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Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The goal of this study was to measure the arm circumferences (AC) and appropriated cuff sizes for children and adolescents and to relate these dimensions to specific age ranges. This is a cross-sectional study, developed in Fortaleza, Ceará, Brazil, with 596 people between 6 and 17 years old. The AC was measured at the midpoint between the olecranon and the acromion. The selected cuff width followed the recommended ratio of 40% the AC. The more suitable cuff sizes were 7x14 cm, 8x16 cm and 9x18 cm, at 19.8%, 26.5% and 25%, respectively. A statistically significant association between AC and age range was found in both genders, as well as between the cuff and the age range, showing that the 7x14 cm (38.9%) and 8x16 cm (29.6%) cuffs were more suitable for children, and 8x16 cm (23.7%) and 9x18 cm (36.1%) cuffs were better for adolescents. Adequate cuffs were concluded to be different from the standard cuffs used for children and adolescents. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PURPOSE. To analyze the relationship between nursing diagnoses and survival rates in children with congenital heart disease. METHODS. A total of 270 observations were carried out in 45 children with congenital heart disease who were followed for 15 days. FINDINGS. Differences in mean survival times were identified in children not more than 4 months of age with respect to the following diagnoses: impaired gas exchange, ineffective breathing pattern, activity intolerance, delayed growth and development, and decreased cardiac output. CONCLUSIONS. The main diagnoses are identified early in the hospitalization period and are conditions resulting from hemodynamic alterations and prescribed medical treatment. IMPLICATIONS FOR NURSING PRACTICE. Congenital heart disease provokes serious hemodynamic alterations that generate human responses, which should be treated proactively. [ABSTRACT FROM AUTHOR]

The nursing theories have an important role in understanding the Nursing practice as a professional tool which brings autonomy and visibility. According to this, the elaboration of a reflexive theoretical study and analysis was chosen based on Barnum (1988) and targeted to develop researches to the adaptation process in mastectomised women. The main objective was the verification of the term Body Image as a convergence criterion with reality, elaborated by Roy in the Adaptation Model and having as corpus the Rodrigues dissertation (1999). Its possible to identify concepts that fit to the term proposed by Roy and Andrews (1999) and that integrate the study analysis of the adaptation process of mastectomised woman through stimulus, answers and adaptation levels in the mentioned phenomenon. Experiences like this lead an important theoretical deepening in nursing theories, making it able to accurate sights for a practical application. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis Impaired skin integrity (00046) in patients admitted to intensive care units (ICUs)., Methods: A cross-sectional diagnostic accuracy study was conducted with 105 adult patients admitted to an ICU. A latent class model with random effects was used to test the sensitivity and specificity of the defining characteristics investigated. The diagnosis Impaired skin integrity (00046) was the dependent variable, whereas sociodemographic and clinical data were the independent variables., Results: Impaired skin integrity was present in 3.75% of the sample. The defining characteristic with the best accuracy for the diagnosis was dry skin, with high sensitivity (0.9994) and specificity (0.9106). Other characteristics stood out in terms of sensitivity measures: altered skin color (0.9994) and foreign matter piercing skin (0.9994). In terms of specificity, the following stood out: desquamation (1.000), localized area hot to touch (0.9901), pruritus (0.9897), bleeding (0.9802), and hematoma (0.9208)., Conclusion: The defining characteristics that helped infer the diagnosis Impaired skin integrity (00046) with greater certainty were dry skin, altered skin color, foreign matter piercing skin, desquamation, localized area hot to touch, pruritus, bleeding, and hematoma., Implications for Nursing Practice: Identifying defining characteristics with high diagnostic accuracy for Impaired skin integrity (00046) enables nurses to expand their clinical perspective on this dysfunction, which can affect the skin of critically ill patients, and to develop individualized care plans., (© 2025 NANDA International, Inc.)

Objective: To clinically validate the nursing diagnosis (ND) inadequate social support network in breastfeeding mothers., Method: This cross-sectional quantitative study employed clinical indicator accuracy analysis and hierarchical modeling for the etiological factors of the ND inadequate social support network. The study included 285 breastfeeding mothers registered in primary healthcare units., Results: The most prevalent clinical indicators within the sample were deficit in instrumental support from health services, imposition of appropriate behaviors, weak social bonds, and negative social interactions. The most frequent etiological factors were deficit in strong bonds, fragility of institutional network organization, unwillingness to provide support, refusal to provide support, and deficit in healthcare professionals., Conclusion: The ND inadequate social support network was clinically validated within the population of breastfeeding mothers, resulting in six clinical indicators with high sensitivity and specificity for identifying the diagnosis. Additionally, the statistical analysis of the etiological factors identified seven antecedents to the emergence of the diagnosis., Implications for Nursing Practice: Based on these findings, nurses can better assist breastfeeding mothers with the aim of preventing an inadequate social support network. By identifying this phenomenon, it becomes possible to plan care and implement nursing interventions to address this issue effectively., (© 2025 NANDA International, Inc.)

Aim: To compare the performance of the SARC-F and SARCCalf questionnaires in sarcopenia screening and their relationship with clinical and sociodemographic aspects of older adults., Methods: Analytical cross-sectional study carried out with 739 elderly people in the community. Clinical, sociodemographic, anthropometric data and screening for signs suggestive of sarcopenia were obtained using the SARC-F and SARCCalf., Results: Evaluation by method showed a difference in the proportion of positive results for the SARC-F regarding female sex (71.7; p = 0.001), among older adults who did not have a partner (49.7; p < 0.001), and osteoarticular diseases (13.4; p < 0.001). On the other hand, the SARCCalf identified a higher proportion of positive results among older adults at risk of malnutrition (12.2; p < 0.001)., Conclusion: The performance of the instruments varied according to the clinical and sociodemographic characteristics of the population, and it is up to professionals to consider these aspects when using them., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Mammography is one of the main methods available for breast cancer screening in Brazil. However, differences in timely access and performance of the exam can be highlighted based on social determinants of health, considered relevant due to their influence on the health situation of a population. Thus, the present study aimed to identify the social determinants of health associated with access to and performance of mammography in Brazilian women. Cross-sectional and analytical study, based on secondary data from the National Health Survey (NHS) from 2013 and 2019 in Brazil. The main determinants of women who did not take the exam during the evaluated period were: aged 65 to 69 years, mixed race and black, living with more than three people, with incomplete primary education, in the 1st quintile of socioeconomic income, without health insurance, registered with the Family Health Strategy (FHS), and residents of the North and Northeast regions. There was a significant improvement in access to mammography exams in all states; however, structural factors, such as economic income, color, level of education, and age group were evident in why mammograms were not performed.

