Clinical judgment in nursing diagnoses of chronic kidney patients on hemodialysis

Authors

DOI: https://doi.org/10.6018/eglobal.373931
Keywords: Renal Dialysis, Nursing, Nursing Process, Nursing Diagnosis, Health Priorities

Abstract

Objective: To analyze the result of the current state in chronic kidney patients on hemodialysis. Method: quantitative study performed with 25 patients undergoing dialysis therapy in a tertiary hospital through the accomplishment of semi-structured interviews, physical examination and analysis of laboratory test results. In order to analyze the diagnostic inferences, we used the clinical reasoning of Alfaro-LeFevre and then applied the Outcome-Present State Test Model.
Results: We inferred 12 nursing diagnoses found in 70% of the sample, where anxiety was the priority diagnosis. In order to minimize changes in the health of the patient, the interventions chosen were: teaching: procedure/treatment; exercise promotion; progressive muscle relaxation; distraction/inattention; emotional support; nutrition control; and improved socialization.
Conclusion: the clinical reasoning technique used by this model can contribute to the agility and execution of the nursing process.

Downloads

Download data is not yet available.

Author Biographies

Letícia Lima Aguiar, Universidade Estadual do Ceará

Enfermeira. Especialista em Enfermagem em Nefrologia. Mestranda em Cuidados Clínicos em Enfermagem e Saúde da Universidade Estadual do Ceará.

Suzana Mara Cordeiro Eloia

Enfermera. Estudiante de Maestría del Programa de Posgrado en Enfermería (PPGENF) de la Universidad Federal de Ceará.

Geórgia Alcântara Alencar Melo

Enfermera. Estudiante de Doctorado del Programa de Posgrado en Enfermería (PPGENF) de la Universidad Federal de Ceará. Becario de la Coordinación de Mejoramiento de Personal de Educación Superior (Capes). Especialista en Enfermería Nefrológica. Fortaleza, Ceará,

Renan Alves Silva

Enfermero. Estudiante de Doctorado del Programa de Posgrado en Enfermería (PPGENF) de la Universidad Federal de Ceará. Profesor Asistente del Curso de Pregrado de Enfermería en la Universidad Federal de Amapá. Fortaleza, Ceará-

Maria Vilani Cavalcante Guedes

Enfermera. Profesora del Programa de Posgrado en Atención Clínica en Enfermería y Salud (PPCCLIS). Profesor Efectivo del Curso de Pregrado en Enfermería de la Universidad Estatal de Ceará.

Joselany Afio Caetano

Enfermera. Profesora del Programa de Posgrado en Enfermería (PPGENF) y Doctora en Enfermería. Profesora Efectiva del Departamento de Enfermería de la Universidad Federal de Ceará. Fortaleza, Ceará,

References

Dhima X, Jaku G, Zefaj D, Ioannis K, Chrysoula V, Margitsa S, et al. Needs of hemodialysis patients and factors affecting them. Glob J Health Sci. 2016;8(6):109-20. doi: http://dx.doi.org/10.5539/gjhs.v8n6p109.

Sociedade Brasileira de Nefrologia. Relatório Censo 2018. 2018. Disponível em: https://sbn.org.br/categoria/censo-2018/

Herdman TH, Kamitsuru S. Diagnósticos de enfermagem da NANDA: definições e classificação 2018-2020. Porto Alegre: Artmed; 2018.

Alfaro-LeFevre R. Critical thinking, clinical reasoning, and clinical judgment: a practical approach. 6ª ed. Elsevier; 2017.

Pesut DJ, Herman J. Clinical Reasoning: The art e science of critical & creative thinking. Columbia: Delmar Publishers; 1999.

Sevilla JCR. Papel de enfermería en el juicio clínico: la valoración y el diagnóstico. Enferm Cardiol. 2014;(61):25-31. Disponível em: https://www.enfermeriaencardiologia.com/wp-content/uploads/62_02.pdf

Gonzáles-Castillo MG, Monroy-Rojas A. Proceso enfermero de tercera generación. Enfermería Universitaria. 2016;13(2):124-129. doi:http://dx.doi.org/10.1016/j.reu.2016.03.003

Bulechek GM, Butcher HK, Dochterman JM. Classificação das intervenções de enfermagem - NIC. 6ª ed. Rio de Janeiro: Elsevier; 2016.

