MIDDLE RANGE THEORY FOR THE CARE OF PEOPLE LIVING WITH THE HUMAN IMMUNODEFICIENCY VIRUS
Nursing diagnosis. Critical patient. Intensive care unit. Aspiration risk. Middle Range Theory.
Introduction: Chronic conditions, such as those of people living with the human immunodeficiency virus, cause necessary changes in lifestyle, which sometimes conflict with socially ingrained and apprehended behaviors and beliefs that impact the health-disease process and the way to take care of yourself. The latest version of NANDA International brought changes in the nursing diagnosis Ineffective Health Self-Management, formerly called Ineffective Health Control, a diagnosis that has a high prevalence among people living with this disease, resulting in compromised health. The presence of diagnoses like this infer high care at all levels of health care by nursing, which transposes the biologicist character and refers to a greater need to deepen the issues that influence it. Objective: To develop a mid-range Nursing theory for Ineffective Health Self-Management in people living with the human immunodeficiency virus, in the light of Roy's Adaptation Model. Methods: This is a theoretical, predictive and deductive study based on the theoretical references of Callista Roy. The study was carried out in five stages, namely: definition of the approach to construct the middle-range theory, definition of the main concepts (key concepts), construction of a pictorial scheme, construction of propositions and the establishment of causal relationships and the evidence for practice. Initially, a scoping review was carried out, which served as the basis for the theory with searches in the following databases: Scopus, Web of Sciense, PubMed, CINAHAL, Cochrane, LILACS and Scielo. The following descriptors were used: “Acquired immunodeficiency syndrome”, “HIV”, “Patient acceptance of health care”, and “Cooperation and adherence to treatment” intermediated by the Boolean operators AND and OR. From this search, the essential elements of the validation process (attributes, factors and indicators) were extracted and analyzed in order to establish the causal relationships between them. Results: Of the 5622 articles obtained, after applying the eligibility criteria, 51 articles made up the final sample. The results show the identification of five essential attributes, 37 antecedents and 19 consequents. Finally, a pictogram was constructed representing the establishment involved in causal relationships with seven prepositions. Conclusion: It is concluded that the middle-range theory on the nursing diagnosis Ineffective health self- management in patients living with the human immunodeficiency virus developed in this study provides a consistent theoretical basis for the aid of nurses' diagnostic reasoning.