Objective: To assess the pragmatic adequacy of the Interactive Theory of Breastfeeding based on the Fawcett's Model., Method: Theoretical study, according to evaluation criteria proposed by Fawcett. The six questions suggested in the model were used, answered based on searches in scientific literature, consultation in legislation supporting nursing professional practice and information from the authors of the theory., Results: It was observed that during their training, Nurses acquire skills for care, but clinical management focused on breastfeeding should be emphasized. Since its creation, the theory has been applied in an ascending manner, proving its application in clinical practice to be viable. The existence of laws and resolutions guarantee clinical nurses the legal support necessary to develop a practice based on the Interactive Theory of Breastfeeding., Conclusion: The pragmatic adequacy of the theory was observed, showing that the Interactive Theory of Breastfeeding subsidizes a care directed at the mother and child binomial, supporting the nurse in their decision-making, contributing to the protection, promotion, and support of breastfeeding.

The objectives were to assess the self-efficacy and consistent condom use by people living with HIV (PLHIV). A cross-sectional, comparative study was carried out in outpatient clinics in Ceará State, Brazil, with a sample of 190 PLHIV, 95 serodiscordant and 95 seroconcordant. Interviews were conducted using the Socio-Demographic, Clinical, Epidemiological and Vulnerability Form and the Condom Use Self-Efficacy Scale. Descriptive analysis, associations between variables, odds ratio and 95% confidence interval were determined. P  < 0.05 was considered statistically significant. Of the sample, 43.1% consistently used condoms (50.5% serodiscordant and 35.7% seroconcordant). Serodiscordant PLHIV without guidance on HIV prevention ( P  = 0.027) and without access to testing ( P  = 0.002) had lower self-efficacy and 11.5 times more chances for inconsistent condom use ( P  = 0.006), while those satisfied with follow-up in health were less likely to use condoms inconsistently ( P  = 0.011). We conclude that there is low consistent use of condoms among PLHIV, which increases the risk of HIV transmission and the acquisition of other sexually transmitted infections. Consistent condom use was greater among serodiscordant individuals, although there was no difference in self-efficacy in condom use between the groups.

Objective: To analyze the concept of "youth.", Methods: This is a concept analysis guided by the method proposed by Walker and Avant, operationalized through an integrative literature review. The search in scientific databases was carried out using the descriptors: youth; young; adolescence. To compose the literary corpus, 22 studies were selected., Results: Various factors were found in the antecedents that influence the separation of youth groups, contributing to the heterogenization of this population. The attributes include characteristics that comprise the formation of youth groups, especially the idea of shared experiences and social construction, as well as the consequences of the mentioned concept. After systematizing the variables, the analysis was conducted, highlighting the conceptions that influence youth., Conclusion: The study demonstrated the multifactorial complexity of the formulation of the concept of youth, highlighting various factors that contribute to this construction. For nursing, this conceptual field allows for an understanding of the population and effective engagement with this group.

Purpose: To evaluate the accuracy of clinical indicators and etiological factors associated with the nursing diagnosis of ineffective overweight self-management among university students., Method: A diagnostic accuracy study with a cross-sectional design was conducted with 108 university students. A latent class analysis model with random effects was used to establish sensitivity and specificity measures of clinical indicators, estimate the prevalence of the diagnosis, and calculate posterior probabilities for the diagnosis. Odds ratios for etiological factors were calculated using univariate logistic regression. The study was approved by the Research Ethics Committee of the responsible institution., Results: The nursing diagnosis of ineffective overweight self-management had an estimated prevalence of 38.1% in the sample. Sensitive clinical indicators included excessive calorie consumption (0.9514) and dissatisfaction with body image (0.8834). Specific indicators included negative self-perception of health (0.9999), inadequate eating behavior (0.9990), and impaired emotional health (0.8273). A personal history of overweight (OR = 2.78; p-value = 0.018) increased the likelihood of developing ineffective overweight self-management by approximately two and a half times., Conclusion: Ineffective overweight self-management is prevalent among university students and is characterized by two sensitive clinical indicators, three specific indicators, and a population at risk that increases the likelihood of this diagnosis., Implications for Nursing Practice: Accurate clinical indicators and the identification of etiological factors for the diagnosis of ineffective overweight self-management support nurses' clinical reasoning in practice. Moreover, verifying accurate components for diagnosing ineffective overweight self-management contributes to the development of interventions aimed at promoting the health of university students., (© 2024 NANDA International, Inc.)

Aim: To test a middle-range theory (MRT) for the nursing diagnosis of ineffective breathing pattern in children with congenital heart disease (CHD) based on analysis of two general propositions., Methods: This cross-sectional study is guided by STROBE. The propositions represent hypotheses about the relationships between the concepts of this MRT to be tested empirically, and thus, log-linear models were used to verify the structure of the proposition related to the stimuli. Diagnostic accuracy measures, univariate logistic regressions and the Mann-Whitney test were used to analyse the structure of the propositions related to behaviours., Results: The analysis of the propositions related to the stimuli (eight concepts, four of which were classified as focal stimuli and four as contextual stimuli) suggested a reclassification of the stimulus "deformities in the thoracic wall" which became too focal. In the analysis of the propositions related to behaviours (17 concepts, five of which were classified as acute confirmatory, nine as acute clinical deterioration and three classified as chronic), guided changes in the operationalisation of concepts were suggested after comparing clinical findings; thus, acute confirmatory behaviours now have 10 concepts, while acute clinical deterioration behaviours and chronic behaviours continued with nine and three concepts, respectively, but with reclassifications between them., Conclusion: Changes in the operationalisation of the classification of the elements of the two propositions occurred after comparing the clinical findings with the theoretical model., Relevance to Clinical Practice: By establishing precise causal relationships and describing how IBP manifests itself over time in children with CHD, empirical testing of this MRT helps nurses understand clinical reasoning based on temporal logic and spectral interaction between diagnostic components, which in turn will improve the use and accuracy of nursing diagnoses., Patient Contribution: Children and adolescents with CHD were recruited for this study sharing their clinical history and physical lung examination., (© 2024 John Wiley & Sons Ltd.)