Moorhead S, Johnson M, Maas ML, Swanson E. Classificação dos Resultados de Enfermagem (NOC). 5ª ed. Elsevier; 2016.

Espinosa C. El modelo AREA es la evolución del PAE que se centra en los resultados. Asociación Española de Nomenclatura, Taxonomía y Diagnósticos de Enfermería. 2011;1-9.

Rajan EJE, Subramanian S. The effect of depression and anxiety on the performance status of end-stage renal disease patients undergoing hemodialysis. Saudi J Kidney Dis Transpl. 2016;27(2):331-34. Available from: http://www.sjkdt.org/text.asp?2016/27/2/331/178555

Melo, GAA, Rodrigues, AB, Firmeza, MA, Grangeiro, AS, Oliveira, PP, Caetano, JA. Musical intervention on anxiety and vital parameters of chronic renal patients: a randomized clinical trial. Rev. Latino-Am. Enfermagem. 2018;26:e2978. doi: http://dx.doi.org/10.1590/1518-8345.2123.2978.

Vasilopoulou C, Bourtsi E, Giaple S, Koutelekos I, Theofilou P, Polikandrioti M. The impact of anxiety and depression on the quality of life of hemodialysis patients. Glob J Health Sci. 2016;8(1):45-55. doi: http://dx.doi.org/10.5539/gjhs.v8n1p45.

Frazão CMFQ, Delgado MF, Araújo MGA, Silva FBBL, Sá JD, Lira ALBC. Cuidados de enfermagem ao paciente renal crônico em hemodiálise. Rev Rene. 2014;15(4):701-9. Available from: http://www.repositorio.ufc.br/bitstream/riufc/10441/1/2014_art_albclira.pdf

Ottaviani AC, Betoni LC, Paravini SCI, Say KG, Zazzetta MS, Orlandi FS. Association between anxiety and depression and quality of life of chronic renal patients on hemodialysis. Texto Contexto Enferm. 2016; 25(3):e00650015. doi: http://dx.doi.org/10.1590/0104-07072016000650015

Dias DR, Shiozawa P, Miorin LA, Cordeiro Q. Prevalência de sintomas depressivos e ansiosos em pacientes com doença renal crônica em programa de hemodiálise: um estudo transversal. Arq Med Hosp Fac Cienc Med Santa Casa. 2015; 60:65-71. Available from: http://www.fcmscsp.edu.br/images/Arquivos_medicos/2015/04-AO83.pdf

Facione PA, Crossetti MGO, Riegel F. Pensamento Crítico Holístico no Processo Diagnóstico de Enfermagem. Rev Gaúcha Enferm. 2017;38(3):e75576. doi: http://dx.doi.org/10.1590/1983-1447.2017.03.75576

Riegel F, Crossetti MGO. Theoretical frameworks and instruments for evaluation of critical thinking in nursing and education. Rev Gaúcha Enferm. 2018;39:e2017-0097. doi: https://doi.org/10.1590/1983-1447.2018.2017-0097

Ceolin S, González JS, Ruiz MCS, Heck RM. Theoretical bases of critical thinking in ibero-american nursing: integrative literature review. Texto Contexto Enferm. 2017;26(4):e3830016. doi: http://dx.doi.org/10.1590/0104-07072017003830016

Published
14-03-2020
How to Cite
[1]
Aguiar, L.L. et al. 2020. Clinical judgment in nursing diagnoses of chronic kidney patients on hemodialysis. Global Nursing. 19, 2 (Mar. 2020), 162–197. DOI:https://doi.org/10.6018/eglobal.373931.
Issue
Vol. 19 No. 2 (2020): #58 Abril
Section
ORIGINAL RESEARCH

The works published in this magazine are subject to the following terms:

1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.

© Servicio de Publicaciones, Universidad de Murcia, 2011  (© Publications Service, University of Murcia, 2011)

2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.

Licencia Creative Commons

3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.