incentive to develop new proposals for nursing diagnoses to be included in the International Classification for Nursing Practice.

[Term base for nursing practices with elderly women with HIV/AIDS]. / Banco de termos para a prática de enfermagem com mulheres idosas com HIV/aids.

The aim of this study was to create a term base for nursing practices with elderly women with HIV/AIDS. This documental descriptive research was conducted at the Universidade Federal de Paraíba, from August 2012 to July 2013, based on a list of terms from the Integrated Plan to Combat the Feminization of AIDS and other STDs. These terms were cross-mapped with those of the International Classification for Nursing Practices 2011 (CIPEr 2011) and use of these terms in nursing practices was confirmed with the help of 15 participants. The base comprised 106 constant terms and 69 non-constant terms in the CIPEr 2011. Results revealed the need to reconsider nursing care for elderly women with HIV/AIDS in light of epidemiological changes in relation to aging and feminization of the disease. The term base will support the construction of more appropriate wording for nursing diagnoses, results and interventions for elderly women with HIV/AIDS.

[The care for institutionalized elderly perceived by the nursing team]. / O cuidar de pessoas idosas institucionalizadas na percepção da equipe de enfermagem.

This article aimed to analyze the perception of the nursing team about the care of institutionalized elderly. It consists of a qualitative and exploratory study developed in the six long-term care nursing homes for elderly in the city of João Pessoa/PB, Brazil, from January to June 2013. The sample was comprised 50% of the nurses from all the institutions, totaling 13 participants, whose data were collected through semi-structured questionnaires. Content analysis was used in the study, which enabled the construction of two thematic categories: I) Perceptions of the delivery of care by the nursing staff of the institutions; II) Perceptions of the care activity to be performed by the nursing staff in the institutions. We conclude that the participants are aware of the need for an individualized and systematized care by the nursing staff, aimed to the prevention of diseases, health promotion and active aging.

[International Nursing Minimum Data Set: a comparative study with tools of a pediatric clinic]. / Conjunto Internacional de Dados Mínimos de Enfermagem: estudo comparativo com instrumentos de uma clínica pediátrica.

Descriptive and comparative study, developed from two historical used to implement the Systematization of Nursing Care in a Pediatric clinic of a teaching hospital. It aimed to compare the International Nursing Minimum Data Set (i-NMDS) with the data contained in nursing clinical assessment tools that are used in the application of the Nursing Process in the area of Children and Teenagers Health in a Pediatric Clinic. From the sixteen items evaluated that belong to the proposal of the i-NMDS, the nursing clinical assessment tool for hospitalized teenagers included 12 (75%), while the instrument for children from 0 to 5 years old presented 7 (43.75%). It was concluded that the nursing clinical assessment tools analyzed did not include the i-NMDS data in its entirety. It is suggested that there should be an improvement on the development of the nursing clinical assessment tools, using standardized nursing language for planning assistance, documenting activities, identify and measure the results of practice.

[Overburden on elderly's family caregivers: association with characteristics of the elderly and care demand]. / Sobrecarga em cuidadores familiares de idosos: associação com características do idoso e demanda de cuidado.

This is an epidemiological research, descriptive and transversal, which had as objectives to estimate the prevalence of overburden among family caregivers of dependent elderly in the city of João Pessoa, Paraíba, and to identify its relationship with the elderly's conditions of health, functionality and demand for care. The population comprised 240 elderly people residents in the twenty census sectors in the referred city. The sample was composed of 52 elderly people with functional inability and their caregivers. To data collection, it was applied a structured questionnaire and the scales of Mini Mental State Examination, Katz Index and Burden Interview. The results demonstrated that 84.6% of caregivers showed overburden, which was associated with clinical and functional characteristics of the elderly and with the demand for care. The findings bring relevant contributions to the elaboration of public policies in order to establish formal support for families' caregivers.

[Construction of terminology subsets: contributions to clinical nursing practice]. / Construção de subconjuntos terminológicos: contribuições à prática clínica do enfermeiro.

The International Classification for Nursing Practice (ICNP®) is a classification system that unifies the elements of nursing practice (diagnoses, interventions and outcomes), enabling elucidation of elements of a specific nursing language through the construction of terminology subsets. In this reflective essay, aspects relevant to the construction of ICNP® terminology subsets are highlighted, as well as their contributions to clinical nursing practice. The development of subsets as a tool that contributes to making nursing language universal, facilitates the communication process, as well as the scientific and technological advancement of the profession, is discussed. Therefore, its use by nurses worldwide is encouraged.