Purpose: To describe a middle range theory (MRT) with conceptual and explicative capacity of cause and effect situations of Ineffective social support network in nursing., Data Sources: Descriptive study developed through the Lopes, Silva, and Herdman theoretical-causal validity method, using five steps for theory construction: definition of the approach for constructing the MRT, definition of the main concepts, development of the pictorial diagram, construction of propositions, and establishment of causal relationships and evidence for practice. The foundation of these steps and the development of a predictive nursing theory occurred through Sanicola's Social Network Theory combined with studies from an integrative literature review using the six steps proposed by Whittemore and Knafl., Data Synthesis-Findings: The theory presents etiological factors and clinical indicators for Ineffective social support network, connecting situations related to the person, the members and the configuration of this network, and external situations. The pictogram, symbolically created, represents the hierarchical classification of proximal, intermediate, and distal etiological factors, and their relationship with clinical indicators., Conclusions: The MRT, predictive for the nursing phenomenon Ineffective social support network, provides understanding of the person from an interpersonal perspective, which interferes with and is affected by a network of virtues and vicissitudes, and has negative influences on health outcomes. Due to its practical vocation, this theory represents an advance in the science and praxis of nursing., Implications for Clinical Practice: The findings of this study will contribute to the understanding of the nursing phenomenon Ineffective social support network and consequently support the identification of the nursing diagnosis Ineffective social support network, proposed for inclusion in the NANDA-I classification., (© 2023 NANDA International, Inc.)

Aims: To test the clinical validity of clinical indicators and causal relationships of aetiological factors of the new nursing diagnosis of inadequate health self-efficacy in people with hypertension., Background: The diagnosis of inadequate health self-efficacy has both theoretical and content validity. However, a clinical validation study is needed to establish an appropriate framework for distinguishing individuals who manifest this unique human response., Design: The study adopts a cross-sectional clinical validation approach, adhering strictly to the STROBE guidelines throughout its design and implementation., Methods: Naturalistic sampling was used to identify 302 adults diagnosed with hypertension. Their data were subjected to latent class analysis, which facilitated the identification of a comprehensive set of clinical indicators that demonstrated better diagnostic accuracy and established posterior probabilities to guide the inference of inadequate health self-efficacy. In addition, logistic regression analysis was used to assess the magnitude of the impact of aetiological factors., Results: The prevalence of inadequate health self-efficacy was 76.61%. Among the 13 indicators examined, seven demonstrated notable sensitivity: 'risk-prone health behaviour', 'failure to take action that prevents health problems', 'inadequate self-control', 'avoidance behaviours', 'negative health self-perception', 'inadequate health-related quality of life' and 'difficulty feeling good about adopting a healthy lifestyle'. Additionally, two indicators showed high specificity: 'difficulty feeling good about adopting a healthy lifestyle' and 'inadequate adherence to treatment regimen'. Notably, 15 aetiological factors were identified as significantly associated with an increased risk of inadequate health self-efficacy., Conclusions: A clinical framework consisting of eight clinical indicators and 15 aetiological factors was developed to characterise inadequate health self-efficacy in individuals with hypertension., Relevance to Practice: Clinical validation provides insight into the precision of clinical indicators and the magnitude of the effect of putative causal elements, thereby facilitating identification and tailored intervention for individuals with hypertension and inadequate health self-efficacy., (© 2024 John Wiley & Sons Ltd.)

Objectives: to develop and evaluate a Middle-Range Theory for the nursing diagnosis "Disrupted Mother-Fetus Dyad Risk" in high-risk pregnancies., Methods: this methodological study was conducted in two stages: theory development and evaluation. Dorothea Orem's General Nursing Model was used as the theoretical-conceptual foundation. Evaluation was conducted using the Delphi method with seven judges, and consensus was achieved when the Content Validity Index of the evaluated items was ≥ 0.80., Results: the theory identified 20 elements of the nursing diagnosis "Disrupted Mother-Fetus Dyad Risk" (10 risk factors, 4 at-risk populations, and 6 associated conditions), 14 propositions, and 1 pictogram. After two rounds of evaluation, the theory was considered consistent, with consensus reached for all items, each achieving a Content Validity Index ≥ 0.80., Conclusions: the Middle-Range Theory included biopsychosocial factors explaining the nursing phenomenon "Disrupted Mother-Fetus Dyad Risk," which aids in nurses' diagnostic reasoning.

Objectives: to develop a Middle-Range Theory for the Risk for imbalanced blood pressure pattern among incarcerated women., Methods: theoretical development study to obtain the theoretical-causal validity of the Nursing Diagnosis Risk for unstable blood pressure. The Middle-Range Theory was developed according to six stages: establishment of the approach to developing the theory; definition of the conceptual models to be later analyzed; definition of the main conceptions; a pictorial diagram; propositions; causal relationships and evidence for practice., Results: two attributes and 20 antecedents related to imbalanced blood pressure were identified, a pictorial diagram was developed, and nine theoretical propositions were presented., Conclusions: the theory developed here favors the diagnostic reasoning of nurses and contributes to planning actions to promote the cardiovascular health of incarcerated women. A new proposition for the diagnosis of Risk for unstable blood pressure was also structured with a new title, definition, and etiological factors.

Objective: To analyze the accuracy of the defining characteristics of four respiratory nursing diagnoses (ND) in patients with COVID-19 and on oxygen therapy., Methods: This is a cross-sectional study conducted in four Brazilian public hospitals in two regions of the country. A total of 474 patients with COVID-19 receiving oxygen therapy were assessed. Latent-adjusted class analysis with random effects was used to establish the sensitivity (Se) and specificity (Sp) of the defining characteristics evaluated for each ND., Results: Among the ND that constituted the study (impaired spontaneous ventilatory, impaired gas exchange, ineffective airway clearance, and dysfunctional ventilatory weaning response), the following defining characteristics had the highest simultaneous Se and Sp (>0.8): decrease in tidal volume, confusion, irritability, dyspnea, decreased breath sounds, orthopnea, impaired ability to cooperate and respond to coaching, and decrease in the level of consciousness., Conclusions: Recognizing the clinical signs that predict respiratory ND in patients affected by COVID-19 can contribute to the nurse's accurate diagnostic inference and designate the appropriate nursing interventions to achieve the desired results and avoid complications., (© 2024 NANDA International, Inc.)

Purpose: To obtain evidence of the clinical validity of the nursing diagnosis (ND) risk for disturbed maternal-fetal dyad in high-risk pregnancy., Method: Causal validation of the ND through a case-control study performed in a university hospital with 155 high-risk pregnant women: 31 cases and 124 controls. A causal association was found between the ND etiological factors and the occurrence of disruption of the symbiotic maternal-fetal dyad; an association was verified when the etiological factor presented a p-value <0.05 and odds ratio >1., Findings: The risk factor absent-inadequate prenatal care; populations at risk, such as young-advanced maternal age and economically disadvantaged pregnant women; and association conditions, such as maternal conditions and compromised fetal oxygen transport, increased the outcome likelihood. The associated condition maternal illnesses appeared as a protective factor., Conclusions: Evidence of clinical validity of the ND risk for disturbed maternal-fetal dyad was obtained, and an association between etiological factors and disruption of the symbiotic maternal-fetal dyad was found., Implications for Nursing Practice: The results contribute to advance scientific knowledge in nursing teaching, research, and practice and support the nursing process in high-risk pregnancies., (© 2023 NANDA International, Inc.)

