NURSING DIAGNOSIS RISK OF DRY EYE IN HOSPITALIZED PATIENTS IN INTENSIVE CARE UNIT
Nursing, Nursing Process, Nursing Diagnosis, Dry Eye Syndromes, Intensive Care Units.
This study aimed to evaluate the NANDA-International Nursing Diagnosis (ND) Risk of Dry Eye in patients admitted to the Intensive Care Unit (ICU). This is a cross-sectional study in adult ICU of the University Hospital Onofre Lopes. The final sample consisted of 206 patients. To collect data an instrument composed of relevant variables to sociodemographic data, clinical and risk factors of ND in study. Inference for the presence of diagnosis in patients was performed by a pair of diagnostician’s nurses with experience in diagnosis and judgment in ICU nursing care. All data collected were organized and stored in a database built in the Statistical Package for Social Sciences (SPSS) version 22.0 for testing. For the descriptive analysis, the frequencies were considered, distribution center measures and their variabilities. To compare means, applied the Student t test for independent samples. In the case of asymmetry, the Mann-Whitney test was used. For associative measurements, we used the chi-square test of Pearson and when the expected frequencies were lower than five, Fisher's test was applied. The magnitude of the association was verified by the prevalence ratio. This study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte and is funded by the National Scientific and Technological Development Council - CNPq, process n ° 444290 / 2014-1. Of the 206 patients, 52.4% were male, mean age 58.41 years and 57.6% lived in the interior of Rio Grande do Norte. Regarding education, the majority (40.3%) had incomplete primary education and 43.3% were retired. According to the type of admission, 49% were clinics, 29.1% urgency/emergency surgery and 21.8% elective surgery. Comorbidities, 59.7% had hypertension and 31.6% diabetes mellitus. 47.6% of patients had the ND in study. Thus, 52.4% have had a clinical diagnosis of ocular dryness. In the analysis by eye, 56.8% had DE, since the ocular dryness was present in 43.2% of eyes. The most prevalent risk factors were: environmental factors and treatment regimen (100%), mechanical ventilation therapy (52.4%), aging (51%), neurological damage with motor reflex sensory loss (50%), female (47.6%) and lifestyle (36.4%). Showed a statistically significant association with the presence of the studied ND in the right eye (RE) the absence of the following clinical features: hospitalization why gastrointestinal disorder, lagophthalmos in RE, lagophthalmos in the left eye (LE), the hyperemia LE, mucous secretion RE, eyelid edema RE, proptosis RE and use of anti-inflammatory. The presence of hyperemia in the RE was significant for the absence of DE in the OD. The schirmer the mean difference in the RE and LE between the presence and absence in the ND in RE also had significance. Regarding the LE, there was a statistically significant association between corneal-palpebral reflex of RE and DE risk of dry eye in RE with the ND presence in the LE. Moreover, the absence of other clinical characteristics were significant with the ND presence in the LE: hyperemia RE and LE, eyelid edema RE and LE, mucous secretion LE, neuromuscular blockers and ocular dryness in the RE and LE. Still, the schirmer of RE and LE showed significant mean differences between presence and absence in the ND in LE. Regarding the analysis of ocular dryness in the LE, the absence of certain clinical characteristics were statistically significant for the absence of dryness in the RE, to know: hospitalization why gastrointestinal disorder, lagophthalmos in RE and LE and ocular dryness in the LE. The presence of hyperemia in RE showed significance with the presence in the dryness of the RE. However, the absence of hyperemia in the LE was associated with the absence of ocular dryness in the RE, as well as the mucous secretion in the RE, eyelid edema RE, proptosis RE and use of anti-inflammatory. The ND presence in the RE and LE demonstrated association with the absence of ocular dryness in the RE. The mean difference of the schirmer in RE showed a significant relationship between the presence and absence of ocular dryness in the RE, as well as the difference of means of posts of schirmer in LE. Regarding the ocular dryness in the LE, the presence of corneal-palpebral reflex in RE and ND in RE and LE statistically showed statistically relationship with the absence of ocular dryness in LE. However, the absence of ocular hyperemia in LE, mucous secretion in LE, eyelid edema in RE and LE and the non use of neuromuscular blockers were significantly associated with the absence of ocular dryness in LE. Moreover, as in other outcomes there were significant mean differences of schirmer in RE and LE between those features or not ocular dryness in the LE. Thus, the knowledge gained has estimated relevance to ensure an action directed to the prevention of ocular dryness in ICU patients.