[Process and results of the development of an ICNP® Catalogue for Cancer Pain]. / Processo e resultados do desenvolvimento de um Catálogo CIPE® para dor oncológica.

This was a methodological study conducted to describe the process and results of the development of an International Classification for Nursing Practice (ICNP®) Catalogue for Cancer Pain. According to the International Council of Nurses (ICN), this catalogue contains a subset of nursing diagnoses, outcomes, and interventions to document the implementation of the nursing process in cancer patients. This catalogue was developed in several steps according to the guidelines recommended by the ICN. As a result, 68 statements on nursing diagnoses/outcomes were obtained, which were classified according to the theoretical model for nursing care related to cancer pain into physical (28), psychological (29), and sociocultural and spiritual (11) aspects. A total of 116 corresponding nursing interventions were obtained. The proposed ICNP® Catalogue for Cancer Pain aims to provide safe and systematic orientation to nurses who work in this field, thus improving the quality of patient care and facilitating the performance of the nursing process.

[Classification of the CNPq areas of knowledge and the nursing field: possibilities and limits]. / Classificação das áreas de conhecimento do CNPq e o campo da Enfermagem: possibilidades e limites.

Knowledge areas have been discussed by Science and Technology managers and administrators and by the scientific community searching for tools to support data systematization, mainly for management and administrative activities. The main table in use by CNPq is admittedly outdated and requires revision or reclassification. The aim of this article is to contribute to the current debate based on previous results from participation in a table review study performed in the 1990 s and on research results in the area of knowledge organization and representation in the context of Information Science. It presents a proposal to reformulate the Nursing Knowledge Area and some reflections about the possibilities of this ongoing process.

[The ICNP® terminology and the Brazilian ICNP® Centre participation on its development and dissemination]. / A terminologia CIPE® e a participação do Centro CIPE® brasileiro em seu desenvolvimento e disseminação.

This paper aims to describe (1) the evolution of the International Classification for Nursing Practice (ICNP® ), since the International Council of Nurses (ICN) assumed, in 1989, the task of developing a classification of the elements of professional practice (nursing diagnoses, interventions and outcomes) with an international ambit; (2) the ICNP® Programme and its structural components, which fit together to conform the ICNP® terminology life cycle; (3) the Centres for ICNP® Research and Development, accredited by ICN; (4) finally, the Brazilian Center's contribution for research, development and dissemination of the ICNP® terminology. The ICNP® is constantly evolving and much has been achieved in nearly twenty-five years of its development. The ICNP® Centres have played a key role in the development, dissemination and use of the terminology in different fields of professional practice - teaching, clinical practice, research and management of nursing care.

[Instrument to collect nursing data in General Intensive Care Unit]. / Instrumento de coleta de dados de enfermagem em Unidade de Terapia Intensiva Geral.

The study aimed to build an instrument to collect nursing data for patients in a General ICU, based in Horta. Action research developed in three phases: identification of the empirical indicators in hospitalized adults in a General ICU; validation of the indicators and formatting of the preliminary instrument; apparent and content validation with a posterior arrangement of the instrument final version. A number of 545 empirical indicators were identified, remaining 179 with IC > 0.80, being the final version of the instrument structured in four main areas: Identification, Interview, Physical Examination, Nurse Impressions and Intercurrences. It is believed that this instrument will identify situations of health and disease and nursing care needs; will promote a more effective interpersonal relationship among nurses, clients and families; will disclose the imperative of the systematization of nursing care on quality of care, as well as raise new researches working with Nursing own tools.

[Concept maps of the graduate programme in nursing: experience report]. / Mapas conceituais no ensino de pós-graduação em enfermagem: relato de experiência.

The conceptual map is considered a strategy that enables the development of critical thinking skills. The aim of this article was to evaluate concept maps produced by students to obtain an understanding of research projects. This is an experience report based on the Special Topic: concept map of the Graduate Program in Nursing/Federal University of Paraiba in February/2012. Methodology comprised interactive reading of concept maps, installation and use of Cmap Tools software and construction of concept maps. Concept evaluation included coherence, propositions, clarity of ideas and logical relation between concepts. This evaluation of maps revealed consistency among concepts, significant relationships, clarity of ideas and logical relationship between the stages of a research project. Results showed that the concept map is a valid strategy to evaluate the learning-teaching process and can be used for education, research and reflection in the nursing practice.

The importance of communication in pediatric oncology palliative care: focus on Humanistic Nursing Theory.