Objective: To analyze the concept of Neonatal Near Miss (NNM) using Walker and Avant's method., Method: This study employs conceptual analysis following Walker and Avant's model, involving concept selection, objective definition, identification of potential uses, determination of attributes, model case creation, additional case consideration, antecedent identification, consequent analysis, and empirical reference examination. To elucidate the concept, a scoping review was conducted across journals indexed in scientific databases such as Web of Science, EMBASE, SCOPUS, and MEDLINE/PubMed., Results: The analysis encompassed 43 articles, revealing diverse definitions of neonatal near miss across different contexts. A comprehensive definition emerged from identified antecedents: risk of death, susceptibility to adverse outcomes, and potential adverse events. These antecedents were categorized into maternal conditions, neonatal conditions, and healthcare assistance., Conclusion: The analysis and definition of the NNM concept was successful, and its antecedents, attributes, and consequences were delineated., Implications: Identifying the risk factors associated with NNM cases may contribute to reducing infant morbidity and mortality and improving the quality of care, facilitating future research and improving the use of the NNM concept., Competing Interests: Declaration of competing interest This work was carried out with the support of the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) - Financing Code 001, (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background and Purpose: To validate the scales of knowledge, attitude, and practice of self-care for arteriovenous fistulas in renal patients on hemodialysis. Methods: A methodological study verified the evidence of validity based on the content, response processes, and internal structure of the scales. The content was evaluated by six judges, and the response processes were verified with six patients. In the evaluation of the internal structure, the scales were applied to 220 patients for exploratory factor analysis with evaluation of McDonald's omega adjustment and calculation indexes. Results: The scales explained variance and McDonald's omega values of 40.4%/0.896, 60.7%/0.843, and 36.9%/0.702 for the knowledge (19 items), attitude (4 items), and practice (8 items), respectively. Conclusions: The scale of attitude was valid after the analysis of the content evidence, response processes, and internal structure. The arteriovenous fistula self-care knowledge and practice scales explained less than 50% of the constructs. Therefore, it is recommended that new studies be conducted to validate scales of knowledge and practice of fistula self-care., (© 2024 Springer Publishing Company.)

Purpose: To analyze the diagnostic concept of "ineffective coping" (00069) proposed by NANDA-I, using Walker and Avant's framework., Data Sources: The theoretical framework of Walker and Avant was used for the concept analysis. A search was performed in the Virtual Health Library portal using the keywords "ineffective coping" and "enfrentamento ineficaz.", Data Synthesis: According to the literature, ineffective coping is defined as an adoption of inadequate psychosocial and behavioral strategies in response to a set of contextual stressors that negatively affect well-being and lifestyle., Conclusions: The concept created for ineffective coping has the potential to address the psychosocial elements associated with life experiences in the face of coping mechanisms., Implications for Nursing Practice: This analysis may contribute to the improvement of nursing care for patients experiencing difficult situations in their lives, as well as the challenges of nursing interventions that promote positive adaptation., (© 2024 NANDA International, Inc.)

Objective: to evaluate the effect of an educational video on the knowledge, attitude, and practice of self-care with arteriovenous fistula in patients undergoing hemodialysis treatment., Method: randomized controlled clinical trial, with two arms and single-blind. The intervention used an educational video on arteriovenous fistula self-care. The Fistula Self-Care Knowledge, Attitude, and Practice Scale was applied to 27 renal patients on hemodialysis in the control group and 28 in the intervention group at baseline, after seven and fourteen days. The data was analyzed using the Statistical Package for the Social Sciences software, using the chi-square test, Student's t-test, Mann-Whitney test, and Friedman's test with post-hoc analysis for multiple comparisons., Results: there were statistically significant differences in the knowledge and practice of self-care with the fistula at 0, 7 and, 14 days in the intervention (p= 0.004 and p<0.001, respectively) and control groups (p<0.001 for knowledge and practice). Attitude showed a significant difference at follow-up (p<0.001), but the post-hoc analysis did not confirm the significance obtained., Conclusion: patients' knowledge and practice showed significant increases at follow-up in the control and intervention groups, while the increase in attitude was not significant in either group. Clinical trial, registration number: U1111-1241-6730.

Objectives: to assess risk factors for excess fluid volume in hemodialysis patients., Methods: a retrospective case-control study was conducted. A total of 392 patients (196 cases and 196 controls) from two hemodialysis centers were included. Sociodemographic data and 23 risk factors for excess fluid volume were assessed using a data collection form. Data were analyzed using a multivariate logistic regression model., Results: the insufficient knowledge (OR=2.06), excessive fluid intake (OR=2.33), inadequate fluid removal during hemodialysis (OR=2.62) and excessive sodium intake (OR=1.91) risk factors may increase the chance of occurrence of excess fluid volume in hemodialysis patients by approximately two times. Education level (OR=0.95) and age (OR=0.97) are protective factors for excessive fluid volume., Conclusions: knowing these risk factors may help nurses with accurate and rapid diagnostic inference of the risk of excessive fluid volume.

Objective: To evaluate evidence of content validity of the nursing diagnosis "inadequate social support network"., Method: A methodological study of the content validation type, carried out with 23 judges who evaluated the adequacy of the title, definition, class and domain of the nursing diagnosis "inadequate social support network". The judges also assessed the relevance of 28 clinical indicators and 32 etiological factors, which were considered valid when the Content Validity Index was ≥ 0.9., Results: The judges agreed with the proposed title and suggested changes to the definition of the nursing diagnosis. They recommended its inclusion in Domain 7 - "Roles and relationships" and Class 3 - "Role performance" of the NANDA-I taxonomy. In addition, 19 clinical indicators and 27 etiological factors were considered relevant., Conclusion: The nursing diagnosis "inadequate social support network" had its theoretical structure validated in terms of content, which can support the practice of nurses in the operationalization of the Nursing Process.

Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care., (© 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Antineoplastic chemotherapy patients are susceptible to vascular trauma. The identification of this problem is possible through accurate clinical indicators. However, there are few diagnostic accuracy studies of vascular trauma in these patients. Thus, the objective was to analyze the accuracy of clinical indicators of vascular trauma in antineoplastic chemotherapy patients. A diagnostic accuracy study was carried out with a sample of 200 patients undergoing antineoplastic chemotherapy, in an oncology reference clinic, during 2018. A data collection form was created with sociodemographic and clinical data and indicators of vascular trauma. The sensitivity and specificity of the clinical indicators were assessed using a latent class analysis of random effects. The clinical indicators of decreased vascular elasticity (0.8384), pain (0.9573), and signs of infection at the catheter insertion site (0.9999) were specific for identifying vascular trauma in antineoplastic chemotherapy patients. The prevalence of vascular trauma in these patients was 11.17%. A set of three clinical indicators was considered accurate and statistically significant for confirming vascular trauma. This study has provided accurate clinical indicators of vascular trauma in antineoplastic chemotherapy patients. These results can contribute to establishing interventions, thereby reducing costs and maximizing health outcomes in this population., Competing Interests: Declaration of Competing Interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2023. Published by Elsevier Inc.)

To analyze the accuracy of clinical indicators of nursing diagnosis, Imbalanced nutrition: less than the body requirements in pediatric patients undergoing chemotherapy. A cross-sectional study was carried out in a pediatric oncohematology unit. A total of 123 children aged 5-18 years were evaluated. The Standards for Reporting Diagnostic Accuracy Studies (STARD) protocol was used. Latent class analysis was performed to obtain sensitivity and specificity of clinical indicators. The diagnosis was identified in six children (5.23%). The most frequent clinical indicator in the study was report of food intake less than recommended daily allowance ( n = 61; 49.6%), followed by excessive hair loss ( n = 49; 39.8%), misperception ( n = 42; 34.1%), satiety immediately upon ingesting food ( n = 32; 26%), lack of information ( n = 30; 24.4%), and pale mucous membranes ( n = 22; 17.9%). The 10 indicators that sensitivity and specificity were statistically superior to 50% were food intake less than recommended daily allowance, misperception, insufficient interest in food, lack of food, hyperactive bowel sounds, body weight 20% or more below ideal weight range, insufficient muscle tone, food aversion, abdominal cramping, and misinformation. The clinical indicators Food intake less than recommended daily allowance and Misperception can be considered the most important indicators for the initial inference of the diagnosis due to their high values of specificity and sensitivity. It is essential that nurses provide targeted and qualified assistance based on the signs and symptoms presented by patients, as they will be able to design appropriate interventions to obtain the desired results., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: to analyze the concept associated with diagnostic proposition Ocular dryness in adult patients hospitalized in an Intensive Care Unit, identifying its attributes, antecedents and consequences., Methods: a methodological study carried out through concept analysis, operationalized by scoping review., Results: the analysis of 180 studies allowed the identification of two attributes, 32 antecedents and 12 consequences. The attributes were tear film deficiency and ocular signs and/or symptoms. The prevalent antecedents were incomplete eyelid closure (lagophthalmos) and blinking mechanism decrease. Major consequences included conjunctival hyperemia and decreased tear volume., Conclusions: this study allowed constructing nursing diagnosis Ocular dryness, part of domain 11, class 2, with 12 defining characteristics, 12 related factors, seven populations at risk and 13 associated conditions. This problem-focused proposal may provide targeted care by promoting early detection and implementing interventions that reduce the risk of ocular damage.

Objective: To analyze the concept of Health Advocacy from the methodological framework of the Evolutionary Model., Method: The concept of interest was evaluated from the perspective of published studies identified in the databases: Web of Science, CINAHL, EMBASE, SCOPUS, MEDLINE and articles of interest. The attributes were determined from 19 scientific productions. Data were analyzed using thematic analysis, proposed by Bardin., Results: The following operational definition was obtained: Health Advocacy is an intentional action, implemented jointly and in favor of individuals and communities, especially for those who suffer from health inequalities, with the aim of preserving and improving health, well-being and empowerment for health promotion., Final Considerations: Thus, a broader concept of Health Advocacy was abstracted, from the micro to the macro, which contemplates the development of the patient's autonomy; includes individuals and groups in care plans and involves them in political activities as possibilities to provide assistance and correct health inequalities.

Aim: To analyse the etiological factors of the nursing diagnosis of impaired comfort in children and adolescents with cancer., Design: This cross-sectional study was carried out in the referral unit for the treatment of childhood cancer in a tertiary hospital located in northeastern Brazil., Methods: A total of 200 children and adolescents who were undergoing cancer treatment were included in this study. Data collection instruments and protocols were constructed with operational and conceptual definitions of clinical indicators and etiological factors for the nursing diagnosis of impaired comfort. A latent class model with adjusted random effects was used to determine impaired comfort and measures of sensitivity and specificity of clinical indicators. A univariate logistic regression analysis was performed for each etiological factor of impaired comfort., Results: The analysis of etiological factors for the nursing diagnosis of impaired comfort in children and adolescents with cancer showed the high prevalence of four factors: noxious environmental stimuli, insufficient situational control, insufficient resources and insufficient environmental control. Illness-related symptoms, noxious environmental stimuli, and insufficient environmental control increased the chance of impaired comfort occurring., Conclusion: The etiological factors with the highest prevalence and most significant impact on the occurrence of impaired comfort were noxious environmental stimuli, insufficient situational control and illness-related symptoms., Impact: The results obtained in this investigation can support more accurate nursing diagnostic inference of impaired comfort in children and adolescents with cancer. Moreover, the results can inform direct interventions for the modifiable factors that trigger this phenomenon to avoid or minimize the signs and symptoms of the nursing diagnosis., (© 2023 John Wiley & Sons Ltd.)

Objective: to verify the clinical validity of the proposition of a new nursing diagnosis called perioperative thirst, based on the diagnostic accuracy of its clinical indicators, including the magnitude of effect of its etiological factors., Method: clinical diagnostic validation study with a total of 150 surgical patients at a university hospital. Sociodemographic variables and clinical indicators related to thirst were collected. The latent class analysis technique was used., Results: two models of latent classes were proposed for the defining characteristics. The model adjusted preoperatively included: dry lips, thick saliva, thick tongue, desire to drink water, caregiver report, dry throat and constant swallowing of saliva. In the postoperative period: dry throat, thick saliva, thick tongue, constant swallowing of saliva, desire to drink water, bad taste in the mouth. The factors related to "high ambient temperature" and "dry mouth" are associated with the presence of thirst, as well as the associated conditions "use of anticholinergics" and "intubation". The prevalence of thirst was 62.6% in the pre and 50.2% in the immediate postoperative period., Conclusion: the diagnostic proposition of perioperative thirst showed good accuracy parameters for its clinical indicators and etiological effects. This proposition in a nursing taxonomy will allow greater visibility, appreciation and treatment of this symptom.(1) Evaluates the accuracy of the proposition of the nursing diagnosis perioperative thirst; (2) Allows refined diagnosis for use in clinical practice, teaching and research; (3) Strengthens the systematization of perioperative nursing care; (4) Highlights thirst management as part of care, considering its high prevalence and discomfort; (5) Presents a structure with good accuracy parameters which are representative of thirst.

