Construction and validation of nursing diagnosis risk of excessive fluid volume from a medium-range theory
Nursing diagnosis. Validation studies. Midlle range theory. Fluid overload. Risk factors. Renal dialysis.
This study aimed to build and validate the nursing diagnosis Risk of excessive fluid volume in patients undergoing hemodialysis from a medium-range theory. Methodological research, developed in three stages: theoretical-causal validation, content validation and clinical-causal. In the first stage, the Risk of excessive fluid volume was constructed from a medium-range theory and operationalized by an integrative literature review. In the second stage, 48 judges judged the adequacy of the diagnosis. In the third stage, the diagnosis was clinically validated, based on a case-control study, with 392 patients on hemodialysis. The project was approved by the Ethics Committee, under the opinion nº 1.257.908 and Certificate of Presentation for Ethical Appraisal nº 49324015.0.0000.5537. The results show that, in the first stage, 82 articles were selected. Were identified eight attributes, 31 clinical antecedents, 12 propositions, 31 causais relations and a pictogram. In the second stage, the judges considered the valid diagnostic proposal, being considered 23 risk factors. In the third stage, risk factors Improper fluid removal during hemodialysis, Excessive intake of fluids, Elderly, Excessive sodium intake, Schooling and Poor knowledge were able to increase the chances for the development of excessive fluid volume in patients undergoing hemodialysis. It is concluded that the construction of the nursing diagnosis Risk of excessive fluid volume is clinically valid for patients undergoing hemodialysis