OBJECTIVE: to investigate and analyze communication in palliative care contexts from the perspective of nurses, based on Humanistic Nursing Theory. METHOD: this is a field study with a qualitative approach, in which ten nurses working in the pediatric oncology unit of a Brazilian public hospital participated. Semi-structured interviews were used to collect data. The testimonies were qualitatively analyzed using Humanistic Nursing Theory and based on the five phases of Nursing Phenomenology. RESULTS: two thematic categories emerged from the analysis of the study's empirical material: "strategy to humanize nursing care, with an emphasis on relieving the child's suffering" and "strategy to strengthen ties of trust established between nurse and child." CONCLUSION: communication is an efficacious element in the care provided to the child with cancer and is extremely important to promoting palliative care when it is based on Humanistic Nursing Theory.

[Nursing diagnoses and interventions for patients with congestive heart failure using the ICNP ®]. / Diagnósticos e intervenções de enfermagem para pacientes portadores de insuficiência cardíaca congestiva utilizando a CIPE®

The aim of this descriptive exploratory study was to construct nursing diagnosis and intervention statements for patients with Congestive Heart Failure. To accomplish this aim, 53 terms were identified in the focus axis of the International Classification for Nursing Practice (ICNP®), which guided the construction of these statements using the guidelines of the International Council of Nurses and ISO 18. 104. A total of 92 nursing diagnosis statements were constructed, which resulted in 66 statements after standardization. The standardized statements were separated according to the following pathophysiological models: 13 related to tachycardia, 20 related to dyspnea, 19 related to edema, and 14 related to congestion. A total of 234 interventions were constructed for these statements using the terms from the 7-Axis Model of the ICNP®, the literature in the area and the clinical experience of the authors. The nursing diagnosis and intervention statements designed are expected to facilitate the evaluation of CHF patients and assist in the construction of a terminological subset for the ICNP®.

[Nursing diagnoses for clients hospitalized in an infectious disease clinic]. / Diagnósticos de enfermagem para clientes hospitalizados em uma clínica de doenças infectocontagiosas.

The aim of this exploratory descriptive study was to create nursing diagnosis statements for hospitalized clients based on the Database of Special Nursing Language Terms of the Infectious Diseases Clinic of a teaching hospital and on the ICNP®. Further, we aimed to validate the diagnosis statements with the participation of clinical nurses and nursing teachers who worked at the clinic. Eighty-eight nursing diagnosis statements were constructed. However, only those that achieved a correlation index (CI) ≥ 0.80, as determined by the experts participating in the study, were validated, resulting in seventy diagnosis statements. The study results showed that the aims were achieved, and the statements will facilitate communication processes among nursing professionals. Furthermore, they will ensure that care is guided by methodological principles, thus providing client care with greater resolvability power.

Nursing diagnoses for the elderly using the International Classification for Nursing Practice and the activities of living model.

OBJECTIVE: To develop nursing diagnosis statements for the elderly based on the Activities of Living Model and on the International Classification for Nursing Practice. METHOD: Descriptive and exploratory study, put in practice in two stages: 1) collection of terms and concepts that are considered clinically and culturally relevant for nursing care delivered to the elderly, in order to develop a database of terms and 2) development of nursing diagnosis statements for the elderly in primary health care, based on the guidelines of the International Council of Nurses and on the database of terms for nursing practice involving the elderly. RESULTS: 414 terms were identified and submitted to the content validation process, with the participation of ten nursing experts, which resulted in 263 validated terms. These terms were submitted to cross mapping with the terms of the International Classification for Nursing Practice, resulting in the identification of 115 listed terms and 148 non-listed terms, which constituted the database of terms, from which 127 nursing diagnosis statements were prepared and classified into factors that affect the performance of the elderly's activities of living - 69 into biological factors, 19 into psychological, 31 into sociocultural, five into environmental, and three into political-economic factors. CONCLUSIONS: After clinical validation, these statements can serve as a guide for nursing consultations with elderly patients, without ignoring clinical experience, critical thinking and decision-making.

[Nursing care protocol to the patient before and after bariatric surgery]. / Protocolo de assistência de enfermagem ao paciente em pré e pós-operatório de cirurgia bariátrica.

This is a methodological study of innovative technology developed which aims to build up nursing care protocol to the patient in the pre and postoperative bariatric surgery. The proposed model of care was based on the General Theory Orem Self-Care and organized from the requirements of self-care (universal, developmental and health deviation). Within each requirement, it is presented nursing diagnoses, expected outcomes and nursing interventions that were identified in a survey conducted with 31 clients suffering from morbid obesity, assisted by the Gastroenterology Outpatient Clinic of a university hospital in the period from April to June 2009. The development of the protocol is considered an important resource both to organize the guidelines provided by nurses to the bariatric patient, aiming their self-care, and to provide subsidies to systematize nursing care to be provided.