Objective: To analyze the content of the nursing diagnosis deficient knowledge in individuals with heart failure., Methods: Methodological study to validate the content of a nursing diagnosis based on the predictive model of diversity, carried out through the organization of the phenomenon of interest and analysis by judges using the collective wisdom model. The NANDA-I Knowledge Deficient diagnosis was evaluated by 48 judges and considered valid when it presented a median content validity index ≥ 0.8 in the confidence intervals., Results: Note that 66.6% of the judges indicated that the new definition proposed was more adequate than the definition adopted by NANDA-I. After the experts' analysis, the following defining characteristics were considered valid: inaccurate statements about the disease and/or therapy, inadequate performance in the management of intercurrences, increase in hospital readmissions, worsened quality of life, deficit in self-care performance, and follow-up of inadequate instruction; related factors are as follows: inadequate guidance offered by health professionals, nonparticipation of the patient in the planning of their health care, weakened relationship between professional and individual; populations at risk-elderly and low level of education of the individual and/or caregiver and the associated condition, mild cognitive impairment. Anxiety, depression, and impaired social interaction were elements considered not relevant to the content domain., Conclusion: The validation of the content of the aforementioned diagnosis in patients with heart failure, through the analysis of judges with different degrees of expertise, made it possible to improve the definition and expansion of new diagnostic indicators., Implications for Nursing Practice: Updated diagnostic elements for the nursing diagnosis deficient knowledge in individuals with heart failure will facilitate accurate clinical judgment and the establishment of a therapeutic plan aimed at etiological factors modifiable by nurses., (© 2022 NANDA International, Inc.)

Objectives: to analyze the accuracy of the clinical indicators of ineffective airway clearance in adult intensive care unit patients., Methods: diagnostic accuracy study, performed in the intensive care unit of a university hospital in northeastern Brazil. The sample consisted of 104 patients hospitalized between June and October 2019., Results: the prevalence of ineffective airway clearance was 36.54%. The indicators with high specificity included absence of cough (0.8326), orthopnea (0.6817), adventitious breath sounds (0.8175), and diminished breath sounds (0.8326). The clinical indicators with high sensitivity and specificity were alteration in respiratory rate (0.9999) and alteration in respiratory pattern (0.9999)., Conclusions: six clinical indicators provided an accurate identification of ineffective airway clearance. The clinical indicators alteration in respiratory rate and alteration in respiratory pattern were the most accurate for critical adult patients. The findings of this study contribute to accurate diagnostic inferences and to prevention of respiratory complications in these patients.

Objective: Check diagnostic accuracy of the defining characteristics of the nursing diagnosis "Ineffective health self-management" in people living with HIV., Methods: Methodological study conducted in a specialized public service for people living with HIV in Northeastern Brazil, between February and April 2021, with a sample of 203 people. Latent class analysis was used to calculate the accuracy measurements of the defining characteristics, as well as the sensitivity and specificity values with their respective 95% confidence intervals. The likelihood ratio test (G 2 ) was applied to evaluate the adequacy of the fit of the models obtained (p > 0.05)., Results: The prevalence of Ineffective health self-management estimated through the latent class model was 67.5%. "Exacerbation of diseases symptoms," "failure to take action that reduces risk factor," "exacerbation of diseases signs," and "ineffective choices in daily living for meeting health goal" had the highest sensitivity values (0.80-0.9429). "Exhibits disease sequelae," "inattentive to diseases signs," and "inattentive to disease symptoms" had the highest specificity values (0.9999-1.0000)., Conclusions: The useful characteristics for discriminating PLHIV with and without diagnosis are "exacerbation of diseases symptoms," "failure to take action that reduces risk factor," "exacerbation of diseases signs," and "ineffective choices in daily living for meeting health goal." The diagnosis can be confirmed by the indicators "exhibits disease sequelae", "inattentive to diseases signs," and "inattentive to disease symptoms.", Implications for Nursing Practices: The study demonstrates the levels of importance of the defining characteristics of "Ineffective health self-management" in people living with HIV contributes to suspicion and accurate diagnostic identification of nurses and researchers., (© 2022 NANDA International, Inc.)

Purpose: To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension., Methods: This is a cross-sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability., Results: Ineffective health management is probably present in 37.5% of people with hypertension. 'Failure to include treatment regimen in daily living' was the clinical indicator with the highest sensitivity value, and 'failure to take action to reduce risk factor' had the highest specificity value., Conclusions: Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario., Implications for Nursing Practice: This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing., (© 2022 NANDA International, Inc.)

Background: Nursing diagnoses should reasonably represent global nursing practice phenomena, organizing indicators in their clinical structure that represent different scenarios and populations. However, few studies have summarized the evidence of these indicators, mainly for behavioral diagnoses., Aim: This systematic review aimed to identify the best clinical indicators (CI) to determine the presence or absence of the nursing diagnosis "Ineffective Health Management" (IHM)., Method: A systematic review with meta-analysis was utilized. Six electronic databases were consulted to retrieve studies that identified the nursing diagnosis IHM, with at least one CI. The period of data collection was between September and October 2020. The research group independently conducted the selection, quality assessment, data extraction, and analysis of all included studies. Fixed-effect measures and meta-analyses summarized sensitivity, specificity measures, and diagnostic odds ratios using the statistical software R. The preferred reporting items for systematic reviews and meta-analyses and standards for reporting studies of diagnostic accuracy guidelines were used to guide this review, and quality assessment of diagnostic accuracy studies was used for the critical appraisal of the methodological quality of the included studies., Results: The systematic review included 11 studies on people with chronic conditions, the elderly, and pregnant women. The analyzed four CI showed diagnostic odds ratios statistically higher than the unit value, highlighting the "Failure to include the treatment regimen in daily living" (DOR = 45.53; CI = 10.1, 205.6)., Linking Evidence to Action: Overall, findings showed that all CI of the IHM nursing diagnosis had good sensitivity, specificity, and diagnostic odds ratio measures to identify their presence correctly. These findings can contribute to better accuracy in nurses' decision-making process, providing indicators to infer the IHM nursing diagnosis early in different population spectra based on the best measures of diagnostic accuracy., (© 2022 Sigma Theta Tau International.)

