Validação do diagnóstico de enfermagem baixa autoeficácia em saúde

• Ano de defesa: 2022
• Autor(a) principal: Barreiro, Reinaldo Gutierrez
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Diagnóstico de Enfermagem; Autoeficácia; Estudos de validação
• Link de acesso: http://www.repositorio.ufc.br/handle/riufc/69058

Self-efficacy is defined as the perceptions that each person has about their abilities to perform a certain behavior. This concept is recognized as an important influencer of health behaviors, however, no validation of self-efficacy as a diagnosis for nursing has been reported. Therefore, the objective of the study was to validate the diagnostic construct of Low Self-Efficacy in Health, for possible incorporation into the NANDA International Nursing Diagnosis Classification. A methodological study of diagnostic validation was carried out, consisting of three stages: the elaboration of a medium-range theory on Low Self-Efficacy in Health, content analysis by judges and analysis of the accuracy of clinical indicators and estimation of the magnitude of the effect of possible factors etiologic factors for this diagnosis. In the development of the middle-range theory, an integrative literature review was carried out for the theoretical-causal validation of the diagnostic construct components, in which 18 etiological factors and 16 clinical indicators were identified. In the second stage, content validation was performed by expert judges on the subject. The Wilcoxon test was applied to verify the values of a content validity index of 0.9 for the correct adequacy and relevance of the analyzed diagnostic structure, with all 18 etiological factors and 13 clinical indicators being validated. Clinical validation was performed on 302 people with systemic arterial hypertension, in a basic health unit in the city of Neiva-Colombia. Data were obtained from the application of an instrument that contained sociodemographic, clinical and diagnostic components data. Data were analyzed with the help of the statistical program R. The analysis included descriptive measures, central tendency, dispersion, adherence to normality was evaluated by applying the Lilliefors test. The sensitivity and specificity of each clinical indicator was verified using a latent class model, which allowed the establishment of diagnostic inference, identifying the set of indicators with the best ability to predict the diagnosis. A logistic regression model was fitted with Odds Ratio measures to estimate the magnitude of the effect of etiological factors. The study was approved by the Research Ethics Committee, opinion number 4,083,083. From the latent class model, it was identified that the estimated prevalence of the diagnosis of Low Self-Efficacy in Health was 76.61%. After adjusting the model, there were 8 clinical indicators that showed statistical significance. As for the etiological factors, 15 factors were related to a greater chance of occurrence of the analyzed diagnosis. It was concluded that the thesis proposed here was confirmed, with the elaboration of the middle range theory, and the content and clinical validation of the nursing diagnosis of Low Self-Efficacy in Health, composed of 8 clinical indicators and 15 etiological factors. The validation of this diagnosis will make it possible to improve nurses' assistance in the early identification of this phenomenon and in the implementation of interventions that aim to encourage patients' confidence in their own abilities, so that they perceive themselves as capable of facing health changes, promoting their state of well-being. be, therefore, improve their quality of life.