Review of the nursing diagnosis Spiritual distress. / Revisão do diagnóstico de enfermagem angústia espiritual

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

This study aimed at making a review of the nursing diagnosis Spiritual distress proposed by NANDA (2006); in order to do so, it was based on the methodological proposals presented by Hoskins and Fehring, and developed in three stages. In the first stage an integrative review was carried out, led by the following guiding questions: What is the definition of spiritual distress and which elements indicate the presence of this nursing diagnosis? Using the descriptors spirituality and nursing diagnosis in addition to the term spiritual distress, 82 studies were found and 18 of them were selected, which were indexed to the PUBMED, COCHRANE, CINAHL and LILACS databases and to the North American Nursing Diagnosis Association Conference Proceedings. Results showed low applicability of this diagnosis what reveals the need for reformulation and improvement of NANDAs proposal. Facing these data alterations in title, definition and defining characteristics to the diagnosis were suggested, as well as enlargement of Class 3 of Domain 10. In the second stage of the study a validation of the diagnosis content and its insertion in the taxonomic structure was conducted. Seventy two nurses took part in this stage, who supported the suggestions for changes. Among the 20 defining characteristics at diagnosis proposals, only one was not validated and a new defining characteristic was suggested by the experts. In the third stage clinical validation of 120 patients with chronic renal failure on hemodialysis treatment was carried out, of whom 25.8% to 35.8% presented the nursing diagnosis studied, identified by different criteria: Spiritual Well-Being Scale; Pinto and Pais-Ribeiro Spirituality Scale; two expert nurses judgment and patients own opinion. Out of the 21 defining characteristics, four were classified as main indicators, 11 as secondary indicators and six were considered irrelevant. It was also calculated specificity, sensibility and predictive values of these characteristics, and the ones considered efficient to identify the diagnosis were: Expresses alteration in behavior: anger; Feels abandoned; Questions meaning of suffering and Expresses alienation. The comparative analysis between Expert Validation and Clinic Validation showed that 14 out of the defining characteristics studied were considered validated and one was refuted by both methods. Five other characteristics were considered validated in the Expert Validation stage, however they were observed in less than 50% of the subjects of the study in clinical environment. According to total score of 0,72 and 0,70 of the diagnosis obtained, respectively, in the second and the stages of the study, the diagnosis was considered validated. The nursing diagnosis proposal Impaired Spirituality was revealed adequate to the validation procedures and representative of this phenomenon in the studied population.

ASSUNTO(S)

chronic validation studies estudos de validação renal insufficiency diagnósticos de enfermagem spirituality insuficiência renal crônica espiritualidade nursing diagnosis

ACESSO AO ARTIGO

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