Background: Diagnostic accuracy studies are important to identify the best set of defining characteristics for a given nursing diagnosis. The reliability of nursing inferences can be increased by using clinical indicators with high prediction capacity helping nurses to be more accurate in their clinical practice., Objective: To clinically validate the nursing diagnosis Decreased diversional activity engagement in adult patients with diabetes., Method: A diagnostic accuracy study with a cross-sectional design was carried out patients with type 2 diabetes. A latent class model with random effects was used to measure the sensitivity and specificity., Results: The diagnosis of Decreased diversional activity engagement was present in 62.2% of the patients. The defining characteristics with high sensitivity (good indicators for confirmation) were discontent with situation, physical deconditioning, and altertion in mood. Boredom, flat affect, discontent with situation, and frequent naps were the defining characteristics with the highest specificity values. These factors are considered good integrating components of the diagnosis under investigation in patients with diabetes., Conclusion: The nursing diagnosis decreased diversional activity engagement is frequent in patients with diabetes, and discontent with situation can be considered a good predictor of its occurrence due to its high values of specificity and sensitivity., Impact: The use of accurate clinical indicators in the diagnostic reasoning of nurses contributes to the achievement of outcomes centered on the patient's human responses.

This study aimed to analyze the accuracy of the clinical indicators of the nursing diagnosis of dysfunctional gastrointestinal motility in infants from neonatal units and identify their association with clinical variables. This is a study of the diagnostic accuracy of clinical indicators of the diagnosis of dysfunctional gastrointestinal motility, with a cross-sectional design, performed on 228 hospitalized infants in neonatal units. A high prevalence of dysfunctional gastrointestinal motility was identified in the studied population. Regarding accuracy measures, clinical indicators such as increased gastric residual, changes in bowel sounds, bile-colored gastric residual, regurgitation, absence of flatus, and hard and formed stool were useful to discriminate between infants with and without dysfunctional gastrointestinal motility. The findings can help nurses during the diagnostic process, as they identify which defining characteristics can be used to confirm or rule out the probability of occurrence of the diagnosis.

Objective: to analyze the accuracy of the defining characteristics of hypothermia in patients on hemodialysis., Methods: a diagnostic accuracy study was assembled within a cross-sectional study with 124 patients from two dialysis centers. A latent class model was used for data analysis., Results: the nursing diagnosis hypothermia was present in 13 (10.48%) study participants. The most prevalent defining characteristics were hypoxia (100%), decrease in blood glucose level (83.1%), hypertension (65.3%), piloerection (45.2%), and skin cool to touch (41.1%). The defining characteristics acrocyanosis (99.96%) and cyanotic nail beds (99.98%) had a high sensitivity. Acrocyanosis (91.8%), skin cool to touch (64.8%), and peripheral vasoconstriction (91.8%) had high specificity., Conclusion: specific and sensitive indicators of hypothermia work as good clinical indicators for confirming this diagnosis in patients on hemodialysis. The study findings can assist nurses in their clinical reasoning for a correct inference of hypothermia.

Purpose: To analyze the short-term survival of the nursing diagnosis of neonatal hyperbilirubinemia in hospitalized neonates within the first 24 h of life and over a maximum of 7 days., Methods: A prospective open cohort study with a longitudinal design was developed with 120 newborns during the first 24 h of life. The survival rate after a nursing diagnosis of neonatal hyperbilirubinemia was analyzed for 7 days., Findings: The number of new cases of neonatal hyperbilirubinemia during the follow-up was 82 (RR: 90.1%, daily incidence rate: 34.17%). The greatest manifestation of the diagnosis occurred in the first three days (n = 97). The median diagnostic survival time was 2 days (95% CI: 2-2). Yellow-orange skin color (RR = 8.08), yellow mucous membranes (RR = 2.05), yellow sclera (RR = 1.99), and female gender (RR = 1.36) had the highest risk ratios., Conclusions: A rapid impairment of neonatal hyperbilirubinemia in hospitalized neonates was observed. Some clinical indicators were associated with an increased risk for this diagnosis., Implications for Nursing Practice: Studies on the prognostic capacity of the clinical indicators of nursing diagnoses like neonatal hyperbilirubinemia strengthen the clinical reasoning of nurses and subsidize diagnostic inferences and accurate clinical decisions., (© 2021 NANDA International, Inc.)

Objective: To evaluate the effectiveness of an educational booklet on the knowledge, attitude and practice of a healthy lifestyle in people with HIV., Methods: Randomized clinical trial with 75 intervention group patients using the booklet, and 75 control group patients undergoing usual service care. Data collection occurred in four moments, with a Survey pertaining Knowledge, Attitude and Practice. Nonparametric analysis of variance of repeated measures was used., Results: 70 participants in the intervention group and 74 in the control group completed the study. In terms of knowledge, there was no difference between groups, the booklet impact came late, increasing after reassessments. In attitudes, there was a difference between groups in the two- and four-month reassessments compared to the baseline. In practices, there was a difference in the intervention group compared to the control group at two, four, and six months compared to baseline., Conclusion: The booklet was effective in improving healthy lifestyle knowledge, attitudes, and practices in people with HIV.

Objective: to develop and evaluate a middle-range theory for the Nursing Diagnosis of Ineffective Breathing Pattern in children with congenital heart disease., Method: a methodological study carried out in two stages: 1) development of a middle- range theory for Ineffective Breathing Pattern in children with congenital heart diseases from the analysis of the NANDA-International taxonomy, Callista Roy's Adaptation Model and a literature review; and 2) assessment of the middle-range theory developed using expert panel evaluation., Results: after three panel evaluations, the final version of the middle-range theory resulted in four metaparadigms, two key concepts, two pictorial diagrams, two propositions and a description of the interrelationships between the key concepts of Ineffective Breathing Pattern in children with congenital heart diseases and evidence for the Nursing practice., Conclusion: the middle-range theory developed and evaluated by experts identified stimuli and behaviors that can assist nurses in identifying the reasons why Ineffective Breathing Pattern is diagnosed and how it manifests itself in children with congenital heart disease, increasing understanding of the relationships between the causes and their temporality.

Objective: To analyze the content of the diagnostic proposition risk of excessive fluid volume in patients undergoing hemodialysis., Method: Content validity study, with 48 judges who assessed the content of the diagnostic proposition risk of excessive fluid volume, using an electronic data collection instrument. The judges' answers were analyzed through the calculation of the Content Validity Index and the T test., Results: The risk of excessive fluid volume was considered adequate, containing 23 risk factors: increased sodium concentration in the dialysate; missing hemodialysis sessions; insufficient water; low self-efficacy for fluid restriction; deficient knowledge; altered body mass index; excessive intake of fluids, proteins and sodium; lower kt/v index; inadequate removal of fluids in hemodialysis; thirst; xerostomia; older people; comorbidities; renal function decline; decreased urinary volume; inflammatory status; hospitalization; low serum level of albumin and lymphocytes, and high level of phosphorus; and use of antihypertensive drugs., Conclusion: The content of the diagnostic proposition risk of excessive fluid volume was considered adequate by the judges.

