{"title":"护理诊断血栓形成风险的具体因果验证:一项病例对照研究。","authors":"Thamires de Souza Hilário MSc, ScD, Vanessa Monteiro Mantovani MSc, ScD, Graziella Badin Aliti MSc, ScD, Amália de Fátima Lucena PhD, Marcos Venícios de Oliveira Lopes PhD, Eneida Rejane Rabelo-Silva MSc, ScD","doi":"10.1111/2047-3095.12451","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This is a case–control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included—344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (<i>p</i> < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25–8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77–6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29–3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03–7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69–39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85–18.37), atherosclerosis (OR:2.07; 95% CI: 1.32–3.27), critical illness (OR: 2.28; 95% CI: 1.42–3.70), and immobility (OR: 2.09; 95% CI: 1.10–4.12).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I.</p>\n </section>\n \n <section>\n \n <h3> Implications for nursing practice</h3>\n \n <p>The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.</p>\n </section>\n </div>","PeriodicalId":49051,"journal":{"name":"International Journal of Nursing Knowledge","volume":"35 4","pages":"345-353"},"PeriodicalIF":1.4000,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Specific causal validation of nursing diagnosis Risk for thrombosis: A case–control study\",\"authors\":\"Thamires de Souza Hilário MSc, ScD, Vanessa Monteiro Mantovani MSc, ScD, Graziella Badin Aliti MSc, ScD, Amália de Fátima Lucena PhD, Marcos Venícios de Oliveira Lopes PhD, Eneida Rejane Rabelo-Silva MSc, ScD\",\"doi\":\"10.1111/2047-3095.12451\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This is a case–control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included—344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Findings</h3>\\n \\n <p>The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (<i>p</i> < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25–8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77–6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29–3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03–7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69–39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85–18.37), atherosclerosis (OR:2.07; 95% CI: 1.32–3.27), critical illness (OR: 2.28; 95% CI: 1.42–3.70), and immobility (OR: 2.09; 95% CI: 1.10–4.12).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Implications for nursing practice</h3>\\n \\n <p>The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.</p>\\n </section>\\n </div>\",\"PeriodicalId\":49051,\"journal\":{\"name\":\"International Journal of Nursing Knowledge\",\"volume\":\"35 4\",\"pages\":\"345-353\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-11-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Nursing Knowledge\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/2047-3095.12451\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Knowledge","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/2047-3095.12451","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
Specific causal validation of nursing diagnosis Risk for thrombosis: A case–control study
Purpose
This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification.
Methods
This is a case–control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included—344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee.
Findings
The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25–8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77–6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29–3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03–7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69–39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85–18.37), atherosclerosis (OR:2.07; 95% CI: 1.32–3.27), critical illness (OR: 2.28; 95% CI: 1.42–3.70), and immobility (OR: 2.09; 95% CI: 1.10–4.12).
Conclusions
The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I.
Implications for nursing practice
The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.
期刊介绍：
The International Journal of Nursing Knowledge, the official journal of NANDA International, is a peer-reviewed publication for key professionals committed to discovering, understanding and disseminating nursing knowledge.
The Journal aims to clarify the knowledge base of nursing and improve patient safety by developing and disseminating nursing diagnoses and standardized nursing languages, and promoting their clinical use. It seeks to encourage education in clinical reasoning, diagnosis, and assessment and ensure global consistency in conceptual languages.
The International Journal of Nursing Knowledge is an essential information resource for healthcare professionals concerned with developing nursing knowledge and /or clinical applications of standardized nursing languages in nursing research, education, practice, and policy.
The Journal accepts papers which contribute significantly to international nursing knowledge, including concept analyses, original and applied research, review articles and international and historical perspectives, and welcomes articles discussing clinical challenges and guidelines, education initiatives, and policy initiatives.
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