Banca de DEFESA: LARISSA DE LIMA FERREIRA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : LARISSA DE LIMA FERREIRA
DATE: 05/12/2024
TIME: 14:00
LOCAL: Departamento de Enfermagem
TITLE:

Validation of the nursing diagnosis of risk of ineffective self-management of blood glucose levels in patients undergoing hemodialysis.

KEY WORDS:

Nursing Diagnosis; Blood Glucose; Hemodialysis; Nursing Theory.

PAGES: 185
BIG AREA: Ciências da Saúde
AREA: Enfermagem
SUMMARY:

Blood glucose level variation is a common occurrence during hemodialysis and is
related to the pathophysiology of renal disease and the hemodynamic changes resulting
from extracorporeal circulation. Thus, the nursing diagnosis of ineffective self-
management risk of glucose pattern may be inferred in this clientele; however, the
NANDA-I taxonomy does not yet indicate hemodialysis as a treatment that makes
patients susceptible to this risk. Therefore, the present study aims to determine the
causal validity evidence of the nursing diagnosis of ineffective self-management of
blood glucose levels in patients undergoing hemodialysis. This is a methodological
study for the validation of the nursing diagnosis, which followed three stages proposed
in the literature: 1) construction of a middle-range theory of the mentioned nursing
diagnosis; 2) content analysis by experts; and 3) clinical validation. The first stage was
operationalized through a Scoping Review, guided by the JBI Reviewer’s Manual and
directed according to the recommendations of the Preferred Reporting Items for
Systematic reviews and Meta-Analyses extension for Scoping Reviews: Checklist and
Explanation, with a research protocol registered in the Open Science Framework (DOI
10.17605/OSF.IO/EGZFS). In the second stage, content validation was carried out by
eight experts, who assessed the adequacy of the content constructed in the first stage
using the nominal group technique. In the third stage, the elements of the nursing
diagnosis were clinically validated through a case-control study involving 60 patients.
The project was approved by the Research Ethics Committee of the responsible
institution (approval number: 5.906.314). Regarding the results of the first stage, 20
studies were identified in the final sample. These were published between 2006 and
2023, mostly in English and from 11 countries. Based on the articles selected in the
Scoping Review, 18 clinical antecedents were identified, which were subdivided into:
seven risk factors, seven associated conditions, and four at-risk populations.
Additionally, a pictogram, six propositions, and 18 causal relationships were created. In
the second stage, the experts evaluated and considered the diagnostic proposal adequate,
with few modifications. However, one risk factor was eliminated. Thus, the final
proposition resulted in six risk factors, seven associated conditions, and four at-risk
populations. In the third stage, the associated conditions of diabetes mellitus and the use
of high-flow dialyzer, as well as the at-risk population of patients with a longer
diagnosis of diabetes mellitus and elderly individuals, were able to increase the chances
of developing unstable glucose risk. It is concluded that there is causal validity evidence
for the nursing diagnosis of ineffective self-management of blood glucose levels in
patients undergoing hemodialysis in patients undergoing hemodialysis, which confirms
the thesis of this study.

COMMITTEE MEMBERS:
Presidente - 1675334 - ANA LUISA BRANDAO DE CARVALHO LIRA
Externo à Instituição - MARCOS VENÍCIOS DE OLIVEIRA LOPES - UFC
Interna - 1054749 - MARIA ISABEL DA CONCEICAO DIAS FERNANDES
Externa ao Programa - 1020269 - PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR - nullExterna à Instituição - VIVIANE PEIXOTO DOS SANTOS PENNAFORT - EBSERH