Aims: The aim of this study is to verify the clinical validity of clinical indicators and aetiological factors of sedentary lifestyle in individuals with arterial hypertension., Background: Diagnostic validation is performed to expand nursing taxonomies and to revise or confirm the described concepts. New elements listed in the literature and those identified by the NANDA International definition for sedentary lifestyle need to be evaluated., Design: This is a cross-sectional and diagnostic validation study. The STROBE guidelines were used in this study., Methods: Two hundred and fifty subjects aged over 18 years were evaluated. The diagnostic status of the participants was obtained by latent class analysis. Logistic regression was used to identify aetiological factors with the manifestation of sedentary lifestyle, considering a significance level of 5%., Results: A total of 57.8% of the study participants met the diagnostic criteria for sedentary lifestyle. The clinical indicators with high sensitivity were as follows: "Average daily physical activity is less than recommended for gender and age"; "Does not perform physical activity during leisure time"; "Preference for activity low in physical activity" and "Overweight." The significantly related factors associated with the diagnosis of sedentary lifestyle were as follows: "Insufficient knowledge on physical activity," "Lack of time," "Negative self-perception of health," "Lack of security," "Lack of appropriate place," "Lack of motivation," "Activity intolerance," "Lack of sports ability," "Having a partner," "Using public transportation," "Perception of physical disability," "Pain," "Having a job/studying," "Laziness," "Impaired mobility," "Living in an urban area," "Education in a public institution," "Female gender," "Lack of confidence to practice physical exercise," "Education level," "Age" and "Lack of social support for the practice of physical exercise.", Conclusion: Four out of eight clinical indicators had a good adjustment by the latent class analysis. Of the 27 aetiological factors, 22 were significantly associated with sedentary lifestyle., Relevance to Practice: The correct identification of sedentary lifestyle and its elements supports care planning, especially for health promotion and disease prevention., (© 2021 John Wiley & Sons Ltd.)

This study evaluated the effect of an educational intervention based on virtual clinical simulation and problem-based learning using a mobile application in a clinical nursing education context as a tool to improve clinical reasoning skills of students on the second year of nursing graduation. A prospective quasi-experimental study was conducted in the year 2018, and assessments were performed before and after the educational intervention. A random convenience sample (n = 32) of nursing students in the second year of a public university in Brazil was divided equally into experimental and control groups. The experimental group underwent educational intervention about clinical reasoning skills and measured the quality of the Diagnostician Nurse software by LORI 2.0 instrument. The control group experienced the conventional class on clinical reasoning skills. Four clinical cases were used to assess reasoning skills before and after the educational intervention. The data were analyzed using descriptive and inferential statistics. The experimental group showed a statistically significant difference regarding the prioritization of nursing diagnoses (p = 0.014) and a higher final score. There was a statistically significant difference in performance between the pre- and post-test in the grades of the students who participated in the intervention (p = 0.003). The control group also showed statistical significance in the score attributed to the clinical reasoning process (p = 0.015). In addition, the Diagnostician Nurse software had excellent usability and quality evaluations (SUS 87.81 and LORI 4.66, respectively). It is concluded that educational intervention based on virtual clinical simulation and learning problems using the Diagnostician Nurse software is effective as a tool to improve clinical reasoning skills and can support early detection of patients. The educational intervention developed was of high quality and attractive and improved students' motivation for the teaching-learning process., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed to identify diagnostic indicators associated with the nursing diagnosis risk-prone health behaviors in pregnant adolescents., Methods: We conducted a cross-sectional study. The sample consisted of 181 pregnant adolescents. A latent class analysis was conducted to verify associations between the defining characteristics of risk-prone health behaviors and diagnostic accuracy measures. Logistic regression was used to identify factors associated with the manifestation of risk-prone health behavior., Findings: The prevalence of risk-prone health behaviors in this sample was 31.04%. The defining characteristics failure to take action that prevents health problems and inappropriate eating habits achieved a high sensitivity. The related factors such as insufficient social support, stressors, low self-efficacy, social anxiety, isolated region of residence, and restricted access to health services presented significant associations with risk-prone health behavior., Conclusions: The diagnostic indicators associated with the nursing diagnosis of risk-prone health behavior were failure to take action that prevents health problems inappropriate eating habits, insufficient social support, stressors, low self-efficacy, social anxiety, isolated region of residence, and restricted access to health services., Implications for Nursing Practice: This study contributes to knowledge about the diagnostic indicators of risk-prone health behavior, which may help nurses reach the proper diagnosis. This will facilitate the application of clinical judgment in nursing care to assist pregnant adolescents., (© 2021 NANDA International, Inc.)

Purpose: To analyze the unidimensionality of the nursing diagnoses low situational self-esteem and low chronic self-esteem proposed by NANDA-I., Desing and Methods: Diagnostic accuracy study carried out with 180 patients with depressed mood in a psychiatric hospital in northeastern Brazil., Findings: The analysis of the latent class considered the hypothesis of low self-esteem as a unique construct and included the indicators: Excessive seeking of reassurance, repeatedly unsuccessfulness in life events, rejection of positive feedback, insomnia, solitude, and nonassertive behavior., Practice Implications: The recognition of low self-esteem as a unique diagnostic construct allows nurses to be more assertive in the provision of care., (© 2021 Wiley Periodicals LLC.)

Objective: To analyze mortality, survival and prognostic factors of patients with AIDS in Intensive Care Unit (ICU)., Method: Retrospective cohort study with a sample of 202 patients with AIDS in ICU, whose sociodemographic, epidemiological, and clinical characteristics were obtained from medical records and assessed., Results: Patients were mostly male (73.8%) and drug users (59.4%), with no regular health follow-up (61.4%) and no adherence to antiretrovirals (40.6%), presenting low CD4+ T lymphocyte count (94.0%) and high viral load (44.6%). The main causes of hospitalization were sepsis and respiratory and renal insufficiency. The mean duration of hospitalization was 11.9 days (p = 0.0001), with a 41.6% survival; 58.5% died in the ICU. Sepsis upon admission (p < 0.001), pressure injury (p = 0.038), sexual exposure (p = 0.002), high viral load (p = 0.00001) and prolonged hospitalization (p < 0.001) increased the risk of death., Conclusion: Most patients had no regular health follow-up, were drug users and presented low CD4+ T lymphocyte count and high viral load. The high mortality indicated that antiretroviral adherence is essential to reduce viral resistance, opportunistic diseases, and mortality.